St. John’s Hospital, Memorial Medical Center, Sangamon County Department of Public Health & SIU School of Medicine Citizens Club of Springfield Dec. 19,

 Required every 3 years for nonprofit hospitals  Must meet Internal Revenue Service rules  Memorial Medical Center (MMC) & St. John’s Hospital (SJH) did 2012 assessments separately  MMC, SJH collaborated on this assessment, to be completed in  SJH and Memorial agreed to select one joint priority and work collaboratively to address it.

 Sangamon County Department of Public Health is conducting its required assessment with the hospitals (IPLAN – Illinois Project for Local Assessment of Needs).  IPLAN is a 5-year cycle. SCDPH, with permission of the Illinois Dept. of Public Health, will do 3-year cycle with the hospitals.  SIU School of Medicine, Office of Community Health and Service, is assisting.  UIS Survey Research program helped with forums and survey analysis; will help with focus groups.

CORE TEAM ‣St. John’s Hospital ‣Memorial Medical Center ‣Sangamon County Department of Public Health ‣SIU School of Medicine

1. Central Counties Health Centers 2. Eastside Ministerial Alliance 3. Illinois Department of Public Health, Division of Health Policy 4. Mental Health Centers of Central Illinois 5. Sangamon County Farm Bureau 6. Sangamon County Medical Society 7. SIU Center for Family Medicine 8. Springfield School Dist Springfield Urban League 10. United Way of Central Illinois 11. University of Illinois at Springfield Survey Research Office

1. Institute of Medicine’s Triple Aim Impact: Improve the health of individuals or the population, and reduce health care costs. 2. Magnitude of the Issue – How many people are affected by this issue in the community? 3. Seriousness of the Issue – How related is the issue to the mortality (deaths) of those affected? 4. Feasibility – Considering available resources to address the issue, how likely are we to make a significant impact on the issue? 6

‣Core Team reviewed more than 100 health indicators for Sangamon County ‣Selected 21 serious indicators for detailed review; ranked using the Defined Criteria ‣Took 12 priorities to the Community Advisory Committee, which ranked and selected 9 issues 7

‣Took those 9 issues to the larger community ‣Five community forums in October: Riverton, Auburn and three in Springfield (Union Baptist Church, Washington Park Botanical Garden and Lanphier High School) ‣Open survey; 781 completed 8

Nine Priorities on the Community Survey ‣Access to Care ‣Asthma ‣Child Abuse ‣Dental Care ‣Diabetes ‣Food Insecurity ‣Heart Disease ‣Mental Health ‣Overweight/Obesity

 Mixed mode survey ◦ Hard copies available at community forums and community locations ◦ Online link publicized  Community Forums ◦ All comments were recorded by UIS staff and then transcribed using both automated transcription software and individual researchers

 The survey was available to Sangamon County community members from September 22 to October 20,  781 individuals completed the survey ◦ 55 from community forums ◦ 137 from community locations ◦ 589 online surveys

Demographics of participants Sangamon County Population (2012 ACS estimates) Community forum participants N=55 Community participants (online and paper surveys) N=726 Female 52.0%52.9%75.2% Male 48.0%45.1%22.3% White 83.7%78.0%83.2% African-American 12.0%16.0%11.3% Other 4.3%6.0%5.5% Hispanic/Latino(a) 1.8%2.2%2.7% years old 6.0%8.0%4.8% years old 12.8%16.0%18.4% years old 12.8%8.0%18.9% years old 15.2%14.0%26.4% years old 13.3%26.0%23.2% 65 and older 13.7%28.0%8.3%

Results

 report that food insecurity is a high priority more than in any other region.  Child abuse ranks high in all zip codes, it is ranked as less of a priority area among respondents in and Almost 90% of respondents living in rank it as a high priority.  86% of women compared to 73.3% percent of men report that child abuse is a high priority.  In addition, 91.3% of women compared to 74.8% men report that mental health is a high priority.  African-American respondents are more likely to report that asthma, child abuse, and heart disease are high priorities than either White respondents or respondents who do not identify as either White or African-American.

‣Data and Images from Memorial Health System’s Healthy Communities Institute Community Dashboard Retrieved Sept. 20, 2014 ‣ Additional data obtained from 2013 Sangamon County Citizens Survey Illinois Department of Public Health 2013 Federally Qualified Health Center reports to Health Resources and Services Administration (Central Counties Health Centers and SIU Center for Family Medicine) Springfield Urban League Head Start Community Assessment Sangamon County Department of Community Resources Voices for Illinois Children – Kids Count USDA Food Atlas Plus other existing surveys and need assessments 15

‣Gauge shows where Sangamon County falls in comparison to other Illinois counties OR other counties in the United States. ‣Like a gasoline gauge on your car, from left to right o GREEN = Good o YELLOW = Falling into the bottom half o RED = Issue to take look at ‣Data comes from both state and national sources ‣Sangamon County residents only ‣Disparities –We added a red star to highlight data that shows a worse outcome for African- American residents.

17 Sangamon County Socio Needs Index Measures socioeconomic need that correlates with poor health outcomes Zip Codes 62701, 62702, About 68,750 people; approximately 35% of county’s population and 59% of the city of Springfield Ranked worst on socio needs index Zip Code About 15,300 people Ranked best in the county on socio needs index Source: Healthy Communities Institute

Access to Care 18

Access is more than having a primary care physician. It may be transportation, paying for prescription medications or other issues. Access to Care Sangamon County Citizens’ Survey (2013) 11.3% do not have health care coverage (state average: 13.1%) 19.1% of African Americans are uninsured vs. 9.2% of Whites 13.8% do not have a primary care physician 20.9% are economically insecure about their family’s health care – at least once in the past 12 months they did not have enough money to pay for health care or medicines for someone in their family

20 Child Abuse

21 Mental Health

Overweight/Obesity

Overweight/obesity has been identified as an issue by Memorial Medical Center St. John’s Hospital SIU School of Medicine genH Kids Springfield Collaborative for Active Child Health (SIU School of Medicine, District 186, Springfield Urban League/Head Start, and the Illinois Department of Public Health are the partners) Programs in 8 elementary schools in Dist. 186 (Ridgely, Fairview, Enos, McClernand, Dubois, Iles, Lindsay, Butler). Spring 2014, the combined overweight and obesity rates of first and fourth graders in these 8 schools was 33%. Overweight/Obesity

 MMC and SJH will focus on areas of greatest need in the community (likely residents living zip codes 62701, and 62703).  Take a narrower, deeper dive into the issue rather than broader, but shallower community-wide approach; consider targeted initiative a pilot project that might be replicated elsewhere in the community, if successful.  We will be collaborative and invite other stakeholders to participate.  We want to demonstrate measurable outcomes.  SCDPH and SIU School of Medicine will also participate in this project. 24

 St. John’s and Memorial each took survey results back to their Internal Advisory Committees.  Priorities were ranked using the defined criteria.  A joint priority was selected and approved by both hospitals’ CEOs.

 Looked for a limited geographic area to address issue of access to care  Enos Park has documented socio-economic and health needs  Both Memorial and St. John’s are neighbors to Enos Park  In considering the Feasibility aspect of our defined criteria, the Enos Park Neighborhood Improvement Association has a strong neighborhood infrastructure that can help us get to know the neighborhood and the access issues affecting its residents. 26

 Both hospitals must complete the CHNA before end of FY15 (June 30 for SJH & Sept. 30 for MMC)  Completion means o Assess needs o Get community input into the priorities, including public health and underserved/vulnerable populations o Select priorities; develop implementation plans; gain board approval o Post on websites before end of FY15 o MMC will coordinate its implementation strategy with three other Memorial Health System hospitals. o St. John’s may collaborate with it’s other HSHS hospitals.

COMPLETED: ‣Majority of the Core Team tasks ‣Advisory Committee work ‣Community Forums and Community Surveys ‣Selection of collaborative priority TO DO: ‣Hold focus groups ‣MMC, SJH and SCDPH identify their other priorities ‣Develop implementation plans ‣SCDPH completes IPLAN

29 ‣ October 2015 – St. John’s, Memorial and Sangamon County Department of Public Health will report: o Priorities selected by each organization o Implementation plans o Plans for the joint priority of Access to Care in Enos Park neighborhood o There will likely be some of the 9 priorities that are not selected. o SIU School of Medicine may convene discussions about some of those issues.