Community Health Needs Assessment and Community Health Service Plan

NewYork-Presbyterian (NYP) is deeply committed to the communities in the boroughs of New York City, Westchester County, and the surrounding areas . NewYork-Presbyterian delivers a range of innovative programs and services intended to educate and provide resources to prevent illness, maintain health, and improve the overall well-being of the community .In 2019, NewYork-Presbyterian

completed its triennial Community Health Needs Assessment (CHNA) to understand the needs of local communities and the conditions that influence their well-being, as well as to assemble a three-year plan to enhance community health in areas identified as highdisparity neighborhoods .

Governance, Engagement, and Collaboration:

The Division of Community & Population Health and the Office of Government & Community Relations partnered to develop an enterprise wide CHNA process to promote community awareness and hospital alignment in order to maximize the impact on those who need it most . A Steering Committee consisting of NewYork-Presbyterian leadership, which included representation across all of our campuses, was key to providing insight and guidance and making decisions that affected the completion of the CHNA .

NewYork-Presbyterian delivers a range of innovative programs and services intended to educate and provide resources to prevent illness, maintain health, and improve the overall well-being of the community .

Process:

NewYork-Presbyterian obtained broad community input regarding local health needs, including those of medically underserved and low-income populations, through focus groups, questionnaires, and surveys . New York Academy of Medicine helped to conduct the targeted focus groups and questionnaires . Data collection included quantitative data for demographics, socioeconomic status, health, and social determinants, as well as qualitative data from community questionnaires and focus groups, which were analyzed to identify high-disparity communities and develop a prioritization process ensuring integration with the Priority Areas of the 2019-2024 NYS Prevention Agenda . Premier Inc . was engaged to partner with the NewYork-Presbyterian team to complete the needs assessment in a transparent and collaborative manner .

Prioritization Method:

Premier Inc . customized a prioritization model utilizing the Hanlon Method to quantify and compare indicators and identify significant community needs . The top-quartile high-disparity neighborhood datasets inclusive of social determinants of health, health outcomes, access, and utilization were analyzed to ensure a dynamic model for NewYork-Presbyterian . The model also included qualitative datasets to allow the voice of the community and our internal service line directors and ancillary staff, otherwise referred to as Think Tanks, to play into the top priorities .

Prioritized Indicators:

The prioritization method allowed the NewYork-Presbyterian team to narrow a vast amount of quantitative and qualitative datasets and define the highest-disparity community and health indicators impacting that community .

The top 10 indicators: 1 . Binge Drinking 2 . Cancer Incidence 3 . Hospitalizations: Drug 4 . Obesity 5 . Diabetes 6 . HIV 7 . Physical Activity 8 . % of adults taking high blood pressure medication 9 . Psychiatry 10 . Late or No Prenatal Care

High-Disparity Communities:

High-disparity communities were identified by calculating a needs score consisting of a composite of 29 indicators, carefully selected, across five domains: demographics, income, insurance, access to care, and New York State Department of Health Prevention Agenda Priorities . For NYC, Neighborhood Tabulation Areas were utilized . For geographies outside NYC, a ZIP-code-level Community Need Index was utilized . Overall, the higher-disparity quartiles are illustrated below in red and orange .

For NYC, the high-disparity communities that NewYork-Presbyterian identified were Washington Heights, Lower East Side, Crown Heights, and Corona . Outside NYC, the high-disparity communities identified were Mount Vernon and Peekskill .

NEW YORK CITY

NON-NEW YORK CITY

Focused Priorities:

The data collection and prioritization allowed NewYork-Presbyterian to identify the highest disparity of need within the communities of highest need and to align initiatives and partnerships to focus efforts and maximize the return to the communities they serve . Based on these findings, the top four priorities for a community service plan are: • Prevention of Communicable Diseases

• Mental Health and Substance Use

• Women, Infants, and Children • Prevention of Chronic Diseases

The focus will not preclude NewYork-Presbyterian from initiatives not related to the focused priorities but allows it to invest in new opportunities of impact .

Preliminary Interventions:

Priority Focus

Prevent Chronic Diseases Healthy eating and food security Chronic disease preventative care and management

Goals

Increase access to healthy and affordable foods and beverages Increase knowledge to support healthy food and beverage choices Increase food security

Promote Healthy Women, Infants & Children Maternal & Women’s Health Increase use of primary & preventative healthcare services for all women

Reduce maternal mortality and morbidity

Promote Well-Being and Prevent Mental & Substance Use Disorders Prevent Mental and Substance Use Disorders

Prevent Communicable Diseases HIV & HCV Prevent underage drinking and excessive alcohol consumption, opioid and other substance misuse, and deaths and suicides

Prevent and address adverse childhood experiences Reduce the prevalence of major depressive disorders and mortality gap

Increase viral suppression Increase the number of persons treated for HCV

Further CHNA Impacts:

The comprehensive and collaboration development of this Community Health Needs Assessment has led to the development of new targeted programs at NewYorkPresbyterian . NewYork-Presbyterian took the understandings and conclusions formed from the CHNA to expand programs that were evidence-based or prime for expansion .

Intervention

Article 28—School-Based Health Center

Obesity prevention program aimed to serve high-risk communities

Address food insecurity and other social determinants of health

Article 28—School-Based Health Center—Teen Pregnancy Program Develop a two-generation approach for improving maternal child health in primary care & community settings Doula/midwife support for high-risk pregnancies in the prenatal and postpartum period

Mental Health First Aid

Geriatric Psychiatric TeleHealth Program

Systemwide HIV and HCV Outreach Dashboard and community navigation program to effect care engagement, HIV viral load suppression, and HCV treatment