Community Health Needs Assessment
Transcription
Community Health Needs Assessment
2016 Community Health Needs Assessment A JOINT REPORT FOR OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, HEART HOSPITAL OF LAFAYETTE AND PARK PLACE SURGICAL HOSPITAL WHO WE ARE Our Lady of Lourdes Regional Medical Center is one of five (5) hospitals within the Franciscan Missionaries of Our Lady Health System. We are a Catholic healthcare system established in Louisiana over 100 years ago. Our current location, 4801 Ambassador Caffery, Lafayette, Louisiana is a replacement facility completed in 2011. We are located on the southern border of the City of Lafayette. Our original location was 611 St. Landry Street, Lafayette, Louisiana, close to the downtown area of Lafayette. This original facility was built in 1949. At that time Our Lady of Lourdes was the third hospital to be built by our Health System. The original hospital, named St. Francis, opened in 1913 in Monroe, Louisiana, Our Mission was and continues to be to provide healthcare to Jesus’s children, especially those most in need. We are a not-for-profit hospital with 186 beds. Our Mission and ministry extend past the physical walls of this building into the community we are privileged to serve. Our Community Services Department currently has several programs and projects to serve those most in need: St. Bernadette Community Clinic, Northside High School Health Clinic, Congregational Health Services and partnerships for nutritional and medical assistance for the clients and residents of Catholic Services of Acadiana. These will be discussed in greater detail in the Implementation Phase of this Community Health Needs Assessment. Heart Hospital of Lafayette is located at 1105 Kaliste Saloom Road, Lafayette, Louisiana. This entire hospital is focused on heart disease care and prevention with a Heart Emergency Center open 24/7. Park Place Surgical Hospital is a surgical facility that is primarily an out-patient surgery center, although there are 10 in-patient beds and 5 observation beds when necessary. This facility is located on the same campus as Our Lady of Lourdes on Ambassador Caffery Parkway and is linked to the hospital by a ped-way on the 2nd floor of both facilities. The address of Park Place Surgical Hospital is 4811 Ambassador Caffery Parkway, Lafayette, Louisiana. Our Lady of Lourdes owns 60% of Heart Hospital and 45% of Park Place. TARGET POPULATION Although Our Lady of Lourdes does not focus on a specific population, we do not routinely treat pediatric patients, with the exception of burn patients in an in-patient setting. However, one of our community services program, Northside High School Health Clinic, does treat high school students on campus for acute injuries and illnesses. It also provides athletes’ physicals each spring. This facility is located in the 70501 zip code area, the neediest in our community. OUR COMMUNITY HEALTH NEEDS ASSESSMENT WORKGROUP Our methodology for completing the 2016 Community Health Needs Assessment was to interview those stakeholders in the community, including those in related departments of state government and those in our own organization, who have an interest, expertise or insight concerning those in our community who are deemed “most in need”. Ultimately, the adoption of the final results of this Community Health Needs Assessment rests with the Board of Directors of Our Lady of Lourdes Regional Medical Center, Heart Hospital of Lafayette and Park Place Surgical Hospital. Once approved by all governing bodies of these facilities, the completed Community Health Needs Assessment will be made widely available to the public by being placed on each facility’s website. Many members of our hospital and joint venture facilities serve on the 2016 Community Health Needs Assessment team (see Attachment A). A smaller group comprised of the Vice President of Mission and Community Services, the Director of Community Services of Our Lady of Lourdes and the Executive Director of Lourdes Foundation oversaw the process of data collection, analysis and results. While this is a joint CHNA report between Our Lady of Lourdes, Heart Hospital of Lafayette and Park Place Surgical Hospital, other hospitals chose not to participate in this report. Although the invitation was extended, these other facilities chose to do their own assessments. Likewise, we did not engage any independent contractors to help us with this process. Those interviewed were the Director of the Department of Health and Hospitals for the State of Louisiana, the Director and nurse practitioner for St. Bernadette Community Clinic, which provides acute medical and dental care for the uninsured of Acadiana, primarily the homeless population. This Director is a member of Good Hope Baptist Church, which is located in zip code area 70501, an area designated as one with the least access to healthcare as described below. The interviews and surveys were conducted in August through November of 2015. See Attachment B for a complete listing of all organizations who participated in the survey. In addition, we solicited written comments on our most recently conducted CHNA and recently adopted Implementation Strategy (2013). These responses, received in the fall of 2015, were from Dr. Stefanski, Bradley Cruice, Lafayette Parish School System Advocate, and Joan Landry, PhD, Project Lead, The Healthy Living Club, BCBSLAF Challenge Grant Program. Dr. Stefanski praised Northside High School Health Clinic for its work with the students with acute needs, and for education and prevention regarding personal actions to reduce their risk from identified priority issues of obesity, heart disease, diabetes and cancer. She also pointed out that a social worker on staff at Northside High addresses students’ mental health issues. Dr. Stefanski acknowledged St. Bernadette Community Clinic as an acute care clinic for the homeless and poor of Acadiana. It provides treatment and lab services for the patients of the clinic. Mr. Cruice recognized that through a collaboration between Our Lady of Lourdes Community Services and the Junior League of Lafayette, The Care Bus provided medical care to middle school children located in the 70501 zip code area. Although, this program no longer exists through the Junior League, Our Lady of Lourdes continues to provide medical care at Acadian Middle School, including acute care, screenings, and education and counseling targeting obesity, diabetes, cancer and other illnesses. Last, according to Dr. Joan Landry, PhD, her own written comments were “more about document flow and presentation than about content.” These written comments further reinforced that, although some progress is being made with significant community health issues, there clearly is more work to be done. SCOPE/PURPOSE The purpose of a Community Health Needs Assessment is more than to fulfill a regulatory requirement (Affordable Care Act of 2010). The ultimate purpose is to improve community health. In our 2013 assessment, we determined what significant community health needs existed at that time. What we hope to accomplish in this current assessment is to determine what, if any, headway we as a community have made in meeting those recognized significant community health needs of 2013 and what are now significant community health needs in 2016. More specifically, we will analyze the goals set forth in the 2013 Implementation Strategy and attempt to provide outcomes for each or in the absence of measurable results, explain why these deficits in measurable outcomes occurred. SERVICE AREA Our Lady of Lourdes Regional Medical Center treats patients from across Acadiana. Acadiana is defined as a nine (9) parish area: Lafayette Parish, Acadia Parish, St. Landry Parish, St. Martin Parish, St. Mary Parish, Iberia Parish, Vermilion Parish, Evangeline Parish, and Jefferson Davis Parish. For purposes of this Community Health Needs Assessment, Our Lady of Lourdes, Heart Hospital of Lafayette and Park Place Surgical Hospital define their community as Lafayette Parish, since this is the area in which the greatest percentage of our patients reside. 60% of the patients treated at Our Lady of Lourdes are from Lafayette Parish. 52% of those treated at Heart Hospital of Lafayette are residents of Lafayette Parish and 56% of patients treated at Park Place are residents of Lafayette Parish. The definition of “community served” does not exclude medically underserved, low-income, or minority populations who live in the geographic areas from which these facilities draw its patients. In addition, our definition of “community served” takes into account all patients without regard to whether (or how much) they or their insurers pay for the care received or whether they are eligible for assistance under the hospital’s financial assistance policy. Zip codes contained in the service area of Our Lady of Lourdes Regional Medical Center are as follows: City of Lafayette, 70501, 70502,70503, 70504, 70505, 70506, 70507, 70508, 70509, 70585, 70596; Broussard, 70518; Carencro, 70520; Duson, 70529; Scott, 70583; and Youngsville, 70592. All of these zip code areas comprise Lafayette Parish. Our Lady of Lourdes Regional Medical Center is physically located in the 70508 zip code area. Evangeline St. Landry Jefferson Davis Acadia Lafayette St. Martin Vermilion DEMOGRAPHICS Iberia St. Martin St. Mary Population Lafayette Parish has a population of 235, 851. Of this, 25.89% are African American and 68.69% are Caucasian. The remaining percentages are made up of American Indian (0.37%), Native Hawaiian or other Pacific Islander (0.05%), Asian (1.64%), 2 or more races (1.82%) and other race (1.54%). Economy-Income and Employment The primary industry in Lafayette Parish has historically been oil and gas exploration and production. Within the top 100 businesses according to the 2013 report, 37 were oil & gas related (see Lafayette Economic Development Authority, 2013 Lafayette Parish Top Employers Report). In addition, manufacturing, healthcare, retail and hospitality, construction, finance, and information and technology play a significant role in the overall Lafayette economy. In October of 2014, the Acadiana area began to experience a downturn in the oil and gas industry, now leaving many without jobs. By all accounts, it appears this will continue to impact our overall economy for at least another year. Unemployment in Lafayette Parish is relatively low, however, within certain areas the rate is somewhat greater. Overall unemployment for Lafayette Parish in September 2015, was 5.6%. The reported national average was 5.2%. However, the unemployment rate for the “Lafayette Area” was higher, at 6.8% in October 2015. “Lafayette Area” is defined as five (5) parishes: Lafayette, Vermilion, Acadia, St. Martin and Iberia (see Bureau of Labor Statistics, www.bls.gov/regions/economic-summaries.htm). DEMOGRAPHICS Families Living Below Poverty Level: 70507 Poverty What we determined in 2013 and what continues to be true is that with poverty comes a lack of access to quality healthcare. The poverty level for families of 4 living in the United States is $24,250 (see Federal Register, notice of 2015 poverty guidelines). The percentage of families living below the level of poverty in Lafayette Parish is 12.7%. In comparison with the State of Louisiana, where 18.3% of families live below the poverty level, Lafayette Parish appears to be doing better. However, the following zip codes within Lafayette Parish have higher rates of poverty than the State of Louisiana, one much greater: 70501 with 27.6%, and 70507 with 14.5% (Healthy Communities Institute, Demographics, 2015 Families below poverty). Families Living Below Poverty Level: Lafayette Parish Education The number of people over the age of 25 with a high school degree in zip code 70501 is only 70.5%, and 70507 is 85.5%. The median for the United States is 85.9%. Lafayette Parish has 85.5%, whereas Louisiana as a whole has 82.6%. (see www.census. gov/Quickfacts). Both zip codes, 70501 and 70507, are definitely lower than the median, however, 70507 is substantially higher than 70501. This tri-color dial represents the distribution of values from reporting areas, in this case the counties of the United States. The top 50% is represented by green and is the best, yellow represents 25% and is the median while red, bottom 25% quartile, represents the worst (Healthy Communities Institute, Community Dashboard, 20092013 Measurement Period). One can see that a disparity exists in the overall poverty rate for Lafayette Parish, which appears to be relatively affluent. The following areas within the City of Lafayette and Lafayette Parish show greater signs of poverty: Families Living Below Poverty Level: 70501 70501 70.5% 70507 85.5% Lafayette 85.5% In addition, the residents of these zip codes continue to rank poorly on multiple health related indices, such as the SocioNeeds Index and Index Values (see Healthy Communities Institute). Risk Factors The 2015 SocioNeeds Index, created by Healthy Communities Institute, is a measure of socioeconomic need that is correlated with poor health outcomes. All zip codes, counties, and county equivalents in the United States are given an Index Value from 0 (low need) to 100 (high need). To determine the areas of highest need in a community, the selected locations are ranked from 1 (low need) to 5 (high need) based on their Index Value (Healthy Communities Institute). Two of the significant risk factors affecting access to healthcare are the percentage of families below the poverty level and the percentage of the population 25 years or older with a high school diploma or greater. In both instances, zip codes 70501 and 70507 rank higher than the median for other U.S. counties and higher than Lafayette Parish. As a result, both rank high on the SocioNeeds Index and Index Value. Although the demographics of the zip codes in Lafayette Parish may vary, those with the greatest need or least amount of access to healthcare at first glance appear to be those residents in 70501, 70507 and 70583 zip codes, with rankings of 5, 4 and 3 respectively (Healthy Communities Institute, 2015 SocioNeeds Index): Zip Code Index Rank Pop. Parish 70501 94.7 5 31,499Lafayette 70583 63.5 4 11,441Lafayette 70507 52.8 3 17,250Lafayette This is a slight deviation from the results of our CHNA of 2013. Although zip code areas 70501 and 70507 continue to hold this designation as was the case in 2013, the addition of the Town of Scott, 70583 was somewhat surprising (see Healthy Communities Institute, 2015 SocioNeeds Index). What we have determined upon further review of the scoring and data is that the SocioNeeds Index does not paint a complete picture. What also needs to be taken into account is the Index Value given to each zip code. The Town of Scott was ranked at 63.5% and 70501 was ranked at 94.7% (see Healthy Communities Institute, 2015 SocioNeeds Index). The lesson we learned is that we cannot simply focus on one index but must also consider the Index Value (national ranking of zip codes from 0%-100% with 100% being the worst) and information gathered from stakeholders in these communities through our surveys. Our determination of those areas within Lafayette Parish who have least access to healthcare continue to be 70501 and 70507. We have based our decision on the data provided by Healthy Communities Institute (HCI), and our surveys and discussions with stakeholders Lafayette Parish. COMMUNITY HEALTH NEEDS ASSESSMENT Implementation Strategy 2013 As part of our Implementation Strategy in 2013, we focused on resources within our organization that could address the issues we identified as significant community health needs and those which we felt we could impact. Our joint ventures, Heart Hospital of Lafayette and Park Place Surgical Hospital, joined us to devise an Implementation Strategy for each of these issues. Heart Hospital focused its efforts on the Heart Disease issue, as this is their scope of expertise. Park Place, which is a surgical facility partnered with Our Lady of Lourdes, decided to fund a nurse practitioner position for the Community Services Department. That nurse practitioner floats between each of the Community Services programs, providing medical care to the patients in each. In addition, Heart Hospital also provides funding for a registered nurse position at Northside High School Health Clinic. In order to fully understand how this Implementation Plan was indeed implemented, a description of programs used in this phase is necessary. Community Services Department of Our Lady of Lourdes has several programs which provide medical and dental care to those most in need in our community, primarily zip code areas 70501 and 70507. These programs are: St. Bernadette Community Clinic; Northside High School Health Clinic, and Congregational Health Services. St. Bernadette Community Clinic provides acute medical and dental services to the poorest of the poor in Acadiana. Although physically located in 70501, they treat patients from locations and parishes all around Acadiana. Many of these patients are street homeless. Northside High School Health Clinic is the only health care clinic located in a high school in Lafayette Parish. This clinic has been in this school since 1996. It is staffed with a nurse practitioner, registered nurse, a social worker and a receptionist. This clinic provides acute medical care for students, faculty and staff, as well as athletic physicals. This school is physically located in 70501 and has the most at-risk youth in the city. Last, Congregational Health Services is a program with its roots in the church. This program, which started approximately 10 years ago, provides services and resources to area congregations and church parishes. The purpose of this program is to link churches with healthcare resources from available community agencies to meet the healthcare needs of each church’s members. This is accomplished with a liaison funded by Lourdes Foundation. Another program mentioned in the 2013 Implementation Plan is The Care Bus. This was a program developed and funded, in part, by the Junior League of Lafayette. This organization partnered with Our Lady of Lourdes Community Services Department, who assisted in providing medical staff and a bus which acted as a mobile health clinic. Although The Care Bus is no longer in existence as of 2015, this program was designed for a nurse practitioner and Junior League volunteer to travel to Acadian Middle School to provide acute care for their students. At the time of this report, a nurse practitioner in the Community Services Department of Our Lady of Lourdes is currently seeing middle school students every week at Acadian Middle School to address their acute medical issues. The following are the significant community health needs identified and adopted by Our Lady of Lourdes in our 2013 Community Health Needs Assessment. For a detailed description of each issue, activities, metrics and outcomes, see Attachment C, Our Lady of Lourdes-Implementation Plan, CHNA Scorecard. Obesity – the goal was to increase the number of individuals with a healthy Body Mass Index (less than 25) and to provide weight loss and education on healthier eating habits in the 70501 and 70507 zip code areas. Our Lady of Lourdes Community Services Department programs: Congregational Health, Northside High School Health Clinic, The Care Bus and St. Bernadette Community Clinic all provided activities to help reach this goal and to provide measurable outcomes. At St. Bernadette Community Clinic BMI (body mass index) decreased overall by 7.14% from April to June 2015. Congregational Health Services provided BMI checks at several churches in 2015 and handed out brochures on women’s and men’s health issues. The initial assessments were done to provide a baseline for the church members. Diabetes – the goal was to decrease the risk of complications and morbidity related to diabetes for residents in the 70501 and 70507 zip code areas. Community services programs provided increased access to diabetes medications and screenings for diabetes and promoted healthy eating and preventive health for diabetic patients. Data is not available to determine what difference these activities have made in patients. Cancer – the goal was to increase the number of individuals screened for cancer and provide early detection for residents of 70501 and 70507. Residents were provided with cancer screenings for skin, breast, colon and prostate cancer. In addition, HPV vaccines were made available to the students at Acadian Middle School through the Care Bus program and Northside High School Health Clinic. Lourdes Primary Care physician practices also made available lung cancer screenings for under and uninsured patients. St. Bernadette Community Clinic saw an increase of 60% in appointments made by patients for preventive health care testing, such as mammograms, prostate exams and colonoscopies. St. Bernadette Community Clinic saw a 13% increase in breast cancer screenings in 2014 and a 4% increase in the number of patients screened for cervical cancer in 2014. As a result of the breast cancer screening, 3% received a positive diagnosis in 2014, hopefully, early detection of disease. Heart Disease – the goal was to improve cardiovascular health and provide early detection of individuals at risk for heart disease for residents in 70501 and 70507. Congregational Health Services increased access to heart medication for the poor of this community along with health fairs, screenings for blood pressure and cholesterol and increased access to expert heart healthy knowledge and education. Further, Heart Hospital partnered with St. Bernadette to conduct Carotid screenings for the patients of St. Bernadette Community Clinic. In 2014 St. Bernadette reported that there was a drop in Systolic pressure of 1.56% and Diastolic blood pressure reduction of 1.26%. In December 2013, Congregational Health Services conducted several health screenings in area churches. In several congregations, stroke assessments, blood pressure checks and glucose screenings were conducted. Of those tested, 25 had abnormal blood pressures, 18 abnormal glucose results and 5 were determined to be at high risk for stroke. These assessments provided these patients with information prior to the onset of disease or complication that would not have been available to them otherwise. Based upon the CHNA Scorecard, it appears some progress was made in each area or issue, but much work remains to affect change in these areas of poverty, limited education and, ultimately, limited access to healthcare. The full impact of the programs implemented in our 2013 Implementation Strategy is not complete. However, we have some evidence that screenings and testing have shown early stages of disease or the potential for same. This provides our patients with an opportunity for preventive care in many situations or early detection that aids in the further treatment and care. Surveys In 2013, we identified obesity, heart disease, mental health issues, alcoholism/drug addition, diabetes and cancer as the top significant community health needs of our area. In this current CHNA, we posed many of the same questions, see Attachment D. It was no surprise that these categories were still identified by those who participated in the survey as significant community needs in our community (see Attachment E). Those significant community health needs identified by our community leaders and survey participants were Mental Health, Obesity, Cancer, Heart Disease, Diabetes, Access/lack of transportation to health care and Substance Abuse. As with our previous Community Health Needs Assessment, we received many responses to our surveys. We had no difficulty obtaining responses from required sources. Prioritized Health Needs Taking into account the input provided by the community leaders and other survey participants, the health needs were prioritized as follows: 1. Mental Health 2.Obesity 3.Cancer 4. Heart Disease 5.Diabetes 6. Access to/Lack of Transportation to Health Care 7. Substance Abuse A determination will be made of what significant community health issues will be part of the hospital’s 2016 Implementation Strategy. In addition to the resources tapped by Our Lady of Lourdes for the Implementation Plan of 2013, other community resources may be available to address many of these issues. University Hospital Medical Center (UHMC), Lafayette Community Health Care Clinic (LCHCC), Catholic Services of Acadiana (CSA) and Tyler Mental Health are facilities located within the City of Lafayette. University Hospital is part of the state’s charity health care system, whose management contracted with Lafayette General Medical Center. This hospital cares for those most in need, and many of the patients seen at St. Bernadette Community Clinic (SBCC) and Northside High School Health Clinic are also patients of UHMC. Since Our Lady of Lourdes does not operate this facility, it is unclear whether any of these significant community needs will be addressed through their programs and/or clinics at this time. Lafayette Community Health Care Clinic (LCHCC) is a free clinic for the working poor of Lafayette Parish. In order to become a patient, one must provide proof of employment and wages to establish the baseline for poverty levels and proof of residency in Lafayette Parish. The clinic currently see patients on Tuesday and Thursday evenings, with limited appointments available. This clinic provides acute care and treatment for chronic conditions, many of which have been identified in this CHNA. But because of LCHCC’s limited hours, St. Bernadette’s will see and treat many of their acute patients during the day hours of operation, Monday through Friday, 8am to 4 pm. Unfortunately, St. Bernadette’s is not staffed or equipped to manage and treat chronic conditions. Those patients are treated for the acute issue presented at the time of the visit but then referred to LCHCC or UHMC for continuing chronic care. Last, Catholic Services of Acadiana is a collaborating partner with Our Lady of Lourdes Community Services department. They are a referral agency to St. Bernadette Community Clinic for their clientele, mostly homeless. Most recently, Lourdes Foundation provided funding to CSA for a social worker who is dedicated to working with the street homeless in the City of Lafayette. In this way, we hope to provide critically needed counseling services that will ultimately lead to employment and permanent shelter. Another mental health facility in Lafayette Parish is Tyler Mental Health. There are few beds available for the mentally ill, and often none are available for the patients of St. Bernadette’s. Although mental health is ranked low on the list of priorities for Our Lady of Lourdes, nevertheless, this issue is high in ranking by community leaders and survey participants. A discussion of whether or not we will address this issue will be presented in our 2016 Implementation Strategy. Once this CHNA is approved by the governing bodies of Our Lady of Lourdes Regional Medical Center, Heart Hospital of Lafayette and Park Place Surgical Hospital, these identified significant community health needs will be addressed individually in the 2016 Implementation Plan. This Implementation Plan will contain goals, objectives and measurable metrics or outcomes for each issue which we determine to address. For those issues not included in the Implementation Plan, an explanation will be provided of why the hospitals have chosen not to address the need. ATTACHMENT A 2016 COMMUNITY HEALTH NEEDS ASSESSMENT TEAM Jim Schellman, VP Mission Integration, Our Lady of Lourdes RMC Bently Senegal, Director, Community Services Department, Our Lady of Lourdes RMC Jeigh Stipe, Executive Director, Lourdes Foundation Elisabeth Arnold, AVP, Marketing and Community Relations, Our Lady of Lourdes RMC Adam Credeur, Accounting Department, Our Lady of Lourdes RMC Tammy Boutte, Director, Quality, Our Lady of Lourdes RMC Rachel Hebert, CFO, Heart Hospital of Lafayette Jason West, Park Place Surgical Hospital Jacqueline Mallett, Surgery, Our Lady of Lourdes RMC Iris Malone, Nurse Practitioner, Community Services Department, Our Lady of Lourdes RMC Linda Peters, Congregational Health Services, Community Services Department, Our Lady of Lourdes RMC ATTACHMENT B 2016 COMMUNITY HEALTH NEEDS ASSESSMENT Survey Participants Good Hope Baptist Church St. Bernadette Community Clinic Lafayette Parish School System Parent & Advocate Boys and Girls Clubs of Acadiana Department of Health & Hospitals/Office of Public Health, Region 4, State of Louisiana FoodNet, Executive Director Junior League of Lafayette, Community Vice President Catholic Services of Acadiana, Executive Director Lafayette Community Health Care Clinic Lafayette Community Health Care Clinic, Community Pharmacy Congregational Health Services, Liaison PACE program, Franciscan Missionaries of Our Lady Heart Hospital of Lafayette United Way of Acadiana Our Lady of Lourdes Regional Medical Center* *Many of the Senior and Leadership team members from various departments participated in the initial and follow up surveys. ATTACHMENT C CHNA INITIATIVE – GOAL OUR LADY OF LOURDES – IMPLEMENTATION PLAN CHNA SCORECARD 2014 ACTIVITIES METRICS DIABETES OBESITY To increase the number of individuals with a healthy BMI - Congregational Health – Health Fairs, Pre & Post Evaluations indicating Body Mass Index (Less than 25) , Screenings, Education on Nutrition change in knowledge and Weight Loss and Healthier eating BMI screening health behaviors habits education in the 70501 Zip Code area. Northside High School Based Health Center – BMI screening of Students, Counseling on Eating Disorders, Nutritional Program partnership with ULL dietetic Seniors Pre & Post Evaluations indicating change in knowledge and health behaviors, eating habits The Care Bus – BMI, BP Screenings, Pre & Post Evaluations indicating Educate Students on Nutrition, Counseling change in knowledge and Students on eating disorders as needed health behaviors OUTCOMES Health Knowledge increased by 60% 60% increase in fruit intake Ideal weight maintained/weight loss Weight decrease overall 5% Health Knowledge increase by 80% St. Bernadette’s Decrease Need for Chronic Medications Risk Assessments reduced by 20% Risk assessments for Chronic diseases reduced CHNA INITIATIVE – GOAL ACTIVITIES METRICS OUTCOMES To decrease the risk of further complications and morbidity related to diabetes for residents in the 70501 Zip Code area. Congregational Health – Increase access to Diabetes Mellitus (DM) medications, Promote Healthy eating, Promote Preventive health for DM patients, Educational programs, workshops and seminars on Diabetes Ideal weight maintained. Healthy medication, Normal BP, cholesterol, Glucose Weight Decreased by 10% Ideal weight maintained. Healthy wellness check-ups, Decrease need for chronic medication, Normal BP, cholesterol, Glucose Weight Decreased by 5% Diabetes support groups & educational programs Northside High School – Screenings for Diabetes, Counseling on Eating Disorders, BMI screenings ATTACHMENT C HEART DISEASE CANCER CHNA INITIATIVE – GOAL OUR LADY OF LOURDES – IMPLEMENTATION PLAN CHNA SCORECARD 2014 (CONT’D) ACTIVITIES METRICS Cancer free after early detection and treatment To increase the number of individuals screened for cancer and provide early detections for residents in the 70502 Zip Code Area. Reduction in cancer mortality and morbidity rate of high risk groups due to early detection and treatment Congregational Health – Cancer screenings for skin, breast, colon and prostate. The Care Bus – HPV vaccines, Pamphlets, Brochures Northside Health School – Cancer screenings, HPV vaccines Primary Care Network Lung cancer screenings for under and uninsured with mail outs placed in Primary Care physician offices. OUTCOMES St. Bernadette’s Appointments made for preventative health care (mammograms, prostate exams, colonoscopies) Increase by 60% CHNA INITIATIVE – GOAL METRICS OUTCOMES Decrease ER and Hospital visits Decrease by 5% ACTIVITIES To improve cardiovascular health Congregational Health – Increase access and provide early detection of to heart medication, Health fairs and individuals at risk for heart screenings for blood pressures and disease for residents in the cholesterol, Increase client access to expert 70501 Zip Code Area. heart healthy knowledge and education. Heart Hospital – Heart Vantage program and Heart Health Program in partnership with St. Bernadette’s for Carotid Screenings. Risk Assessment for chronic diseases reduced Decrease need for chronic medications Normal Blood Pressure Increase by 3% ATTACHMENT D Our Lady of Lourdes COMMUNITY HEALTH NEEDS ASSESSMENT (2015) Thank you for taking part in Lourdes’ 2015 Community Health Needs Assessment (CHNA). Yours is one of dozens of community organizations being asked to take part. Your response will help us identify and address the top health issues in our community. Please respond to these questions as concisely as possible and return this questionnaire by Thursday August 20th to Jim Schellman at Our Lady of Lourdes Email: [email protected] OR Fax: 337-470-2574 Name of Organization: Your Name: Contact Information: In our previous CHNA, we identified the following as the top health issues in Lafayette Parish. oCancer o Heart Disease oObesity oDiabetes 1.Do you feel that these are still the primary health issues in Lafayette Parish? Can you help us identify others? 2.What do you see as barriers to the health issues you identified? 3.In your opinion, what are the most effective methods of addressing the health needs you identified? 4.What area (i. e., zip code) do you see as having the greatest unmet health needs? 5.Other comments? ATTACHMENT E 2016 COMMUNITY HEALTH NEEDS ASSESSMENT Agency Medically unserved, low-income or Minority Population Agency serves Question 1: Do you feel that these are still the primary health issues in Lafayette Parish? Can you help us identify others? Question 2: What do you see as barriers to the health issues you identified? Question 3: In your opinion, what are the most effective methods of addressing the health needs you identified? Question 4: What are (i.e., zip code) do you see as having the greatest unmet health needs? Question 5: Other comments? Good Hope Baptist Congregation is located in zip code area 70501 Yes, Arthritis Suffer in silence; remedy creams have bad odors Trying to find remedy creams that are odorless and affordable 70501 Mental health is a great need Acute medical and dental care clinic located in 70501 and serves the impoverished and homeless of community Dental care, general medical care & vision care/ prescription assistance Access to care is the number one barrier and the inability to pay for the access. More dental clinic days at SBCC could decrease the wait time for an appointment and provide better quality of life for hundreds of patients. Free clinics that monitor chronic conditions; providers and clinics that accept Medicaid or Medicare. 70501, 70506, 70570, 70520 and 70508 Access to quality healthcare is a growing concern in our community. These are still the primary health issues in Lafayette Parish Dietitians often have limited time to educate patients in the hospital and have very limited referral resources upon discharge Thorough education and adequate follow up. 70507 St. Bernadette Community Clinic Our Lady of Lourdes Regional Medical Center Leadership Director of Nutritional Services Lafayette Parish School Board Advocate Children of Lafayette Parish who attend all public schools, some of which are located in zip code areas of 70501 and 70507 Healthy Lifestyles &/or choices Health information, supportive policies, engaging programs A community wide coalition focused on raising the health indices of Acadiana. One which guides healthcare policy, collaboratively develops healthy programs, and assists with the implementation of health initiatives All of Acadiana, but more so 70501 Boys & Girls Clubs Members are children who are typically from areas/schools which are medically underserved, from low-income households and are in a minority population of Lafayette Parish Mental illness/mental disease Affordable healthcare for individuals who do not qualify for the medical card yet they are unable to afford medical insurance due to low wages, and other daily household/family expenses More variety of reputable options for individuals with mental illnesses and mental diseases. Also, access to follow-up treatment to insure that patients are fully recovering. Need to stop these individuals from “falling through the cracks” 70501 I look forward to reviewing the final document and helping to enact change. ATTACHMENT E Agency Medically unserved, low-income or Minority Population Agency serves Our Lady of Lourdes Regional Medical Center, Leadership Safety Management Our Lady of Lourdes Regional Medical Center Leadership Department of Health and Hospitals /Office of Public Health, Acadiana Region 4 Regulates all health and hospital facilities in the State of Louisiana, particularly of Acadiana, Region 4 2016 COMMUNITY HEALTH NEEDS ASSESSMENT CONT’D Question 1: Do you feel that these are still the primary health issues in Lafayette Parish? Can you help us identify others? Question 2: What do you see as barriers to the health issues you identified? Question 3: In your opinion, what are the most effective methods of addressing the health needs you identified? Question 4: What are (i.e., zip code) do you see as having the greatest unmet health needs? Hypertension Unhealthy eating habits Congregational Health services which offer education and assessments 70501 and 70503 Overuse of prescription meds in addition to those previously identified Income and media over advertising drugs and poor nutritional choices Stop advertising that you need a drug for every aspect of your daily life Mental Health and Addictive Disorders, Stroke Limited resources, difficulty accessing resources that are available and not a good understanding of what is available, stigma attached to mental health. Lack of understanding the importance of seeking treatment early if signs of stroke are present Mental Health-better education for policy makers and better funding, public education; work to de-stigmatize mental health Stoke-educate the general public on signs of stroke and importance of seeking care immediately affect all socioeconomic groups Building OLOL outpatient services; more specialists in Acadiana community North Lafayette, Vermilion Parish/rural areas Our Lady of Lourdes Regional Medical Center, Leadership Income, lack of health inMental Health & Substance surance/inadequate covAbuse, Renal Failure erage; no family support Patient non-compliance; delays for outpatient treatment/follow-up cause readmissions Our Lady of Lourdes Regional Medical Center, Leadership Mental Health De-funding or under-funding of mental health services Lobby to reinstate funding; community outreach services Downtown area High Blood Pressure Lack of understanding diet and how it relates to health issues Nutritional education through community outreach/ cooking demonstrations 70501, now however there are more health clinics than ever before in this area FoodNet Food Bank used by the impoverished of Acadiana Question 5: Other comments? More education about choosing the right health care plan. Gutting of Medicaid services has placed at-risk populations at greater risk of being neglected ATTACHMENT E 2016 COMMUNITY HEALTH NEEDS ASSESSMENT CONT’D Agency Medically unserved, low-income or Minority Population Agency serves Question 1: Do you feel that these are still the primary health issues in Lafayette Parish? Can you help us identify others? Question 2: What do you see as barriers to the health issues you identified? Question 3: In your opinion, what are the most effective methods of addressing the health needs you identified? Question 4: What are (i.e., zip code) do you see as having the greatest unmet health needs? Junior League of Lafayette Organization of women committed to promoting volunteerism, developing the potential of women, and improving the community through the effective action and leadership of trained volunteers. Its purpose is exclusively education and charitable. Mental Health Access and education Access to treatment and education 70501, 70507, 70520, 70583 Mental Health Reimbursement; lack of treatment facilities Working with other agencies to provide access to more mental health treatment facilities Mental Health Ltd treatment options and long wait times for MD appointments; lack of continuity in treating physicians; no follow-up care; no refills for prescriptions; lack of short or long-term beds Comprehensive Mental Health Reform on a national level 70501 Mental Disorders Funding and lack of facilities for placement, minimal reimbursement Communicating to federal/ state government about the lack of placement facilities for these disorders 70501 Mental Health Access to health care; lack of understanding of how to navigate through the medical system; Support for free medical clinics and those that work on sliding scales Our Lady of Lourdes Regional Medical Center, Administrative Assistant Catholic Services of Acadiana Organization that offers human services to individual and families experiencing hunger, poverty and homelessness in Acadiana Our Lady of Lourdes Regional Medical Center, Leadership Director of Oncology Lafayette Community Health Care Clinic, Past Chairman Agency provides medical and dental care to the working uninsured of Lafayette 70501 70501, 70529 (Duson) Question 5: Other comments? Tremendous population of homeless laying on the sidewalk in front of SBCC Continued support for the Community Pharmacy to provide free meds to working uninsured, underinsured and homeless ATTACHMENT E 2016 COMMUNITY HEALTH NEEDS ASSESSMENT CONT’D Agency Medically unserved, low-income or Minority Population Agency serves Question 1: Do you feel that these are still the primary health issues in Lafayette Parish? Can you help us identify others? Question 2: What do you see as barriers to the health issues you identified? Question 3: In your opinion, what are the most effective methods of addressing the health needs you identified? Question 4: What are (i.e., zip code) do you see as having the greatest unmet health needs? Lafayette Community Health Care Clinic, Community Pharmacy Program of Lafayette Community Health Care Clinic that provides medication for patients of the Clinic who are the working uninsured of Lafayette Mental Health access to medical care; funding; education, transportation education, patient advocacy; access All of Acadiana Congregational Health Services Program of Our Lady of Lourdes Community Services Department working with church congregations to identify health needs and resources to meet those needs within the community. Learning & Developmental issues for children access to information and treatment; limitations of health insurance Importance of information to be available in a non-clinical setting 70501 Physical Inactivity Lack of education Our Lady of Lourdes Regional Medical Center, Leadership Medical Staff Services Yes these are still relevant health issues Availability of specialists willing to treat un/under insured patients Unsure Carencro, Crowley, Opelousas Our Lady of Lourdes Regional Medical Center, Leadership Quality Services Bicycle Safety Lack of safety education Classes at ULL and other schools 70501 Our Lady of Lourdes Regional Medical Center, Leadership Director of Health Promotion Center Physicians & medical executives need to direct the message of more daily activity Question 5: Other comments? ATTACHMENT E Agency Medically unserved, low-income or Minority Population Agency serves Our Lady of Lourdes Regional Medical Center, Leadership Director Intensive Care Unit Our Lady of Lourdes Regional Medical Center, Leadership Palliative Care PACE Program – Programs of Allinclusive Care for the Elderly 2016 COMMUNITY HEALTH NEEDS ASSESSMENT CONT’D Question 1: Do you feel that these are still the primary health issues in Lafayette Parish? Can you help us identify others? Question 2: What do you see as barriers to the health issues you identified? Question 3: In your opinion, what are the most effective methods of addressing the health needs you identified? Question 4: What are (i.e., zip code) do you see as having the greatest unmet health needs? Smoking & uncontrolled hypertension education; patient compliance; access to health care Follow-up post discharge; improved transportation; community education Unsure Dementia, COPD and renal disease insurance, financial, community resources, transportation, late referrals from physicians collaboration with our community partners, increase social worker support Communities outlying Lafayette Major depressive disorders; access to care, lack chronic paranoid schizophre- of housing for the nia; bipolar disorder mentally ill More housing for mentally ill individuals; access to quality healthcare for the mentally ill 70501 Heart Hospital of Lafayette, CFO Alcohol/drug abuse affordable healthcare/ treatment Education 70501 & 70507 Our Lady of Lourdes Regional Medical Center, Leadership RAC Supervisor childhood obesity/ psychiatric disorders Transportation; failure of population to seek healthcare services; lack of knowledge free and open health symposiums/free screenings/ testings rural areas/North Lafayette, Maurice patient compliance with plan of care; financial resources/ health care benefits effective discharge planning; transition clinics; education Northside of Lafayette Lack of reimbursement that equals the costs of providing such care an effective business plan that makes it possible to provide mental health treatment 70501 Our Lady of Lourdes Regional Medical Center, Leadership Quality Services/Medical Staff Services Div. Director Our Lady of Lourdes Regional Medical Center, Leadership VP of Support Services Health care for low-income elderly Asthma/COPD Mental Health Question 5: Other comments? Need to revisit providing mental health, perhaps in the old park place building ATTACHMENT E Agency Question 1: Do you feel that these are still the primary health issues in Lafayette Parish? Can you help us identify others? Question 2: What do you see as barriers to the health issues you identified? Question 3: In your opinion, what are the most effective methods of addressing the health needs you identified? Question 4: What are (i.e., zip code) do you see as having the greatest unmet health needs? Question 5: Other comments? Lack of access to primary care follow-up; wellness care; drug abuse; chronic pain transportation; funding; available providers resource schedulers Use NP’s instead of MD’s to assist in availability of continuing care models through proper follow up and notification of testing/ results, etc. Many don’t have internet access and cannot access home portal 70501,70503, 70506, 70510 Follow up is an integral part of decreasing re-admits/emergency department overuse and wellness. Proper NP usage would allow for a continuity of care through primary care/hospitalist service to allocate proper resources for specific targets Our Lady of Lourdes Regional Medical Center, Leadership VP Ambulatory and Lourdes Primary Care Physician Practices Psych/behavioral/pain/ afflictions re elderly funding, available specialists; medicaid; cost of meds comprehensive care structure with appropriate resources for referrals a multi-specialty clinic with available resources & comprehensive care offerings St. Martin, Vermilion, St. Landry Parishes; 70501 Our Lady of Lourdes Regional Medical Center, Leadership Nurse Practitioner Dementia, COPD and renal disease Finances, social support/ not enough community resources United Way Acadiana Nutrition/Healthy Eating/ Childhood hunger; mental health counseling; insurance barriers lack of insurance, insufficient amount of mental health services; duplication of services Our Lady of Lourdes Regional Medical Center, Leadership Director of Emergency Department Medically unserved, low-income or Minority Population Agency serves 2016 COMMUNITY HEALTH NEEDS ASSESSMENT CONT’D collaboration with community partners collaboration and coordination between healthcare providers to avoid duplication of programs that focus on prevention; advocacy on health-related public policy issues Unsure 70501, 70506, 70508 337-470-2000 / LourdesRMC.com 4801 Ambassador Caffery Parkway / Lafayette, LA 70508 Made with Sway Park Place Surgical Hospital, as a partner with Our Lady of Lourdes Medical Center, participates in the Implementation Plan Phase of the Affordable Care Act. As a Tier 2 Hospital that specializes in surgical services, Park Place’s administration works closely with the Our Lady of the Lourdes team to help identify ways to most effectively impact the system’s overall mission and plan. Park Place’s objective is to support those system needs in fulfilling their goals. Park Place’s administration, with the direction of the team at Our Lady of Lourdes, has determined the following to be avenues to help reach the community’s needs and goals: • Park Place Surgical Hospital supplies, through financial contribution, the funding for a fulltime nurse practioner at St Bernadette’s Clinic servicing the indigent of the community. This program provides access to care for a population of people who otherwise would be unserved. • Park Place Surgical Hospital, identifies needs and helps to contribute and reinvest financially in the community through Lourdes Foundation directed initiatives. • Park Place Surgical Hospital provides support both financially and through volunteer time to the Miles Perret Cancer Center. The center is focused on the support of cancer patients in several phases of cancer care. Many patients serviced by this organization phases of cancer care. Many patients serviced by this organization were Park Place patients. These support services include counseling services for family and patients, nutritional services, treatment items and supplies, and patient health system navigation and support. • Park Place Surgical Hospital contributes to the Lafayette Community Healthcare Clinic. This organization aids the underserved in the community who are not eligible for Medicare or Medicaid, but do not have the economic resources for traditional health insurance. Park Place provides access to care for the patients of Acadiana and beyond through its physician partners and the cases these physicians refer to the facility. Of those served at Park Place, 10% of all services are provided to patients in the three zip codes which are identified by the Community Needs Assessment as underserved: • 70501 • 70583 • 70507 As a physician-owned facility, Park Place Surgical Hospital’s purpose is to provide patients with cost effective, less invasive, quality healthcare in a unique environment that promotes individual attention to the needs as a patient. Facility size, nurse to patient ratio, and a team of experienced staff and physicians are key components in making Park Place Surgical Hospital the perfect setting for elective healthcare procedures. Park Place is committed through its surgical services to providing excellent diagnosis and treatment of cancer in the following specialties: • COLON AND RECTAL SURGERY • EAR, NOSE & THROAT (OTOLARYNGOLOGY) • GENERAL SURGERY • GYNECOLOGY • ORTHOPEDICS • UROLOGY Park Place’s goal is to remain a resource for the community through its service lines as well as continued support of the Lourdes Foundation, the system as a whole, and other outside community focused programs. Made with Sway Create and share interactive reports, presentations, personal stories, and more. Get started Park Place Surgical Hospital 901 Wilson Street | Lafayette, LA 70503 Community Health Needs Assessment Implementation Plan NOVEMBER 2012 Description of community served Table OF Contents As an active, caring member of the communities we serve, Our Lady of Lourdes Regional Medical Center is vigilant in carrying out its mission to serve those of Jesus’ children who are most in need. Parish. These interviews all occurred during October, November and December of 2011. PAGE 3 PAGE Narrative 1. Community Benefit Service Area, Defined 2. Description of Community Benefit Service Area 3. Community Health Assessment Partners 4. Those involved in the Decision Making Process 5. Justification of Community Identified Priorities 6. Our Lady of Lourdes Current Community Benefit Activities 7. Other Health Disparities Identified in CHNA 8. Our Lady of Lourdes Implementation of Strategic Plan PAGE 4 PAGE 4 PAGE 4 PAGE 5 PAGE 7 12 Implementation Strategy Plan PAGE 8 PAGE 10 PAGE 10 2 Narrative 3 Narrative 1 Define the hospital’s Community Benefit Service Area (CBSA) and identify the hospital’s community benefit priorities. Park Place Surgical Hospital is a joint venture between Park Place Surgical Hospital and Our Lady of Lourdes Regional Medical Center located in Lafayette, Louisiana. Park Place Surgical Hospital’s vision is to provide patients with highly technical, less invasive, quality healthcare in a unique environment that promotes individual attention to patient needs. Facility size, nurse to patient ratio and team of experienced staff and physicians are key components in making Park Place Surgical Hospital the perfect setting for healthcare procedures. For purposes of this 2012 Community Health Needs Assessment, Park Place Surgical Hospital defines its “community” as Lafayette Parish. This is based upon the fact that at least 58% of all patients are from Lafayette Parish with the remaining patients sprinkled over an 8 parish area. Our Lady of Lourdes Regional Medical Center (Lourdes), our partner in this joint venture, has identified Lafayette Parish as its community for purposes of its own Community Health Needs Assessment. Lourdes went through a detailed and thorough community health needs assessment process in order to identify the health needs of the residents of Lafayette Parish. As such, Park Place Surgical Hospital, hereby adopts the information gathered, analysis performed and community health needs identified by Lourdes in the Our Lady of Lourdes Regional Medical Center’s 2012 Community Health Needs Assessment. The prioritization of identified health needs of the community is a process whereby the Community Health Needs Assessment team reviewed the actual number of responses from interviews and then reviewed the in-patient and out-patient procedure reports of Lourdes for the 70501 zip code area. From this process we gleaned the following priority of identified health care needs for the community we serve: (1) Obesity; (2) heart disease; (3) mental health issues; (4) alcoholism/drug abuse; (5) diabetes; and (6) cancer. However, this Implementation Strategy will only focus on four of these six issues. 2 Provide a description of the CBSA. Lafayette Parish encompasses both urban and rural areas known as the “Acadiana Region.” However, the broader Acadiana Region is much more rural in nature with numerous smaller municipalities. The entire area is largely dependent on the oil and gas industry although not as dependent as in the past. Other major industries include manufacturing, construction, finance, retail, information technology and healthcare (Source: http://lafayette.org/ uploads/LafayetteLAEconomicProfile121611.pdf). Demographically, Lafayette Parish is comprised of 67.2% Caucasian, 25.8% African American, 3.6% Hispanic, 1.6% two or more races, 1.5% Asian and .3% American Indian. Within the parish there is approximately 13.7% of its population living in poverty; uninsured adults comprise 30% of the population; and 19% of children under the age of 18 are living in poverty (Sources: countyhealthrankings.org, quickfacts.census.gov). 4 Narrative 3 Identify community health assessment program partners and their expertise or contribution to the process. The assessment process was initiated by Our Lady of Lourdes Regional Medical Center beginning with a review of the 2006 Our Lady of Lourdes Community need and benefit study. Also reviewed was the 2010 Strategic Planning Fact book prepared for Our Lady of Lourdes Regional Medical Center. Other sources of information include County Health Rankings, Community Needs Index data from Thompson Reuters, additional data from Our Lady of Lourdes employees, leaders of community organizations and other sources as cited in this assessment. In addition to this information, we developed questions to be used during all interviews. Since this was a “Community Health Needs Assessment,” we felt that employee input from different departments and many areas of Lafayette Parish and the Acadiana Region would provide valuable information about the health needs specific to their individual communities. As a result, much was learned about the healthcare issues prevalent in their lives outside of Our Lady of Lourdes Regional Medical Center. As part of the Implementation Strategy phase, the CHNA team met with joint venture partners, Heart Hospital of Lafayette and Park Place Surgical Hospital, to discuss an approach to the prioritized list. Each partner has a specific ability to address one or more of the issues identified in Part 1: Community Health Needs Assessment. Briefly, we will discuss current charity work and plans for future expansion of charity care. Park Place Surgical Hospital (PPSH)’s charitable work consists of treating without charge certain patients of Lafayette Community Health Care Clinic that have an identified financial need. These procedures are done at the request of the staff of Lafayette Community Health Care Clinic. The services provided are done so with volunteer physicians affiliated with Park Place Surgical Hospital. 4 State who was involved in the decision making process. To ensure input from persons with a broad range of knowledge and interests of the community, several employees of Our Lady of Lourdes in different facets of the organization were enlisted to conduct interviews of persons with knowledge and interests of the community. No other organization was involved in conducting the assessment. However, representatives of organizations serving the community were interviewed as well as church leaders, groups of Lourdes employees, civic leaders, local government officials, physicians, state and local health departments and volunteers to obtain the information contained in this document. Interviews of public health experts such as Dr. Tina Stephanski, Office of Public Health, primary care physicians for Lourdes; and leaders within the medically underserved areas (Zip Code Area 70501) were relied upon heavily for interpretation of data and trends in healthcare in Louisiana and Lafayette Parish. 5 Narrative Participants of Community Focus Groups Community Health Needs Assessment Team Barbara Feske, Vice President Management/Support Services Jeigh Stipe, Executive Director, Lourdes Foundation Stacy Patin, Physician Recruiter Adam Credeur, Financial Analyst II Christina Naquin, Marketing Analyst Iris Malone, Nurse Practitioner Lani Smith, Phd., Director Clinical Research Jan Martin, Executive Assistant Interview Participants Dr. Earl Washington, Physician Executive Donna Landry, Vice President Business Development Michelle Crain, Vice President Patient Care Services Michelle Hensgens, Chair Service Excellence Committee Traci Thibodeaux, Director Physician Practice Management Bently Senegal, Director Community Services Laura Williams, Director Utilization Management Vicki Provost-Anderson, Clinical Manager Sam Price, Director Hyperbarics Kate Oliver, Director Surgical Services Valerie Kratzer, Clinical Manager Elaine Gordon, Clinical Manager Emily Dressel, Clinical Manager Terry Broussard, Assistant Vice President Patient Care Services Stacy Comeaux, Director Lab/Blood Center Elizabeth Champion, Corporate Compliance Director Ed Broussard, Director Pharmacy Natalie Blanchard, Nurse Practitioner Dr. Kathryn Strother, Family Medicine Dr. Ed Lafleur, Family Medicine Dr. Bridget Girouard, Family Practice Dr. Kelly Cahill, Family Medicine Dr. Tina Stephanski, Office of Public Health Shanon McLaughlin, Supervisor North Side School Health Center Scott Family Clinic, Herbert Druilhet Family Nurse Practitioner SWLAHEC, Jennifer Burris Chris Martin, Executive Director Boys & Girls Club of Acadiana Larry Van Pelt, Diocese Justice & Peace Office Barbara Friedrichs, Lafayette Parish School Board Holly Howatt and Shauna Landry, Cecil J. Picard for Childhood Development and Lifelong Learning Progressive Baptist Church Outreach Center, Kitty Joseph Covenant Methodist Church, Pastor Chris Blanchard Christa Billeaud, President Junior League of Lafayette Jan Swift, Executive Director Upper Lafayette Chief Jim Craft, Lafayette Police Department Raymond Hebert, Executive Director Community Foundation of Acadiana Dee Stanley, CAO Lafayette Consolidated Government Angela Morrison, Chief of Community Impact United Way of Acadiana Nicole Jones, Executive Director Miles Perret Cancer Services Faith House, Crystal Scrantz Program Director Our Lady of Lourdes Participants Martha Paddio, Housekeeping Therese Haywood, Gift Shop 6 Narrative Our Lady of Lourdes Participants, Continued Verda Alexander, Housekeeping Thomas Herpin, Reprographics Myra Joseph, Housekeeping Mary Lilly, Housekeeping Georgie Roy, Reprographics Shellie Prejean, Food Services Joyce Obey, Dietary Sherry Gobert, Cafe’ Kimberly Short, Food Services Mary Stagg, Food Services Gay Coles, Radiology Patrick Potier, Operating Room Adrienne Davis, Radiology Lisa Griffin, Radiology Laura Mills, Dietary Geraldine Martin, Dietary Annette Lavergne, Radiology Laura Thacker, Cashier Joseph Francis, Radiology Lorita Roy, Housekeeping 5 Justify why the hospital selected its community benefit priorities. The opinions of our interviewees were supported by data from the research sources identified above. Initially, the issues with the greatest number of responses identified from the questionnaire and interviews were defined. Next, national level data were reviewed. It was found that those issues identified by members of the Lafayette community mirrored those identified on both a national and state level. Although statistics show that Lafayette Parish is much healthier than the state of Louisiana as a whole, it apparent that health disparities exist between zip code areas. This belief was evident in the answer to our question: “What location or area do you see as having the greatest unmet health care need?” The interview participants had a similar overwhelming response…the northern portion of the city of Lafayette. These opinions were supported by our findings in the Community Needs Index (CNI). The Community Needs Index (CNI) score is an average of five different barrier scores that measure various socio-economic indicators of each community by zip code. These barriers, and the statistics that comprise them, were carefully chosen and tested individually by both Catholic Healthcare West and Thomson Reuters. (Refer to Exhibit B on page 7) According to the Community Needs Index (scores based upon 2010 Population data) areas within Lafayette Parish showing the greatest need for healthcare access were zip code areas 70501 with a score of 5 and zip code area 70507 with a score of 4.2. The 70501 zip code area had scores of 5 for all of the five barrier scores. Based upon the interviews conducted during the Community Health Needs Assessment Surveys, the top unmet healthcare issues were identified in Lafayette Parish by those with a broad interest in the community and public health officials/participants. 7 Narrative 6 Does the hospital currently have community benefit activities that support other key health needs that were identified as important in the Community Health Needs Assessment? In partnering with Our Lady of Lourdes Regional Medical Center, Park Place Surgical Hospital supports the medical and community outreach activities of Lourdes. Our Lady of Lourdes Regional Medical Center currently operates several community outreach programs to address the healthcare needs of the poor in our area, namely, St. Bernadette Community Clinic, Northside High School Health Clinic and Congregational Health Services. Each plays a vital role in our care of those most in need in our community. St. Bernadette Community Clinic is a primary care clinic serving the homeless, sheltered and uninsured poor in our community. Located in the 70501 zip code, the Family Nurse Practitioner and two Registered Nurses care for the medical, dental, mental and spiritual needs of those they serve. This clinic is an acute care clinic providing: medical examinations, treatments and referrals; pelvic examinations and PAP Smears for women; evaluation and treatment for sexually transmitted infections; flu and pneumonia vaccinations; TB skin testing; weekly dental extractions; and referrals for dental hygiene appointments. With current staffing levels, they average approximately 254 medical visits and 46 dental visits per month. All services are free of charge to the patients. Northside High School Health Clinic is a school based health clinic located in the 70501 zip code. Our Lady of Lourdes Regional Medical Center has operated this clinic within the walls of Northside High School for 16 years. In 1996, Community Services Department of Our Lady of Lourdes partnered with the Lafayette Parish School Board to create this school-based health clinic after determining that the students at Northside High had the least amount of access to health care. Since its inception, this clinic has served as the only primary health care for many of the students. Currently, the clinic’s patients are about 91% African American and 71% receive Medicaid benefits. This clinic provides sports and comprehensive physical exams; diagnosis, treatment and follow up care of medical conditions; provides laboratory services; administers over the counter medications for minor aches or illness; provides education and supportive counseling by a licensed social worker with appropriate referral; provides prescription medication if needed; conducts obesity, hypertension and diabetes screenings; and provides for testing and treatment of sexual transmitted diseases. During the 2011–2012 school year, the staff of Northside High School Health Clinic conducted 3,052 patient visits, all free of charge to the students and faculty. Northside High School Health Clinic provides much needed awareness, diagnosis and treatment of obesity and potential heart disease as a routine part of their course of treatment. In addition, through the licensed social worker, mental health issues of these young people are being observed, diagnosed and referred for additional treatment. Although Lourdes is not specifically addressing the issue of mental health on a broad scale, this service is reaching the young people of the affected zip code area. Hopefully, this early detection and treatment can begin to reduce the high rate of unaddressed mental health issues in our community. 8 Narrative Congregational Health Services (CHS) is a community outreach program whereby Our Lady of Lourdes Regional Medical Center partners with church congregations and parishes to help them promote health and wellness among their members. This is done through a liaison that is also a healthcare professional. The liaison makes available hospital and community resources to the churches that they might not otherwise be aware. Such resources are educational brochures, programs, flyers, seminars and health classes to address health issues on a holistic approach. The liaison will help a church establish a healthcare ministry team made up of church volunteers or work with an existing ministry team. Together they promote access to a Family Nurse Practitioner, Medication Assistance Program, or any other healthcare needs specific to that church community. Currently, CHS serves six (6) church congregations and/or parishes exceeding 7,000, most of which are in the 70501 zip code or surrounding areas. Park Place Surgical Hospital has committed to funding the salary of a Nurse Practitioner that will support all three of the above-mentioned outreach programs as discussed further in this Implementation Strategy. Our Lady of Lourdes has programs in place to serve this population, such as St. Bernadette Community Clinic, Northside High School Clinic and Congregational Health Services. St. Bernadette Community Clinic is an acute care clinic serving mainly the homeless population from all zip codes of the northern part of the City of Lafayette. Northside High School Health Clinic serves students from primarily the 70501 zip code area. This clinic serves the mental and physical needs of the students of Northside High School. Last, Congregational Health Services is a program whereby a Liaison, in this case a nurse, works with health ministry committees in church parishes and congregations to bring health and wellness to those churches through health fairs, health workshops and screenings. Although this program is spread throughout the city, its roots are in the 70501 zip code area. Each of these serve a particular niche in the area, however, from this assessment, there is clearly more work to be done. 9 Narrative 7 List other health disparities that were identified in the CHNA and describe why the Hospital did not select them. Park Place Surgical Hospital has decided that it will not attempt to address the issues of Mental Health and Alcoholism/Drug Addiction as this is outside our scope of practice. However, mental health issues and addictions are diagnosed and referred by our community outreach clinics to other community agencies such as The Extra Mile, Lafayette Community Health Clinic and University Medical Center. However, in most cases, these conditions are monitored by the healthcare providers at each of Lourdes’ clinics. Thus PPSH indirectly will help address these needs through the funding of the Nurse Practitioner who will work in these clinics and will help diagnose and refer needy individuals to these other community agencies but an ongoing, long-term plan to address these wide-reaching conditions is outside the scope of our Implementation Strategy. 8 Describe how the hospital will institutionalize community benefit programming to support the implementation strategy. Park Place Surgical Hospital Implementation Strategy Plan will serve as a guide to address the community health needs identified during the CHNA process of Lafayette Parish. The areas identified through this process will be addressed through coordination and cooperation with key partners identified during this process to improve the health and wellness of the community. 10 Implementation Strategy Plan 11 Implementation Strategy Plan Park Place Surgical Hospital, herein referred to as “PPSH” is a joint venture with Our Lady of Lourdes Regional Medical Center located in Lafayette, Louisiana. Park Place Surgical Hospital’s vision is to provide patients with highly technical, less invasive, quality healthcare in a unique environment that promotes individual attention to patient needs. Facility size, nurse to patient ratio and team of experienced staff and physicians are key components in making Park Place Surgical Hospital the perfect setting for healthcare procedures. As a result of the 2012 Community Health Needs assessment completed by Our Lady of Lourdes Regional Medical Center, PPSH adopts the findings of said assessment and acknowledges the needs identified therein: (1) Obesity (2) Heart Disease (3) Mental Health Issues (4) Alcoholism/Drug Addiction (5) Diabetes (6) Cancer For many years, PPSH’s charitable work has consisted of providing procedures for certain patients of Lafayette Community Health Care Clinic at no charge to the patient. These procedures are done at the request of the staff of Lafayette Community Health Care Clinic. The services provided are done so with volunteer physicians affiliated with Park Place Surgical Hospital. PPSH will continue its program treating without charge certain patients with an identified financial need. Many of these patients are in the zip codes of 70501 and 70507. Increasing access to surgical procedures to patients in these zip codes will serve to improve outcomes for those suffering with the identified health needs outlined above. PPSH also provides care to Medicaid patients. Serving Medicaid patients is an important service PPSH provides to the community. Improving access to care for the poor of our community improves outcomes for each identified community need. PPSH will help address the identified community needs by continuing to offer procedures to Medicaid patients even at its reduced rate of reimbursement. In addition, PPSH has committed funding to establish another Nurse Practitioner position in the Community Services Department of Our Lady of Lourdes Regional Medical Center. This position will float between the community service programs: Northside High School Health Clinic, St. Bernadette Community Clinic, and Congregational Health Services. This additional staff in the Community Services Department will insure a continuum of care for all the patients served in these programs, most of who reside in the 70501 and 70507 zip code areas. Also, this additional medical staff will allow Community Services to increase patients seen at the various clinics, while providing additional opportunities for expanding components of existing community services programs. The community health needs identified and addressed by Our Lady of Lourdes Regional Medical Center and adopted by PPSH, particularly, obesity, heart disease, diabetes and cancer, will be the focus of this Nurse Practitioner’s role as he or she treats the patients in each of these outreach clinics. This commitment by Park Place Surgical Hospital is a direct result of the findings of the Community Health Needs Assessment and the Joint Venture with Our Lady of Lourdes Regional Medical Center. 12 337.237.8119 | parkplacesurgery.com | 901 Wilson Street | Lafayette, LA 70503