3.2 timberlake · kayla brenner, mph/mpa candidate university of wisconsin population health...

5/11/2014

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WISCONSIN’S SHARED HEALTH PRIORITIES

Karen Timberlake, Director

Kayla Brenner, MPH/MPA Candidate

University of Wisconsin Population Health Institute

May 14, 2014

SETTING THE STAGE

� Current sources of health priorities

� “New” opportunities – ACA and community benefit

� Our scan of hospital CHNAs and local health department

CHIPs – what did we do?

� What did we find?

� What does it mean, and what’s next?

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HEALTHIEST WISCONSIN 2020

� Goals

� Improve health across the life span

� Eliminate health disparities and achieve health equity

� 23 focus areas to be addressed by the public health system

partners and Wisconsin communities over the decade from 2010

to 2020.

� New:

� Healthiest Wisconsin 2020 Baseline and Health Disparities

Report

Wisconsin Department of Health Services

http://www.dhs.wisconsin.gov/hw2020/index.htmWisconsin Department of Health Services

January 2014 P-00522B

Healthiest Wisconsin 2020 Baseline

and Health Disparities Report

An Introduction to the Report

http://www.dhs.wisconsin.gov/hw2020/hw2020baselinereport.htm

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LOCAL HEALTH DEPARTMENTS

� Since 1993, LHDs have been

required to conduct

Community Health

Assessment’s (CHAs) &

Community Health

Improvement Plans (CHIPs)

every three years

� Wisconsin State Statutes

Chapter 251.05

COMMUNITY BENEFIT AND THE ACA

� Tax-exempt hospitals must report their community benefits annually

to IRS on Form 990, Schedule H

� Under the ACA, 501(c)(3) hospital organizations are required to:

� Conduct a community health needs assessment (CHNA) and adopt an

implementation strategy at least once every three years

� Hospital CHNA must be posted on-line

� No requirement for Implementation plan to be on line

� Financial penalties for failure to meet the CHNA requirements

CREATE SYNERGY TO MAXIMIZE IMPACT

� Barriers to Alignment

� Planning timetables -

� 3 year process for hospitals

� 5 year process for LHDs

� Planning together?

� Lack of awareness of what other organizations are doing to address their communities priority areas

� Opportunities to Align Planning and Implementation Efforts

� CHIPP infrastructure improvement project

� UWPHI scan of most recent CHNAs and CHIPPs

STARTED WITH DATA COLLECTION

� Collected both hospital and LHD CHNA’s

� Coded all plans by priority area to analyze common priorities

� Eight top themes emerged and overlapped between hospital and

LHD plans

� Collected LHD CHIPs and hospital implementation plans

� Based on the top eight priority areas, then gathered strategies and

tactics relevant to each priority area

� Only strategies and interventions that pertained to the top 8

priorities were collected

PRELIMINARY FINDINGS

Wisconsin’s Shared Health Priorities (Alphabetical)

1) Access to care

2) Alcohol Use

3) Drug Abuse (Prescription and Illicit Drugs)

4) Mental Health

5) Nutrition

6) Obesity

7) Physical Activity

8) Tobacco

Karen, can we insert

that picture of the

cheesehead with

beer and a brat on it?

I couldn’t find it….

BROAD THEMES

� Substance abuse

� Broken down into excessive alcohol use and prescription/illicit drug abuse categories

� Access to Care

� Includes acute/primary, behavioral health, and dental

� Obesity

� Separate category even if physical activity and nutrition priorities were also listed

� Chronic disease management, prevention and wellness

� Broken down by specific priority area since most of the top eight priorities were found under this category

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ASSUMPTIONS

� Some implementation strategies targeted more than one priority in

certain strategies. This is evident within implementation snapshots.

� Not all plans for hospitals and LHDs were included

� LHD

� Different timeframe for completion

� Any outdated plans were not included

� Hospital

� No IRS requirement to post Implementation plan on line

� Different fiscal year end dates

ALCOHOL: Iron County LHD

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ALCOHOL: Memorial Medical Center in Ashland MENTAL HEALTH

� From 2000 to 2010, suicide rates in Wisconsin increased by 26%

in males and by 21% in females.

� The greatest increases occurred among people ages 45-64.

� Females, Blacks, Hispanics, low-income people, Milwaukee

County residents, people who are obese, and smokers, report

higher rates of frequent mental distress.

� People with low household incomes and those with disabilities

had significantly higher rates of experiencing four or more

Adverse Childhood Experiences.

Healthiest Wisconsin 2020 Baseline and Health Disparities Report

MENTAL HEALTH: Wheaton Franciscan All Saints in

RacineMENTAL HEALTH: Burnett Medical Center in

Grantsburg

MENTAL HEALTH: Burnett Medical Center DRUG ABUSE

� Individuals who abuse drugs are more likely to engage in risky

behaviors that may result in motor vehicle accidents and fatalities,

employment problems, relationship problems, unplanned

pregnancies and sexually transmitted diseases, birth

abnormalities, child abuse, and crime.

� The abuse of illicit drugs, like heroin, cocaine, marijuana, and including the non-medical use of mood-altering prescribed drugs, inflicts harm upon individuals, families, and communities.

� Drug-related deaths involving heroin or other opioids increased

nearly four-fold during 2000-2011.

Healthiest Wisconsin 2020 Baseline and Health Disparities Report

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DRUG ABUSE: Langlade LHD

DRUG ABUSE: Langlade LHD

Continued…

DRUG ABUSE: Shawano Medical Center

DRUG ABUSE: Shawano Medical Center

ALCOHOL, MENTAL HEALTH & DRUGS: Beaver Dam Community Hospital

ALCOHOL, MENTAL HEALTH & DRUGS: Beaver Dam Community Hospital

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SOCIAL/ECONOMIC DETERMINANTS OF

HEALTH

24 LHDs and 20 hospitals prioritized social and economic determinants of health.

� Education

� Academic Achievement gap

� High school graduation rates

� Employment/Unemployment

� Community Safety

� Injury and Violence Prevention

� Violent Crime

� Youth safety/injury prevention

� Income

� Poverty/ Financial hardship

� Social Support

� Parenting

� Family/ high-risk families

SOCIAL/ECONOMIC DETERMINANTS: LHDs

� Injury and Violence

� Calumet County Health Department

� Greenfield Health Department

� La Crosse County Health Department

� Manitowoc County Health Department

� Menominee County Human Services

� Waukesha County Health Department

� Waushara County Health Department

� Unintentional Injuries

� Calumet County Health Department

� Jackson County Health & Human Services Dept.

� Lincoln County Health Department

� South Milwaukee Health Department

� Waushara County Health Department

SOCIAL/ECONOMIC DETERMINANTS : LHDs

� Domestic Violence

� Chippewa County Department of Public Health

� Greendale Health Department

� Youth Violence

� Langlade County Health Department

� Family/ High risk families

� Outagamie County Public Health Division

� Walworth County Health Department

� Healthy Homes

� Wauwatosa Health Department

� West Allis-West Milwaukee Health Department

� Injury Prevention

� Kenosha County Division of Health

SOCIAL/ECONOMIC DETERMINANTS : LHDs

� Socioeconomic Factors

� Clark County Health Department

� Crawford County Health Department

� Milwaukee City Health Department

� Support for well-being of children and families

� Eau Claire City/County Health Department

� Parent Education

� Jackson County Health & Human Services Dept.

� Juneau County Health Department

� High School Graduation Rates

� Appleton- Menasha- Neenah Health Department

� Kenosha County Division of Health

SOCIAL/ECONOMIC DETERMINANTS : HOSPITALS

� Parenting

� St Elizabeth Hospital

� Mile Bluff Medical Center

� St Nicholas Hospital

� Social Support

� Moundview Memorial Hospital and Clinics

� Academic Achievement Gap

� Ministry Saint Michaels Hospital

� Poverty

� Theda Clark Medical Center

� Shawano Medical Center

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� Injury and Violence Prevention

� Appleton Medical Center

� Boscobel Area Health Care

� Aurora Medical Center in Grafton

� Monroe Clinic

� Theda Clark Medical Center

� Aurora Medical Center Summit

� Domestic Violence

� Ministry Good Samaritan Health Center

� Ministry Saint Clares Hospital

� Violent Crime

� Edgerton Hospital and Health Services

� Mercy Health System and Trauma Center


� Employment

� Upland Hills Health


� Moundview Memorial Hospital and Clinics

� Mercy Health System and Trauma Center

� Ministry Saint Michaels Hospital

� Vernon Memorial Hospital

� Financial Hardship


� Youth Safety

� Aurora Medical Center in Grafton

� Aurora Medical Center Kenosha

� Youth Injury Prevention

� Aurora Medical Center-Washington County

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RESOURCES

� Healthiest Wisconsin 2020 Baseline and Health Disparities Report

� Baseline data by topic for the HW2020 focus areas, and documentation of health disparities in Wisconsin populations and communities.

� http://www.dhs.wisconsin.gov/hw2020/hw2020baselinereport.htm

� What Works for Health

� Continuous additions to policies and programs for health

� http://whatworksforhealth.wisc.edu

� County Health Rankings & Roadmaps

� Data, tools, strategies for change

� http://www.countyhealthrankings.org

� Wisconsin Guidebook on Improving the Health of Local Communities

� Assessment, Implementation and Evaluation resources

� http://www.walhdab.org/NewCHIPPResources.htm

http://www.walhdab.org/CHIPPInfrastructure.htm

DISCUSSION

� Questions and feedback highly encouraged!

� Questions down the road?

� Email Kayla: [email protected]

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Acknowledgements

� Bridget Catlin, PhD, Director, Mobilizing Action Toward Community

Health, UW PHI

� Thank you to the Wisconsin Partnership Program for its ongoing

support of Making Wisconsin the Healthiest State

THANK YOU, GOOD LUCK, AND

KEEP IN TOUCH

3.2 timberlake · kayla brenner, mph/mpa candidate university of wisconsin population health...

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