RHODE ISLAND HEALTH IMPROVEMENT PLAN PROGRESS REPORT June 2014

Transcription

1 RHODE ISLAND HEALTH IMPROVEMENT PLAN PROGRESS REPORT June Strategic Objectives: Improve the overall health of Rhode Islanders Goal: Make Rhode Island the # 1 state in the America s Health Rankings 1. Develop a strategy and timeframe to address the selected priority areas A workgroup comprised of department leadership has met bi-weekly for over a year to develop strategies to meet this goal. To date, the workgroup has identified the following public health priorities: 1. Increase Physical Activity Among Adults (RI currently ranks # 30 in physical activity) 2. Reduce the Rate of Drug Deaths (RI currently ranks # 42 in drug overdose deaths) 3. Reduce Preventable Hospitalizations (RI currently ranks # 37 in preventable hospitalizations) Sarah Harrigan To address priority #1, we have constituted a physical activity workgroup that includes representation from each division in the department. This workgroup is designed to enhance and improve the work that our Nutrition and Physical activity program is already accomplishing. Specifically, the workgroup is developing a plan to better utilize the Department's existing channels of communications to provide targeted messages to Rhode Islanders and the healthcare provider community on the health risks associated with sedentary lifestyle and opportunities for physical activity They will also work to build on and improve existing partnerships and initiatives with both clinical and non-clinical Rhode Island organizations to incorporate physical activity promotions. To address priority #2, the Department has taken a leadership role in a state-wide Governor's Task Force on Drug Overdose Deaths. The Department of Health is coordinating closely with our sister agency, Behavioral Health, Developmental Disabilities and Hospitals, to identify new ways to approach the most recent drug overdose epidemic. To date, the group has succeeded in RI Health Improvement Plan Progress Report June

2 supplying and training all State Police officers on the administration of Narcan, a drug which can reverse the effects of an overdose. We have also worked closely with CDC's Epidemiology Aid to improve our drug overdose surveillance system. We are now monitoring deaths, overdoses that do not result in deaths, and Narcan doses administered by EMTs on a weekly basis. Additionally, we have sought and received private grant funding to develop and implement a robust Public Health Information campaign, focusing on the message: addiction is a disease; recovery is possible; help is available. Finally, we are seeking to promulgate regulations on the prescribing of narcotics. To support the need for these regulations, we have recently developed a public website to provide monthly updates on information on the amount of narcotics prescribed by Rhode Island doctors ( To address priority #3, the group has developed a comprehensive matrix of contributing factors to preventable hospitalizations in Rhode Island. We are working closely with a medical student intern to complete a literature review and draft a series of articles for the Rhode Island Medical Journal on the complexity of this public health measure and the variety of solutions we could implement to help reduce the overall rate of preventable hospitalizations. We will identify both regulatory and public health education solutions to the problem. Goal: Reduce years of potential life lost and days of lost work, school, and leisure in Rhode Island 1. Maintain the statewide coalition created in 2012 to further engage providers in the use of patient education tools and other strategies and A multi-disciplinary collaborative meets bi-monthly to address education gaps in the prescriber community. Currently efforts are focused on providing 3 separate grant funded CME events in September and November of 2014 focusing on long acting opioid prescribing. In addition, efforts are under way to address gaps in knowledge among prescriber's regarding addiction. Progress with the PMP remains slow, currently 25% of James McDonald RI Health Improvement Plan Progress Report June

3 provide training and assistance to enforcement agencies to review and develop state policy prescriber's are approved to use the Prescription monitoring program, and approximately 10,000 reports are obtained monthly by prescribers. In June of 2014, legislation changed which requires all holders of a CSR to register for the PMP program. The PMP Program is currently working on sending all eligible prescribers a user name and password. It is anticipated by End of September, 2014, all eligible prescribers will be sent a user name and password for the PMP. Efforts will then shift to getting providers to use the PMP prior to prescribing a controlled substance. Goal: Develop a culture of quality improvement in the work we do 1. Promote the ongoing training and use of QI tools among staff. In Rhode Island a new QI team is selected and trained in the Spring of each year. QI team 2 was selected in the spring of 2013 and exhibited their 16 projects at the annual QI Fair held on April 7, QI Team 3 was selected in the Spring of 2014 and is composed of 22 staff, while QI Team 1 was composed of 15 and Team 2 of 21. The training for Team 3 was scheduled in separate components and took place on June 4 th, July 9 th, 25 th, and August 18 th, Projects are expected to be completed by early Training for all staff is being prepared in webinar format and will be made available to all staff by Magaly Angeloni 2. Conduct customer satisfaction surveys in selected units/programs within the Department the end of The HEALTH Laboratories administer a customer satisfaction survey each year. Reported results for calendar year 2013 as follows: Environmental Lab: 95.2% (89.2% for 2012) Forensics Lab: 95.1% (94.6% for 2012) Biological Lab: 97% (98.3% for 2012) Laboratories RI Health Improvement Plan Progress Report June

4 2. Programmatic Objectives: Improve health outcomes Goal: Promote initiatives that reduce obesity in patients with diabetes 3. Increase the proportion of persons at-risk for diabetes who have been screened for pre-diabetes per current standards of care Staff is currently compiling and analyzing data from the 14 RICCC who submitted their first quarter reports (July 2014). Virginia Paine 4. Increase provider referrals to the Diabetes Prevention Program for their patients with prediabetes or at risk for pre-diabetes 5. Cultivate partnerships with non-traditional partners, such as smart growth advocates, neighborhood revitalization groups, and environmental groups. 6. Provide seed funding to core cities to coordinate communitywide efforts. 7. Develop community action plans to maximize strengths and address gaps by leveraging existing resources for policy and environmental The RIPIN consultant, hired to coordinate the DPP is working with three RICCC sites to identify patients with pre-diabetes and to implement the program at their site or in their community. Increased the number of WIC vendors in Central Falls and Pawtucket Started Fresh to You mobile produce market in Providence s South Side Developed bike and pedestrian master plan in Woonsocket Started Sankofa growers market in West End of Providence Established Lots of Hope program to redevelop cityowned land into community gardens in Providence Assisted Olneyville Housing Corporation with assessment, community engagement and development and implementation of action plan to improve neighborhood design, increase physical activity, improve nutrition, increase safety and expand access to health care Provided training and technical assistance on coalition building, evaluation, healthy community design, complete streets, urban agriculture Developed the Learning Collaborative as a way to offer training and technical assistance to cohorts of communities Developed the Healthy Communities Plan to guide city Virginia Paine Eliza Lawson RI Health Improvement Plan Progress Report June

5 change. and town planning and to be used as a review rubric for municipal plans Assisted N. Kingstown, S. Kingstown, and Pawtucket with assessing and revising their comprehensive plans to align with the Healthy Communities Plan Goal: Reduce the percent of youth initiation tobacco use 1. Increase the number of communities that pass local tobacco license ordinances. In June, 2014, the town of Richmond passed an ordinance requiring a tobacco retail license. Providence, Cranston, Coventry and Warwick already have a tobacco retail license. With Richmond, there are 5 towns in RI with this requirement. 2. Promote a mass media campaign to discourage high school and incoming college students from starting smoke. Developed a youth text cessation program and related media campaign seeking to encourage RI youth smokers to utilize the text cessation program, set to launch in Goal: Decrease the rate of adolescents (ages 15-19) who become pregnant Erin BolesWelsh Erin BolesWelsh 1. Coordinate training and technical assistance for healthcare providers and allied professionals who provide direct services, especially home visits. HEALTH, together with the RI Preconception Health Collaborative, has worked to promote routine provision of preconception care through public health initiatives, comprehensive health policies, healthcare practices and promotion, and consumer awareness in Rhode Island. HEALTH coordinated training opportunities and technical assistance for reproductive health topics, including preconception health for healthcare providers and allied professional staff at Title X family planning, home visiting, Sounivone Phanthavong 2. Develop resources to educate populations (e.g., adolescents, parents) about and social service agencies throughout the state. In collaboration with a nationwide preconception health campaign to educate consumers, HEALTH coordinated community partners to share messages of CDC s Show Your Love campaign. The RI Preconception Health Collaborative has developed workgroups to address gaps and build upon existing initiatives to strengthen systems RI Health Improvement Plan Progress Report June

6 preconception of care for preconception health. health. 3. Develop a comprehensive website that serves as a clearinghouse for preconception health information and a networking source for healthcare providers and allied professionals. Preconception health resources for both healthcare providers and consumers have been integrated into the HEALTH website. Sounivone Phantavong Goal: Carry out a comprehensive approach to prevent cancer in Rhode Islanders for all age groups 1. Reduce the percentage of adults who report being overweight or obese 2013 BRFSS: 64.6% HEALTH s Physical Activity and Nutrition Program is working to implement the Eat Smart Move More Plan for Action, which includes 13 objectives to decrease obesity in RI. Objectives address policies and practices in communities, schools, childcare, worksites, healthcare Eliza Lawson 2. Reduce the percentage of high school students who report being overweight or obese to 24% 3. Conduct yearly skin cancer screenings at RI beaches. 4. Provide a yearly RI cancer summit that focuses on education and prevention. systems and state infrastructure YRBS: 26.9% See as above Skin cancer screenings were performed at RI beaches in July and August of people were screened at 4 beach events. Out of 450 people screened, 106 (23.8%) were referred to Dermatologists for follow up and 46 (10.2%) were referred for biopsies. The yearly educational RI Cancer Summit was held in June of individuals attended. Eliza Lawson Manuela Raposo Same as above RI Health Improvement Plan Progress Report June

7 Goal: Promote the health and wellness of all Rhode Islanders 1. Foster state policy that reduces adverse effects of emergencies on individual with special needs The Climate Change program is working a variety of emergency preparedness activities, including the following: developing a coordinated HEALTH Heat Response plan with the Center for Emergency Preparedness and Response (CEPR), assisting elderly housing through the Senior Resiliency Project, and planning for statewide climate related policies with the Executive Climate Change Coordinating Council (aka EC4). This Council was created by Governor's executive order this past year and then written into legislation with the passing of the Resilient RI Act. It is a group made up of all Julia Gold 2. Train first responders and emergency preparedness personnel on disability-specific strategies to communicate with persons with special needs 3. Require that all childcare facilities the state agency directors. The Disability & Health Program and CEPR planned, developed, and facilitated two First Responder Emergency Preparedness Trainings for fire and police personnel. The trainings have been offered since 2013 and attended by over 150 first responders representing police, fire, emergency management services, and emergency management agency organizations in the state. First Responders were provided with an overview of Autism Spectrum Disorder (ASD) behavioral symptoms, educated about effective communication techniques, and provided practical skills to safely interact with persons with ASD or language disabilities during an emergency. In addition to first responders, the DHP and CEPR developed and hosted six Personal Preparedness Workshops that focused on personal preparedness for people with disabilities, chronic conditions, functional needs, access needs, other special needs and their caregivers. To date, attendees included 124 Rhode Islanders who were guided through the completion of a personal emergency preparedness plan workbook encouraging self-sufficiency for the first 72 hours after a disaster. The workshops were conducted across the state varying between days, nights, and weekends in English and one workshop was conducted entirely in Spanish. Attendees were also supplied some materials to start their own go-kits. The 2013 update of the childcare center licensing regulations included nutrition requirements consistent Deborah Garneau Eliza Lawson RI Health Improvement Plan Progress Report June

8 serve meals and snacks that comply with Dietary Guidelines for Americans. with the USDGA. Currently, training is being developed to assist childcare providers with improving their menus and providing training to staff. 4. Develop a co-op program with Johnson and Wales University to place students in restaurants to provide additional training and technical assistance. 5. Provide adult providers with tools and training to better address obesity prevention. Developed a relationship with Johnson & Wales University to host students at HEALTH to provide support to initiatives focused on implementing nutrition guidelines. Held a workshop series on assessment, counseling, referral, and billing for obesity prevention and treatment. Held a RICCC Training on link between mental health and obesity management. Goal: Prevent violence and injuries in Rhode Island 1. Decrease or maintain the 2009 death rate due to unintentional falls among adults ages 65 and older The Violence and Injury Prevention Program (VIPP) convenes a statewide falls injury prevention coalition. Partners in the coalition continue to offer A Matter of Balance, an evidence-based falls management program that increases physical activity levels among older adults. To date, 230 older adults have graduated from the program. The VIPP has a contract with Coastal Medical, Inc to implement a CDC falls risk assessment tool in the primary practice. To date, 723 older adults have been assessed. Jan Shedd 2. Increase the percent of older adults who exercise on most days of the week 3. Decrease the rate of hospitalizations See above. The VIPP participates in the RI Traffic Safety Coalition. With support from the TSC, a primary seatbelt law was Jan Shedd RI Health Improvement Plan Progress Report June

9 due to unintentional motor vehicle injuries in Rhode Island passed and has been enforced. The seatbelt use rate has gone from 78% in 2012 to 86% in 2013 (above the national average). Unbelted crash fatalities have decreased. 4. Decrease the number of deaths due to suicide for year-olds in the six core cities The Rhode Island Youth Suicide Prevention Program (RIYSPP) has provided suicide prevention gatekeeper training for over 2,500 educators and community based organization staff since The program has also provided youth Signs of Suicide gatekeeper training for over 500 high school students in 5 Rhode Island core city* schools since The RIYSPP has participated in additional gatekeeper training with several youth serving organizations with special emphasis on minority and LGBTQ youth populations. RIYSPP has also actively participated with local colleges and universities to promote suicide prevention activities and programs to college age students on their campuses. There have been approximately 54 youth suicides reported from in Rhode Island with approximately 19 occurring in core cities. Rhode Island core cities experienced five youth suicides each year in 2009 and 2010, four youth suicides each year 2011 and 2012, and one suicide in *Rhode Island core cities are Pawtucket, Central Falls, Providence, and Woonsocket. Goal: Mobilize statewide assets and partnerships to achieve significant reduction on key health issues affecting the Rhode Island community 1. Conduct a statewide campaign to mobilize partnerships and efforts to get to zero new cases of HIV by 2016 In December of 2013, following months of CDC-funded formative research and community input, HEALTH's HIV Program launched a new "Getting to Zero" multi-tiered communications, education, and marketing campaign that aims to reduce and eliminate new HIV infection in RI by HEALTH reported 74 new cases in 2013, down from 78 new cases in The Getting to Zero campaign aims to: Christine Goulette RI Health Improvement Plan Progress Report June

10 1) Raise awareness among RI's general population about new CDC recommended routine HIV testing guidelines for everyone sexually active ages 13-64; 2) Increase access to HIV testing and prevention services among RI's highest risk populations (especially men who have sex with men and commercial sex workers); 3) Expand education and training for healthcare providers on the latest CDC guidelines and advances for HIV testing, treatment, and prevention. These efforts rely heavily on mobilizing and partnering with state agencies, healthcare providers, businesses, schools, and community-based organizations, as well as the utilization of social marketing and media strategies involving community outreach, online advertising, print publications, billboards, buses and bus shelters, drink coasters, posters, flyers, translated materials, and other web-based applications. Additionally, HEALTH has launched and continues to expand its free condom distribution program to promote HIV and STD prevention. This program is also supported by a social marketing campaign. As of August of 2014, HEALTH had placed more than 80 free condom dispensers throughout Rhode Island in strategic locations to maximize outreach to highest risk populations. Hosting venues now include LGBTQ nightclubs, bath houses for MSM, other adult bars and clubs, commercial sex worker drop-in centers, community agencies, health centers, colleges and universities, and more. 2. Collaborate with RI Department of Education, RI Asthma Control Coalition, and Hasbro Children's Hospital Community Asthma Program to increase the number of schools participating in Project CASE: Controlling Asthma Project CASE (Controlling Asthma in Schools Effectively) is a multi-level, multi-component intervention that aims to decrease the burden of asthma in Rhode Island, by improving the environmental health of schools; increasing student knowledge of how to self-manage asthma; increasing staff knowledge of how to decrease asthma triggers in the school environment, and; supporting students and their families in effectively managing their asthma. Project CASE has been piloted in three core cities, with four elementary schools that have an asthma emergency department (ED) visit or hospitalization rate ranging between 11%-15% and student asthma claims prevalence of 14%-21% of the student body. As of June Julian Drix RI Health Improvement Plan Progress Report June

11 in Schools Effectively 2014, two schools have received thorough environmental asthma inspection reports and all four schools have received asthma education classes for both faculty and staff, as well as for students and family members with asthma; 70 students, 49 families/caregivers, and 102 staff members received asthma education through Hasbro's Draw a Breath classes. Goal: Increase and promote healthy environments for all Rhode Islanders 1. Provide technical assistance to schools. 2. Create a unified, systematic approach so that home visiting professionals use an approved healthy housing checklist as part of home assessments, and are trained on follow-up procedures and protocols. 3. Criteria for awarding HEALTH requests for proposals, contracts and formal agreements will be 1. Conducted a health and safety walkthrough of Bailey Elementary school as a follow-up to the asthma prevention work conducted at Fogarty. 2.Trained new staff to conduct asbestos compliance inspections of RI public schools. 3. Provided expert review and participated in staff meeting regarding solvent contamination at Varieur School. 4. Instituted a program with oversight from New England Tech, for all vocational school students in RI to get training in the Renovator Repair Rule ( Lead rule ) Standard healthy housing checklist is being used; training needs to be conducted The Healthy Homes and Environment Team took an active role in reviewing the Health Equity Zone Request for Proposals Robert Vanderslice Robert Vanderslice RI Health Improvement Plan Progress Report June

12 evaluated for opportunities to include healthy homes/community standards or assessments as part of the selection process Goal: Ensure that all children enter school healthy and ready to learn 1. Increase the number of children who receive standardized developmental screening in primary care Two HEALTH staff support primary care providers to implement systems of standardized developmental screening at 9, 18, and 30 months. Currently 8 practices are participating Blythe Berger 2. Increase the capacity of evidence based resources available for families that improve outcomes HEALTH works to expand the capacity of evidence based home visiting and other parent support programs that can improve children s health and learning. Currently RI has the capacity to serve 750 families with evidence based home visiting and will be expanding the capacity of other types of programs in RI Health Improvement Plan Progress Report June

13 3. Process Objective: Establish an ongoing Health Assessment and Improvement Plan development process Goal: Promote the use of rihealthcarematters.org within communities and other partners 1. Add health indicators at the city/town level Lack of resources to identify, classify, and prepare data in this format have prevented the agency from making progress in this activity. Magaly Angeloni 2. Jointly maintain the site with HARI, with recent reports and publications 3. Joint presentations and promotion of the software for use by researchers, students, municipalities, etc. The recently issued RI Health Assessment and Improvement Plan has been published in the website. Other reports from the individual community forums will be posted in the site as well. No presentations have been planned or conducted in the first part of Goal: Maintain the Community Health Assessment group to jointly formulate the state s Community Health Assessment and Health Improvement Plan 1. Conduct 2-3 community engagement meetings per year The Community Health Assessment Group agreed to conduct a total of four community forums per calendar year. For 2014, two forums have already been conducted and the remaining two are in the planning stages, with Magaly Angeloni 2. Complete and make publicly available an annual progress report of community engagement activity 3. Revise and report progress on the Health Improvement dates in October and November The Community Health Assessment Group has been meeting since early 2012 and 3 community forums have been conducted since late The reports for each of the forums are being prepared in two formats: a one pager, as well as a methods report. In addition, a report of all communities visited will be designed in the future. At the moment the reports are in draft form and will be finalized in the Fall of The RI Health Improvement Plan was completed in early 2014 and progress reports are planned to be issued in mid 2014 as well as at the end of calendar year One RI Health Improvement Plan Progress Report June

14 Plan every 3-5 years annual report will be prepared thereafter, and all reports will be posted on the Internet as well as the Goal: Assure resources and a structure that allows prompt use and access to health data maintained by HEALTH 1. Maintain multiple mechanisms to make data accessible to the public via query systems, data requests, annual reports, websites, surveys and other mechanisms During FY 2014, the number of service requests the Center for Health Data and Analysis received from community partners and other external sources rose from 104 in FY2013 to 224 in FY2014. This increase is largely due to the implementation of an improved tracking system. Among all service requests received during FY2014 (n = 799), 224 (28.0%) were made by community organizations, healthcare providers, state agencies, students, and others. During FY2014, the number of external requests rose from 15 in July 2013 to 19 in June Samara Viner- Brown Goal: Establish a coordinated process and structure to share health assessment and health improvement planning efforts in the state 1. Inventory partners and efforts to conduct health assessment and health improvement plans The Community Health Assessment Group agreed to conduct a total of four community forums per calendar year. A complete listing of partners, businesses and others are identified for each community forum and receive an invitation through the mail. At least two key partners are identified for each forum and to assist with the event s facilitation, and subsequent dissemination of reports and Magaly Angeloni 2. Develop a schedule, format and methodology to leverage resources and results from community health assessments follow up. The methodology for the community health forums is discussed after each event and adjustments are made as needed. Follow up after the forum is also being designed, and it is expected to be complete for the Fall RI Health Improvement Plan Progress Report June