Teton Valley CHNA 2016_summary

2016

COMMUNITY HEALTH NEEDS ASSESSMENT

THE PROCESS

THE DATA

As a not-for-profit hospital, Teton Valley provides care to the community that goes above and beyond patients who walk through the doors. Every three years, Teton Valley will determine the most critical health needs facing the community through a Community Health Needs Assessment (CHNA), and then develop a plan for addressing those needs.

Demographics DATA ANALYSIS

LOCAL EXPERT SURVEYS

Statistical data and trends are gathered from top industry sources and include: • Population analysis • State rankings • Peer rankings • National rankings

A select group of ‘local experts’ who meet federal criteria are assembled to participate in two surveys: • The first survey asks for opinions on the previous CHNA (done in 2013) and whether those health needs are still most important today • The second survey asks the experts to review the collected data to be sure it accurately reflects the community. They then rank all the health needs in order of most important to least important

2016 Population % Increase/Decline Estimated Population in 2021 % White, non-Hispanic % Hispanic Median Age Median Household Income Unemployment Rate % Population >65 % Women of Childbearing Age

TETON COUNTY

IDAHO

U.S.

10,430 3.7% 10,816 80.2% 17.7% 36.3 $54,896 4.0% 9.1% 19.5%

1,662,154 5.3% 1,750,200 82.2% 12.3% 35.9 $48,905 3.9% 14.7% 19.3%

322,431,073 3.7% 334,341,965 61.3% 17.8% 38.0 $55,072 4.9% 15.1% 19.6%

Comparison to Idaho Counties

HEALTH OUTCOMES IMPLEMENTATION PLAN

Teton County ranks

#9 out of 42 Idaho counties

Premature death (deaths prior to age 75) presents better values (longer survivability) than the average for Idaho and the U.S.

Once the data and surveys are complete and the top health needs are determined, an Implementation Plan is created for each need.

The plan includes activities the hospital is already doing, activities to explore or begin, how progress will be tracked, and who the hospital will partner with to meet these needs.

CLINICAL CARE Teton County ranks

#30 out of 42 Idaho counties

Teton Idaho U.S. Best Uninsured 26% 18% 11% Population to Primary Care Physician 1,675:1 1,618:1 1,045:1 Population to Dentist 1,713:1 1,565:1 1,377:1 Population to Mental Health Provider 934:1 554:1 386:1

Teton County ranks

#10 out of 42 Idaho counties

Access to Exercise Opportunities Excessive Drinking

Teton 58% 20%

Idaho 79% 15%

U.S. Best 92% 10%

HEALTH FACTORS Teton County ranks

#11 out of 42 Idaho counties

Children in Poverty Number of Social Associations* Injury Deaths^ *Per 10,000 residents

Teton 20% 3 82

^Per 100,000 residents

Idaho 19% 7.7 66

U.S. Best 13% 22 50

SOCIAL & ECONOMIC FACTORS

THE DATA

THE SURVEYS

Comparison to Peer Counties The federal government groups all 3,144 counties in the U.S. into ‘peer groups’ that have similar social, economic, and demographic characteristics. In the following six categories, Teton County is significantly BETTER or WORSE than its peer counties.

MORTALITY Cancer, Male Life Expectancy

BETTER WORSE

Top 10 Causes of Death in Teton County

The hospital put together a list of Local Experts who are knowledgable about the community and care about its health and welfare to participate in two surveys. These experts also met federal criteria by falling into at least one of five categories: 1. Public Health 2. Departments and Agencies

Cancer

Unintentional Injury (including motor vehicle) = 65.3 deaths/100K; 3rd worst among 13 peer counties, U.S. avg. 50.8

3. Priority Populations 4. Chronic Disease Groups 5. Broad Interest of the Community

2013 Significant Health Needs • Affordability • Mental Health/Suicide • Alcohol Abuse/Substance Abuse • Palliative Care and Hospice • Accidents • Prevention/Wellness • Compliance Behavior

Heart Disease A total of 26 individuals responded to the Round 1 survey and provided feedback on the 2013 CHNA. Comments included:

Lung

MORBIDITY

Adult Obesity, Alzheimer’s Diseases/Dementia, Cancer, Gonorrhea, Older Adult Depression, Preterm Births, Syphilis

HEALTHCARE ACCESS & QUALITY

HEALTH BEHAVIORS Adult Smoking

Adult Female Routine Pap Tests (63.9%; worst among 13 peer counties; U.S. avg.

77.3%)

SOCIAL FACTORS

Children in Single-parent Households, Violent Crime

PHYSICAL ENVIRONMENT Air Quality, Limited Access to Healthy Food, Living Near Highways

High Housing Costs, No High School Diploma, Poverty

Housing Stress

Affordability of insurance is a continuing problem. Even more significant is the coverage available. The insurance plans provide catastrophic coverage rather than full coverage.

Accidents

Cost Barrier to Care (21.8% of adults not visiting doctor due to cost; worst among 13 peer counties, U.S. avg. 15.6%) Uninsured (28.6% of population w/o health insurance; 2nd worst among 13 peer counties, U.S. avg. 17.7%)

Most all of the priority populations likely struggle with transportation which I feel is unique to this area.

5

Stroke

6

Diabetes

7

Alzheimer’s

8

Suicide

9

Flu/Pneumonia

10

Liver

Currently, there are absolutely zero local options for high-quality substance abuse treatment. Residents must travel to Jackson, WY or to the Rexburg/Idaho Falls area. This is an unrealistic obstacle to service for many.

Poor mental health contributes to many of these other issues.

There are a lot of unsafe behaviors in the community. It is common to see children and adults not using their seatbelts.

A total of 21 individuals responded to the Round 2 survey and reviewed the data collected to determine if it represented an accurate picture of the community, and then ranked the health needs in the area. Comments included: Limited access to parks is interesting. We have locations that may not be considered parks, but I feel are exercise opportunities (pathways, groomed nordic trails, mountains, streams, etc.)

I’d emphasize ‘accidents’ as a higher priority. I like the high ‘prevention/wellness’ emphasis.

Services for people suffering from mental health issues are more available, accessible and appropriate than in other rural communities.

Affordability--the hospital has a charity policy to reduce expenses and staff to assist in applying for health insurance. Mental health and substance abuse --I agree are issues facing our community.

Rather than assuming responsibility for treatment I would like financial support provided to existing organizations.

SIGNIFICANT HEALTH NEEDS Affordability/Accessibility Current Services/Programs

• Financial Assistance Policies – sliding fee schedule for clinics and charity care policy for hospital and clinic (no cap) • Free Mammography Program – free, basic mammography screening for anyone who requests assistance; also includes radiologist reading and free follow-up visits • Annual health fair with reduced-cost lab screenings and free preventive screenings • Bilingual Community Outreach Coordinator who guides people through ACA and is a certified medical translator • Telemedicine offerings for stroke, burns, and acute care (in affiliation with University of Utah Healthcare) • Underwrote the operations costs for the Community Resource Center of Teton Valley • Extended hours on clinics • ACA counseling services • Free concussion screenings for local athletic teams (ages 8+)

New Services/Programs

• Launching Patient Portal that provides access to results, records, physician refills, and can make appointments, which reduces transportation needs • Chronic Care Management – proactive communication with doctors/specialists facilitated by dedicated nurse coordinator to make treatment of chronic conditions more cohesive and effective

Mental Health/Suicide Current Services/Programs

• Telepsychiatry (ages 18+) • Community Resource Center – Executive Director is bilingual with a social work background and family counseling emphasis • Certified mental health counselor sees patients weekly (adolescent to geriatric) • Sponsored annual SPAN walk and active on local Board

New Services/Programs

• Adolescent psychiatry offered in cooperation with the University of Utah • Tele-mental health in partnership with local behavioral health center in Idaho Falls; will assist in assessing and admitting patients as needed • Assessing expansion of telepsychiatry services and partnerships

SIGNIFICANT HEALTH NEEDS Prevention/Wellness

Current Services/Programs • • • • • • • • • •

Free sugar screenings, discounted lab draws and screenings, carotid checks at health fairs around the area Free concussion baseline testing Free mammography screenings Bundled, discounted pricing for colonoscopy screenings Low-cost flu vaccines and sports physicals State-funded vaccine program for pediatrics (vaccines provided by state, serviced by TVHC) ‘Doc Talk’ column in the newspaper providing healthcare information to the area Coumadin Clinic Senior Center health outreach (foot checks, sugar checking, blood pressure checks) Dietician services

New Services/Programs • • • • •

Looking to become a Patient-centered Medical Home (PCMH) Added dermatology to screen for skin cancer Investigating grants for adult vaccinations Bringing in speakers to talk on a variety of health issues Starting Chronic Care Management program specifically to address preventive care and catch up residents on preventive healthcare

Alcohol Abuse/Substance Abuse TVHC is unable to provide a substance abuse treatment center or add intensive substance abuse services at this time. We do assist with prevention efforts through the following actions: 1. Public service campaigns 2. Financial and staffing support for collaborative partners such as the Community Resource Center of Teton Valley 3. Maintaining updated referral information for people seeking help with substance abuse addictions 4. Implementation of narcotics contracts between patients and their providers 5. Participation in the Idaho Prescription Monitoring program that shares prescription opioid information among pharmacies, healthcare professionals, and other care providers

Accidents

Current Services/Programs • • • • • •

Free concussion baseline screenings High altitude safety materials Sun safety materials (and sunscreen giveaways) Free bystander CPR training Education on seat belts and safety for adolescent drivers Newspaper ads for safety regarding helmet use during activities like skiing, snowboarding, and ATV use (“Got Brains”)

New Services/Programs

• As TVHC seeks Level IV Trauma designation, TVHC will implement processes to assess causes for accidents and provide education on prevention • Begin tracking and monitoring the types of accidents presenting at the Hospital to help focus prevention efforts

This summary of the Teton Valley Health Care 2016 Community Health Needs Assessment has been assembled to provide a general understanding of the process and results. For complete details, including citations, IRS language, and supporting documentation, please go to www.tvhcare.org.

The 2016 Community Health Needs Assessment was performed in partnership with Quorum Health Resources, LLC, Brentwood, Tennessee