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Lakeview Medical Center - Community Health Needs Assessment

TABLE OF CONTENTS

About Page

Lakeview Medical Center ……………………………………………………………………………………………… 3

Background Steering Committee Members...…………………………………………………………………………………. .5

Planning Timeline……………………………………………………………………………………………………….. 7

Data Demographics ……………………………………………………………………………………………….. 8

Community Perception …………………………………………………………………………………. 8

Healthy Wisconsin 2020……………………………………………………………………………….… 9

Community Planning Day ……………………….……………………………………………… 10

Community Health Improvement Plan Development …………………… 14

Supporting Materials

Your Opinion Counts – Press Release ……………………………………………………………. 16 Surveys

English …………………………………………………………………….……………… 17

Spanish …………………………………………………………………….…………….. 20 Somali ……………………………………………………………………….…………… 24

Data Sheets ……………………………………………………………………………………………….……………... 28 Partnering Together – Press Release ……………………………………………………………..…………... 49 Partnering Together – Newspaper Ad ………………………………………………………….……….…… 51 Health Priority SWOT Analysis …………………………………………………………………….….…….….. 52

Community Health Action Team Commitment Agreement ……………………………..……….. 59

Prepared by Lisa Laatsch Marketing and Community Relations Manager Lakeview Medical Center December 20, 2012

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About

Lakeview Medical Center

Lakeview Medical Center (LMC) is a non-profit 40-bed community hospital located in Rice Lake, Wisconsin. Founded by the Wisconsin Methodist Hospital Association as Rice Lake Hospital in 1919, LMC has grown to become a regional medical center of choice. In 1922, 100 dozen eggs were sold to provide the first operating capital for Rice Lake Hospital. Early on, the hospital became a leader in the area as the first to initiate ambulance service in 1926 and paramedic service in 1978. LMC remains committed to bringing needed healthcare solutions to the area, being the first hospital to add Peritoneal Dialysis in 1992, as well as adding Ultrasound and Chemotherapy the same year. In 2002, LMC was proud to begin offering Pulmonary Rehab and Wound Ostomy Continence Care. Lakeview Medical Center, along with its affiliate Marshfield Clinic, continue to assess the healthcare needs of the community to determine what other programs services may be needed. Today, Lakeview Medical Center is one of two Sole Community Provider hospitals in Wisconsin. LMC services a primarily rural area and is greater than 35 miles from the next similar (non-Critical Access) Hospital. As a Disproportion Share Hospital, LMC sees a high percentage of Medicaid and low-income patients. Lakeview Medical Center has shown an increase in community program dollars, from $294,000 in 2008 to $425,000 in 2011, as well as a growth in the use of charity care from $284,000 in 2010 to $503,000 in 2011. LMC has always provided care to patients covered by BadgerCare, the state program for the uninsured. The Hospital also offers a discount for private pay patients without insurance. Last year, LMC provided nearly $7 million in community benefit through uncompensated care, Medicare/Medicaid shortfall and community programs. LMC also provides numerous wellness and prevention programs otherwise not available in Barron County. For the wellbeing of the community, the Hospital opened a fully-staffed health and wellness center in 2000 at Cedar Mall to provide a medically-managed exercise option for the community. Plus, provides a multitude of educational opportunities for our community throughout the year, providing classes and community programs focusing on nutrition and fitness, screenings and vaccinations, pre-natal classes, support groups and more. The hospital continues to serve the community by adhering to its mission, vision and values. Mission To enhance the health of the communities we serve through healthcare, education, and research. Vision The Marshfield Clinic/Lakeview Medical Center Campus will be the premiere regional referral center providing primary and secondary care to residents of Northwest Wisconsin. The campus will be distinguished by its wide breadth of services and programs for patients referred by both Marshfield and independent providers. As measured by improvement in the community’s health, the patient’s experience, and the cost of care provided, Lakeview Medical Center will be among the leading Wisconsin hospitals in providing value to those it serves.

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Values

Patient safety and clinical quality

Efficiency and cost-effectiveness

Teamwork

Integrity and honesty

Embrace our whole community

Patient privacy and dignity

Sensitivity and compassion

LMC’s service area includes Barron County encompassing the communities of Rice Lake, Chetek, Cameron, Barron, Spooner, Cumberland and Birchwood. For fiscal year 2011-2012, 54% of the hospital’s total discharges were from Barron County. It was a natural fit for LMC’s CHNA to focus on Barron County since over half of the patients served by the hospital come from that county alone.

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Background

Steering Committee Members In January 2011, a group of health care leaders came together to form a steering committee to lead the community health needs assessment (CHNA) for Barron County. Founding members of the steering committee include: Jolene Anderson, Marshfield Clinic

Deb Dietrich, Mayo Health System

Kelli Engen, Barron County Public Health

Laura Johnson, Be Well Barron County Coalition

Lisa Laatsch, Lakeview Medical Center

Beverly Mahler, University of Eau Claire Student Nurse

Heidi Massey, Western Regional Office, Public Health

Char Mlejnek, Lakeview Medical Center

Karen Morris, Western Regional Office, Public Health

Danessa Sandmann, AmeriCorps, Lakeview Medical Center

Laura Sauve, Barron County Public Health

Sarah Turner, Safe and Stable Family Coalition

Bobbi Wyss, Cumberland Health Care Joe Willger, Marshfield Clinic

Steering Committee Members

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Community Health Expertise Since it was the first health needs assessment that many of the steering committee had worked on, expertise from the Wisconsin State Department of Health was enlisted to provide guidance on the process. With guidance from Karen Morris and Heidi Massey, the Steering Committee began to research best practices on conducting community assessments by reviewing materials and talking to representatives from other counties that had already completed the task. As the process for Barron County started to take shape, a planning timeline and outline for the assessment was developed to keep the project moving forward. Kelli Engen, Barron County Public Health Officer In 2008 Kelli started at the Ho-Chunk Health Care Center in the clinic as a clinic nurse, and educator. This job showed Kelli what “community health” looks like. During her tenure at the Ho-Chunk Nation (HCN), a community health assessment had been completed. Working for a tribal health department, demonstrated the perfect picture of how a specific community; assesses, identifies and plans for improving health. Since beginning at Barron County as Health Officer in Jan of 12, Kelli has been a part of Thrive Barron County’s steering committee. Karen Morris, Western Region Office of Public Health Karen is a Public Health Nurse Consultant with the Division of Public Health in the Western Regional Office in Eau Claire. One of her responsibilities is to provide technical assistance and consultation to Local and Tribal Health Departments, other organizations and partners to enhance and support public health programs and services that address the priorities identified in Healthiest Wisconsin 2020. Specifically by providing assistance on Community Health Improvement Process and Plan (CHIPP). Over the years she had worked with six counties in the western region, including Barron to complete their CHIPP. Heidi Massey, Western Region Office of Public Health Heidi is a Public Health Educator with the Division of Public Health in the Western Regional Office located in Eau Claire. She provide technical assistance and support to Local Health Departments and other state and local partners on a wide variety public health services. This includes guidance on Community Health Improvement Process and Plan (CHIPP) to public health agencies when requested. She has worked with 4 counties in the western region, providing consultation at various stages of their CHIPP.

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Planning Timeline November 2011: Lakeview Medical Center approached Barron County Public Health Department about

collaborating on this project January 2011: Steering committee formed February 2011: Assessment plan/Timeline developed March 2011: Data collection begun January 2012: Kelli Engen (Barron County Public Health Officer) joined the committee February/March 2012: Promotion of community survey (newspaper/radio/flyers) March 2012: Electronic/paper community survey conducted June 2012: Initiative gets its own brand, “Thrive Barron County, Growing Together in Health” August 2012: Promotion of Community Meeting (invitations, newspaper, radio) September 2012: Community Meeting to Prioritize Health Initiatives for Barron County October 10, 2012: Community meeting to kick off the Community Health Improvement Planning

Process October 15, 2012: Alcohol and Drug Abuse, Mental Health and Chronic Disease workgroups begin meeting.

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Data

Data for Barron County was compiled by the committee for the following 3 areas to use in the CHNA

process:

Demographics,

Community perceptions

Healthy Wisconsin 2020 Health Priorities

Demographics:

Lakeview Medical Center is an acute care community hospital located in Rice Lake, Wisconsin. Rice Lake has a population of 15,363 and is located in Barron County, which is home to 44,963 people, 17,851 households, and 12,352 families. The racial makeup of the county is 97.69% White, 0.14% Black or African American, 0.81% Native American, 0.32% Asian, 0.04% Pacific Islander, 0.32% from other races, and 0.69% from two or more races. 0.96% of the population is Hispanic or Latino of any race. 34.4% is of German ancestry, 21.8% is Norwegian and 5.3% is of Irish ancestry. There are 17,851 households, out of which 31.3% have children under the age of 18 living with them, 56.9% are married couples living together, 8.2% have a female householder with no husband present, and 30.8% were non-families. 25.4% of all households were made up of individuals and 12.2% have someone living alone who was 65 years of age or older. The average household size is 2.48 and the average family size is 2.97. In the county, the population is spread out with 25.3% under the age of 18, 8.1% from 18 to 24, 26.8% from 25 to 44, 23.4% from 45 to 64, and 16.4% who were 65 years of age or older. The median age is 39 years. For every 100 females there were 98.2 males. For every 100 females age 18 and over, there were 96.00 males The county hosts a variety of markets including rural agriculture, manufacturing, frac-sand mining and a seasonal tourist economy. Data for this section was pulled for the US 2000 Census. Community Perception Survey The committee decided to conduct a survey to engage the community in the process and gather input on what the community at large felt were the health concerns for Barron County. The surveys were distributed by committee members to libraries, hospitals, clinics, the free clinic, food pantries, and senior centers. On March 1, 2012, a press release was released to the Rice Lake Chronotype, Barron News-Shield, Chetek Alert, Cumberland Advocate and The Washburn County Register in Shell Lake announcing the initiative and asking for community participation. The survey process was also explained and promoted on the Sally B morning talk radio show on WJMC in Rice Lake on Thursday March 1, 2012. The survey was translated into both the Spanish and Somali languages (prevalent populations in Barron County) to ensure that the opinions of those populations were included and distributed at key community centers for both populations. The committee received 13 Somali Translated surveys and 12 Spanish Translated surveys. Care was taken to personally forward the survey to Public Health Contacts at the St. Croix Tribal Health Clinic in Hertel, WI to get the information to this Native American population in the county. Over 1,100 surveys were completed both online and on paper and the results tabulated.

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Based on the surveys returned, community members felt the health issues in Barron County were:

1. Alcohol and Drugs 23.0% 2. Chronic Disease 12.0% 3. Nutrition 10.8% 3. Physical Activity 10.8% 5. Tobacco 8.6% 6. Mental Health 7.4% 7. Injury and Violence 6.5% 8. Oral Health 4.6% 9. Growth and Dev. 4.2% 10. Reproductive health 4.1% 11. Communicable Disease 3.2% 12. Environment 2.2%

No answer 0.4%

The results from the survey were weighted and included in the voting process of the Community Planning Day on September 26, 2012

Healthiest Wisconsin 2020 The steering committee used Healthiest Wisconsin (HW) 2020 as a foundation to conduct the data collection for the process. HW 2020 encompasses 2 main focus areas. Crosscutting, this includes eliminating health disparities and socioeconomic and educational determinants. The other main focus area is Health which includes 12 focus areas:

Alcohol and Drug Use

Chronic Disease Prevention and Management

Communicable Diseases

Environmental and Occupational Health

Healthy Growth and Development

Injury and Violence Prevention

Mental Health

Nutrition and Healthy Foods

Oral Health

Physical Activity

Reproductive and Sexual health

Tobacco Use and Exposure

The committee compiled a data sheet for each of the 12 focus areas to be given to all participants of the Community Planning Day on September 26, 2012. Key points from the sheets along with the community survey results and demographic data was included in a PowerPoint presentation given to the attendees. Data for the sheets were pulled from a variety of sources but footnoted.

Community Planning Day The committee hosted a Community Planning Day on September 26, 2012, and invited business leaders, health experts and the general community to come together to help select the top three health priorities for Barron County. Ninety-nine community leaders, health experts and community members

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from Barron County were in attendance. A PowePoint presentation including data on the 12 health priorities for Healthiest Wisconsin 2020 was presented in the morning to attendees. After lunch, small groups broke out on each of the 12 priority areas and were charged to come up with three reasons why that priority should be chosen as a Barron County Health Priority. Community experts with expertise in each of the 12 areas were invited to the day to ensure that along with community members, people who have a working understanding of the issues were included in the process. These small groups made a case to the large group why their priority are should be selected for one of the top 3 issues during the voting process. After the presentations to the group were made and community input from the March 2012 surveys was considered, a vote was taken to determine the top three priorities which were:

1. Alcohol and Drugs 2. Mental Health 3. Chronic Disease

Once the top 3 priorities were identified, attendees interested in working on one of the top 3 issues turned in a commitment form expressing their interest. On October 10, 1012, the steering committee is planning another day to bring the parties interested in working on the 3 topics together to do some root cause analysis work and begin to form the work groups that will carry on. The groups will develop work plans and measurable goals.

Opening Presentation Community Planning Day

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Auditorium on Community Planning Day

Community Planning Day Attendees

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Voting Tabulation

Voting Results -Top 3 Health Priorities for Barron County

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Community Health Improvement Plan On October 10, 2012, the Community Health Improvement Plan was kicked off with a planning day lead by Dorothy Chaney. Dorothy is an accomplished organizational leader who offers a unique and results-focused blend of experience in community health improvement, community organizing, non profit management, adult education and corporate training. She is an effective strategic thinker and dynamic leader with demonstrated ability to clarify vision, facilitate communication, and motivate change to achieve results along with a deep passion for and commitment to community development and social justice. In 2010- 2011, Dorothy chaired the State Council on Alcohol and Other Drug Abuse’s Controlled Substances Work Group which resulted in the landmark report “Reducing Wisconsin’s Prescription Drug Abuse: A Call To Action” www.scaoda.state.wi.us. In 2012, after years of community outreach work, Dorothy started her own company called the “Wisconsin Community Health Alliance”. As part of the Barron County Community Health Improvement Planning Day, Dorothy worked with the attendees on how to do root cause analysis to help identify what really is the bottom line cause of the health issue they are trying to address. Identifying the root cause is importance so that you can fully understand the underlying issues and develop targeted strategies to affecting the larger health priority. Attendees also learned how to create logic models which will be used by the steering committee to monitor the progress of the work groups. The logic models are designed to study, plan for, and evaluate the community interventions that have been identified by the 3 work groups. Each of the 3 work groups is focusing on one of the 3 top health priorities for Barron County and are currently developing their logic models. To continue to manage the process, the steering committee has asked the 3 workgroups to turn in their logic models by Mid February 2013. Once all of the logic models have been submitted to the steering committee, Lakeview Medical Center will look at ways that they can support the strategies identified and develop their own CHIP plan. Currently, Lakeview Medical Center staff Lisa Laatsch and Char Mlejnek are serving on the Chronic Prevention group that has identified Diabetes management as their first undertaking and Cindy Arts- Strenke is on the Mental Health Work Group.

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Supporting Materials

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Press Release

Your Opinion Counts March 1, 2012 Released to:

Rice Lake Chronotype

Barron News-Shield

Cumberland Advocate

Chetek Alert

Washburn County Register

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Surveys: English, Somalian, Spanish

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Press Release

Partnering Together August 13, 2012 Released to: • Rice Lake Chronotype • Barron News-Shield • Cumberland Advocate • Chetek Alert • Washburn County Register

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Newspaper Ad

Community Planning Meeting Wednesday September 19, 2012 Released to: • Rice Lake Chronotype • Barron News-Shield • Cumberland Advocate • Chetek Alert • Washburn County Register

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SWOT Analysis Health Priorities for Barron County

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Community Health Action Team Commitment Form

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