Improving Community Health In Kansas

1. Improving Community Health In Kansas • Greg Crawford, KDHE Bureau of Epidemiology and Public Health Informatics • Michelle Ponce, Kansas Association of Local Health Departments • Cindy Samuelson, Kansas Hospital Association

2. So, how did Kansas – a diverse state with de-centralized public health and a plethora of small hospitals – evolve into a position of readiness to improve community health?

3. A Brief History • KHI connects with Community Issues Management (CIM) staff in 2009 • KHI engages potential partners to explore interest on CIM and group starts meeting regularly • KALHD, KHI, KAMU, KHPA, KPHA, KDHE, KHF • CIM demonstrated at KALHD mid-year meeting 2010 • Multiple meetings with CARES and partners • Formal MOA process for partners started • Data list definition workgroup established

4. Fall 2010 • Kansas Hospital Association joins the partnership! • Non-profit hospitals required to complete CHA-CHIP by end of 2012 or pay penalties • Focus shifts more clearly to support all steps of CHA-CHIP • Healthy Communities Institute (HCI) system identified as option

5. March 2011 • Functional requirements more clearly defined • HCI-HCN system demonstrated, gains support • Partnership decides to pursue HCI-HCN option • Contract negotiation with vendor started

6. Common Issues--Hospital and Community Health Needs Assessment • At least once every three years; first one must be completed by end of tax year beginning after March 23, 2012 • Include input from persons who represent the broad interest of the community • Include input from persons having public health knowledge or expertise • Make assessment widely available to the public • Adopt a written implementation strategy to address identified community needs • Failure to comply results in excise tax penalty of $50,000 per year Patient Protection and Affordable Care Act (Health Care Reform Law March, 2010)

7. Common Issues--Local Health Departments and Accreditation • Conduct community assessments focused on population health status and public health issues • Collect and Maintain Population Health Data • Analyze Public Health Data • Use Data for Public Health Action • Engage with the community to identify and address health problems • Develop public health policies and plans • Develop and Implement a Strategic Plan • Conduct a Community Health Improvement Planning Process • Promote strategies to improve access to healthcare services • Assess Healthcare Capacity and Access to Healthcare Services • Implement Strategies to Improve Access to Healthcare Services • Evaluate and continuously improve processes, programs, and interventions • Implement Quality Improvement

8. A Partnership is Formed In March 2011, the Kansas Hospital Association and the Kansas Association of Local Health Departments signed a joint resolution that encourages local health departments and hospitals to work together in conducting community health assessments and community health improvement plans. In order to encourage this joint planning process, both accreditation standards and PPACA requirements were considered when addressing solutions.

9. Continuous Improvement Cycle Evaluation Needs Assessment Health Improvement Planning

10. Kansas Partnership for Improving Community Health Hospitals - Health Departments - Organizations Legal Compliance • Needs Assessments Kansas Health Matters Strategic Plans Accreditation Health Improvement Plans Community Health Assessment

11. Based On Change Theory Evaluation & Tracking Community Dashboard Promising Practices Collaboration Centers

12. Secondary Data: • Core indicators developed by partners • KDHE maintains statistics, updates quarterly • HCI provides templates to assist users working data • HCI maintains 30 core non-health indicators • Local data uploads supported

13. Data Analysis • Meta-data context describes indicator and importance • Multi-year statistics enables trends assessment and communication • Indicator page links to KIC website for drill down or related statistics • dashboard approach enables state or regional comparisons. • Healthy People 2020 tracker can dynamically display progress with national health targets Context Trend Drill Down Comparison Target

14. Primary Data • Integration with local resource and services directory information possible • Collaboration with Kansas 211 system underway • Community polling feature supported

15. Links to other resources: Prioritize Issues • Identifies resources tools/links: assessments , prioritization. Kan PICH responsible for identifying/developing resource pagescontent • Some of these resources will include tools to assist teams in prioritization of issues • Customization or embedded site possible at added cost

16. Communications • Helps communicate with stakeholders as well as the community • Communicates Data, Tools for the Community and Resources for the Public • Link from you Web site • Public Web site • Upload state, regional and county information, assessments, reports • Report Assistant – enables access to topical local reports

17. Service Gap Analysis Links to 211 community resources Planning team can correlate indicators and priorities, with available community health assets. 211 data updated through the primary data collection Coordination helpful in sustaining the community asset inventory. Option 1 Link to Search Option 1 – Categories HCI set-up search categories take the user to the 211 site and show those search results. Option 2 Link to Service

18. Evidence Based Interventions • Promising Practices – • 1500+ promising practices provided • Scope covers 8 taxonomy areas; • each practice is classified as good idea, effective practice or evidence-based practice. • links subject-specific promising practices to particular site health indicators.

19. Develop Action Plan, Monitoring Plan • Site will include tools and links for resources for conducting community health assessments. • KanPICH to identify/develop resource page content in collaboration with Tool Box

20. Healthy Communities Network • Counties – Regions – State • 56 Core Indicators from KanPICH • 30 Social determinants from HCI • More Indicators possible • Tie in to Community Toolbox • Tie in to Kansas Information for Communities • Tie to local 211 resources

21. Resources and links organized by categories/steps to achieve Community Health Needs Assessment • Preparing for CHNA • Data Collection and Analysis • Engagement and Prioritization • Development of Community Action Plan • Plan Implementation and Monitoring • Create “Ask an Expert” module to handle Kansas inquiries

22. Migrate KIC to Information Network of Kansas Servers • Recreate and expand query modules using more modern software application • Add data and variables

23. Cost • System development with Kansas-specific content: $75,000 • Annual license, maintenance and support fees: $90,000 • Initial funding: • Kansas Health Foundation • CDC infrastructure grant • Would cover through end of 2012

24. Sustainability • Users and stakeholders will have to come up with $90,000 a year: • Local Health Departments • KDHE • Hospitals • KHA • KHF • Others…? • Possibly the greatest challenge for this project • Potential number of users, supporters is large (>100 hospitals, 100 LHDs, etc.)

25. Proposed Project Timeline Initiate Contract Soft Launch Data Population & Facilitator Training Team Launch Public Launch July Jan. 1, 2012--------------Dec. 31, 2012 Oct.1, 2011 Dec.1, 2011 • “Train the trainer” concept: • Skilled facilitators that can assist in the CHA-CHIP process and use of the HCI system • Technical assistance: • Data use, interpretation, display, reporting

26. Questions