Community Health Needs Assessment Report - MHA > Web viewCommunity Health Needs Assessment Report. ... This $475,000 grant from the George Family Foundation and Allina Health has made

Community Health Needs Assessment Report

The Health of Aitkin County

Riverwood Healthcare Center, Aitkin, Minnesota

September 30, 2013

1

Community Health Needs Assessment

Riverwood Healthcare Center

Table of Contents

Introduction…………………………………………….page 4

Acknowledgements…………………………………...page 5

Executive Summary…………………………..………page 6

Community Assessment Process……………….…..page 7

Description of Process and Methods………….page 7

Data Sources…………………………………….page 8

Public Health Input………………………………page 9

Community Description……………………………….page 11

Demographic Data…………………………………….page 13

Population Trends

Household Trends

Ethnicity

Age

Workforce

Socioeconomic

Community Systems Data……………………….…..page 19 2

Healthy Community Data Key Indicators…………….page 20

Bridge to Health Survey

Prioritization Process of CHNA Needs……………….page 23

Community Input

Communication of Results……………………………..page 39

Strategies for Implementation…………………….……page 39

Riverwood’s Addressing of Needs

Conclusion……………………………………….………page 42

Attachments:

Community Health Resources Attachment A

Riverwood Wellness Resources Attachment B

3

Introduction

The Health of Aitkin County is a Community Health Needs Assessment (CHNA) developed by Riverwood Healthcare Center, in partnership with other health and wellness organizations. This document fulfills the requirements for community hospitals, as set forth by the Patient Protection and Affordable Care Act (PPACA).

The Patient Protection and Affordable Care Act set additional criteria for community hospitals to maintain their tax exempt 501c (3) status. This requirement applies for tax years beginning after March 3, 2012, and must be completed at least every three years, with input from the broader community including public health experts. This plan meets the requirements of IRS Notice 2011-52, which specifies information that needs to be included in the CHNA, including implementation strategies that address the issues identified by the assessment. The required information is contained in sections in this report, as summarized below.

Community Assessment Process Community Description Demographic Data Community Systems Data Healthy Community Indicators Prioritization Process of CHNA Needs Communication of Results Strategies for Implementation Conclusion

4

Acknowledgements

Special thanks to the many individuals and organizations that assisted with the completion of the Community Health Needs Assessment process. Most specifically to the Core Project Team who provided input and guidance on the project. Thanks also to the many Riverwood Healthcare Center staff who assisted during various phases including Arlene Wheaton and Connie Gretschmann. Special thanks to Shelli Urness Consulting, HBH Associates, and Health Planning and Management Resources, Inc. for their expertise and involvement. I especially want to thank the many community members who provided input via the Community Feedback Sessions and Telephone Interviews. An engaged community has contributed to the success of Riverwood Healthcare Center since our inception in 1955, and we have partnered with the community to meet the health and wellness needs of the residents and visitors of Aitkin County and the surrounding area. This assessment has been a true community endeavor.

Chad CooperCEO, Riverwood Healthcare Center

CHNA Core Project Team Members:

Jayne Anderson, Riverwood Healthcare Center, Aitkin, Minnesota

Cynthia Bennett, Aitkin County Public Health, Aitkin, Minnesota

Liz Dean, Riverwood Healthcare Center, Aitkin, Minnesota

Mike Hagen, Riverwood Healthcare Center, Aitkin, Minnesota

John Hodson, Aitkin ISD #1 Community Education, Aitkin, Minnesota

Lisa Kruse, McGregor ISD #4 Community Education, McGregor, Minnesota

Beth Leaf, Aitkin County CARE, Aitkin, Minnesota

Alison Matalamaki, Aicota Healthcare Center, Aitkin, Minnesota

Heidi Olesen, Aitkin ISD #1, Aitkin, Minnesota

Dan Schletty, Riverwood Healthcare Center, Aitkin, Minnesota

Judy Turner, Riverwood Healthcare Center, Aitkin, Minnesota

Shelli Urness, Shelli Urness Consulting, Brainerd, Minnesota

5

Executive Summary

Riverwood Healthcare Center (RHCC) operates a 25-bed critical access hospital serving Aitkin County and surrounding communities in north central Minnesota, with full service primary care clinics in Aitkin, Garrison and McGregor. Patients can access urgent care and a wide range of specialty care at our integrated hospital and clinic in Aitkin. Our facility has achieved several designations that demonstrate our commitment to outstanding delivery of medical care. These include Level III Trauma Center, Level I Heart attack program protocol in affiliation with the Minneapolis Heart Institute at Abbott-Northwestern Hospital, and Comprehensive Advanced Life Support Hospital.

Riverwood delivers top quality medical care delivered with a team of caring healthcare professionals. Since 1955, we've been committed to providing our community with a comprehensive array of medical services close to home. Since 1955, we have expanded our portfolio of clinical services, added medical staff members, as well as increased the programs and number of sites to access care. Despite this growth in the range and extent of services, we have long realized that the full measure of accountability to the communities we serve is to improve and maintain health and wellness.

The Health of Aitkin County report is a comprehensive community health needs assessment (CHNA). The report outlines community health needs based on primary and secondary data sources. This report is intended to give Riverwood, our staff, and our community information on county health indicators that will serve to guide strategic activities and programs, and chart the course for future community health initiatives. Improving and sustaining community health is a collaborative effort that integrates many stakeholders including county public health, school districts, nonprofit organizations, and many other public and private entities. This CHNA report is the product of an 18-month process that sought community input, medical staff input, involved key representatives such as public health, and selected primary and secondary data sources to identify target areas and implementation plans.

Health and wellness is an issue of concern for all of us, and we hope that the information in this report creates conversation and action among the private and public sector, so that we all work to improve the health of our county.

It is Riverwood’s intention to continue to use research and data on a three-year rotating cycle, as this allows time to make some changes, recruit any needed personnel, develop more services, and communicate to the community the services available.

6

Community Assessment Process

In order to fulfill the new requirements set forth by the IRS, Riverwood Healthcare Center has undertaken a community health needs assessment (CHNA), the purpose of which is to gain input on community health needs and identify gaps and barriers to service, with the ultimate goal of better serving the health and wellness needs of Aitkin County.

Description of Process and Methods

RHCC enlisted the services of Shelli Urness Consulting to design a project plan and coordinate the construction of the CHNA and report.

Project Overview

The Community Health Needs Assessment is a new federal requirement for private, non-profit hospitals including Riverwood Healthcare Center (RHCC). Part of the Patient Protection and Affordable Care Act (ACA), the Community Health Needs Assessment is the requirement of additional criteria for Riverwood and other hospitals to maintain their tax-exempt, 501(c) (3) status. This requirement applies for tax years beginning after March 23, 2012. A CHNA must be completed at least every three years with input from the broader community, including public health experts. The CHNA describes how Riverwood will address needs identified in the community health needs assessment as well as identify any needs not being addressed and explain why not, and contain an implementation strategy. Riverwood Healthcare Center has contracted with Shelli Urness Consulting to facilitate the CHNA Project in conjunction with a Project Team of Riverwood Healthcare Center staff and other key stakeholders previously identified.

In addition, Riverwood regularly conducts specific research on its services and community awareness. Health Planning and Management Resources, Inc. (HPMRI) conducted primary research in both 2008 and 2011 to help RHCC Management better understand the needs of the communities they serve. HPNRU completed telephone surveys-one in 2008 and one in 2011- of 400 randomly selected households in the market area. Because the related questions were asked for all household members, information was obtained for well over 500 persons residing in the market area. The telephone calls and analysis of the results were completed by professional market research firms. RHCC’s management has used this information in the development of its strategic plan, including development of new services to serve the community needs.

HBH Consultants obtained input from residents in Riverwood’s primary service communities: Aitkin, Garrison and McGregor. Through community input sessions telephone interviews and email questionnaires, we have evaluated perceptions regarding health and wellness resources available through both Riverwood and the wider community and have identified some missing links. Details of community input are detailed later in this report.

7

Phase 1 - Planning•Step 1- Engage Shelli Urness Consulting•Step 2-Compile Project Team•Step 3 – Inventoryof Existing Resources 3

Phase 3 - Strategy•Step 6- Prioritize Needs•Step 7- Determine response to needs•Step 8- Determine Implementation Plan

Phase 4– Execution•Step 9 – Reporting•Step 10 –Implementation

Phase 2- Compiling/Collecting•Step 4 Defining‐scope of NeedsAssessment•Step 5 – Collectingdata/information

•Phase 5– Execution•Step 11– Evaluate Progress and Means for sustainability

Phase 1

Phase 2

Phase 3Phase 4

Phase 5

Flow Diagram of Riverwood’s CHNA Project

Project Approach

RHCC took a phased approach to the CHNA.- Phase 1 – Planning- Phase 2 – Compiling/collection- Phase 3 – Strategy analysis- Phase 4 – Action/execution- Phase 5 – Evaluation and measurement

8

CHNA Riverwood Healthcare Center – Timeline

█ __________ █ ___________ █ ___ ___ █ ____________ █ ___________ █ __ _______ █

Data SourcesIn addition to the primary data sources noted earlier (surveys, community input sessions, phone contact), extensive secondary data was utilized as a reliable basis of information. The list of data sources used includes:

Minnesota Department of Health US Census Bureau Minnesota Hospital Association, Community Health Needs Assessment Requirements,

Matt Anderson Vice President, Regulatory/Strategic Affairs, January 12, 2012 County Health Rakings and Report 2012 Bridge to Health Survey, Northeastern Minnesota and Northwestern Wisconsin Regional

Health Status Survey, Aitkin County Data Tables 2010 Riverwood Healthcare Market Study 2012, Maureen Swan, MedTrendInc. Community Health Needs Assessment (CHNA) Done Right: A Practical Guide, 10/2011,

RSM McGladrey, Inc. Consumer Survey Regarding Health Services in the Aitkin Market Area, Patricia

McCollough, Health Planning and Management Resources Inc. Edina, MN September 2011 Healthy People 2020, Association for Community Health Improvement IRS Form 990 and attachments, including Schedule H (Hospitals) – page 4 Riverwood Healthcare Center Strategic Plan 2012-2014 Aitkin County Wellness Initiative Information

Public Health InputCommunity Health Boards The Community Health Board (CHB) is the legal governing authority for local public health in Minnesota, and CHBs work with the Minnesota Department of Health in partnership to prevent diseases, protect against environmental hazards, promote healthy behaviors and healthy communities, respond to disasters, ensure access to health services, and assure an adequate local public health infrastructure.

9

Begin Project

April 2012

Phase 1

April./May/June 2012

Phase 2

July/August/September/October 2012

Phase 3

November/December 2012January 2013

Phase 4

February/March 2013

Phase 5

April/May 2013

CHNA Required

October 1, 2013

CHBs have statutory responsibility under the Local Public Health Act and must address and implement the essential local public health activities. Additionally, CHBs must assure that: - A community health assessment and plan are completed on a regular cycle. - Community health needs are prioritized in a manner that involves community participation. - Needed public health services are developed and implemented.

The Local Public Health Act requires each CHB to serve a population of at least 30,000 people. If a single county doesn’t meet the population requirement, it can form a CHB with one or more neighboring counties. If a CHB serves three or more contiguous counties, the minimum population requirement does not apply. The number of CHBs in the system has varied over time and is subject to change; MDH maintains a map of current CHBs online. CHBs in Minnesota take a number of forms:

Single-County Multi-County Statutory (City-Based) Human Services Board Contracted Services

CHBs are required to have a community health services administrator and a medical consultant, and may appoint an advisory committee. Members of the CHB are either elected themselves or appointed by elected officials. Due to local control and local investment of resources, the membership, composition, and business practices of CHBs vary throughout the state. This flexibility is a great strength of the state’s public health system; it helps ensure public health activities are aligned with community need.

Organizational and Governance Changes Over the past decade, several counties and CHBs have made changes to their public health organizational and governance structures, and more changes are being considered as local elected officials look for ways to address significant budget concerns, create efficiencies, and anticipate the retirements of public health leaders. Between May 2009 and May 2010, 28 percent of county boards and 28 percent of CHBs considered, proposed, or decided to change their organizational or governance structure. Some top public health officials expressed satisfaction with current structures, whereas others identified limitations with current structures or concerns about the motivation for changing structures.

The CHB for the Aitkin County region is Aitkin-Itasca-Koochiching Community Health Board includes and includes:

Aitkin County Itasca County Koochiching County

Cynthia Bennet, Aitkin County Public Health Supervisor, was a member of Riverwood’s CHNA Core

10

Project Team. Tom Burke, Human Services Director from Aitkin County, also participated in a telephone interview. Aitkin County Public Health is also conducting a Community Public Health Assessment as a requirement to Minnesota’s Local Public Health Act, which requires local health departments to conduct a comprehensive assessment and planning process ever five years. They are working in collaboration with other Public Health groups in their region and expect completion of the report in 2014.

In 2012 Dr. Ed Edhlinger, Minnesota Commissioner of Public Health, also commented on the County Health Rankings and Roadmap for Aitkin County (referenced later in this report). He said: “We spend only a fraction of the amount on prevention that we spend on medical care in this county. We need to do a better job of investing in disease prevention within communities if we really want to improve the health of Minnesotans and get a handle on rising health care costs.”

Community DescriptionThe CHNA identifies the Community as primarily all of Aitkin County for the purposes of this report. Riverwood Healthcare’s Aitkin Clinic and Hospital, the Specialty Clinic, and the McGregor Clinic are all located in Aitkin County. It should be noted that a portion of Crow Wing County is also served by Riverwood Healthcare’s Garrison Clinic. Community input was solicited from the entire service area.

It can be reasonably expected that the hospital and clinics can serve the majority of the health needs of Aitkin County. It includes a primary population served of approximately 18,000 people.

11

Riverwood Healthcare Center Market Area

Riverwood Healthcare Center Service Area Definitions

Primary Service Area S e c o n d a r y S e r v i c e Ar e a Total Primary and Secondary Service Area 2011 Population: 55,166

12

ZipCode Community 2011 Population

56401 Brainerd 29,05056441 Crosby 4,370

56342 Isle 2,55656450 Garrison 1,158

Total 37,134

ZipCode Community

2011Population

56431 Aitkin 8,61556444 Deerwood 3,227

55760 McGregor 2,88756469 Palisade 1,439

55748 Hill City 1,19255787 Tamarack 672

Total 18,032

Demographic DataPopulation Trends

Aitkin County population in July 2011: 16,220 (all rural); it was 15,301 in 2000. The population density was 8.9 people per square mile (3/km²). As of the census of 2010, there were 16,202 people, 7,542 households, and 4,458 families residing in the County.

Low Growth, 2.5% in the Riverwood TSA Market2011 – 2016 Projected Population Change

The total market is projected to grow by 1,392 or 2.5% over next five years

Population Change 2011-2016

-0.9%

Garrison Isle Deerwood Brainerd Palisade Crosby McGregor Tamarack Aitkin

Hill City

-1%

(63)

(132)

(112)

(881)

(39) (70)

(36)

(7)

(63)

(-11)

1.2%

1.0%

0.7%

1.6%

3.0%

2.7%

3.5%

5.4%

5.2%

The PSA will grow by246 or 1.4%

Percentage Change and absolute growth in ( ) Source: Claritas, 2011

13

-1% 0% 1% 2% 3% 4% 5% 6%

CHNA Riverwood Healthcare Center

Household Trends

There were 6,644 households out of which 22.60% had children under the age of 18 living with them, 57.50% were married couples living together, 6.30% had a female householder with no husband present, and 32.90% were non-families. Of all households, 28.70% were made up of individuals and 14.00% had someone living alone who was 65 years of age or older. The average household size was 2.28 and the average family size was 2.76.

14


Average household size:Aitkin County: 2.0 peopleMinnesota: 2 people

Estimated median household income in 2009: $36,760 ($31,139 in 1999)Aitkin County: $36,760Minnesota: $55,616

Median contract rent in 2009 for apartments: $420 (lower quartile is $273, upper quartile is $576) Aitkin County: $420Minnesota: $683

Estimated median house or condo value in 2009: $170,582 (it was $86,200 in 2000) Aitkin County:$170,582Minnesota: $200,400Lower value quartile - upper value quartile: $106,009 - $272,433

15


Mean price in 2009:Detached houses: $199,468 Aitkin County: $199,468Minnesota: $247,637

Townhouses or other attached units: $2,568,324 Aitkin County: $2,568,324

Minnesota: $193,158

In 2-unit structures: $20,230 Aitkin County: $20,230Minnesota: $233,138

In 5-or-more-unit structures: $242,671 Aitkin County:$242,671Minnesota: $177,950

Mobile homes: $121,465 Aitkin County:$121,465Minnesota: $34,666

Occupied boats, RVs, vans, etc.: $318,878 Aitkin County:$318,878Minnesota: $94,976Median monthly housing costs for homes and condos with a mortgage: $1,233Median monthly housing costs for units without a mortgage: $309

Institutionalized population: 195

Ethnicity

The racial makeup of the county was 95.63% or 15,494 people White, 0.35% or 57 people Black or African American, 2.4% or 390 people Native American, 0.17% or 27 people Asian, 0.025% or 4 people Pacific Islander, 0.13% or 21 people from other races, and 1.29% or 209 people from two or more races. Of the population with two or more races, 0.9% of the population were Hispanic or Latino of any race. 29.5% were of German, 14.3% Norwegian, 13.0% Swedish, 6.2% Irish, 5.3% United States or American and 5.2% Finnish ancestry.

16


Age

According to the US Census Bureau (2010) In the county the population was spread out with 20.90% under the age of 18, 5.50% from 18 to 24, 21.60% from 25 to 44, 29.10% from 45 to 64, and 23.00% who were 65 years of age or older. The median age was 46 years. For every 100 females there were 101.60 males. For every 100 females age 18 and over, there were 99.90 males.

This trend has changed slightly demonstrating the aging of the population, according to July 2011 data (City-Data.com) the average age and gender is as follows:

Median Aitkin County resident age: 51.0 years

Minnesota median age: 37.0 years

Males: 8,205 (47.6%)Females: 7,997 (52.4%)

Workforce

The median income for a household in the county was $44,139, and the median income for a family was $58,290. Males had a median income of $51,604 versus $30,633 for females. The per capita income for the county was $21,848. About 5.20% of families and 7.60% of the population were below the poverty line, including 15.50% of those under age 18 and 11.00% of those age 65 or over.

Industries providing employment: Educational, health and social services (20.8%), Arts, entertainment, recreation, accommodation and food services (14.4%), Retail trade (11.1%), Manufacturing (10.5%), Construction (10.3%).

Type of workers: Private wage or salary: 73% Government: 15% Self-employed, not incorporated: 12% Unpaid family work: 0%

Socioeconomic

County owner-occupied with a mortgage or a loan houses and condos in 2010: 3,412County owner-occupied free and clear houses and condos in 2010: 2,717County owner-occupied houses and condos in 2000: 5,666Renter-occupied apartments: 1,170 (it was 978 in 2000)Mar. 2012 cost of living index in Aitkin County: 89.4 (less than average, U.S. average is 100)

17


Percentage of residents living in poverty in 2009: 13.9%(12.4% for White Non-Hispanic residents, 2.6% for Black residents, 52.9% for Hispanic or Latino residents, 51.4% for American Indian residents, 78.3% for other race residents, 32.9% for two or more races residents)Median age of residents in 2010: 51 years old(Males: 51 years old, Females: 52 years old)(Median age for: White residents: 52 years old, Black residents: 37 years old, American Indian residents: 25 years old, Asian residents: 31 years old, Hispanic or Latino residents: 21 years old, Other race residents: 49 years old)

Residents with income below the poverty level in 2009: This county: 11.6%Whole state:7.9%

Residents with income below 50% of the poverty level in 2009: This county: 3.6%Whole state:3.2%

Fair market rent in 2006 for a 1-bedroom apartment in Aitkin County is $424 a month.Fair market rent for a 2-bedroom apartment is $557 a month.Fair market rent for a 3-bedroom apartment is $695 a month.

Cities in this county include: Aitkin, Hill City, McGregor, Palisade, McGrath, Tamarack.

18


Community Systems DataAttachments B and C provide information on the assets and resources available in Aitkin County to address community health is presented in list/directory format. It is a comprehensive listing of identified potential health resources and assets in Aitkin County. It’s likely that some resources have been missed, or may be duplicative in some manner.

Riverwood Healthcare Specific Services

Riverwood Healthcare Center and Clinic operates a 25-bed critical access hospital serving Aitkin County and surrounding communities in north central Minnesota, with full service primary care clinics in Aitkin, Garrison and McGregor. Patients can access urgent care and a wide range of specialty care at our integrated hospital and clinic in Aitkin. Our facility has achieved several designations that demonstrate our commitment to outstanding delivery of medical care. These include Level III Trauma Center, Level I Heart attack program protocol in affiliation with the Minneapolis Heart Institute at Abbott-Northwestern Hospital, and Comprehensive Advanced Life Support Hospital.

19


Riverwood Healthcare Center's Specialty Clinic brings the specialist to the community. Riverwood patients can consult and visit with a specialist without traveling far from home. The Specialty Clinic in Aitkin, MN, brings highly skilled medical specialists to Riverwood in Aitkin. These specialists treat a wide variety of diseases including:

Allergies & Asthma Cardiology/Heart Heath Ear, Nose & Throat Gastroenterology Mental Health/Psychiatry Neurology OB/GYN Orthopedics Urology

Riverwood Healthcare Center – McGregor ClinicRiverwood's McGregor Clinic in Northern Minnesota, provides much of the care found at the Aitkin Clinic, from routine exams to specialized serviceslike cardiopulmonary, physical therapy and nutrition therapy – located right in downtown McGregor.

Riverwood Healthcare Center - Garrison Clinic and PharmacyRiverwood's Garrison Clinic, in Northern Minnesota, offers a full range of primary healthcare services to the Garrison area, including same-day scheduled appointments, as well as a full retail pharmacy with a drive-up window. The clinic offers personalized healthcare that includes family practice physicians, nurse practitioners, and lab and radiology services, including mammography.

Healthy Community Data Key IndicatorsIntroductionA thorough secondary data review was conducted utilizing documents available through the internet. A multitude of resources were utilized and were listed previously in this report. The primary data sources included the U.S. Census Bureau, County Health Tables and other documents available through the Minnesota Department of Health, the Minnesota Department of Human Services, The County Health Rankings (through the University of Wisconsin) and the Minnesota Student Survey. Additional information was utilized from other sources. The secondary data was grouped into several subsections based on whether they were aggregate data (County Health Rankings, the Community Health Status Indicators, some U.S. Census Bureau Reports, etc.), specific demographic data, financial information, and student/school district information, unemployment data, violence information, etc. There may be sources of additional information, which were not discovered after a fairly exhaustive search.

Aitkin County – County Health Rankings (The County Health Rankings & Roadmaps program is a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute). We know that much of what influences our health happens outside of the doctor’s office—in our schools,

20


workplaces and neighborhoods.) According to this report, Aitkin County is ranked 77th in health factors - those things that influence the health of a county, out of 87 counties.

Areas to Explore OnOff

AitkinCounty

ErrorMargin Minnesota National

Benchmark* Trend Rank(of 87)

AitkinCounty



Health Outcomes 77

Mortality 72

Premature death 6,611 5,009-8,213 5,126 5,317

Morbidity 70

Poor or fair health 17% 9-28% 11% 10%

Poor physical health days 3.0 1.8-4.2 2.9 2.6

Poor mental health days 3.4 1.5-5.4 2.7 2.3

Low Birthweight 5.7% 4.3-7.2% 6.5% 6.0%

Health Factors 78

Health Behaviors 23

Adult smoking 13% 8-21% 17% 13%

Adult obesity 29% 23-35% 26% 25%

Physical inactivity 23% 18-29% 19% 21%

Excessive drinking 16% 9-26% 20% 7%

Motor vehicle crash death rate 18 11-28 10 10

Sexually transmitted infections 56 276 92

Teen birth rate 31 25-38 26 21

Clinical Care 73

Uninsured 13% 12-15% 10% 11%

Primary care physicians** 1,352:1 1,140:1 1,067:1

Dentists** 8,249:1 1,660:1 1,516:1

Preventable hospital stays 61 52-70 51 47

Diabetic screening 80% 68-93% 88% 90%

21


AitkinCounty



Mammography screening 82% 67-97% 73% 73%

Social & Economic Factors 78

High school graduation** 85% 77%

Some college 63% 57-70% 72% 70%

Unemployment 8.9% 6.4% 5.0%

Children in poverty 23% 16-30% 15% 14%

Inadequate social support 14% 8-24% 14% 14%

Children in single-parent households 29% 22-35% 27% 20%

Violent crime rate 131 248 66

Physical Environment 80

Daily fine particulate matter 9.7 9.6-9.7 10.0 8.8

Drinking water safety 65% 1% 0%

Access to recreational facilities 0 11 16

Limited access to healthy foods** 12% 6% 1%

Fast food restaurants 26% 47% 27%

* 90th percentile, i.e., only 10% are better.** Data should not be compared with prior years due to changes in definition.Note: Blank values reflect unreliable or missing data

2013

2013* 90th percentile, i.e., only 10% are better.** Data should not be compared with prior years due to changes in definition.Note: Blank values reflect unreliable or missing data

Aggregate DataMany governmental agencies and private organizations collect health data and produce summaries of the results. These reports may include “rankings” and are referred to as aggregate data in this CHNA. The following subsections discuss the aggregate data and their implications in regard to the health of Aitkin County.

2013 County Health Rankings The County Health Rankings & Roadmaps program helps communities create solutions that make it easier for people to be healthy in their own communities, focusing on specific factors that we know affect health, such as education and income.

22


Having health insurance and quality health care are important to our health, but we need leadership and action beyond health care. Ranking the health of nearly every county in the nation, the County Health Rankings illustrate what we know when it comes to what’s making people sick or healthy. The County Health Roadmaps show what we can do to create healthier places to live, learn, work and play. The Robert Wood Johnson Foundation collaborates with the University of Wisconsin Population Health Institute to bring this groundbreaking program to cities, counties and states across the nation.

The County Health Rankings (CHR) are based on two overall measures—Health Outcomes and Health Factors. In the most recent (2013) CHR, all 87 Minnesota counties were ranked according to their scores on the Health Outcomes and Health Factors. In the Health Outcomes category, Aitkin County ranked 77 out of the 87 counties.

Prioritization Process of CHNA NeedsBased on analysis of primary and secondary data, the CHNA Core Project Team identified several community health priorities. The major health priorities are chronic disease conditions.

The Core Project Team ranked these key health needs in priority order using a weighted method: Mental health issues and access Diabetes issues Heart disease issues Behavioral health issues Insurance coverage Aging issues Cancer mortality Dialysis services

Community Input IntroductionIn order to fulfill new requirements set forth by the IRS, Riverwood Healthcare Center has undertaken a Community Health Needs Assessment (CHNA), the purpose of which is to gain input on community health needs and identify gaps and barriers to service, with the ultimate goal of better serving the health and wellness needs of Aitkin County.

Riverwood’s strong focus on health and wellness has been recently augmented by selection for participation in a three-year program called the Healthy Communities Partnership. This $475,000 grant from the George Family Foundation and Allina Health has made possible implementation of a community-wide wellness initiative, which includes the services of a full-time wellness coach and a part-time wellness coordinator, all free to the public.

23


HBH Consultants (HBH) has been asked to obtain input from residents in Riverwood’s primary service communities: Aitkin, Garrison and McGregor. Through community input sessions, telephone interviews, and email questionnaires we have evaluated perceptions regarding health and wellness resources available through both Riverwood and the wider community and have identified some missing links. This report incorporates the collective insights gathered during this information-gathering process.

Executive SummaryThis report contains summaries of the two community input sessions held in McGregor and Aitkin in late July 2013. HBH also solicited opinions via email and telephone from community and health industry leaders of Aitkin County, the results of which will be shared later in the report.

After analyzing the input received from all of the sources included in this assessment, we have arrived at the following observations and recommendations for Riverwood Healthcare Center:

Email is the preferred method of communication: Overwhelmingly, community session participants expressed an interest in receiving Riverwood communications via email. While Riverwood’s quarterly direct mail Healthy Living Newsletter is appreciated, participants felt that frequent, as-needed email communication would be more effective in keeping upcoming events and health and wellness opportunities fresh in the public’s mind. Participants agreed that email is available to most community members and that a fairly comprehensive contact list could be obtained by list-sharing with other community organizations and asking for an email address at each clinic/hospital check-in. Advertising through local newspapers, flyers at community meeting places, and the NewsHopper should be continued to reach those without e-mail access.

Location makes a difference: McGregor participants voiced concern that many of Riverwood’s health and wellness offerings are located in Aitkin, making distance and transportation an issue for McGregor citizens. Attendees repeated the running joke: “while Aitkin is 20 miles from McGregor, McGregor is 100 miles from Aitkin.” Many hoped that Riverwood would make an effort to more evenly distribute its health and wellness events among the communities. Video conferencing was also mentioned as another alternative for participating in presentations originating from the Aitkin campus.

Tailor communications/programs to a specific audience: McGregor has a relatively large retiree population, which was reflected in the attendee demographics present at the McGregor community input session. By contrast, Aitkin’s session attendees were generally significantly younger. As such, the conversations at each meeting were quite different. McGregor participants were more interested in talking about issues of aging and aging in place, while Aitkin participants focused heavily on healthy lifestyle and health and wellness education. Riverwood staff should be aware of these population differences and target their offerings accordingly.

Evening/weekend clinic hours needed: Participants agreed that lack of evening/weekend clinic hours is a barrier to service, especially in the summer when the tourist population increases.

24


The public is unaware of Riverwood’s free resources: Attendees at both community meetings were unaware that the biometric screenings and wellness coaching are free services and do not require a previous patient relationship with Riverwood. Because cost is often an issue with healthcare, the fact that these resources are free should be continuously emphasized in order to increase participation.

Education/awareness is key: Both McGregor and Aitkin attendees felt that a good portion of the population was simply not aware of the importance of preventative health and wellness strategies to overall health or not yet willing to work toward health and wellness goals. For this segment of the population, education will be of utmost importance, and Dan Schletty’s wellness coaching services, because they are free to the public, will be an excellent vehicle for delivering this message.

People living in poverty are possibly not being reached: Though only one interviewee described marketing efforts as being aimed at “middle class and above,” it is important for Riverwood to seek avenues for reaching community members in poverty. Partnering with organizations that serve people experiencing financial hardship may prove beneficial in these outreach efforts.

Dialysis access and transportation are major issues: It seems everybody knows somebody who has to travel to Brainerd three times a week for dialysis treatments, and they recognize the toll it takes on these patients and their caregivers. If a dialysis center at Riverwood is not a viable option, perhaps a closer look needs to be taken at a more organized transportation solution.

An array of mental/behavioral health services is available, but awareness lacks: Aitkin County’s Department of Health and Human Services provides access to private clinicians of mental health, counselors, and referrals for intensive treatment. However, some participants perceived a shortage of mental/behavioral health services, and Health and Human Services also believes this is a common public misperception. A solid working partnership between Riverwood and Health and Human Services would make a well-rounded approach to addressing the mental/behavioral health needs of the area.

Community Input SessionsMcGregor session attendees, July 22, Fireside Inn:

Bob Lewis, former Riverwood board member Artie Lewis, McGregor resident Lowell LaBerge, McGregor resident Kathy LaBerge, McGregor resident Linda Farah, McGregor resident Lois Meachum, McGregor resident Ramona Hooper, Taking Off Pounds Sensibly (TOPS) Beth Leaf, Aitkin County CARE Three others, names not recorded

25


Lisa Kruse, Riverwood Healthcare Center Wellness Coordinator, also attended the McGregor session.

Aitkin session attendees, July 24, The Beanery: Lee Ann Hohenstein, Bremer Bank Ruth Hamman, southern Aitkin County resident Shanda Meager, Aitkin schools paraprofessional Linda Weimer, Mille Lacs Energy Cooperative Jesse Peterson, Aitkin elementary school principal Amy Wyant, Bremer Bank and Fit City Aitkin Judy Christy, holistic fitness instructor, massage therapist Lynn Mizner, farmer, DNR forester, mediator, firefighter Julie Miller, Children’s Center, Aitkin City Council Stacy Westerlund, County Assessor Matthew Hill, Aitkin Furniture, Riverwood Foundation board chair, Chamber of Commerce board

member Amber Hunt, Aitkin schools fourth grade teacher Penny Harms, Aitkin County Veterans Service Office Michele Plagman, Aitkin County Health & Human Services Council, Aitkin high school teacher

Also in attendance in Aitkin were Lisa Kruse, Riverwood Healthcare Center Wellness Coordinator; Liz Dean, Riverwood Healthcare Center Marketing Manager; and Shelli Urness, Shelli Urness Consulting.

First off, attendees were asked to review two health and wellness resource lists – one with resources available at Riverwood and one with resources available community-wide in Aitkin, McGregor, Garrison and surrounding areas. Attendees were asked to mark resources of which they were aware and also those resources they had used. The following charts display those results, with separate charts for each list and each community.

26


Biometric H

ealth Scre

ening

Diabetes Education

I CAN PREVENT Diabetes

Nutrition Educa

tion

Health Educa

tion Seminars/Classe

s

Family Health

Manager

Patient Porta

l Onlin

e Access

SAGE Breast/Cervi

cal C

ancer S

creening

SAGEPlus Heart

Health Scre

ening

Breast Cance

r Support

Group

Diabetes Support

Group

Grief G

roup

Prostate Cance

r Support

Group0123456789

1011

Riverwood Health and Wellness ResourceAwareness and Use - McGregor

Aware of Resource Have Used Resource

Aitkin Community

Education

Aitkin County

CARE

Aitkin Co. H

ealth &

Human Service

s

Army C

orp of Engineers

Big Sandy Lodge &

Resort

The CAM Center

Cuyuna Country

Club

Cuyuna Country

State Rec. Area

Fit City

Aitkin

Healthy C

onnections

Hallett Center

Karmady Y

oga

Kathio State Park

McGregor C

ommunity Educa

tion

McGregor C

ommunity Fitn

ess Center

Mille La

cs Golf C

ourse

MN National G

olf Course

Riverw

ood Healthca

re Center

Rice La

ke N

ational Wild

life Refuge

Ruttger's Bay L

ake Lo

dge

Savanna Porta

ge State Park

Snap Fitness

Weight Watch

ers0123456789

1011

Community Health and Wellness ResourceAwareness and Use - McGregor


27


Of McGregor’s 11 attendees, less than half were aware of these Riverwood health and wellness resources (except for the health education seminars, of which slightly more than half had knowledge), and even fewer had actually taken advantage of these resources. Awareness of community health and wellness resources was slightly better, perhaps because of greater visibility, and usage was greater for resources in or very near McGregor. Interestingly, many Aitkin-based resources were not used at all by McGregor attendees, which may be indicative of a general unwillingness to travel for access to health and wellness resources.

Biometric H

ealth Scre

ening

Diabetes Education

I CAN PREVENT Diabetes

Nutrition Educa

tion

Health Educa

tion Seminars/Classe

s

Family Health

Manager

Patient Porta

l Onlin

e Access

SAGE Breast/Cervi

cal C

ancer S

creening

SAGEPlus Heart

Health Scre

ening

Breast Cance

r Support

Group

Diabetes Support

Group

Grief G

roup

Prostate Cance

r Support

Group02468

101214

Riverwood Health and Wellness ResourceAwareness and Use - Aitkin


Awareness and use of Riverwood offerings among Aitkin attendees was also fairly low. At most, only 5 of 14 attendees were aware of available resources. Highest use was for the Family Health Manager, which only 3 of 14 participants had accessed. Community health and wellness resources had a much higher rate of awareness and use. Around two-thirds of attendees were aware of most community resources, and on average, about one-third had used many of them.

28


Aitkin Community

Education

Aitkin County

CARE

Aitkin Co. H

ealth &

Human Service

s

Army C

orp of Engineers

Big Sandy Lodge &

Resort

The CAM Center

Cuyuna Country

Club

Cuyuna Country

State Rec. Area

Fit City

Aitkin

Healthy C

onnections

Hallett Center

Karmady Y

oga

Kathio State Park

McGregor C

ommunity Educa

tion

McGregor C

ommunity Fitn

ess Center

Mille La

cs Golf C

ourse

MN National G

olf Course

Riverw

ood Healthca

re Center

Rice La

ke N

ational Wild

life Refuge

Ruttger's Bay L

ake Lo

dge

Savanna Porta

ge State Park

Snap Fitness

Weight Watch

ers0

2

4

6

8

10

12

14

Community Health and Wellness ResourceAwareness and Use - Aitkin


The answers to the following questions are a compilation of responses from both community meetings.How do you learn about Riverwood Healthcare opportunities?

Flyers Word of mouth NewsHopper (delivery area should be checked as southern tip of Aitkin County may not receive it) Newspapers Healthy Living Newsletter Website Facebook

What more can we do to increase awareness of Riverwood health and wellness resources? E-mail. Almost all attendees reported they had e-mail and checked it regularly. Aitkin radio station Church bulletins. The newly formed ministerial group could be a useful resource. VFW newsletter Clinic waiting rooms Accent, Aitkin’s community education bulletin (delivery area should be checked as southern tip of

Aitkin County may not receive it)

29


Greater presence in social media: Facebook, Twitter, LinkedIn. About 80% of Aitkin attendees reported using Facebook. A quick check of the Riverwood Facebook page yielded page “likes” of 340, yet the population of Riverwood’s service area is over 16,000. Though clearly not every person uses Facebook, Riverwood could still have a much larger following on this platform.

Text messaging Radio Local cable network Referrals from other community agencies and organizations Electronic signs Wellness fairs Chamber of Commerce Community bulletin boards

What currently available services are missing from the Riverwood Resources and Community Resources lists?

Taking Off Pounds Sensibly (TOPS) Community seminars on health topics Hospice, which still serves this area but is not well known Recover Health, a home health service Diabetic foot care Caregiver support groups Farmers’ market and CSA Alcoholics Anonymous and Al-Anon Aitkin City Park, including walking trail, disc golf, baseball field, and ice skating Serenity Center in Crosby

What services would you like to see in this area that do not currently exist? Meals on Wheels. Currently, it only exists inside Aitkin city limits, though there is a “Frozen Meals on

Wheels” for greater Aitkin County. Faster lab service. It is stressful waiting so long for test results. Riverwood’s Wellness Coordinator,

suggested using the Patient Portal for easier access to results. A show of hands revealed about half of McGregor attendees had used this online feature.

Availability of specialists could be better. More seminars/health education in McGregor and Garrison rather than having to travel to Aitkin for

those opportunities.

30


With McGregor’s relatively large retiree population, would like to see more emphasis on health care for the elderly. One Aitkin attendee brought up end-of-life issues and would like to see Riverwood offer more education and support.

Free or reduced-fee student sports physicals.

It should be noted that one McGregor attendee voiced generally high satisfaction with Riverwood’s local service and referrals, and the rest of the participants agreed.

What do you see as barriers to accessing services? Lack of insurance/cost Lack of awareness of availability of services Distance and lack of public transport

o Arrowhead Transport’s timetable and routes are inconvenient.o Could faith communities help? Churches sometimes shuttle for medical appointments, but this

is limited and based on availability of volunteers. Health/wellness not yet viewed as a priority for many

o Education is key.o People are not willing/ready to change.o The mindset shift often starts at the clinic with the provider.o Simple steps, one at a time, may be another key to changing mindsets. The road to wellness for

many is overwhelming and may seem unobtainable.o Example of success: Rippleside School’s garden, part of the Farm-to-School Initiative, is teaching

kids to use fresh/homegrown foods in daily meals. Lack of weekend/evening clinic hours, especially in the summer when the tourist population increases. Infrequent dental care, especially in younger generations, perhaps due to lack of insurance/funds to

pay for it. Traditional medicine’s resistance to alternative/holistic perspectives and vice versa.

Staff shared with both groups information about the biometric screening events that had taken place in May and June 2013. Most attendees had not heard about this opportunity and did not know that the screening was free to the public. Some questioned if a biometric screening would be beneficial to someone who gets a yearly physical, and staff said it would not. As such, the biometric screening should be aimed at those not currently receiving regular healthcare. Advertisements emphasizing that the screening is free and that one need not be a current Riverwood patient to take part could help boost participation. Other suggestions included:

Sending an e-mail announcing the screening Making the screening ambulatory so as to market to employers as an employee benefit Resurrecting the health fair, which has not been done for a few years, and adding the screening to it

31


Offering the screening on different days and times and perhaps weekends. Past events were scheduled to start at 7:00 a.m. to accommodate fasting for cholesterol screening, but that time is not very convenient for working individuals.

Staff also spoke about Family Health Manager, another screening tool that is free to the public and can be followed up with Riverwood’s wellness coaching, also at no charge. Again, most attendees were unaware of this service and were particularly happy and surprised to hear it was free. Two participants, one from McGregor and one from Aitkin, were new patients of our Wellness Coordinator and spoke very highly of his knowledge, caring nature, and listening and motivating skills. Ideas for increased use of the Wellness Coordinator/Coach as a resource included:

Health education seminars Civic group presentations Support group appearances

What services do you think are needed to help people “age in place?” Affordable healthcare/services Alzheimer’s resources Dementia-ready communities Caregiver respite care

Other comments: There sometimes seems to be a disconnect in communication between the hospital and clinic.

Participants would like to be able to schedule all services on one day. There was general agreement that the billing process is confusing. Participants would like to see a

streamlined billing process rather than receiving separate bills from physician, hospital, clinic, lab, etc. One participant was particularly frustrated with the phone system. She likes to call the McGregor clinic

and talk to staff members who know her because they are familiar with her health issues. She does not like the current system in which a call is shuffled from one clinic to another in order to shorten the wait time to speak with a scheduling representative. This participant would rather be placed on hold to wait to talk to someone from her home clinic.

Some attendees were unaware of Riverwood’s farmers market with SproutMN.

Telephone and E-Mail InterviewsSeveral area community and health industry leaders were interviewed by phone and email to gather their opinions regarding community health needs identified by the CHNA Core Project Team. Interviewees included:

Tom Burke, Aitkin County Health and Human Services Jan Cherry, ANGELS of Aitkin County Kim Clement, Kinship of Aitkin County

32


Greg Erickson, Garrison Fire Chief Sue Foster, Garrison City Council Sarah Johnson, Aitkin Health Services Tricia Martin, Aitkin County CARE Ann Schwartz, Aitkin County Habitat for Humanity

The following questions were posed to each interviewee:These are the health needs identified by the community ranked in priority order:

Mental health issues and access Diabetes issues Heart disease issues Behavioral health issues Insurance coverage Aging issues Cancer mortality Dialysis services

Do you agree with these needs and rankings? Why or why not?Though all participants agreed that items on the list were definite priorities, many disagreed with the order and, perhaps not surprisingly, ranked issues according to their particular area of work or other viewpoint. Respondents from both Garrison and McGregor, towns with high retiree-age populations, suggested aging issues, heart disease and diabetes could top the list. Another issue that kept surfacing as a top-tier item was the lack of dialysis services and, linked to that, scarcity of transportation for those who have to travel to Brainerd for dialysis. One participant mentioned that Medi-Van had been in place at one time but is no longer, and another described Rides for Health as being overloaded with transport requests.

Also at the forefront was lack of insurance coverage in a high-poverty area and the health consequences that follow: “Some people don’t seek medical help for any of these health needs because it costs too much, or they feel they won’t get the same quality health care as those who have insurance. This causes people to wait too long and they don’t receive a diagnosis until it becomes an emergency.”

Mental and behavioral health issues were also consistently ranked high on the list as areas in need of improvement. One interviewee’s organization turns to Lakewood Health System in Staples for their clients with mental and behavioral health issues, which is a long way to travel. She said they do have one provider who comes to their facility for counseling services, but she sees a need for more mental/behavioral health professionals in their facility. Another participant felt there should be a “one-stop shopping place” for mental health needs in Aitkin County, and another added that it is a real challenge to get people the help they need.

33


Of note, one Aitkin respondent said that because there is no mental health center in Aitkin, people assume there are no mental health services in the community, when nothing could be further from the truth: “Health and Human Services has developed a service array for use by citizens of the county that includes access to private clinicians of mental health and chemical health, in-home providers of counseling and skills-building, and referrals to more intensive treatment options.” Perhaps a working partnership between Riverwood and Health and Human Services with a focus on publicizing these existing services would be of benefit.

More than one interviewee questioned why mental and behavioral health were listed as separate issues, envisioning them more as a single entity, unless chemical health was viewed as part of behavioral health. Chemical/behavioral health issues were viewed as contributors to physical health problems: “People with diabetes or heart issues might do things to make their conditions worse, or not take care of themselves because of behavioral issues (I’m thinking alcoholism, drug addiction, smoking, etc.)”

Is anything missing from this list?Transportation (especially as it relates to dialysis), dementia issues, chemical health, general physical fitness, and obesity were mentioned as items that could be added to the list of concerns. One interviewee spoke about her work with Alzheimer’s and dementia patients and their families who are working to keep them living in their homes. She sees a need for dementia-capable communities and provided information from ACT on Alzheimer’s (www.ACTonALZ.org), a statewide collaboration preparing Minnesota for the impacts of Alzheimer’s and related dementias.

How would you suggest these issues be addressed in the community?Unfortunately, no one interviewed offered a “magic wand” solution. Lack of funding was repeatedly named as a constant obstacle with no quick fix. General awareness of available resources continues to be a confounding factor, and “the people who need the information the most are usually the ones who are unaware.”However, interviewees did offer suggestions to help manage different pieces of the health and wellness puzzle. As it relates to the general fitness of Garrison citizens, one participant hoped to see more effort by city leaders and the Garrison Commercial Club to host community events promoting fitness and perhaps to consider creating a bike trail in the park south of town.

In terms of improving access to mental/behavioral health services – and this could also be extended to other branches of health care – one idea was to consider the development of telemedicine. Additionally, the Minnesota Collaborative Psychiatric Consultation Service, a state initiative that allows private physicians to access psychiatric consultation services for their work with their mental health patients (especially pediatric patients), was also mentioned as a resource that should be promoted to area physicians.

What is currently in place that could be better publicized and utilized by community members?One person mentioned the various support groups could be better publicized and utilized. A Garrison respondent felt their community center was underutilized, though she did recall a group of seniors had used it for walking at one point. Another was under the impression that Aitkin County Health and Human Services headed up a mental health coalition of some sort, but she did not know much about it and would like to.

34

http://www.ACTonALZ.org/


One participant said, “I love [Riverwood’s] marketing program for the prevention. It has been outstanding and has been a real asset. People are responding and engaged.” Another expressed a sentiment that also came up at the community meetings: “The resources are out there, but until you need to know about it, who keeps track of everything?”

What resource gaps presently exist around these issues that should be addressed?A couple of participants expressed concern about the relatively high rate of people living in poverty in the county and whether or not they are being reached. One felt that Riverwood’s programs target “middle class and above, but there is a large number in our community living below the poverty line. That’s where the true mental health issues are, where the children without proper nutrition and proper medical care are.” Another participant who works with a lot of low-income seniors reports that many are fairly isolated and withdrawn from their community: “They don’t get the newspaper; they don’t listen to the radio as much as they would watch TV. Sometimes the families of seniors need to be targeted, but often our seniors have no family around.”

ConclusionThe general consensus is that, between Riverwood’s health and wellness offerings and the wider community resources, the menu of services in the area is fairly comprehensive. However, everyone has a wish list, and those items have surfaced during this community input and interview process, including dialysis access or better patient transportation solutions; dementia-ready communities; and additional or improved access to mental, behavioral, and chemical health resources.

Additionally, this process has brought to light several barriers to service. There is still a portion of the population that is unaware of the importance of making healthy lifestyle choices, or perhaps some who are aware but are not ready or able to take the first step. There is also a general lack of awareness of the health and wellness resources that are available through Riverwood and the greater community.

HBH has identified some areas in which Riverwood can work to create better awareness and encourage people to become proactive in their own health and wellness journeys, including:

Creating an email list-serve Building the social networking contact base Offering health education opportunities in various formats (community seminars, video conferencing,

support groups, etc.), and Partnering with other local health entities, charitable organizations, and businesses to more effectively

publicize existing services.

Building increased awareness about Riverwood’s two very significant free resources--the biometric screenings and wellness coaching--could also help make a dent in those perpetual barriers to service including lack of insurance or financial means, and fear and anxiety around seeking healthcare services.

Included on the next pages are the invitation to the community input session, and the session agenda.35


Invitation to Community Input SessionJuly 5, 2013

[NAME][ADDRESS][CITY, STATE, ZIP]

Dear [NAME],

As a community leader in the Aitkin area, your opinion is important to us. That’s why we are extending a warm invitation for you to join us for a 90-minute community input session at 11:30am on Wednesday, July 24 at The Beanery in Aitkin. Riverwood Healthcare Center has asked HBH Consultants to assist with the session.

We promise to make good use of your time and serve a healthy lunch. We will also gift you with a free pedometer as a small token of thanks.

The purpose of our time together is to gain feedback from you on your perceptions of health and wellness resources that are available in your community. You will not be asked to join any committees as a result of participating in this short session.

Your candid input is extremely valuable to help us identify gaps so that we can continue to enhance the health and wellness of your community. We very much appreciate your time and are looking forward to meeting with you in person to learn more about your needs.

Please RSVP to Connie Gretschmann by July 18 at 218-927-2121 or [email protected]. Thank you for considering attending and bringing forth your opinions, experiences and ideas.

Sincerely,

Chad Cooper, CEORiverwood Healthcare Center

Community Health Needs Assessment Core Project Team

Michael Hagen, Riverwood Healthcare Center | Shelli Urness, ConsultantLiz Dean, Riverwood Healthcare Center | Judy Turner, Riverwood Healthcare Center|Dan Schletty, Riverwood Healthcare Center|

Jayne Anderson, Riverwood Healthcare Center| Cynthia Bennett, Aitkin County Health Department|Beth Leaf, Aitkin County CARE| Allison Matalamaki, Riverwood Healthcare Center Board of Directors|John Hodson, ISD #1 | Lisa Kruse, McGregor Community

Education

36


Agenda for Community Input SessionsRiverwood Healthcare Center Community Input SessionMonday, July 22, 2013│11:30 a.m. – 1:00 p.m.Fireside Inn, McGregor

AGENDA

1. Welcome and Overview Introductions

Purpose for the session; review the agenda

2. Discussion Questions What are the local health and wellness services and resources of which you are aware?

Among these resources, which do you utilize on a regular basis?

What are the barriers to taking advantage of these resources?

How do people learn about the availability of these resources? What more could be done to promote them or

make them more accessible to a greater number of residents?

Are you aware of any particular health or wellness resources that are missing in the community?

What health and wellness services or resources do you access in other communities? Where?

Riverwood intends to make available annual health screenings for community members. Would you participate

in these? Why or why not?

Riverwood is promoting the use of an online web tool that will help individuals and families better manage their

health. Do you think you will utilize this tool? Why or why not?

Are you interested in working with Riverwood wellness coaches? Why or why not?

What is required to make this a community for a lifetime (age in place)?

3. Wrap Up Final go-around

37


Communication of Results

The results of the CHNA Assessment process will be made available to the public via several means. Riverwood Healthcare Center’s Marketing Department will do a news release announcing to the public that the results are available. They will make the report available online at their website www.riverwoodhealthcareorg, and via a hardcopy in the Administrative Department at Riverwood.

Strategies for Implementation

The mission of Riverwood Healthcare Center is to provide quality inpatient and outpatient care. The implementation strategy is designed to address the health care needs of the people of Aitkin County, and their unique characteristics and healthcare needs. The implementation strategies are based on Riverwood’s current programming, survey data, and community input. Riverwood’s strategic plan is developed by its leadership team and reviewed annually. The implementation strategy also identifies how existing and planned Riverwood services, partnerships and programs will be utilized to help address community health needs.

The implementation strategy for The Health of Aitkin County CHNA is the hospital/community plan for addressing the community health needs. IRS Notice 2011-52 dictates the contents of an implementation strategy, and states that the hospital must address how it both intends and does not intend to address the identified community health needs. Riverwood Healthcare Center’s implementation strategy is described in this section of the report. We will continue to stay the course and follow our strategic plan. We will create the future we seek by focusing on six critical strategic goals:

(1) Quality: Our customers are demanding more efficiency, better quality, and superior safety. We will lead in delivering on these requirements through improved data, reporting and process improvements.

(2) People: Our people are key. We will inspire their trust, improve their skills, and develop leadership and engagement that leads us into a stronger future.

(3) Care Delivery Model: Redesigning for the care model of the future will ensure readiness in a post reform world.

(4) Growth: We will grow our primary care services and share of our market. We intend to build the confidence of our community in their ability and desire to stay local for care and know that when they need specialized or tertiary care we will make the transition easy.

(5) Technology: We will install platforms and systems that ensure we maximize efficiency, productivity and support the improvement of quality.

(6) Finance: We will achieve operating margins that ensure long term financial strength and the capacity to continue to invest for the benefit of patients and families.

38

http://www.riverwoodhealthcareorg/


In addition we will continue to build community health partnerships and initiatives and programs such as:

Health and Wellness ScreeningsAsthma ScreeningsDiabetes SeminarsI can Prevent Diabetes ProgramsWomen’s Health ProgramsGrief SupportContinue to pursue a redesigned Care Delivery Model (Medical Home Model)Explore additional/niche services (dialysis, dermatology, etc.)Continue to Partner with other providers (CRMC, Minneapolis Heart Institute etc.)Continue Market Research and Surveys, and CHNA to monitor needsInvestigate transportation PartnershipsContinue to build awareness around our physicians and services to ensure residents stay local. Continue to recruit/retain more doctors, including female doctors, as needed by 2016(general surgery, OB/GYN, Orthopedics)Evaluate ways to grow surgical services

Through the dedication of our board, staff, physicians, and managers, this plan will result in a future filled with new opportunities and new accomplishments for Riverwood Healthcare Center.

Riverwood’s Addressing of NeedsRiverwood’s implementation strategy will address all the identified priorities. Except on a limited scale, the strategy will not address the provision of dialysis services due to cost-effectiveness, too few local patients to cost justify the program, and inability to expand that service line via equipment and staffing.

39


Riverwood’s Current Services: Allergies & Asthmao Allergies and Asthmao Audiologyo Birthing Centero Breast Healtho Cancer/Oncology o Cardiology/Heart Heatho Dermatologyo Diabeteso Ear, Nose & Throato Emergencyo Family Medicineo Flight Physicalso Gastroenterologyo Hospitalo Intensive Careo Internal Medicineo Maternity/Birthing Centero Mental Health/Psychiatryo Wellness Screenings o Neurologyo Nutritiono OB/GYNo Orthopedico Palliative Care/Hospiceo Pharmacyo Podiatryo Radiology/Diagnostic Imagingo Rehabilitationo Respiratory Careo Sleep Healtho Support Groupso Surgeryo Urgent Careo Urologyo Wellnesso Wound Care

40


Riverwood’s strong focus on health and wellness has been recently augmented by selection for participation in a three-year program called the Healthy Communities Partnership. The $475,000 grant from the George Family Foundation and Allina Health has made possible implementation of a community wide wellness initiative, which includes the services of a full-time wellness coach and a part-time wellness coordinator, all free to the public.

Conclusion

In addition to specific strategies and mission driven programs, Riverwood Healthcare Center will continue to build its Patient-Centered Medical Home (PCMH) as it addresses community needs. It is what aligns with the hospital strategic plan and with the CHNA. We know that the PCMH is not only the wave of the future, but will positively impact the health of the people of Aitkin County.

RHCC builds evaluative measures and goals into all of its programs and services. In addition, the CHNA plan will be reviewed and rewritten every 3 years. RHCC’s management team will continue to play a leadership role in the implementation strategies and monitor its progress, and make adjustments to strategies as needed.

41

Documents

Community Health Needs Assessment Report - MHA > Web viewCommunity Health Needs Assessment Report. ... This $475,000 grant from the George Family Foundation and Allina Health has made