The Community Health Needs Assessment and Improvement Plan Process in Yellowstone County

1. The Community Health Needs Assessment and Improvement Plan Process in Yellowstone County Engagement and Accreditation Montana Public Health Association Conference October 1, 2014 Heather Fink and Shawn Hinz

2. Community Engagement What is Community Engagement?

3. The Alliance • Community Health Improvement

4. Objectives To introduce a Community Health Needs Assessment approach including potential strategies for engaging key collaborators and community members in the process. To demonstrate alignment with required domains of Public Health Accreditation.

5. ACHI Framework for the CHNA and CHIP Suggested 7th step: revisit and refine plan and process. http://www.assesstoolkit.org/assesstoolkit/ACHI-CHAT-intro-slides-8-27-10.pdf

6. COMMUNITY HEALTH NEEDS ASSESSMENT TIMELINE ACHI steps 1 & 2: Establish and Assess Infrastructure Survey Design CHNA Advisory Group PRC Contract Survey tools finalized (HBDL) ACHI step 4: Select Priorities Prioritization Process Community process Institutional processes Alliance final adoption ACHI step 3: Analyze Data Results Returned Alliance & HBDL review BC, RSH & SVH internal review CHNA Advisory Group review HBD Coalition review ACHI step 6: Plan for Action Author CHIP ACHI step 6: Monitor Progress CHIP begins July-Sept 14 Mar-July 13 Aug-Oct 13 Nov-Dec 13 Jan-Feb 14 Mar-June 14 ACHI step 5: Document and Communicate Results Results Released Publicly a) Press Conference (Jan) b) Internal, key groups, community, & media – results, priorities & engage step 7: Revisit and Refine plan and process ACHI step 3: Collect Data Survey Conducted Focus Groups (PRC) Telephone (PRC) ACHI step 6: Plan for Action CHIP Adopted (June 30) BC adopts facility plan SVH adopts facility plan CHNA= Community Health Needs Assessment PRC= Professional Research Consultants – vendor CHIP= Community Health Improvement Plan HBDL=Healthy By Design Leadership ACHI=Association of Community Health Improvement (framework for CHNA-steps referenced)

7. Assess DOMAIN 1: Conduct and disseminate assessments focused on population health status and public health issues facing the community • Standard 1.1: Participate in or Conduct a Collaborative Process Resulting in a Comprehensive Community Health Assessment • Standard 1.2: Collect and Maintain Reliable, Comparable, and Valid Data That Provide Information on Conditions of Public Health Importance and On the Health Status of the Population • Standard 1.3: Analyze Public Health Data to Identify Trends in Health Problems, Environmental Public Health Hazards, and Social and Economic Factors That Affect the Public’s Health • Standard 1.4: Provide and Use the Results of Health Data Analysis to Develop Recommendations Regarding Public Health Policy, Processes, Programs, or Interventions

8. Community Engagement DOMAIN 4: Engage with the community to identify and address health problems • Standard 4.1: Engage with the Public Health System and the Community in Identifying and Addressing Health Problems Through Collaborative Processes • Standard 4.2: Promote the Community’s Understanding of and Support for Policies and Strategies That will Improve the Public’s Health

9. Community Health Needs Assessment • Completed every 5 years, now every 3 • Sponsored by the Alliance • Randomized telephone survey of 404 Yellowstone County adults • Secondary Data • Public health data & vital records statistics • Focus Groups • Physicians & other Health Professionals • Legislators • Social Service Providers • Educators • Employers • South side neighborhood residents

10. Action Plan

11. Community Resources • The Alliance • Community Health Improvement Leadership • CHNA Advisory Group • Healthy By Design Coalition • CHIP workgroup Points of engagement • Press Conference and Preview Meetings • CHNA Advisory Group Check-Ins • Community Forum • Content Expert Meetings • CHIP Strategy Discussions

12. Areas of Opportunity Access to Health Services* Cancer* Chronic Kidney Disease Dementias, Including Alzheimer’s Disease Heart Disease & Stroke* Injury & Violence* Infant Health & Family Planning Mental Health & Mental Disorders* Nutrition, Physical Activity & Weight* Respiratory Diseases* Substance Abuse* Tobacco Use Bold items were identified as a top concern in focus groups. * Denotes issues identified as Areas of Opportunity in 2010 as well. Underlined-identified in 2014 Community Forum

13. Identified Community Priorities • Access to Health Services • Mental Health & Mental Disorders, Substance Abuse • Nutrition, Physical Activity & Weight

14. Policies and Plans • DOMAIN 5: Develop public health policies and plans • Standard 5.1: Serve As a Primary and Expert Resource for Establishing and Maintaining Public Health Policies, Practices, and Capacity • Standard 5.2: Conduct a Comprehensive Planning Process Resulting in a Tribal/State/Community Health Improvement Plan • Standard 5.3: Develop and Implement a Health Department Organizational Strategic Plan • Standard 5.4: Maintain an All Hazards Emergency Operations Plan

15. Action Plan

16. 2014-2017 Community Health Improvement Plan Priorities

17. Healthy Weight Priority Healthy By Design’s Current Initiatives • Making the healthy choice the easy choice • Focused on Policy, Systems and Environmental Change!

18. Healthy By Design Coalition • Better Billings Foundation • Big Sky EDA • Big Sky State Games • Billings Clinic • Billings Family YMCA • Cancer Control Coalition • Chamber of Commerce/CVB • City-County Planning Dept. • community health advocates • League of Women Voters • MET Transit • McCall Development • MSU Billings • MSU Extension Service • Northern Plains Resource Council • Nutrition for the Future • Parks and Rec • Peaks to Plains Design • RiverStone Health • Safe Routes to School • Salvation Army • St. Vincent Healthcare • School Health Advisory Council • United Way

19. Priority: Healthy Weight (Brand: Healthy By Design) Focus Areas Wellness Built Environment Health Equity Workgroups Worksite Projects: BSED Recognition Active Living Every Day Food Access Alternative Transportation Gardeners’ Market Children/ Families (partners: BAFHK, SHAC) Community Message: 5-2-1-0

20. Evidence Based Practice • DOMAIN 10: Contribute to and apply the evidence base of public health • Standard 10.1: Identify and Use the Best Available Evidence for Making Informed Public Health Practice Decisions • Standard 10.2: Promote Understanding and Use of Research Results, Evaluations, and Evidence-based Practices With Appropriate Audiences

21. Healthy By Design Workgroup WorkplanExample

23. “Complete Streets” passed unanimously by City Council. Adopted by Billings August 22, 2011 Complete streets are designed and operated to enable safe access for all users. Pedestrians, bicyclists, motorists, and public transportation users of all ages and abilities are able to safely move along and across a complete street.* Zimmerman Trail near Poly Drive * Source: National Complete Streets Coalition www.completestreets.org

24. Gardeners’ Market • Report on 2014… • Average of 150-200 customers each week • Average of 12 sellers weekly • Moved to South Park • SNAP, Debit, Credit

25. Active Living Every Day Classes Address identified physical activity barriers and opportunities.

26. Action Plan

27. Let’s Go Maine, Hawaii Initiative for Childhood Obesity Research and Education, Healthy By Design.

28. Healthy Weight Collaborative Project

29. Community Message

30. Healthy By Design www.healthybydesignyellowstone.org

31. Alliance and Community Health Improvement Leadership Community Health Improvement Staff Community Health Needs Assessment Community Community Health Improvement Plan Priorities Mental Health/ Substance Abuse Healthy Weight Access to Care

32. Priority: Mental Health/ Substance • Strategy team meeting 8/27/14: Heather Fink, Nathan Stahley, Kristin Lundgren, TommiLee Harper, Libby Carter • Proposed co-chairs: Libby Carter, DPHHS and Barbara Mettler, Mental Health Center (to be approached by Kristin) • Common strategies of focus: • Increase capacity for trauma informed care • Support advocacy efforts for co-occurring treatment and family treatment • Identify mental health and substance abuse related resources (integrate trauma informed certification) • Actions: • Outline strategy plan, aligned with DESTRESS grant • Finalize chairs • Hiring for grant coordinator • Identify opportunity to connect/collaborate with Tobacco and Substance Abuse Coalitions • Pursue potential interns to support

33. Priority: Clinical/Access • Finalizing Alliance organizations strategy team representatives • Determine meeting time and date • Review CHNA, CHIP, strategies • Recognize current efforts underway • Determine priority strategies and potential opportunities • Meeting scheduled in October • Determine where Healthy Weight Plans fit

34. Alliance and Community Health Improvement Leadership Community Health Improvement Staff WHO? Community Health Needs Assessment Community Community Health Improvement Plan Priorities Mental Health/ Substance Abuse Healthy Weight Access to Care

35. Backbone Structures Who does the work? • Collaborative • Nonprofit organization • Dedicated staff

36. Collective Impact Making a difference

37. THANK YOU Shawn Hinz Vice President, Public Health Services RiverStone Health shawn.hin@riverstonehealth.org 406-247-3365 Heather Fink Community Health Improvement Manager On behalf of the Alliance: Billings Clinic, RiverStone Health, St. Vincent Healthcare heather@healthybydesignyellowstone.org 406-247-3272