1. REGIONAL HEALTH IMPROVEMENT PLANNING PROCESS
ACH Development Council Meeting

2. July 2014: Data in the 6-County Region
We really began our understanding of who we are at our second meeting as a Community of Health (COH) in July of 2014 looking at data about our 6 county region. We used a report generated by the Community Action Connection (CAC) using the American Community Survey (ACS) tool. (community needs assessment online tool) It had a wealth of information about the social determinants of health.

3. Fall 2014: SWOT Analysis in the 6- County Region
Strengths, Weaknesses, Opportunities & Threats
As part of our discovery process we had presentations from the 6 counties on their Community Health Needs Assessment (CHNA) and conducted a Strengths, Weaknesses, Opportunities & Threats (SWOT) analysis. Each County presented their CHNAs (except for Asotin). As the regional service area grew, we asked the Counties to fill in the data. As more information comes out, we add to the SWOT. It is a living document.

4. December 2014: Now a 9-County Region
By November 2014 we had added 3 more counties to the service area so we held a nine county retreat in December to look at data and determined our top 3 issues by County. The Managed Care Organizations (MCOs) participated as their own group. Dr. Patrick Jones facilitated the retreat where we looked at highlights from the County Health Rankings as a preface to the breakout exercise for the 3 top health priorities from each County. He noted that shared measurement (Collecting data and measuring results consistently across all participants) and common agenda (All participants have a shared vision for change including a common understanding of the problem and a joint approach to solving it through agreed upon actions) were elements of the Collective Impact model that Sue had just talked about. He picked 8 indicators using a couple of different filters: indicators that presented challenges to the 9 counties; and ones that highlighted a great deal of variety among the 9 county region. He reviewed measures in Health Outcomes: Premature death (potential years of life lost before age 75), Poor physical health days, Poor mental health days. Health Behaviors: Adult Obesity, Teen births. Health Access: Dentists to population ratio, Mental Health providers to population. Social & Economic Factors: High school graduation, Children in poverty (all counties are above the state average). People broke into groups by County to reflect on CHNAs, what has been eye opening during his presentation, prior work, County Health Rankings, and report out on top 3 issues.

5. August 2015 Retreat: 10-County Region Social Determinants of Health
Determinants of Health Share of Population 25+ w/out a High School Degree (or equivalency): ‘09-13 (%)
Determinants of Health Population w/out a High School Degree (or equivalency): ‘09-13 (%)
At the August retreat we focused on examining the social determinants across the nine counties, and reaffirmed our priority areas. As a result of looking at our regional service area education rates, and understanding that poverty, health, and education are inextricably linked, we added a 4th priority, high school graduation rates. The August retreat was well attended by 71 participants with each County represented.

6. OBESITY PREVALENCE * 2015 County Health Rankings (WA State=28%)
Fall 2015: 10-County Region Regional Inventory of Programs
Benton-Franklin Community Health Alliance
Where program is delivered
Youth Medicaid Pop (under 19)
2,699
28,511
451
22,024
271
3,996
2,771
8,070
2,888
62,218
Adult Medicaid Pop (19 & over)
3,876
26,501
736
12,707
326
5,768
3,619
8,763
4,613
50,842
Program Name
Description
Asotin
Benton
Columbia
Franklin
Garfield
Kittitas
Klickitat
Walla Walla
Whitman
Yakima
PROGRAMS/ACTIVITIES ADDRESSING CARE COORDINATION
Good Health Begins with Me
Rack card listing Urgent Care Centers, Mental & Dental facilities in Community distributed by EMS x
Consistent Care
Inappropriate use of Hospital EDs
PROGRAMS/ACTIVITES ADDRESSING BEHAVIORAL HEALTH
Crisis Intervention Training
Teaches police/fire how to respond to people in crisis situation, especially those with mental illness
Housing Inventory for Mental Health
Compiliation of a list of housing resources for people with mental illness
OBESITY PREVALENCE * 2015 County Health Rankings (WA State=28%)
29%
32%
31%
33%
27%
26%
PROGRAMS/ACTIVITIES ADDRESSING OBESITY/DIABETES
Community Gardens
Access to Healthy Foods
Good Health is Good Business
Worksite Wellness Initiative
Tri-City Herald Column
monthly article on nutrition and chronic disease
Following the August retreat we started gathering an inventory of all of the programs addressing our priority areas across the nine county region. Each agency/organization filled out a template which we started populating with data. The inventory is being used to filter our top programs/projects and the Chairs of each priority Work Group has narrowed down the list of programs using the Spokane Priority criteria, a list of “speed dating” questions, and the Medicaid Transformation Goals.

7. December 2015: Performance Results for GCACH compared to all WA State ACHs
Community Checkup report: WA Health Alliance - Indicators of concern for Greater Columbia ACH
Asotin
Benton
Columbia
Franklin
Garfield
Kittitas
Klickitat
Walla Walla
Whitman
Yakima
Child & adolescent access to primary care ages 7-11 years
Average- C Average-M
Worse - C Average-M
No data-C Average-M
Average -C Average-M
No Data C&M
Worse -C Average-M
Average- C Worse-M
Average-C Better-M
Worse-C Worse-M
Adolescent well-care visits (M)
Average -C Worse-M
Worse-C Worse-M
Average C&M
Worse-C Average-M
Average-C Better-M
Better-C Better-M
Average-C Worse-M
Screening for cervical cancer
Worse-C No Data-M
Worse-C Average-M
Screening for chlamydia
No Data-C No Data-M
Average-C Better-M
Average-C Worse-M
Screening for colon cancer
Average-C No Data-M
Average-C Average-M
Average-C No Data-M
Average-C No Data-M
Average-C No data-M
Well-child visits- ages 3-6 years
No Data-C Average-M
No Data-C Worse-M
Antidepressant medication (12 weeks)
no data
Antidepressant medication (6 months)
Worse C Average M
Blood sugar (HbA1c) test)
Average-C No data-M
Worse-C No data-M
Kidney disease screening
Worse - C Average-M
Antacid medication (proton pump inhibitors)
No Data
Adherence for Diabetes Medication
Most recently we are using the WHA Common Measures and understanding where we have the worse scores. Very problematic for us is a lack of data for the smaller Counties like Asotin, Columbia, Garfield and Klickitat. We have recently hired a Project Manager to develop our Regional Health Improvement Plan. Her next step is to help each Chair determine a goal for their committee, determine their outcome measures, compare the top 10 projects in our priority areas with the Medicaid Waiver projects to find commonalities, and put those 50 projects through another set of criteria as expressed at the Medicaid Waiver webinar. The hope is that we will come up with about 2-3 projects from each Work Group and have a discussion about the root causes of the issues in these projects. We will try to find common themes across the projects, and then determine strategies that address the themes. We will pick one project from each Priority Work Group to become the basis for our Regional Health Improvement Plant.