Community Health Needs Assessment

CHNA Phase Implementation Strategy Phase Assess Conduct Community Health Needs Assessment (CHNA) Prioritize Review Data and Prioritize Health Needs Update CHNA Report With Prioritization Method/Results Disseminate Formally Adopt CHNA Report Share CHNA Report/Data With the Community [e.g., HealthForecast.net™] Strategize Develop an Implementation Strategy for CHNA-Identified Issues Adopt Create & Formally Adopt an Implementation Strategy Document Submit Attach Implementation Strategy to Form 990 Schedule H Implement Implement Planned Strategies for FY2013-FY2015 Report Progress to IRS Annually Repeat CHNA/Implementation Strategy Must Be Completed Every 3 Years

 Logansport Memorial Hospital  Indiana Health Centers, Inc.  Cass County Health Department  Ivy Tech Community College  Cariage of Logansport (Chase Center)  Four County Counseling Center  Caston School Corporation  City of Logansport Parks Department  Cass County Family Y  United Way of Cass County  Area Five Council on Aging  Logansport/Cass County Chamber of Commerce  Logansport Community School Corporation  Peak Community Services Community Collaborators

Objectives of 2013 CHNA Provide baseline information about the health status of our community based on existing data. Identify the priority health needs within Cass County. Can be used by healthcare providers, community partners, and policymakers to improve the health status Provide public access to the CHNA results in order to inform the community of the overall health status and opportunities to transform the community’s health status.

PRC Community Health Needs Assessment Customized Local PRC Community Health Survey Key Informant Focus Groups Key Informant Focus Groups Secondary Data Secondary Data Surveys among 400 adults in Cass County, Indiana Random distribution 144 survey items; minute interview ±4.9% max error overall Key Informant Focus Group, comprised of 16 community stakeholders: o Public health, physicians & other health providers o Social services & other community leaders BENCHMARKING  PRC National Health Survey  State BRFSS data  Healthy People 2020 targets  National vital statistics data

*Surrounding Counties include Fulton, Miami, Pulaski, White, & Carroll *Status based on 10% relative change of area being compared to Cass Socio-Economic Status Indicators

Cass Surrounding Counties* Indiana U.S. Benchmark Range Dentists** Mental Health Professionals** Primary Care Practitioners** Adults who Have Health Insurance 81.4% 79.2%79.7%78.7%70.8% % Could not see a Physician Due to Cost 19.0% 22.4%15.0%14.6%14.6% % Prenatal Care Began in First Trimester 70.6% 77.4%70.3%71.0%71.0% % Adults who Visited a Dentist in the Past Year 60.4% 64.1%68.1%59.7%53.7% % Access to Care

Cass Surrounding Counties* Indiana U.S. Benchmark Range Diabetes Prevalence 9.1%10.6%9.6%9.0%9.0% - 9.9% Ever had a Heart Attack 3.8%6.1%5.1%4.2%4.2% - 4.6% Diagnosed with Angina or Coronary Heart Dx 3.5%4.4%4.8%4.2%4.2% - 4.6% Ever had a Stroke 5.1% 3.6%2.8%2.7%2.7% - 3.0% Current Asthma Prevalence 10.6% 7.2%9.3%8.5%8.5% - 9.4% Chronic Disease

Cass Surrounding Counties* Indiana U.S. Benchmark Range Ever had Cancer 13.2%10.9%9.6% 9.6% % Ever had a Mammogram 50.1%66.7%65.8%66.5%59.9% % Ever had a Pap Test 93.2%92.4%94.8%93.5%84.2% % Ever had a PSA Test 45.3% 62.8%64.5%64.7%58.2% % Ever had Sigmoid/colonoscopy 63.2% 59.8%60.9%63.8%57.4% % Cancer and Screening

Cass Surrounding Counties* Indiana U.S. Benchmark Range Smoking Prevalence 26.9%21.9%23.4%17.8%17.8% % Prenatal Smoking 20.4%26.3%17.1%13.0%13.0% % Binge Alcohol Drinking 12.2%11.4%14.6%15.0%15.0% % Heavy Alcohol Consumption 0.6%1.6%4.0%5.0%5.0% - 5.5% High Blood Pressure Prevalence 43.0% 39.5%40.7%38.4%38.4% % High Cholesterol Prevalence 47.8% 50.0%45.4%43.5%43.5% % Health Behaviors and Indicators

Cass Surrounding Counties* Indiana U.S. Benchmark Range Perceived Health as Excellent, Very Good, or Good 83.6%83.3%83.2%83.5%75.2% % At Least One Day in the Past 30 Mental Health was Poor 37.4%34.5%34.0% 34.0% % Suicide Rate – 13.0 Well Being

Cass Surrounding Counties* IndianaU.S. Benchmark Range Exercise In Past 30 Days 65.1%71.9%72.9%75.1%67.6% % Percent Overweight 35.2%35.6%36.0%36.3%36.3% % Percent Obese 33.8%30.3%29.1%27.3%27.3% % Consumed 5 or more Servings of Fruit 9.6%19.7%19.5%24.5%22.1% % Nutrition, Physical Activity, & Weight

General Health Status Areas of Opportunity Access to Health Services Cancer Diabetes Heart Disease & Stroke Injury & Violence Maternal, Infant & Child Health Mental Health & Mental Disorders Nutrition, Physical Activity & Weight Oral Health Respiratory Disease Tobacco Use

Health Indicator PRC Focus Group Rank Rank From Focus Group and 2 o Data Taskforce RankDetails Access to Health Services23 Deficient in dentists & mental health professionals. However, dentist visits in past year comparable Mental Health & Mental Disorders 44 Mental health professionals low, suicide rates better, poor mental health days comparable but on high side of benchmark range Nutrition, Physical Activity, & Weight 11 Obesity, exercise, and desired fruit consumption worse than Indiana and U.S. Tobacco Use321 Overall smoking & prenatal smoking prevalence higher than Indiana and U.S. Chronic Disease2 Diagnosed with diabetes, heart attach, heart disease, stroke and asthma Maternal/Child Health Lack of Prenatal Care 3 Higher percentage in first trimester lacking prenatal care. Comparison to PRC Report

Priority Determination  Severity of Issue  Size of Affected Population  Quick Impact  Potential for Change  Existing Program to Address Change  Ability to Evaluate Outcomes

Priorities and Objectives Access to Care To lessen physical, financial, cultural and educational barriers to care. Chronic Disease Management and Health Screens To focus on chronic disease management and whole-person healthas a way of providing patient care.

Priorities and Objectives Maternal, Infant and Child Health To increase access to prenatal care. Nutrition, Physical Activity and Weight By encouraging healthier lifestyles, LMH and collaborative partners aim to improve the quality of life for the population, specifically as well as promote and engage participants in healthy lifestyles.

Implementation Strategy – Access to Care  Provide healthcare services where the patient/consumer can easily access.  Develop patient materials at appropriate age and reading levels, as well as deliver in English and Spanish.  Provide education to patient/consumer on how to access healthcare system.  Utilize technology to improve access to care.

Implementation Strategy – Chronic Disease Management and Health Screens  Choose top 3-5 chronic diseases to impact.  Implement the Medical Home Model.  Provide education to patient/consumer on the importance of preventative healthcare services and the impact of chronic disease.  Provide community education related to chronic disease management and the role of modifiable health risks behaviors, effective strategies for behavior change, and co-morbidity of mental health/substance abuse.

Implementation Strategy – Maternal, Infant, and Child Health  Provide education to patient/consumer on how to access healthcare system.  Provide education to patient/consumer related to healthy pregnancy and prenatal care.

Implementation Strategy – Physical Activity and Weight  Promote the availability of healthy food choices.  Promote increased physical activity and exercise for all age groups.  Engage community partners to examine what actions and policy changes can be taken as a community to influence the overall health of the community.

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