May 2015 VVV Research & Development, LLC Olathe, KS

Transcription

1 Ellis County, KS Community Health Needs Assessment Round #2 May 2015 VVV Research & Development, LLC Olathe, KS

2 Community Health Needs Assessment Table of Contents I. Executive Summary II. Methodology a) CHNA Scope & Purpose b) Local Collaborating CHNA parties (The identity of any and all organizations with which the organization collaborated and third parties that engaged to assist with the CHNA) c) CHNA & Town Hall Research Process (A description of the process & methods used to conduct the CHNA, a description of how the organization considered the input of persons representing the community, and an explanation of the process / criteria used in prioritizing such needs) d) Community Profile (A description of the community served by the facility and how the community was determined) III. Community Health Status a) Town Hall CHNA Findings: Areas of Strengths & Areas to Change and/or Improve b) County Health Area of Future Focus (A prioritized description of all of the community needs identified by the CHNA) c) Historical Health Statistics IV. Inventory of Existing County Health Resources a) A description of the existing health care facilities and other resources within the community available to meet the needs identified through the CHNA V. Detail Exhibits a) Patient Origin & Access to Care b) Town Hall Attendees, Notes & Feedback (Who attended with qualifications) c) Public Notice & News d) Primary Research Detail Shaded lines note IRS requirements 1

3 I. Executive Summary [VVV Research & Development, LLC] 2

4 I. Executive Summary Ellis County, KS Community Health Needs Assessment (CHNA) Round #2 Creating healthy communities requires a high level of mutual understanding and collaboration among community leaders. The development of this assessment brings together community health leaders and providers, along with local residents, to research and prioritize county health needs and document community health delivery successes. This health assessment will serve as the foundation for community health improvement efforts for the next three years. The last CHNA for Ellis County, KS was published in May of <Note: The Patient Protection and Affordable Care Act (ACA) requires not-for-profit hospitals to conduct a CHNA every three years and adopt an implementation strategy to meet the needs identified by the CHNA>. This assessment was coordinated and produced by VVV Research & Development, LLC (Olathe, Kansas) under the direction of Vince Vandehaar, MBA. Important CHNA benefits for both the local hospital and health department, as well as for the community, are as follows: 1) Increases knowledge of community health needs and resources, 2) Creates a common understanding of the priorities of the community's health needs, 3) Enhances relationships and mutual understanding between and among stakeholders, 4) Provides a basis upon which community stakeholders can make decisions about how they can contribute to improving the health of the community, 5) Provides rationale for current and potential funders to support efforts to improve the health of the community, 6) Creates opportunities for collaboration in delivery of services to the community and 7) Provides guidance to the hospital and local health department for how they can align their services and community benefit programs to best meet needs. Town Hall Community Health Strengths cited for Hays Medical Center s Primary Service Area are as follows: Ellis County, KS - Community Health "Strengths" # Topic # Topic 1 Collaborative Community 9 Good Doctors Good Community Health with Complete Healthcare 2 10 Support Groups 3 Good Acute Care Hospital 11 Strong Local Economy 4 Pressure of Being a Regional Leader (Makes Them Better) 12 Schools are Supportive of Struggling Families 5 Safe Community 13 Activites for Senior Population 6 Sound Education System 14 "Work Well Kansas" 7 Walk-In Clinic at Oak Park 15 Longevity 8 Walking Club 16 Access to Fitness/Wellness 3

5 Town Hall Community Health Changes and/or Improvements Ranking cited for Hays Medical Center s Primary Service Area are as follows: # 2015 Health Needs to Change and/or Improve Votes % Accum 1 Add Primary Care Physicians % 12.5% 2 Reduce Drinking in the Community % 22.5% 3 Increase Childcare Providers % 31.7% 4 Improve Sources/Quality of Water 9 7.5% 39.2% 5 Reduce Mental health Isolation (placement) 8 6.7% 45.8% 6 Expand Hays Public Transportation 8 6.7% 52.5% 7 Reduce Drug Abuse 8 6.7% 59.2% 8 Increase Senior Care (Skilled Care) options 7 5.8% 65.0% 9 Decrease Tobacco usage 6 5.0% 70.0% 10 Expand Dental Care for Medicaid/Uninsured 6 5.0% 75.0% 11 Add Affordable Rent/Housing 5 4.2% 79.2% Total Town Hall Votes % Note: Ellis County KS (Hays Medical Center PSA) Town Hall Community Health Needs Priorities (30 Attendees) Other items receiving votes: Medical Billing, Gerontology, IP Dementia, Mental Health Services, Family Support, Available Healthcare Services, Community Stakeholder Healthcare Communication, Handicap Housing, Homeless Shelter, Family Planning, Medical Detox, Personal Responsibility in Healthcare, Healthy Food Options Key Community Health Needs Assessment Conclusions from secondary research for Hays Medical Center s Primary Service Area are as follows: KS HEALTH RANKINGS: According to the 2014 RWJ County Health Rankings study, Ellis County s highest State of Kansas ranking (of 105 counties) was in Physical Environment. TAB 1: Ellis County has a population of 28,939 residents as of 2013, a growth of 1.4%. 14% of Ellis County s population consists of the elderly (65+), and 30.5% percent of these elderly people (65+) are living alone. The percent of Hispanics and Latinos in Ellis County is 11.2%. 23% percent of children in Ellis County live in single-parent households, lower than the Kansas rural norm of 29%. The percent of people living below the poverty level in is 16.2%, higher than the Kansas rural norm of 12.5%. The percent of people with limited access to healthy food is 6%. The percent of people 65+ with low access to a grocery store in Ellis County is 2.6%, much lower than the Kansas rural norm of 9.5%. 4

6 TAB 2: Ellis County s per capita income equals $26,845. The median value of owneroccupied housing units is $127,400, higher than the Kansas rural norm of $75,775. The percent of unemployed workers in the civilian labor force in Ellis County is 2.1%. Ellis County has a lower percentage of low-income persons with low access to a grocery store (5.8%), compared to the Kansas rural norm of 15.4%. The percent of solo drivers with a long commute is 6.2%, lower than the Kansas rural norm of 12.2%. The percent of people in Ellis County experiencing severe housing problem (12.2%) is higher than the Kansas rural norm of 8.5%. The number of renters in Ellis County spending 30% or more of their household income on rent is much higher than the Kansas rural norm (37%) at 51.7%. TAB 3: In Ellis County, 27.6% of students are eligible for the free or reduced lunch program. The county maintains a 91.7% high school graduation rate, significantly higher than the Kansas rural norm of 84.6%. The percent of persons (25+) with a Bachelor s degree or higher in Ellis County is 30%. The student-to-teacher ratio in Ellis County is 13.9, higher than the Kansas rural norm of 9.4. TAB 4: The percent of births where prenatal care began in the first trimester in Ellis County is 84.5%, higher than the Kansas rural norm of 78.9%. The percent of births with low birth weights is 6.4%. The average monthly WIC participation in Ellis County is 13.1%, lower than the Kansas rural norm of 20.9%. TAB 5: The ratio of the population in Ellis County to primary care physicians is 1,624. The staffed hospital bed ratio in Ellis County is 5.9%. The congestive heart failure hospital admission rate in Ellis County is 242, higher than the Kansas rural norm of 191. The COPD hospital admission rate (202) in Ellis County is higher than the Kansas rural norm of 194. TAB 6: The depression rate for the Medicare population in Ellis County is 18.1%, higher than the Kansas rural norm of 15.2%. The percent of alcohol-impaired driving deaths in Ellis County (39.3%) is higher than the Kansas rural norm of 36.4%. The percentage of people in Ellis County with inadequate social support is 10% lower than the Kansas rural norm. TAB 7: The adult obesity rate in Ellis County is 29%. The percent of adults who binge drink in Ellis County (21.9%) is higher than the Kansas rural norm of 16.7%. The percent of people in Kiowa County who are physically inactive is 27%. The percent of people who are physically inactive in Ellis County is 26%. The percent of adults with fair or poor self-perceived health status is 10.7%, lower than the Kansas rural norm of 12.4%. 100% of the population in Ellis County served unaffected by SDWA Nitrate violations. The sexually transmitted infection rate in Ellis County is 543, much higher than the Kansas rural norm of 369. The percent of the Medicare population in Ellis County with Diabetes is 23.4%, and the percent of the Medicare population with Alzheimer s disease or dementia is 13.2%. Hyperlipidemia and rheumatoid arthritis in the Medicare population are both higher than the Kansas rural norms in Ellis County. TAB 8: The uninsured adult population rate in Ellis County is 15.7%. 5

7 TAB 9: The mortality rate in Ellis County per 100,000 is 72. TAB 10: The percent of infants fully immunized at 24 months is 70.6%, which is lower than the Kansas rural norm. The percent of diabetic screenings in Ellis County is 80%, lower than the Kansas rural norm of 86%. The percent of people in Ellis County are consuming fruit and vegetables less than one time per day is high. 6

8 II. Methodology [VVV Research & Development, LLC] 7

9 II. Methodology a) Scope and Purpose The new federal Patient Protection and Affordable Care Act requires that each registered 501(c)3 hospital conduct a Community Health Needs Assessment (CHNA) at least once every three years and adopt a strategy to meet community health needs. Any hospital who has filed a 990 is required to conduct a CHNA. IRS Notice was released in late fall of 2011 to give notice and request comments. JOB #1: Meet/Report IRS 990 Required Documentation 1. A description of the community served by the facility and how the community was determined; 2. A description of the process and methods used to conduct the CHNA; 3. The identity of any and all organizations with which the organization collaborated and third parties that it engaged to assist with the CHNA; 4. A description of how the organization considered the input of persons representing the community (e.g., through meetings, focus groups, interviews, etc.), who those persons are, and their qualifications; 5. A prioritized description of all of the community needs identified by the CHNA and an explanation of the process and criteria used in prioritizing such needs; and 6. A description of the existing health care facilities and other resources within the community available to meet the needs identified through the CHNA. Section 501(r) provides that a CHNA must take into account input from persons who represent the broad interests of the community served by the hospital facility, including individuals with special knowledge of or expertise in public health. Under the Notice, the persons consulted must also include: Government agencies with current information relevant to the health needs of the community and representatives or members in the community that are medically underserved, low-income, minority populations, and populations with chronic disease needs. In addition, a hospital organization may seek input from other individuals and organizations located in or serving the hospital facility s defined community (e.g., health care consumer advocates, academic experts, private businesses, health insurance and managed care organizations, etc). JOB #2: Making a CHNA Widely Available to the Public The Notice provides that a CHNA will be considered to be conducted in the taxable year that the written report of the CHNA findings is made widely available to the public. The Notice also indicates that the IRS intends to pattern its rules for making a CHNA widely available to the public after the rules currently in effect for Form 990. Accordingly, an organization would make a facility s written report widely available by posting the final report on its website either in the form of (1) the report itself, in a readily accessible format or (2) a link to another organization s website, along with instructions for accessing the report on that website. The Notice clarifies that an organization must post the CHNA for each facility until the date on which its subsequent CHNA for that facility is posted. 8

10 JOB #3: Adopt an Implementation Strategy by Hospital Section 501(r) requires a hospital organization to adopt an implementation strategy to meet the needs identified through each CHNA. The Notice defines an implementation strategy as a written plan that addresses each of the needs identified in a CHNA by either (1) describing how the facility plans to meet the health need or (2) identifying the health need as one that the facility does not intend to meet and explaining why the facility does not intend to meet it. A hospital organization may develop an implementation strategy in collaboration with other organizations, which must be identified in the implementation strategy. As with the CHNA, a hospital organization that operates multiple hospital facilities must have a separate written implementation strategy for each of its facilities. Great emphasis has been given to work hand-in-hand with leaders from both hospitals and the local county health department. A common approach has been adopted to create the CHNA, leading to aligned implementation plans and community reporting. 9

11 IRS Notice Overview Notice and Request for Comments Regarding the Community Health Needs Assessment Requirements for Tax-exempt Hospitals Applicability of CHNA Requirements to Hospital Organizations The CHNA requirements apply to hospital organizations, which are defined in Section 501(r) to include (1) organizations that operate one or more state-licensed hospital facilities, and (2) any other organization that the Treasury Secretary determines is providing hospital care as its principal function or basis for exemption. How and When to Conduct a CHNA Under Section 501(r), a hospital organization is required to conduct a CHNA for each of its hospital facilities once every three taxable years. The CHNA must take into account input from persons representing the community served by the hospital facility and must be made widely available to the public. The CHNA requirements are effective for taxable years beginning after March 23, As a result, a hospital organization with a June 30 fiscal year end must conduct an initial CHNA for each of its hospital facilities by June 30, 2013, either during the fiscal year ending June 30, 2013 or during either of the two previous fiscal years. Determining the Community Served A CHNA must identify and assess the health needs of the community served by the hospital facility. Although the Notice suggests that geographic location should be the primary basis for defining the community served, it provides that the organization may also take into account the target populations served by the facility (e.g., children, women, or the aged) and/or the facility s principal functions (e.g., specialty area or targeted disease). A hospital organization, however, will not be permitted to define the community served in a way that would effectively circumvent the CHNA requirements (e.g., by excluding medically underserved populations, low-income persons, minority groups, or those with chronic disease needs). Persons Representing the Community Served Section 501(r) provides that a CHNA must take into account input from persons who represent the broad interests of the community served by the hospital facility, including individuals with special knowledge of or expertise in public health. Under the Notice, the persons consulted must also include: (1) government agencies with current information relevant to the health needs of the community and (2) representatives or members of medically underserved, low-income, and minority populations, and populations with chronic disease needs, in the community. In addition, a hospital organization may seek input from other individuals and organizations located in or serving the hospital facility s defined community (e.g., health care consumer advocates, academic experts, private businesses, health insurance and managed care organizations, etc). 10

12 Required Documentation The Notice provides that a hospital organization will be required to separately document the CHNA for each of its hospital facilities in a written report that includes the following information: 1) a description of the community served by the facility and how the community was determined; 2) a description of the process and methods used to conduct the CHNA; 3) the identity of any and all organizations with which the organization collaborated and third parties that it engaged to assist with the CHNA; 4) a description of how the organization considered the input of persons representing the community (e.g., through meetings, focus groups, interviews, etc.), who those persons are, and their qualifications; 5) a prioritized description of all of the community needs identified by the CHNA and an explanation of the process and criteria used in prioritizing such needs; and 6) a description of the existing health care facilities and other resources within the community available to meet the needs identified through the CHNA. Making a CHNA Widely Available to the Public The Notice provides that a CHNA will be considered to be conducted in the taxable year that the written report of the CHNA findings is made widely available to the public. The Notice also indicates that the IRS intends to pattern its rules for making a CHNA widely available to the public after the rules currently in effect for Forms 990. Accordingly, an organization would make a facility s written report widely available by posting on its website either (1) the report itself, in a readily accessible format, or (2) a link to another organization s website, along with instructions for accessing the report on that website. The Notice clarifies that an organization must post the CHNA for each facility until the date on which its subsequent CHNA for that facility is posted. How and When to Adopt an Implementation Strategy Section 501(r) requires a hospital organization to adopt an implementation strategy to meet the needs identified through each CHNA. The Notice defines an implementation strategy as a written plan that addresses each of the needs identified in a CHNA by either (1) describing how the facility plans to meet the health need, or (2) identifying the health need as one that the facility does not intend to meet and explaining why the facility does not intend to meet it. A hospital organization may develop an implementation strategy in collaboration with other organizations, which must be identified in the implementation strategy. As with the CHNA, a hospital organization that operates multiple hospital facilities must have a separate written implementation strategy for each of its facilities. Under the Notice, an implementation strategy is considered to be adopted on the date the strategy is approved by the organization s board of directors or by a committee of the board or other parties legally authorized by the board to act on its behalf. Further, the formal adoption of the implementation strategy must occur by the end of the same taxable year in which the written report of the CHNA findings was made available to the public. For hospital organizations with a June 30 fiscal year end, that effectively means that the organization must complete and appropriately post its first CHNA no later than its fiscal year ending June 30, 2013, and formally adopt a related implementation strategy by the end of the same tax year. This final requirement may come as a surprise to many charitable hospitals, considering Section 501(r) contains no deadline for the adoption of the implementation strategy. 11

13 Year IRS and Treasury Finalize Patient Protection Rules for Tax-Exempt Hospitals ACCOUNTING TODAY 1/2/15 The Internal Revenue Service and the Treasury Department have issued final regulations under the Affordable Care Act to protect patients in tax-exempt hospitals from aggressive debt collection practices and to provide other rules for charitable hospitals. Under the final regulations, each Section 501(c)(3) hospital organization is required to meet four general requirements on a facility-by-facility basis: establish written financial assistance and emergency medical care policies; limit the amounts charged for emergency or other medically necessary care to individuals eligible for assistance under the hospital's financial assistance policy; make reasonable efforts to determine whether an individual is eligible for assistance under the hospital s financial assistance policy before engaging in extraordinary collection actions against the individual; and conduct a community health needs assessment, or CHNA, and adopt an implementation strategy at least once every three years. The first three requirements are effective for tax years beginning after March 23, 2010 and the CHNA requirements are effective for tax years beginning after March 23, The ACA also added a new Section 4959, which imposes an excise tax for failure to meet the CHNA requirements, and added reporting requirements. These final regulations provide guidance on the entities that must meet these requirements, the reporting obligations relating to these requirements and the consequences for failing to satisfy the requirements. Charitable hospitals represent more than half of the nation s hospitals and play a key role in improving the health of the communities they serve, wrote Emily McMahon, Deputy Assistant Secretary for Tax Policy at the U.S. Department of the Treasury, in a blog post Monday explaining the requirements. But reports that some charitable hospitals have used aggressive debt collection practices, including allowing debt collectors to pursue collections in emergency rooms, have highlighted the need for clear rules to protect patients. For hospitals to be tax-exempt, they should be held to a higher standard. That is why the Affordable Care Act included additional consumer protection requirements for charitable hospitals, so that patients are protected from abusive collections practices and have access to information about financial assistance at all tax-exempt hospitals. She noted that as a condition of their tax-exempt status, charitable hospitals must take an active role in improving the health of the communities they serve, establish billing and collections protections for patients eligible for financial assistance, and provide patients with the information they need to apply for such assistance. These final rules adopt the same framework of proposed regulations but simplify the compliance process for charitable hospitals, while 12

14 continuing to provide meaningful guidance on protections for patients and requirements to assess community health needs, she added. Under the new rules, hospitals cannot charge individuals eligible for financial assistance more for emergency or other medically necessary care than the amounts generally billed to patients with insurance (including Medicare, Medicaid, or private commercial insurance). In addition, every tax-exempt hospital must establish and widely publicize a financial assistance policy that clearly describes to patients the eligibility criteria for obtaining financial assistance and the method for applying for financial assistance. Charitable hospitals are also prohibited from engaging in certain collection methods (for example, reporting a debt to a credit agency or garnishing wages) until they make reasonable efforts to determine whether an individual is eligible for assistance under the hospital s financial assistance policy. In addition, each charitable hospital need to conduct and publish a community health needs assessment at least once every three years and disclose on the tax form that it files on an annual basis the steps it is taking to address the health needs identified in the assessment. Many of the requirements have been in place since the Affordable Care Act passed in 2010, but in response to comments on the proposed regulations, the final rules also expand access to translations for patients, by lowering the threshold for having translations of financial assistance policies available from 10 percent of the community served as proposed, to five percent of the community served or population expected to be encountered by the hospital facility, or 1000 persons, whichever is less, according to McMahon. The final rules also revise the notification requirements to maintain important protections for patients while making it easier for hospitals to comply with them, she wrote. General notifications regarding a hospital s financial assistance policy must appear on bills and in the hospital. However, individual written and oral notifications of the hospital s financial assistance policy are now only required when a hospital plans to use extraordinary collections actions, such as reporting a debt to a credit bureau, selling the debt to a third party or garnishing wages. While charitable hospitals must continue to make a good-faith effort to comply, the rules provide charitable hospitals with time to fully update their policies and programming to implement the changes. But if a charitable hospital fails to meet the consumer protection provisions required by the law, the hospital could have its tax-exempt status revoked. If a hospital fails to properly conduct a community health needs assessment or adopt an implementation strategy, an excise tax will apply, McMahon noted. However, if a hospital fails to meet a requirement, but the failure is neither willful nor egregious, the hospital can correct and publicly disclose the error to have it excused, thus avoiding revocation of taxexempt status, but the excise tax would still apply, she wrote. 13

15 II. Methodology b) Collaborating CHNA Parties Working together to improve community health takes collaboration. Listed below is an in depth profile of the local hospital and Health Department CHNA partners: Hays Medical Center Profile 2220 Canterbury Dr, Hays, KS CEO: John H. Jeter, MD About HaysMed: Hays Medical Center is a private, not-for-profit hospital formed by the 1991 merger of two religiously affiliated facilities, and provides the only tertiary level services in the region. The organization's Vision Statement, developed collaboratively with local and regional physicians, hospital administrators and community board representatives, was refined to a single core purpose: "To Help People Be Healthy," and an overriding goal: "To Be the Best Tertiary Care Center in Rural America." HMC's DeBakey Heart Institute provides heart surgery for the western half of the state. Additionally the 207-bed facility provides medical, surgical and pediatric care along with cardiac, neonatal and intensive care units; cancer, joint and spine care, diagnostic imaging and eye surgery center; emergency department, rehabilitation, hospice and lifeline. A total of 6,696 admissions and 173,321 outpatient procedures documented last year, while the medical group's specialty and rural health clinics accounted for more than 145,464 office visits. In addition, the DeBakey Heart Institute had 2,374 admissions while the Dreiling/Schmidt Cancer Institute provided services to 2,580. Last year 721 births were also recorded at the hospital while 13,644 patients were seen in the Emergency Department. The Center for Health Improvement, a MFA accredited fitness center, incorporates hospital-based fitness and rehabilitation programs with occupational medicine and independent physician clinics, opened it's doors 11 years ago and has a membership in the fitness area of 2,000. Hays Medical Center maintains a local market share of nearly 90%; with total primary/secondary/tertiary service are at 25%. Patient utilization figures demonstrate approximately one-half of all hospitalizations in the region are maintained in the small rural hospitals surrounded by Hays Medical Center. Administering perhaps the largest Critical Access hospital network in the country, HMC earned the 1997 National Rural Health Association Outstanding Program Award for its EACH/RPCH and Telemedicine programs. It is NIAHO Hospital accredited, a Level 3 Trauma Center, an accredited Chest Pain Center with PCI and Primary Stroke Center. More than one thousand associates staff the medical center and physician clinics, accredited by DNV Healthcare and the American College of Radiology. 14

16 Mission Statement: Patient, physicians and employers will first think of Hays Medical Center and our regional partners to meet their health care needs. We will provide the best in compassionate care and will help communities understand and improve their health. We support health care as a component of rural life by combining tertiary services in a rural delivery system using primary care physicians, local hospitals and other health care providers. Vision: To help people be healthy. Hays Medical Center offers the following services to its community: - Bariatrics - Nursing - Billing/Financial - OB/GYN - Bone, Joint and Spine Center - Occupational Therapy - Breast Care Center - Orthopedics - Cancer - Out Patient Rehab - Convenient Care Walk-In Clinic - Palliative Care - Cosmetic Surgery - Pastoral Care - Diabetes Solutions - Pediatrics - Dietary - Pharmacy - Dodge City Specialty Center - Pulmonology - Education - Rehabilitation - Emergency Department - Robot Surgery - Eye - Senior Focused Care - Family Medicine - Sleep and Neurodiagnostic - Fitness Center - Special Nursing Services - Great Bend Healthcare Center - Sports Medicine - HaysMed Partners - Surgery - Heart - Urology - Hospice - Volunteer Services - Hospitalists - Weight Loss Surgery - Imaging - WorkSMART - Internal Medicine - Woman/Infant Services - Lifeline - Wound Healing Hyperbaric Center - Nephrology 15

17 Ellis County Health Department Profile 601 Main St., Ste. B, Hays, KS, Administrator: Robert Butch Schlyer, RN Medical Consultant: Katrina Hess, MD Phone: Regional District Office: NW Trauma Region: NW The Ellis County Health Department is open Monday through Friday from 7:30 am to 4:30 pm. In 2004, ECCP applied for funding from KDHE through the partnership of the Ellis County Health Department in the Chronic Disease Risk Reduction Grants, to assist with tobacco cessation opportunities. ECCP is the acting Juvenile Justice Authority Committee for Ellis County and over the years assisted with securing mini-grant funds for juvenile delinquency prevention efforts. Efforts specifically focused on Intensive Tutoring facilitated at the Northwest Kansas Juvenile Intake Program and mentoring through Big Brothers Big Sisters of Ellis County. The health department also offers WIC services, including immunizations screening, breastfeeding education & support, and classes for nutrition & health. Offerings: Screenings (Blood pressure, Cholesterol, Glucose, Prostate (PSA), and Tuberculosis), metabolic panels, CBC Blood count, Hemoglobin AIC, Protime, TSH (Thyroid stimulating hormone), wellness physicals, lead testing, education on children s health matters. Immunizations: Hepatitis A/B, HPV, Meningococcal, Diphtheria, Tetanus, Pertussis, Pneumonia, Influenza, Zostavax, MMR, Polio, Rabies, Rotavirus, and Varicella. Mission: It is the philosophy of the Ellis County Health Department that every citizen of Ellis County should have access to basic public health services at an affordable cost. This agency will promote, provide and maintain these services while encouraging personal responsibility for individual health care. However, individuals will not be denied supported services due to inability to pay. Accreditation: Ellis County Health Department currently considering working towards CHNA accreditation. 16

18 II. Methodology b) Collaborating CHNA Parties Continued Consultant Qualifications VVV Research & Development, LLC Company Profile: 601 N. Mahaffie, Olathe, KS (913) VINCE VANDEHAAR, MBA Principal Consultant & Owner of VVV Research & Development, LLC VVV Research & Development, LLC was incorporated on May 28th, With over 30 years of business & faculty experience in helping both providers, payors, and financial service firms obtain their strategic planning and research & development needs, Vince brings in-depth health industry knowledge, research aptitude, planning expertise and energy. VVV Research & Development services are organized, formal processes of listening to the voice of the customer. Vince started his consulting business after working for Saint Luke s Health System (SLHS) of Kansas City for 16 years. (Note: Saint Luke s Hospital of Kansas City, SLHS s largest hospital, won the Malcolm Baldrige National Quality Award in March of The Baldrige examiners cited Vince s department as Best Practice in the areas of customer satisfaction, market research and evaluation efforts <Kansas City Star 3/10/04>). VVV Research & Development, LLC consultants have in-depth experience helping hospitals work with local Health Departments to engage community residents & leaders to identify gaps between existing health community resources & needs and construct detailed strategies to meet those needs - while still adhering to the hospital s mission and budget. Over the past 20 years, Vandehaar has completed 8 comprehensive Baldrige aligned Community Health Needs Assessments for Saint Luke s of Kansas City System facilities (3 campuses) and was contracted to conduct 2 additional independent Dept. of Health consulting projects (prior to IRS 990 regs). To date, VVV has completed 39 CHNA IRS aligned assessments for Kansas, Iowa and Missouri hospitals & Health Departments. Vince Vandehaar, MBA is actively involved in the Kansas City community. He is a member the Greater Kansas City Employee Benefits Association, the Society for Healthcare Strategy & Market Development, the American Marketing Association Kansas City Chapter and Co-Chair of the AMA Kansas City Healthcare Special Interest Group. In addition to these roles, from 2000 to 2008, Vince served as the state chairman for MHA s Data Committee and was a member of KHA s Data Taskforce. Collaborating Consultants Alexa Backman, MBA VVV Research & Development, LLC Lead Planning & Marketing Analyst 17

19 II. Methodology c) CHNA & Town Hall Research Process Our Community Health Needs Assessment process began in December of At that time an inquiry by Hays Medical Center (Hays, KS) to all NW KS Health Alliance Network member hospitals was communicated to explore the possibility of a group buy to meet IRS CHNA requirements. (Note: Most NW KS Alliance Network hospitals work closely with Hays Medical Center to provide onsite IT, Telemedicine, Mobile Radiology and Bio- Medical services. In addition, many Hays based specialists will travel to neighboring counties to provide visiting outreach clinics). In late December of 2014 a meeting was called (hosted) by Hays Medical Center to learn more from the NW Alliance members (24) regarding their CHNA needs and to review the possible CHNA collaborative options. VVV Research & Development, LLC from Olathe, KS was asked to facilitate this discussion with the following agenda: VVV Research CHNA experience, review CHNA requirements (regulations) and discuss CHNA steps/options to meet IRS requirements and to discuss the next steps. VVV CHNA Deliverables: Uncover/Document basic secondary research health of county (Organized by 10 TABS) Conduct Town Hall meeting to discuss secondary data and uncover/prioritize county health needs Conduct & Report CHNA primary Research (valid N) if elected by client Prepare & publish IRS-aligned CHNA report to meet requirements 18

20 VVV CHNA Work Plan - Hays Medical Center Project Timeline & Roles 2015 Step Date (Start-Finish) LEAD Task 1 12/11/2014 VVV / Hold kickoff Northwest Alliance review. 2 1/1/2015 Hosp Select CHNA Option A/B/C. Approve (sign) VVV CHNA quote. 3 1/20/2015 VVV Send out REQCommInvite Excel file. Hosp & Hlth Dept to fill in PSA Stakeholders Names/Address/ . 4 1/20/2015 VVV 5 On or Before 01/28/15 VVV 6 On or Before 1/28/2015 VVV / Hosp 7 2/2/2015 VVV 9 2/11/2015 VVV / Hosp 10 On or Before 2/15/2015 VVV 11 2/18/2015 Hosp 12 2/18/2015 VVV / Hosp 13 3/6/2015 ALL 14 3/11/2015 VVV 15 On or Before 04/30/15 VVV 16 On or Before 05/31/15 VVV Request Hospital Client to send KHA PO reports (PO101, 103 and TOT223E) to document service area for FFY 13, 12 and 11. In addition, request hospital to complete 3 year historical PSA IP/OP/ER/Clinic patient origin file (Use ZipPSA_3yrPOrigin.xls). Prepare CHNA Round#2 Stakeholder Feedback "online link." Send text link for hospital review. Prepare/send out PR story to local media announcing upcoming CHNA work (general story). Hospital to place. Mail Round #2 CHNA Community Survey. Hospital will request to participate to all stakeholders. Prepare/send out PR story to local media CHNA survey announcing CHNA Round #2 survey. Request public to participate. Assemble & complete secondary research - Find/populate 10 TABS. Create Town Hall Ppt for presentation. Prepare/send out Community Town Hall invite letter and place local ad. Prepare/send out PR story to local media announcing upcoming Town Hall. VVV will mock-up PR release to media sources. Conduct conference call (time TBD) with Hospital/Public Hlth to review Town Hall data/flow. Conduct CHNA Town Hall. Lunch 11:30-1pm at Hays Medical Center. Review & Discuss Basic health data plus rank health needs. Complete Analysis - Release Draft 1- seek feedback from leaders (Hospital & Health Dept). Produce & Release final CHNA report. Hospital will post CHNA online (website). 17 On or Before 05/31/15 Hosp Conduct Client Implementation Plan PSA Leadership meeting Days Prior to End of Hosp Fiscal Year Hosp Hold Board Meetings to discuss CHNA needs, create & adopt an implementation plan. Communicate CHNA plan to community. 19

21 To meet IRS aligned CHNA requirements, a four-phase methodology was reviewed and approved as follows: Phase I Discovery: Conduct a 30 minute conference call with CHNA hospital client and County Health Department. Review / confirm CHNA calendar of events, explain / coach client to complete required participants database and schedule / organize all Phase II activities. Phase II QUALIFY Community Need: A) Conduct secondary research to uncover the following historical community health status for PSA. Use Iowa Hospital Association (IHA), Vital Statistics, Robert Woods Johnson County Health Rankings, etc. to document current state of county health organized as follows: TAB 1. Demographic Profile TAB 2. Economic/Business Profile TAB 3. Educational Profile TAB 4. Maternal and Infant Health Profile TAB 5. Hospitalization / Providers Profile TAB 6. Behavioral Health Profile TAB 7. Risk Indicators & Factors TAB 8. Uninsured Profile TAB 9. Mortality Profile TAB 10. Preventative Quality Measures B) Gather historical primary research to uncover public health needs, practices and perceptions for hospital primary service areas. Phase III QUANTIFY Community Need: Conduct 90 minute Town Hall meeting with required county PSA residents. (Note: At each Town Hall meeting, CHNA secondary data will be reviewed, facilitated group discussion will occur, and a group ranking activity to determine the most important community health needs will be administered). Phase IV - Complete data analysis & create comprehensive Community Health Needs Assessment: Post CHNA report findings to meet IRS CHNA criteria. After consideration of CHNA stakeholders (sponsoring hospital & local health department) the CHNA Basic option was selected with the following project schedule: Phase I: Discovery January 2015 Phase II: Secondary / Primary Research Jan - Feb 2015 Phase III: Town Hall Meeting..... March 12, 2015 Phase IV: Prepare / Release CHNA report.... May

22 Detail CHNA Development Steps Include: Steps to Conduct Community Health Needs Assessment Step # 1 Commitment Development Steps Determine interest level of area healthcare leaders (Hospital, Health Dept, Mental Health Centers, Schools, Churches, Physicians etc), hold community meeting. Step # 2 Planning Prepare brief Community Health Needs Assessment Plan - list goals, objectives, purpose, outcome, roles, community involvement, etc. Hold Community Kick-off meeting. Step # 3 Secondary Research Collect & Report Community Health Published Facts. Gather data health practice data from published secondary research sources i.e. census, county health records, behavioral risk factors surveillance, etc. Step # 4a Primary Research Conduct Community Roundtable (Qualitative Research). Review Secondary Research (Step3) with Community Stakeholders. Gather current opinions and identify health needs. Step # 4b Primary Research <Optional> Collect Community Opinions. (Quantitative Research). Gather current opinions (Valid sample size) regarding community health needs and healthcare practices. If appropriate, conduct Physician Manpower Assessment to determine FTE Physician need by specialty. Steps # 5 Reporting Prepare/Present comprehensive Community Health Needs Assessment report (to community leaders) with Recommended Actions to improve health. < Note: Formal report will follow IRS Notice regs > VVV Research & Development, LLC

23 Overview of Town Hall Community Priority Setting Process Each community has a wealth of expertise to be tapped for CHNA development. For this reason, a town hall is the perfect forum to gather community insight and provide an atmosphere to objectively consensus build and prioritize county health issues. All Town Hall priority-setting and scoring processes involve the input of key stakeholders in attendance. Individuals and organizations attending the Town Halls were critically important to the success of the CHNA. The following list outlines partners invited to Town Hall: local hospital, public health community, mental health community, free clinics, communitybased clinics, service providers, local residents, community leaders, opinion leaders, school leaders, business leaders, local government, faith-based organizations and persons (or organizations serving them), people with chronic conditions, uninsured community members, low income residents and minority groups. Hays Medical Center s Town Hall was held on Wednesday, March 11th, 2015 at Hays Medical Center. Vince Vandehaar and Alexa Backman facilitated this 1 ½ hour session with thirty (30) attendees. (Note: a detail roster of Town Hall attendees is listed in Section V a). The following Town Hall agenda was conducted: 1. Welcome & Introductions 2. Review Purpose for the CHNA Town Hall and Roles in the Process 3. Present / Review of Historical County Health Indicators (10 TABS) 4. Facilitate Town Hall participant discussion of data (probe health strengths / concerns). Reflect on size and seriousness of any health concerns sited and discuss current community health strengths. 5. Engage Town Hall participants to rank health needs (using 4 dots to cast votes on priority issues). Tally & rank top community health concerns cited. 6. Close meeting by reflecting on the health needs / community voting results. Inform participants on next steps. At the end of each Town Hall session, VVV encouraged all community members to continue to contribute ideas to both hospital and health department leaders via or personal conversations. (NOTE: To review detail Town Hall discussion content, please turn to Section V for detailed notes of session and activity card content reporting of open end comments). 22

24 Community Health Needs Assessment Ellis County KS Town Hall Meeting on behalf of Hays Medical Center Vince Vandehaar, MBA VVV Marketing & Development INC. Owner and Adjunct Marketing Professor Olathe, Kansas Community Health Needs Assessment (CHNA) Town Hall Discussion Agenda I. Opening / Introductions (10 mins) II. Review CHNA Purpose & Process (10 mins) III. Review Current County "Health Status - Secondary Data by 10 TAB Categories Review Community Feedback Research (35 mins) IV. Collect Community Health Perspectives Hold Community Voting Activity: Determine MOST Important Health areas. (30 mins) V. Close / Next Steps (5 mins) VVV Marketing & Development INC. I. Introduction: Background and Experience Town Hall Participation (You) Vince Vandehaar MBA, VVV Marketing & Development INC Principal Consultant, Olathe, KS Professional Consulting Services: Strategic Planning, Marketing Management, Business Research &Development Focus : Strategy, Research, Deployment Over 25 years of experience with Tillinghast, BCBSKC, Saint Luke s Adjunct Professor - Marketing / Health Admin.- 26 years + Webster University (1988 present) Rockhurst University (2010 present) ALL attendees welcome to share. Parking Lot There are no right or wrong answers. Only one person speaks at a time. Please give truthful responses. Have a little fun along the way. Alexa Backman MBA 2015, VVV Collaborative Analyst 23

25 I. Introductions: a conversation with the community. Community members and organizations invited to CHNA Town Hall Consumers: Uninsured/underinsured people, Members of at-risk populations, Parents, caregivers and o ther consumers of health care in the community, and Consumer advocates. Community leaders and groups: The hospital organization s board members, Local clergy and congregational leaders, Presidents or chairs of civic or service clubs -- Chamber of Commerce, veterans' organizations, Lions, Rotary, etc., Representatives from businesses owners/ceo's of large businesses (local or large corporations with local branches.),business people & merchants (e.g., who sell tobacco, alcohol, or other drugs), Representatives from organized labor, Political, appointed and elected officials., Foundations., United Way organizations. And other "community leaders." Public and other organizations: Public health officials, Directors or staff of health and human service organizations, City/Community planners and development officials, Individuals with business and economic development experience, Welfare and social service agency staff,housing advocates - administrators of housing programs: homeless shelters, low-income- family housing and senior housing,education officials and staff - school superintendents, principals and teachers, Public safety officials, Staff from state and area agencies on aging,law enforcement agencies - Chiefs of police, Local colleges and universities, Coalitions working on health or other issues. Other providers: Physicians, Leaders in other not-for-profit health care organizations, such as hospitals, clinics, nursing homes and home-based and community-based services, Leaders from Catholic Charities and other faith-based service providers, Mental health providers, Oral health providers, Health insurers, Parish and congregational nursing programs, Other h ealth professionals II. Purpose: Why conduct Community Health Needs Assessment? To determine health-related trends and issues of the community. To understand/evaluate health delivery programs in place. To develop strategies to address unmet health needs. To meet Federal requirements both local hospital & Health Department. II. Review CHNA Definition A Community Health Needs Assessment (CHNA) is a systematic collection, assembly, analysis, and dissemination of information about the health of the community. <NOTE: Some the data has already been collected (published) by local, state and federal public health organizations. Some data will be collected today.> CHNA s role is to identify factors that affect the health of a population and determine the availability of resources to adequately address those factors. Acuity Future System of CARE Sg2 Home Community-Based Care Health Dept./ Pharmacy Wellness and Fitness Center Physician Clinics Diagnostic/ Imaging Center IP = inpatient; SNF = skilled nursing facility; OP = outpatient. Ambulatory Procedure Center Urgent Care Center Hospital IP Rehab SNF Recovery & Rehab Care Home Care Hospice Acute Care OP Rehab 24

26 Community Health Needs Assessment Joint Process: Hospital & Health Department II. Required Written Report IRS 990 Documentation.. a description of the community served a description of the CHNA process the identity of any and all organizations & third parties which collaborated to assist with the CHNA; a description of how the organization considered the input of persons representing the community (e.g., through meetings, focus groups, interviews, etc.), who those persons are, and their qualifications; a prioritized description of all of the community needs identified by the CHNA and a description of the existing health care facilities and other resources within the community available to meet the needs identified through the CHNA. III. Review Current County "Health Status Secondary Data by 10 TAB Categories plus IA State Rankings County Health Rankings Robert Wood Johnson Foundation & University of WI Health Institute TAB 1. Demographic Profile TAB 2. Economic/Business Profile TAB 3. Educational Profile TAB 4. Maternal and Infant Health Profile TAB 5. Hospitalization / Providers Profile TAB 6. Behavioral Health Profile TAB 7. Risk Indicators & Factors TAB 8. Uninsured Profile TAB 9. Mortality Profile TAB 10. Preventative Quality Measures 25

27 1 2b Physical Environment (10%) Social and Economic Environment (40%) Measure Description Focus Area Measure Description Focus Area Air and water Air pollution - particulate The average daily measure of fine particulate matter Community Violent crime Violent crime rate per 100,000 population quality (5%) in micrograms per cubic meter (PM2.5) in a county safety (5%) matter Drinking water violations Percent of population potentially exposed to water Injury deaths Injury mortality per 100,000 exceeding a violation limit during the past year Housing and Severe housing problems Percent of households with at least 1 of 4 housing transit (5%) problems: overcrowding, high housing costs, or lack of kitchen or plumbing facilities Driving alone to work Percent of the workforce that drives alone to work 3 Health Outcomes (30%) Long commute - driving Among workers who commute in their car alone, the 3a Health Behaviors alone percent that commute more than 30 minutes Clinical Care (20%) 2a Focus Area Measure Description Tobacco use Adult smoking that report smoking Focus Area Measure Description Percent of adults >= 100 Access to care Uninsured Percent of population under age 65 without health Diet and Adult obesity Percent of adults that report a BMI >= 30 (10%) insurance exercise (10%) Primary care Ratio of population to primary care physicians Food Index of factors that contribute to a healthy physicians environment food environment index Dentists Ratio of population to dentists Physical inactivity Percent of adults aged 20 and over reporting Mental health Ratio of population to mental health providers Access to exercise Percent of the population with adequate providers opportunities access to locations for physical activity Quality of care Preventable hospital Hospitalization rate for ambulatory-care sensitive Alcohol and Excessive drinking Binge plus heavy drinking (10%) stays conditions per 1,000 Medicare enrollees drug use (5%) Diabetic screening Percent of diabetic Medicare enrollees that receive Alcohol-impaired Percent of driving deaths with alcohol HbA1c screening driving deaths involvement Mammography Percent of female Medicare enrollees that receive Sexual activity Sexually Chlamydia rate per 100,000 population screening mammography screening (5%) transmitted infections Social and Economic Environment (40%) 2b Teen births Teen birth rate per 1,000 female population, ages Focus Morbidity / Mortality Area Measure Description 3b / 3c Education High school Percent of ninth grade cohort that graduates in 4 Focus Area Measure Description (10%) graduation years Some college Percent of adults aged years with some postsecondary Quality of life Poor or fair Percent of adults reporting fair or poor health education (50%) health (age-adjusted) Employment Unemployment Percent of population age 16+ unemployed but Poor physical Average number of physically unhealthy days (10%) seeking work health days reported in past 30 days (age-adjusted) Average number of mentally unhealthy days Income (10%) Children in poverty Percent of children under age 18 in poverty Poor mental health days reported in past 30 days (age-adjusted) Family and Inadequate social Percent of adults without social/emotional support Low birthweight Percent of live births with low birthweight (< social support support 2500 grams) (5%) Children in singleparent Percent of children that live in household headed by Length of life Premature death Years of potential life lost before age 75 per households single parent (50%) 100,000 population (age-adjusted) Yr 2012 CHNA Needs 2012 Health Needs - Ellis County KS (Ranked) # Health Areas of Future Focus N=40 Votes % Aging Services (Nursing Home & Assisted Living 1 facilities ) % 2 Low Cost Health Services / Providers % 3 Mental Health services % 4 Alternative to ER (Urgent Care Facility) % 5 Public Transportation 9 6.7% 6 Additional Dentists services 8 5.9% 7 Preventative Care services 8 5.9% Delivery & Integration of Care. Health Ed 8 Coordination 7 5.2% 9 Obesity 7 5.2% 10 Business Culture Promoting Healthy Living 6 4.4% 11 Geriatrics 6 4.4% 12 Bike / Walking Path 5 3.7% IV. Collect Community Health Perspectives Ask your opinion. Your thoughts? 1) Tomorrow: What is occurring or might occur that would affect the health of our community? 2) Today: What are the strengths of our community that contribute to health 3) Today: Are there healthcare services in your community / neighborhood that you feel need to be improved and / or changed? Community Health Needs Assessment Questions Next Steps? VVV Research & Development INC. vmlvandehaar@aol.com

28 II. Methodology d) Community Profile (A Description of Community Served) Ellis County Community Profile Demographics The population of Ellis County was estimated to be 29,316 citizens in 2014, and had a 0.71% change in population from The county covers square miles is one of the top pheasant hunting states in the nation. It also has the Cedar Bluff Reservoir and Lake Wilson for recreation and is home to the Cathedral of the Plains 1. The county has an overall population density of 33 persons per square mile. The county is located in Central Western Kansas and the most common industries are education, health and social services and retail trade 2. The county was founded in 1867 and the county seat is Hays 3. The major highway transportation access to Ellis County is U.S. Interstate 70, which runs through the center of the county. Kansas Highway 183 is the major North South road. Also, Old Highway 40 runs parallel to I-70 throughout the county. Ellis County KS Airports 4 Name Hays Medical Center Heliport Hays Regional Airport Philip Ranch Airport Rans Airport Saint Anthony Hospital Airport USGS Topo Map Hays North Hays South Victoria Hays North Hays North

29 Schools in Ellis County: Public Schools 5 Name Ellis High Felten Middle Hays High Kathryn O Loughlin McCarthy Elem Kennedy Middle Lincoln Elem Roosevelt Elem Victoria Elem Victoria High Washington Elem Washington Elem Woodrow Wilson Elem Level High Middle High Primary Middle Primary Primary Primary High Primary Primary Primary Private Schools 6 Name High Plains Christian School Holy Family Elementary Maranatha Christian School St. Mary s School Thomas More Prep Marian High Sch Level Elementary Elementary Elementary Elementary Secondary

30 Detail Demographic Profile Population: Households HH Per Capita ZIP NAME County Yr2014 Yr2019 Chg Yr2014 Yr2019 Avg Size Income Hays ELLIS 24,656 25, % 10,405 10, $23, Catharine ELLIS % $32, Ellis ELLIS 2,720 2, % 1,159 1, $22, Pfeifer ELLIS % $22, Victoria ELLIS 1,797 1, % $22, Walker ELLIS % $33,325 Totals 29,377 30, % 12,395 12, $26,150 Population 2014: YR 2014 Females ZIP NAME County Yr2014 POP65p KIDS<18 GenY MALES FEMALES Age20_ Hays ELLIS 24,656 3,292 6,137 9,778 12,324 12,332 3, Catharine ELLIS Ellis ELLIS 2, ,325 1, Pfeifer ELLIS Victoria ELLIS 1, Walker ELLIS Totals 29,377 4,149 7,301 11,146 14,677 14,700 3,934 Population 2014: Aver Hholds ZIP NAME County White Black Amer IN Hisp HH Inc14 Yr2014 HH $50K Hays ELLIS 22, ,546 $55,998 10,405 4, Catharine ELLIS $64, Ellis ELLIS 2, $52,705 1, Pfeifer ELLIS $54, Victoria ELLIS 1, $54, Walker ELLIS $64, Totals 27, ,663 $57,819 12,395 5,264 Source: ERSA Demographics 29

31 III. Community Health Status [VVV Research & Development, LLC] 30

32 III. Community Health Status a) Historical Health Statistics Health Status Profile This section of the CHNA reviews published quantitative community health indicators and results of our recent CHNA Town Hall. To produce this profile, VVV Research & Development staff analyzed data from multiple sources. This analysis focuses on a set of published health indicators organized by ten areas of focus (10 TABS), results from the 2015 County Health Rankings and conversations from Town Hall primary research. (Note: The Robert Wood Johnson Foundation collaborates with the University of Wisconsin Population Health Institute to release annual County Health Rankings. As seen below in model, these rankings are based on a number of health factors). 31

33 Secondary Research 2015 State Health Rankings for Ellis County, KS # Kansas 2015 County Health Rankings (105 Counties) Definitions ELLIS CO 2015 Trend NW Alliance (12) 1 Physical Environment Environmental quality Health Factors a Clinical Care Access to care / Quality of Care b Social & Economic Factors Education, Employment, Income, Family/Social support, Community Safety Health Outcomes a Health Behaviors Tobacco Use, Diet/Exercise, Alcohol Use, Sexual Activitiy b Morbidity Quality of life c Mortality Length of life 7 42 OVERALL RANK NW KS Norms include the following 12 counties: Barton, Ellis, Gove, Kiowa, Norton, Osborne, Pawnee, Phillips, Russell, Sheridan, Smith and Thomas When considering the state of community health, it s important to review published health data by topic area. Below is a summary of key TABS of information collected: 32

34 Tab 1 Demographic Profile TAB Health Indicator ELLIS CO 2015 TREND KANSAS NW Alliance (12) SOURCE 1a a Population, 2013 estimate 28,939 2,895, ,831 People Quick Facts 1a b Population, ,531 2,853, ,876 People Quick Facts 1a c Pop Growth % - April 1,10 to July 1, % 2.1% -0.5% People Quick Facts 1a d Persons under 5 years, percent, % 6.9% 6.0% People Quick Facts 1a e Persons under 18 years, percent, % 21.8% 22.1% People Quick Facts 1a f Persons 65 years and over, percent, % 13.6% 20.4% People Quick Facts 1a g Female persons, percent, % 49.7% 49.2% People Quick Facts 1a h White alone, percent, 2013 (a) 87.1% 95.6% 95.4% People Quick Facts Black or African American alone,% a i (a) 6.2% 1.0% 1.7% People Quick Facts 1a j Hispanic or Latino, percent, 2013 (b) 11.2% 5.4% 5.2% People Quick Facts 1a Foreign born persons, percent, k % 2.6% 2.1% People Quick Facts % Language other than English spoken 1a l at home 10.9% 7.6% 4.7% People Quick Facts % Living in same house 1 year +, a m % 75.8% 86.6% People Quick Facts 1a n People 65+ Living Alone, % 29.4% 32.4% American Community Survey TAB Health Indicator ELLIS CO 2015 TREND KANSAS NW Alliance (12) SOURCE 1b a Veterans, ,185 NA 18,731 People Quick Facts 1b b Population per square mile, Geography Quick Facts 1b c Violent crime rate (Rate of Violent Crime per 1,000) % Kansas Bureau of Investigation 1b d Children in single-parent households 23% NA 29% County Health Rankings 1b 1b e f People Living Below Poverty Level, % 13.7% 12.5% Children Living Below Poverty Level, % 18.7% 18.1% American Community Survey American Community Survey 1b g Limited access to healthy foods 6% NA 8% County Health Rankings 1b People 65+ Living Below Poverty Level, h % 7.6% 8.5% American Community Survey People 65+ with Low Access to a Grocery U.S. Department of Agriculture - Food 1b i Store, % NA 9.5% Environment Atlas 1b j Voter Turnout, % 66.8% 71.0% Kansas Secretary of State 33

35 Tab 2 Economic Profiles TAB Health Indicator ELLIS CO 2015 TREND KANSAS NW Alliance (12) SOURCE 2a a Households, ,094 1,110,440 42,866 People Quick Facts 2a b Median household income, $43,085 $51,332 $44,017 2a 2a c d American Community Survey Per capita money income in past 12 months (2012 dollars), $26,845 $24,625 $25,046 People Quick Facts Households with Cash Public Assistance Income, % 2.3% 1.6% American Community Survey 2a e Housing units, ,397 NA 106,387 People Quick Facts Median value of owner-occupied housing 2a f units, $127,400 $134,700 $75,775 People Quick Facts 2a g Homeownership rate, % 60.7% 62.6% 2a h American Community Survey Housing units in multi-unit structures, % % 23.4% 9.0% People Quick Facts 2a i Persons per household, People Quick Facts 2a j Severe Housing Problems, % 12.8% 8.5% County Health Rankings 2a k Homeowner Vacancy Rate, % 2.0% 1.8% Renters Spending 30% or More of 2a l Household Income on Rent, % 45.5% 37.0% American Community Survey American Community Survey TAB Health Indicator ELLIS CO 2015 TREND KANSAS NW Alliance (12) SOURCE 2b a Retail sales per capita, 2007 $12,444 $18,264 $9,577 Business Quick Facts 2b b Total number of firms, , ,040 10,781 Business Quick Facts 2b 2b 2a c Unemployed Workers in Civilian Labor Force, % 3.9% 2.7% Private nonfarm employment, percent U.S. Bureau of Labor Statistics d change, % (1) 4.6% 5.3% Business Quick Facts U.S. Department of Households with No Car and Low Access Agriculture - Food e to a Grocery Store, % 2.1% Environment Atlas 2b f Child Food Insecurity Rate, % 22.5% 20.8% Feeding America 2a g Grocery Store Density, % 0.4% U.S. Department of Agriculture - Food Environment Atlas 2b Low-Income and Low Access to a h Grocery Store, % 15.4% U.S. Department of Agriculture - Food Environment Atlas 2b 2b 2b 2b i j k l Low-Income Persons who are SNAP Participants, % 12.3% Households without a Vehicle, % 5.3% 4.2% U.S. Department of Agriculture - Food Environment Atlas American Community Survey Mean travel time to work (minutes), workers age 16+, People Quick Facts Solo Drivers with a Long Commute, % 19.5% 12.2% County Health Rankings 2b m Workers who Walk to Work, % 2.4% 4.6% American Community Survey 34

36 Tab 3 Public Schools Health Delivery Profile Currently school districts are providing on site primary health screenings and basic care. TAB Health Indicator ELLIS CO 2015 TREND KANSAS 3 a Students Eligible for the Free Lunch Program, % 38.9% 34.2% Poverty Status by School Enrollment, 3 b % 12.9% 12.6% Student-to-Teacher Ratio (% Student / 3 c Teacher), NW Alliance (12) SOURCE National Center for Education Statistics American Community Survey National Center for Education Statistics 3 d High School Graduation, % 85.8% 84.6% Annie E. Casey Foundation Bachelor's degree or higher, percent of 3 e persons age 25+, % 32.1% 20.5% People Quick Facts # School Health Indicators Ellis Co 2015 Districts USD 489 USD 388 USD 432 Overall Ellis Co 2012 Trend 1 Total # Public School Nurses School Nurse is Part of the IEP Team Yes/No Yes yes As needed Yes 3 School Wellness Plan (Active) Yes yes Yes No 4 VISION: # Screened / Referred to Prof / 1707/ 150/ Seen by Professional 1636/130/34 285/7/6 250/8/ HEARING: # Screened / Referred to Prof / Seen by Professional 1234/17/1 285/10/7 250/2/2 1516/ 39/ 20 6 ORAL HEALTH: # Screened / Referred to 1328/ 132/ Prof / Seen by Professional 1197/54/0 259/25/15 Doing Soon 30 7 SCOLIOSIS: # Screened / Referred to Prof / Seen by Professional Per Athletic 0/0/0 0/0/0 Physical 0/ 0/ 0 8 # of Students Served with No Identified Chronic Health Concerns School has a Suicide Prevention Program No No As Needed No 10 Compliance on Required Vaccincations (%) 99% 100% 94% 100% 35

37 TAB 4 Maternal and Infant Health Profile Tracking maternal & infant care patterns are vital in understanding the foundation of family health. # Criteria - Vital Satistics ELLIS CO 2015 TREND KANSAS NW Alliance (12) a Total Live Births, ,815 1,293 b Total Live Births, ,388 1,317 c Total Live Births, ,439 1,274 d Total Live Births, ,628 1,315 e Total Live Births, ,304 1,370 f Total Live Births, Five year Rate (%) 14.0% 14.5% 11.5% TAB Health Indicator ELLIS CO 2015 TREND KANSAS 4 a Percent of Births Where Prenatal Care began in First Trimester, % 78.4% 78.9% Percentage of Premature Births, b % 9.0% 8.9% Percent of Births with Low Birth Weight, 4 c % 7.1% 7.6% Percent of births Where Mother Smoked 4 d During Pregnancy, NA 13.5% NA Percent of all Births Occurring to Teens 4 e (15-19), % 8.1% 7.6% Percent of Births Occurring to Unmarried 4 f Women, % 36.7% 31.3% Average Monthly WIC Participation per 4 g 1,000 population, % 23.6% 20.9% Percent of WIC Mothers Breastfeeding 4 h Exclusively, % 12.9% 14.6% NW Alliance (12) SOURCE Kansas Department of Health and Environment Kansas Department of Health and Environment Kansas Department of Health and Environment Kansas Department of Health and Environment Kansas Department of Health and Environment Kansas Department of Health and Environment Kansas Department of Health and Environment Kansas Department of Health and Environment 36

38 TAB 5 Hospitalization/Provider Profile Understanding provider access and disease patterns are fundamental in healthcare delivery. Listed below are several vital county statistics. 5 a Ratio of Population to Primary Care Physicians, Staffed Hospital Bed Ratio (per 1,000 5 b Pop), % 3.4% 13.1% Percent of Births with Inadequate Birth 5 c Spacing, % 11.0% 10.8% Kansas Department of Health and Environment Kansas Hospital Association Kansas Department of Health and Environment 5 d Preventable hospital stays 72 NA 64 County Health Rankings Heart Disease Hospital Admission Rate, Kansas Department of 5 e Health and Environment 5 f Congestive Heart Failure Hospital Chronic Admission Obstructive Rate, Pulmonary Disease Kansas Department of Health and Environment (COPD) Hospital Admission Rate, Kansas Department of 5 g Health and Environment 5 Bacterial Pneumonia Hospital Admission h Rate, Kansas Department of Health and Environment 5 i Injury Hospital Admission Rate, Kansas Department of Health and Environment Ellis County IP 2015 FFY2012 FFY2013 FFY2014 Trend 1 Total Discharges Total IP Discharges-Age 0-17 Ped Total IP Discharges-Age Total IP Discharges-Age Total IP Discharges-Age Total IP Discharges-Age Psychiatric Obstetric Surgical % 27.1% 25.1% 28.4% # KS Hospital Assoc PO103 Hays Medical Center (Only) FFY2012 FFY2013 FFY2014 Trend 1 Total Discharges Total IP Discharges-Age 0-17 Ped Total IP Discharges-Age Total IP Discharges-Age Total IP Discharges-Age Total IP Discharges-Age Psychiatric Obstetric Surgical % 24.8% 24.0% 27.1% # KS Hospital Assoc PO103 # Kansas Hospital AssocOP TOT223E FFY2012 FFY2013 FFY2014 Trend 1 ER Market Share - Hays Reg 92.8% 93.3% 92.5% 2 OPS Market Share - Hays Reg 70.9% 88.0% 88.6% 3 OP Market Share - Hays Reg 81.9% 78.9% 77.1% 37

39 TAB 6 Social & Rehab Services Profile Behavioral health care provide another important indicator of community health status. TAB Health Indicator ELLIS CO 2015 TREND KANSAS 6 a Depression: Medicare Population, % 16.2% 15.2% 6 b NW Alliance (12) SOURCE Centers for Medicare & Medicaid Services Alcohol-Impaired Driving Deaths, % 34.7% 36.4% County Health Rankings 6 c Inadequate social support 6% NA 16% County Health Rankings 6 d Poor mental health days 2.0 NA 2.8 County Health Rankings TAB 7 Health Risk Profiles Knowing community health risk factors and disease patterns can aid in the understanding next steps to improve health. Being overweight/obese; smoking, drinking in excess, not exercising etc can lead to poor health. TAB Health Indicator ELLIS CO 2015 TREND KANSAS 7a a % of Adults with High Cholesterol, % 38.1% 41.0% NW Alliance (12) SOURCE Kansas Department of Health and Environment 7a b Adult obesity 29% 30% 30% County Health Rankings Percent of Adults Who are Binge Kansas Department of 7a c Drinkers, % 15.4% 16.7% Health and Environment Percent of Adults Who Currently Smoke Kansas Department of 7a d Cigarettes, % 20.0% 22.0% Health and Environment % of Adults with Diagnosed Kansas Department of 7a e Hypertension, % 31.3% 31.7% Health and Environment 7a f % of Adults with Doctor Diagnosed Arthritis, % 23.9% 23.3% Kansas Department of Health and Environment 7a g % Physical inactivity 26.0% NA 25.0% County Health Rankings 7a % of Adults with Fair or Poor Selfh Public Perceived Water Health Supply Status, - Percent 2013of 10.7% 15.4% 12.4% Kansas Department of Health and Environment Population Served Unaffected by SDWA Kansas Department of 7a i Nitrate Violations, % 99.7% 96.2% Health and Environment 7a j Sexually transmitted infections 543 NA 369 County Health Rankings 38

40 TAB 7 Health Risk Profiles TAB Health Indicator ELLIS CO 2015 TREND KANSAS NW Alliance (12) SOURCE 7b a Hypertension: Medicare Population, % 52.7% 55.2% Hyperlipidemia: Medicare Population, 7b b % 39.3% 38.1% Rheumatoid Arthritis: Medicare 7b c Population, % 27.7% 33.5% Ischemic Heart Disease: Medicare 7b d Population, % 26.7% 29.7% 7b e Diabetes: Medicare Population, % 24.6% 23.0% 7b f Heart Failure: Medicare Population, % 14.0% 18.3% Chronic Kidney Disease: Medicare 7b g Population, % 13.9% 13.1% 7b h COPD: Medicare Population, % 11.0% 12.9% Alzheimer's Disease or Dementia: 7b i Medicare Pop % 9.9% 10.6% Atrial Fibrillation: Medicare Population, 7b j % 8.0% 9.3% 7b k Cancer: Medicare Population, % 8.0% 9.1% 7b l Osteoporosis: Medicare Population, % 6.1% 8.2% 7b m Asthma: Medicare Population, % 3.8% 3.5% 7b n Stroke: Medicare Population, % 3.2% 2.6% Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services Centers for Medicare & Medicaid Services TAB 8 Uninsured Profiles Based on state estimations, the number of insured is documented below. Also, the amount of charity care (last 3 years of free care) from area providers is trended below. # Charity Care by Individual Facility YR 2012 YR 2013 Yr 2014 TREND 1 Local Hospital Charity Care $2,276,103 $2,925,065 $1,834,923 TAB Health Indicator ELLIS CO 2015 TREND KANSAS NW Alliance (12) SOURCE 8 a Uninsured Adult Population Rate, % 17.6% 17.4% U.S. Census Bureau 39

41 TAB 9 Mortality Profile The leading causes of county deaths are listed below. Areas of higher than expected are so noted. Causes of Death by County ELLIS CO NW Alliance TREND KANSAS # of Residence, KS TOTAL , Major Cardiovascular Diseases 67 7, All Other Causes 53 4, All Malignant Neoplasms 52 5, Diseases of Heart 42 5, Ischemic Heart Disease 33 2, Malignant Neoplasms of Respiratory and 22 1, Chronic Lower Respiratory Diseases 20 1, Cerebrovascular Diseases 15 1, Alzheimer's Disease Pneumonia and Influenza Atherosclerosis Other Heart Diseases 9 2, Malignant Neoplasms of 13 Digestive Organs 9 1, Other Malignant Neoplasms 9 1, Suicide Diabetes Mellitus Residual Infection & 17 Parasistic Disease Motor Vehicle Accidents

42 TAB 9 Mortality Profile TAB Health Indicator ELLIS CO 2015 TREND KANSAS 9 a Life Expectancy for Females, b Life Expectancy for Males, c Infant Mortality Rate, % 6.4% 3.9% Age-adjusted Mortality Rate per 100,000 9 d population, Age-Adjusted Years of Potential Life Lost - 9 e Traffic Injury, Age-adjusted Cancer Mortality Rate per 9 f 100,000 population, Age-adjusted Heart Disease Mortality 9 g Rate Age-adjusted per 100,000 Chronic population, Lower Respiratory Disease Mortality Rate per 100,000 9 h population, Age-adjusted Traffic Injury Mortality 9 i Age-adjusted Rate per 100,000 Unintentional population, Injuries Mortality Rate per 100,000 population, 9 j Age-adjusted Suicide Mortality Rate per 9 k 100,000 population, NW Alliance (12) SOURCE Institute for Health Metrics and Evaluation Institute for Health Metrics and Evaluation Kansas Department of Health and Environment Kansas Department of Health and Environment Kansas Department of Health and Environment Kansas Department of Health and Environment Kansas Department of Health and Environment Kansas Department of Health and Environment Kansas Department of Health and Environment Kansas Department of Health and Environment Kansas Department of Health and Environment TAB 10 Preventive Health Profile The following table reflects future health of county. This information also is an indicator of community awareness of preventative measures. TAB Health Indicator ELLIS CO 2015 TREND KANSAS NW Alliance (12) SOURCE 10 a Access to Exercise Opportunities, % 70.9% 51.3% County Health Rankings % of Infants Fully Immunized at 24 Mo, Kansas Department of 10 b % 71.7% 78.6% Health and Environment 10 c 10 d 10 e Percent of Adults Ages 65 Yrs + Who Were Immunized Against Influenza Past 12 Mo, % 64.8% NA Percent of Adults Who Reported Consuming Fruit Less than 1 Time Per Day, % 41.7% NA Percent of Adults Who Reported Consuming Vegetables Less than 1 Time Per Day, % 22.9% NA Kansas Department of Health and Environment Kansas Department of Health and Environment Kansas Department of Health and Environment 10 f Diabetic screening 80% NA 86% County Health Rankings 10 g Mammography screening 75% NA 64% County Health Rankings 10 h % Annual check-up visit with PCP NA NA NA TBD 10 i % Annual check-up visit with Dentist NA NA NA TBD 10 j % Annual check-up visit with Eye Doctor NA NA NA TBD 41

43 Community Feedback Research For CHNA Round #2, it also important to gather community perspective from key stakeholders on their views of progress to address baseline CHNA needs documented 3 years ago. Below are findings of this online community primary research: Question 1- Overall Quality Ranking 42

44 Questions 5 & 6- Community Ranking of Healthcare Services 2015 Community Healthcare Needs Assessment 2015 How satisfied are you with each of the following...? CHNA NORM (23) N=8959 Poor / Very Poor % Hays 2012 PSA N=577 Hays 2015 PSA N=520 Trend a) Ambulance Service 3.5% 1.6% 1.6% 0.0% b) Child Care 9.1% 13.3% 12.2% -1.1% c) Chiropract or 4.7% 1.6% 0.9% -0.7% d) Dent ist s 7.8% 2.0% 3.1% 1.1% e) Emergency Room 10.6% 11.5% 17.2% 5.7% f) Eye Doctor / Optometrist 5.4% 1.0% 1.5% 0.5% g) Family Planning Services 14.6% 7.5% 17.3% 9.8% h) Home Healt h 6.3% 6.3% 10.4% 4.1% i) Hospice 5.0% 2.7% 4.2% 1.5% j) Hospit al I npat ient Services 5.5% 4.7% 7.2% 2.5% k) Ment al Health Services 31.1% 13.9% 21.8% 7.9% l) Nursing Home 13.2% 10.6% 12.7% 2.1% m) Outpat ient Services 4.2% 2.5% 3.5% 1.0% n) Pharmacy 2.2% 1.4% 1.1% -0.3% o) Primary Care Doctors 4.4% 5.6% 4.8% -0.9% p) Public Health Depart ment 5.8% 6.6% 6.2% -0.3% q) School Nurse 7.6% 4.3% 7.0% 2.7% r) Specialist Physician care 10.5% 8.1% 8.2% 0.1% 43

45 Question 7- Receiving Healthcare Services Outside our Community Community Healthcare Needs Assessment 2015 Over the past 2 years, did you or your household receive health care services outside of your county? CHNA NORM (23) N=8959 Hays 2012 PSA N=577 Hays 2015 PSA N=520 T re nd Yes No Totals 60.0% 36.6% 37.6% 1.0% 40.0% 63.4% 62.4% -1.0% 100% 100.0% 100.0% 44

46 Question 8- Requested Discussion Items for Town Hall Agenda Community Healthcare Needs Assessment 2015 In your opinion, what areas need additional education or attention in our community? CHNA NORM (23) N=8959 Hays 2012 PSA N=577 Hays 2015 PSA N=520 l) Obesity 8.2% 8.2% 4.2% b) Aging (Dement ia) 5.7% 6.7% 5.9% y) Drugs 2.3% 5.8% 3.5% k) Nutrit ion 5.5% 5.2% 3.1% a) Abuse / Violence 5.4% 5.2% 0.5% c) Alcohol 5.4% 7.0% 5.3% i) Ment al I llness 5.7% 4.6% 2.9% p) Prevent ative Healt hcare 5.5% 6.0% 4.6% n) Pain Management 3.8% 4.2% 3.1% x) Wellness Educat ion 4.8% 5.4% 2.2% t) Tobacco Use 4.8% 5.2% 3.5% u) Uninsured 5.2% 5.1% 5.3% e) Child Care 2.9% 4.7% 5.7% v) Vaccinat ions / I mmunizat ions 2.1% 2.0% 5.3% d) Alt ernative Medicine 3.3% 3.2% 1.8% f) Chronic Diseases 3.4% 3.4% 0.7% o) Povert y 4.5% 3.1% 2.8% j) Neglect 3.1% 2.9% 3.8% g) Family Planning / Birt h Control 3.8% 2.9% 4.6% s) Teen Pregnancy 4.8% 4.2% 5.6% w) Wat er Qualit y 2.4% 3.0% 7.7% r) Suicide 3.1% 3.7% 4.5% q) Sexually Transmit ted Diseases 2.3% 2.4% 4.5% h) Lead Exposure 0.8% 0.9% 3.0% m) Ozone (Air Qualit y) 0.6% 0.4% 5.4% Other (please specif y) 0.9% 0.5% 0.7% TOTALS 100.0% 100.0% 100.0% T re nd 45

47 IV. Inventory of Community Health Resources [VVV Research & Development, LLC] 46

48 Inventory of Health Services - Ellis County, KS Cat HC Services Offered in County: Yes / No Hospital Hlth Dept Other Clinic Primary Care y n y Hosp Alzheimer Center n n n Hosp Ambulatory Surgery Centers y n n Hosp Arthritis Treatment Center n n n Hosp Bariatric/Weight Control Services y n n Hosp Birthing/LDR/LDRP Room y n n Hosp Breast Cancer y n n Hosp Burn Care n n n Hosp Cardiac Rehabilitation y n n Hosp Cardiac Surgery y n n Hosp Cardiology Services y n n Hosp Case Management y n n Hosp Chaplaincy/Pastoral Care Services y n n Hosp Chemotherapy y n n Hosp Colonoscopy y n n Hosp Crisis Prevention y n y Hosp CT Scanner y n n Hosp Diagnostic Radioisotope Facility y n n Hosp Diagnostic/Invasive Catheterization y n n Hosp Electron Beam Computed Tomography (EBCT) y n n Hosp Enrollment Assistance Services y y n Hosp Extracorporeal Shock Wave Lithotripter (ESWL) y n n Hosp Fertility Clinic n n n Hosp Full Field Digital Mammography (FFDM) y n n Hosp Genetic Testing/Counseling y n n Hosp Geriatric Services y n n Hosp Heart y n n Hosp Hemodialysis y n n Hosp HIV/AIDSServices y n n Hosp Image-Guided Radiation Therapy (IGRT) y n n Hosp Inpatient Acute Care - Hospital Services y n n Hosp Intensity-Modulated Radiation Therapy (IMRT) 161 y n n Hosp Intensive Care Unit y n n Hosp Intermediate Care Unit y n n Hosp Interventional Cardiac Catherterization y n n Hosp Isolation Room y n n Hosp Kidney y n y Hosp Liver y n n Hosp Lung y n n Hosp Magnetic Resonance Imaging (MRI) y n n Hosp Mammograms y n n Hosp Mobile Health Services y n n Hosp Multislice Spiral Computed Tomography (<64 slice CT) y n n Hosp Multislice Spiral Computed Tomography (<64+ slice CT) y n n Hosp Neonatal n n n Hosp Neurological Services y n n Hosp Obstetrics y n n Hosp Occupational Health Services y n n Hosp Oncology Services y n n Hosp Orthopedic services y n n Hosp Outpatient Surgery y n n Hosp Pain Management y n n Hosp Palliative Care Program y n n Hosp Pediatric y n y Hosp Physical Rehabilitation y n y Hosp Positron Emission Tomography (PET) y n n Hosp Positron Emission Tomography/CT (PET/CT) y n n Hosp Psychiatric Services y n y Hosp Radiology, Diagnostic y n n Hosp Radiology, Therapeutic y n n 47

49 Inventory of Health Services - Ellis County, KS Cat HC Services Offered in County: Yes / No Hospital Hlth Dept Other Hosp Reproductive Health y n n Hosp Robotic Surgery n n n Hosp Shaped Beam Radiation System 161 y n n Single Photon Emission Computerized Tomography Hosp y n n (SPECT) Hosp Sleep Center y n n Hosp Social Work Services y n y Hosp Sports Medicine y n y Hosp Stereotactic Radiosurgery n n n Hosp Swing Bed Services y n n Hosp Transplant Services n n n Hosp Trauma Center y n n Hosp Ultrasound y n n Hosp Women's Health Services y n y Hosp Wound Care y n n SR Adult Day Care Program n n n SR Assisted Living n n y SR Home Health Services y n y SR Hospice y n n SR Long Term Care n n y SR Nursing Home Services n n y SR Retirement Housing n n y SR Skilled Nursing Care y n y ER Emergency Services y n n ER Urgent Care Center n n y ER Ambulance Services n n y SERV Alcoholism-Drug Abuse n n y SERV Blood Donor Center n n y SERV Chiropractic Services n n y SERV Complementary Medicine Services n n y SERV Dental Services n n y SERV Fitness Center y n y SERV Health Education Classes y n y SERV Health Fair (Annual) n y y SERV Health Information Center y y y SERV Health Screenings y y y SERV Meals on Wheels y n y SERV Nutrition Programs y y n SERV Patient Education Center y y y SERV Support Groups y n y SERV Teen Outreach Services n n n SERV Tobacco Treatment/Cessation Program n n y SERV Transportation to Health Facilities n n y SERV Wellness Program y n y 48

50 2015 Physician Manpower - Ellis County, KS # of FTE Providers Supply Working in County # of # of Physicians PA's/NP's County County Based Based Primary Care: Family Practice Internal Medicine Obstetrics/Gynecology Pediatrics Medicine Specialists: Allergy/Immunology 0.5 Cardiology Pediatric Cardiology 0.0 Dermatology Endocrinology 0.0 Gastroenterology 0.0 Oncology/RADO Infectious Diseases 0.0 Nephrology 2.0 Neurology 0.0 Psychiatry 3.0 Pulmonary 1.0 Rheumatology 0.0 Pathology 2.0 Child Neurology 0.0 Surgery Specialists: General Surgery Neurosurgery 0.0 Ophthalmology 3.0 Orthopedics Otolaryngology (ENT) 1.0 Plastic/Reconstructive Thoracic/Cardiovascular/Vasc Urology Oral Surgery 3.0 Spine Surgery 1.0 Hospital Based: Anesthesia/Pain 5.0 Emergency Radiology 6.0 Pathology 4.0 Hospitalist * Neonatal/Perinatal 0.0 Physical Medicine/Rehab 0.0 Dentistry 18.0 TOTALS

51 Specialty Clinic Outreach Schedule Name of Specialty Telephone # Location Cardiology Dr. Anaya monthly unless noted Dodge City twice a month Great Bend Lakin Russell- twice a month Dr. Carter monthly Dighton LaCrosse Dr. Fisher monthly unless noted Colby twice a month Hill City Larned Tribune Dr. Freeman monthly Colby Ness City Norton Oakley Phillipsburg Dr. Janif monthly unless noted Great Bend twice a month Plainville twice a month Scott City Dr. Pandit monthly unless noted Atwood Great Bend Larned Jetmore Norton St. Francis Dr. Thapa monthly unless noted Quinter Scott City- twice a month Tribune WaKeeney ENT Dr. Black Quinter - 2 times a month (1 visit for surgery) Plainville once a month 50

52 Mobile Cardiovascular Screening Mobile Echo Only Mobile Mammography Mobile Ultrasound, Echo, Vascular OB/GYN Oncology Contact the local radiology department for an appointment Contact the local hospital for an appointment Contact the local radiology department for an appointment Quarterly Oakley Hill City Phillipsburg Ransom Scott City Weekly Norton Osborne Atwood every 4 weeks Dighton - every 6 weeks Franklin, NE every 4 weeks Great Bend Monday through Friday Hill City every 3 weeks Hoxie every 4 weeks Kinsley every 4 weeks LaCrosse every 4 weeks Lakin every 8 weeks Larned every 3 weeks Leoti- quarterly Oakley every 3 weeks Phillipsburg every 3 weeks Ransom quarterly Sharon Springs every 8 weeks St. Francis every 4 weeks Syracuse every other month Tribune every 8 weeks Atwood - weekly Dighton - weekly Great Bend - M-F (Ultrasound) and Tuesday (Echo) Hill City twice a week Hoxie - weekly Larned 3 times a week Oakley 2 times a week Oberlin - weekly Phillipsburg twice a week Ransom - weekly Dr. Fort Monthly Great Bend Dr. Hodny Monthly Great Bend Dr. Lloyd Monthly Great Bend Dr. Weber Monthly Great Bend Dr. Abuerreish - monthly Colby Larned Dr. Fields Colby twice a month Dr. O Dea monthly Norton Quinter 51

53 Ophthalmology Dr. McDonald Beloit- Surgery & Clinic once a month Larned Surgery & Clinic once a month Smith Center- Surgery & Clinic once a month Dr. Pokorny Alma, NE -Surgery & Clinic once a month LaCrosse Clinic once a month Norton - Surgery & Clinic once a month Phillipsburg - Surgery & Clinic once a month Orthopedic Surgery Surgery Urology Dr. Cheema monthly Great Bend Larned Quinter Tribune (Jared Reed, PA-C) Dr. DeCarvalho - monthly Hill City Norton Scott City three times a month Dr. Lee - monthly Colby two times a month Oakley WaKeeney Dr. Sharma (spine) monthly Colby (Rebecca Green, PA-C) Great Bend Larned Dr. Cunningham - monthly Dodge City Larned Phillipsburg Plainville Dr. Hornick - monthly Russell Phillipsburg Dr. Schultz monthly Hoxie Oakley Phillipsburg Plainville Quinter WaKeeney Dr. Teget monthly Great Bend Norton Smith Center Dr. Tsereteli monthly Hill City Plainville Dr. Azzouni monthly Dodge City Great Bend Larned Norton Phillipsburg Dr. McDonald monthly 52

54 Wound Care Dodge City Goodland Great Bend Larned Scott City Dr. Werth monthly Colby Dodge City Great Bend Scott City Ed Habash, PA - 3 times a week Great Bend Norton - weekly Schedules are tentative and subject to change on occasion. 53

55 Ellis County Area Health Services Directory Emergency Numbers Police/Sheriff 911 Fire 911 Ambulance 911 Non-Emergency Numbers Ellis County Sheriff Ellis County Ambulance Municipal Non-Emergency Numbers Police/Sheriff Fire Hays Catharine Ellis Pfeifer Schoenchen Victoria Walker To provide updated information or to add new health and medical services to this directory, please contact: Ellis County Extension 601 Main Street, Suite A (Hays)

56 Other Emergency Numbers Health Services Hospitals Kansas Child/Adult Abuse and Neglect Hotline Domestic Violence Hotline Emergency Management (Topeka) Federal Bureau of Investigation htm Kansas Arson/Crime Hotline 800-KS-CRIME Kansas Bureau of Investigation (Topeka) Kansas Crisis Hotline (Domestic Violence/Sexual Assault) 888-END-ABUSE Kansas Road Conditions KDOT Poison Control Center Suicide Prevention Hotline 800-SUICIDE TALK Toxic Chemical and Oil Spills Hays Med 2220 Canterbury Drive (Hays) Hays Med Services Include: Billing/Financial Dietary Education Community Programs Professional Programs Fitness Center Aquatics Child Care Massage Therapy Nutrition Personal Training Swimming Lessons Hospice Hospitalists Imaging Lifeline Occupational Therapy General Orthopaedic Hand Care Center Neurological Rehabilitation Sports Medicine Palliative Care Pharmacy Rehabilitation (In-Patient) Rehabilitation (Out-Patient) Respiratory Therapy BiPAP/CPAP Breathing Exercises Delivering Aerosolized Drugs Management of Life Support Oxygen Therapy Pulmonary Function Diagnostic Testing Senior Focused Care Sleep and Neurodiagnostic Sleep Disorder Test Special Nursing Services Sports Medicine Volunteer Services Wound Healing and Hyperbaric Weight Loss Surgery WorkSMART Health Department safety Ellis County Health Department 601 Main Street (Hays) Ellis County Health Department Services Include: -Monitor health status to identify community health problems -Diagnose and investigate health problems in the community -Inform, educate, and empower people about health issues -Mobilize community p[partnerships to identify and solve health problems -Develop policies and plans that support individual and community health efforts -Enforce laws that protest health and ensure 55

57 Mental Health -Link people to needed personal health services and ensure the provision of health care when otherwise unavailable -Assure a competent public health and personal health care workforce -Evaluate personal and population based health services -Research for new solutions to health problems High Plains Mental Health Center 208 East 7 th Street (Hays) Medical Professionals Clinics First Care Clinic 105 West 13 th Street (Hays) Knoll Clinic 1106 East 27 th, Suite 2 (Hays) Hess Medical Clinic 2201 Canterbury Drive (Hays) Surgical Associates of Hays 2501 East 13 th Street (Hays) Chiropractors Advanced Chiropractic Clinic 2721 Canal Boulevard (Hays) Arnett Chiropractic Care 2705 Vine (Hays) Davidson Chiropractic Clinic 1905 Vine (Hays) Great Plains Chiropractic 1011 West 27 th Street (Hays) Koerner Chiropractic 2707 Vine Street, Suite 1 (Hays) Mark Schupman 1011 West 27 th (Hays) Riverside Chiropractic 4333 Vine Street (Hays) Robin C. Hale 2705 Vine (Hays) Steimel Chiropractic Office 107 East 27 (Hays) Solomon Chiropractic 206 West 8 th (Hays) Stuart Chiropractic 2919 Hall Street (Hays) Specialty Clinics Center Dentists Kelly A. Christine 1010 Downing Avenue (Hays) Heartland Dermatology and Skin Cancer 2707 Vine, Suite 10 (Hays) High Plains Cardiology 2214 Canterbury Drive (Hays) Nuclear Oncology 718 Main Street (Hays) Renal Care Group 2905 Canterbury Drive (Hays) Cedar Lodge Dental Group 1001 Cody Avenue (Hays) Complete Family Dentistry 2703 Hall (Hays) Daniel R. Loftus 2501 Canterbury Drive ( Kurt L. Glendening 2707 Vine, Suite 3 (Hays) Larry R. Good 3005 Hall Street (Hays) 56

58 Optometrists Physicians Leiker Orthodontics 1010 Downing Avenue (Hays) Les Ward 3001 Hall (Hays) Lifetime Dental Care 2701 Sternberg Drive (Hays) Lynn Kinderknecht 2770 Hall (Hays) Miner Family Dentistry 1010 Downing Avenue, Suite 10 (Hays) Purviance Dental Lab 2707 Vine Street (Hays) Candy K. Charowhas 4301 Vine (Hays) Hattan & Akers Family Eye Care 1517 East 27 th (Hays) Krug & Jones Family Eye Care 2203 Canterbury Drive (Hays) Schmidt & Robben 625 East 8 th Street (Hays) Travis Kinderknecht 2214 Canterbury Drive (Hays) HMC Physician Practice 1403 Main (Hays) Michael B. Lasley 2501 East 13 th Street, Suite 7 (Hays) Ronald R. Holweger 2503 Canterbury Drive (Hays) Rehabilitation Services FE T. Villarante 208 East 8 th, Suite B (Hays) Hays Rehabilitation Center 2220 Canterbury Drive (Hays) Progressive Physical Therapy Center 2209 Canterbury, Suite B (Hays) SKIL of Western Kansas 1013 Centennial Boulevard (Hays) Other Health Care Services General Health Services Ellis County Health Department 601 Main Street (Hays) Good Samaritan Society Home Health of Central Kansas 205 East 7 th Street, Suite 300A (Hays) Assisted Living/Nursing Homes/TLC Diabetes Brookdale-Sterling House 1801 East 27 th Street (Hays) Cedarview Assisted Living 2929 Sternberg Drive (Hays) Good Samaritan Society 27 & Canal (Hays) Schoenberger Nursing Agency 106 West 10 th Street (Hays) St. John Assisted Living 2225 Canterbury (Hays) Arriva Medical

59 Diabetes Care Club Disability Services American Disability Group Kansas Department on Aging Domestic/Family Violence Food Programs Child/Adult Abuse Hotline e_services.htm Family Crisis Center (Great Bend) Hotline: Business Line: Kansas Crisis Hotline Manhattan Sexual Assault/Domestic Violence Center (Hutchinson) Hotline: Business Line: Hays Meal Site 1035 Highway 40 Bypass (Hays) Kansas Food Bank 1919 East Douglas (Wichita) Health and Fitness Centers The Center for Health Improvement 2500 Canterbury Drive (Hays) Curves for Women 1702 Vine Street (Hays) Main Street Gym & Fitness 806 Main Street (Hays) Sun Yi s Academy of Taw Kwon Do Karate 806 Main Street (Hays) Home Health Hospice U-Save Pharmacy 2505 Canterbury Drive (Hays) Good Samaritan Society Home Health of Central Kansas 205 East 7 th Street, Suite 300A (Hays) Hospice/Palliative Care at Haysmed 2220 Canterbury (Hays) Massage Therapy Massage by Wanda Massage Therapy Associates 2707 Vine Street, Suite 4 (Hays) Studio Ultimate Massage 205 East 7 th Street, Suite 219 (Hays) Medical Equipment and Supplies School Nurses American Medical Sales and Repair Apria Healthcare 2009 Vine Street (Hays) Felten Middle School 29 & Fort (Hays) Hays Public Schools USD 489 Lincoln Elementary School 1906 Ash (Hays) Kathryn O Loughlin McCarthy Elementary School 1401 Hall (Hays) Roosevelt Elementary School 2000 MacArthur Road (Hays) Washington Elementary School 58

60 Senior Services 305 Main (Hays) Wilson Elementary School 101 East 28 (Hays) Felten Middle School 201 West 29 th (Hays) Kennedy Middle School 1309 Fort (Hays) Hays High School 2300 East 13 th (Hays) High Plains Christian School 2700 Canterbury Road (Hays) Holy Family Elementary School 1800 Milner Street (Hays) Little Sprouts Preschool and Childcare Center 2818 Grant Avenue (Hays) Thomas More Prep 1701 Hall (Hays) Kansas Department on Aging Northwest Kansas Area Agency on Aging 510 West 29 th Street (Hays) Schoenberger Nursing Agency 106 West 10 th Street (hays) Veterinary Services The Animal Health Center of Hays 3340 East 27 th Street (Hays) Hays Veterinary Hospital 1016 East 8 th Street (Hays) Hillside Veterinary Clinic 5250 North Vine Street (Hays) Rohleder Veterinary Services 1954 Vineyard Road (Hays) Local Government, Community, and Social Services Adult Protection Adult Protective Services (SRS) Elder Abuse Hotline Alcohol and Drug Treatment Alcohol and Drug Abuse Services Alcoholics Anonymous 410 Oak (Hays) Dream Incorporated 2818 Vine (Hays) G&G Addiction Treatment Center Seabrook House Smokey Hill Foundation for Chemical Dependency 209 East 7 th Street (Hays) The Treatment Center Children and Youth Children s Alliance 627 Southwest Topeka Boulevard (Topeka) Kansas Children s Service League Crime Prevention Ellis County Sheriff 105 West 12 th Street (Hays) Ellis Police Department 815 Jefferson Street #A (Ellis) 59

61 Hays Police Department 105 West 12 th Street #112 (Hays) Highway Patrol Department 1821 Frontier Road (Hays) Victoria Police Department th Street (Victoria) Day Care Providers Adult Hays Med 2220 Canterbury Drive (Hays) Day Care Providers - Children Extension Office Funeral Homes Happy Days Childcare & Preschool 216 West 38 th Street (Hays) Hays Area Children s Center 94 Lewis Drive (Hays) Little Sprouts Preschool 2818 Grant Avenue (Hays) Ellis County Extension 601 Main Street, Suite A (Hays) Brock s North Hill Chapel 2509 Vine Street (Hays) Cline s Mortuary 1919 East 22 nd Street (Hays) (Victoria) Hays Memorial Chapel 20 & Pine (Hays) Keithley Funeral Chapel Head Start Housing Legal Services 400 East 17 th Street (Ellis) Head Start 320 West 13 th (Hays) Hays Housing Authority 1709 Sunset Terrace (Hays) Anderson & Wichman 1400 Main (Hays) Bittel & Johnson & Oller 111 West 10 th Street (Hays) Caleb Boone Attorney at Law 1200 Main (Hays) Clinkscales Elder Law Practice 201 West 11 th Street (Hays) Court Trustee 3000 Broadway Avenue (Hays) Don C. Staab 1301 Oak (Hays) Dreiling, Bieker, & Hoffman 111 West 13 th Street (Hays) Glassman, Bird, Braun & Schwartz 200 West 13 th Street (Hays) Jack Curtis Box 807 (Hays) Jeter Law Firm 1200 Main, Suite 202 (Hays) John C. Herman 235 West 10 th Street (Hays)

62 Kansas Legal Services 2017 North Vine (Hays) Law Office of Michael N. Flesher 209 Highland Avenue (Hays) Leslie Hess 1200 Main (Hays) Melvin J. Sauer, Junior 111 West 1 Northwest Kansas Area Agency on Aging 510 West 29 th Street (Hays) Ross J. Wichman 1400 Main (Hays) Seibel Law Office 1805 West 27 th Street (Hays) Simon Roth 108 West 25 (Hays) Stan Basgall Attorney at Law 2703 Hall Street (Hays) Thomas M. Wasinger 110 East 12 th (Hays) Thomas C. Boone 1200 Main, Suite 304 (Hays) Willis K. Musick 107 West 13 (Hays) East US Highway 40 Bypass (Hays) Hays Public Library 1205 Main Street (Hays) State of Kansas Wildlife & Parks 1426 US Highway 183 (Hays) Victoria Municipal Pool 603 Iron Street (Victoria) Pregnancy Services Adoption is a Choice Adoption Network Adoption Spacebook Graceful Adoptions Kansas Children s Service League Ellis County Health Department 601 Main Street (Hays) Public Information Chamber of Commerce 2700 Vine Street (Hays) Libraries, Parks and Recreation Buffalo Hills Park 2400 East 7 th Street (Hays) Ellis Public Library 907 Washington Street (Ellis) Forsyth Library 600 Park Street (Hays) Hays Park Department Rape Red Cross Domestic Violence and Rape Hotline Family Crisis Center th Street (Great Bend) Kansas Crisis Hotline Manhattan

63 Social Security Transportation American Red Cross 208 East 8 th Street (Hays) Social Security Administration Access Transportation 1205 East 22 nd Street (Hays) Development Services of Northwest Kansas 1205 East 25 (Hays) State and National Information, Services, Support Adult Protection Adult Protection Services Domestic Violence and Sexual Assault (DVACK) Elder Abuse Hotline Elder and Nursing Home Abuse Legal Kansas Coalition Against Sexual and Domestic Violence END-ABUSE ( ) Kansas Department on Aging Adult Care Complaint Program NationalCenter on Elder Abuse (Administration on Aging) p_hotline.aspx National Domestic Violence Hotline SAFE( ) (TTY) National Sexual Assault Hotline (TTY) National Suicide Prevention Lifeline Poison Center Sexual Assault and Domestic Violence Crisis Line Social and Rehabilitation Services (SRS) (HAYS) Suicide Prevention Helpline Alcohol and Drug Treatment Programs Center A 1 A Detox Treatment AAAAAH Abandon A Addiction Able Detox-Rehab Treatment (NATIONAL) Abuse Addiction Agency AIC (Assessment Information Classes) Al-Anon Family Group AL-ANON ( ) Alcohol and Drug Abuse Hotline 800-ALCOHOL Alcohol and Drug Abuse Services Alcohol and Drug Addiction Treatment Programs Alcohol and Drug Helpline Alcoholism/Drug Addiction Treatment

64 Kansas Alcohol and Drug Abuse Services Hotline Mothers Against Drunk Driving GET-MADD ( ) National Council on Alcoholism and Drug Dependence, Inc NCA-CALL ( ) Recovery Connection Regional Prevention Centers of Kansas Better Business Bureau Better Business Bureau 328 Laura (Wichita) Children and Youth Adoption Boys and GirlsTown National Hotline Child/Adult Abuse and Neglect Hotline Child Abuse Hotline Child Abuse National Hotline (TDD) Child Abuse National Hotline A-CHILD ( ) Child Find of America Child Help USA National Child Abuse Hotline Child Protective Services ces.htm HealthWave P.O. Box 3599 Topeka, KS (TTY) Heartspring (Institute of Logopedics) 8700 E. 29 TH North Wichita, KS Kansas Big Brothers/Big Sisters KS4-BIGS Kansas Children s Service League (Hays) Kansas Department of Health and Environment info@kdheks.gov Kansas Society for Crippled Children 106 W. Douglas, Suite 900 Wichita, KS National Runaway Switchboard RUNAWAY National Society for Missing and Exploited Children THE-LOST ( ) Parents Anonymous Help Line ml Runaway Line (TDD) Talking Books Community Action Peace Corps Public Affairs Hotline (Kansas Corporation Commission) 63

65 Counseling Care Counseling Family counseling services for Kansas and Missouri Carl Feril Counseling 608 North Exchange (St. John) CastlewoodTreatmentCenter for Eating Disorders Catholic Charities Center for Counseling 5815 West Broadway (Great Bend) Central Kansas Mental HealthCenter Will roll over after hours to a crisis number. Consumer Credit Counseling Services Kansas Problem Gambling Hotline National Hopeline Network SUICIDE ( ) National Problem Gambling Hotline SamaritanCounselingCenter 1602 N. Main Street Hutchinson, KS Self-Help Network of Kansas Senior Health Insurance Counseling Sunflower Family Services, Inc. (adoption, crisis pregnancy, conflict solution center) Disability Services American Association of People with Disabilities (AAPD) American Council for the Blind Americans with Disabilities Act Information Hotline (TTY) Disability Advocates of Kansas, Incorporated Environment Disability Group, Incorporated DisabilityRightsCenter of Kansas (DRC) Formerly Kansas Advocacy & Protective Services (TTY) Hearing Healthcare Associates Kansas Commission for the Deaf and Hearing Impaired Kansas Relay Center (Hearing Impaired service) NationalCenter for Learning Disabilities National Library Services for Blind & Physically Handicapped Parmele Law Firm 8623 East 32 nd Street North Suite 100 (Wichita) Big Bend Ground Water Management 125 S Main St. (Stafford) Environmental Protection Agency (TTY) 64

66 Food and Drug Health Services Kansas Department of Health and Environment Salina Hays Topeka Center for Food Safety and Applied Nutrition SAFEFOOD ( ) US Consumer Product Safety Commission (TDD) USDA Meat and Poultry Hotline (TTY) U.S. Food and Drug Administration INFO-FDA Poison Hotline AIDS/HIV Center for Disease Control and Prevention 800-CDC-INFO (TTY) AIDS/STD National Hot Line AIDS (STD line) American Health Assistance Foundation American Heart Association American Lung Association American Stroke Association STROKE heart.org Center for Disease Control and Prevention 800-CDC-INFO (TTY) Hospice Housing Legal Services Elder Care Helpline Eye Care Council EYES Kansas Foundation for Medical Care National Health Information Center National Cancer Information Center (TTY) National Institute on Deafness and Other Communication Disorders Information Clearinghouse (TTY) Hospice-Kansas Association Kansas Hospice and Palliative Care Organization Southwind Hospice, Incorporated Kansas Housing Resources Corporation US Department of Housing and Urban Development Kansas Regional Office Kansas Attorney General (Consumer Protection) (Crime Victims Rights) (TTY) Kansas Bar Association

67 Kansas Department on Aging Kansas Legal Services Southwest Kansas Area Agency on Aging 240 San Jose Drive Dodge City, KS (316) Medicaid Services First Guard Kansas Health Wave or (TTY) Kansas Medical Assistance Program Customer Service Medicare Information 800-MEDICARE U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services 800-MEDICARE ( ) or (TTY) Mental Health Services Kansas Alzheimer's Association or (TTY) Developmental Services of Northwest KansasAlliance for Mentally Ill(Topeka, KS) Make a Difference Mental Health America MHA ( ) National Alliance for the Mentally Ill Helpline NAMI ( ) or (TTY) Nutrition National Institute of Mental Health or (TTY) National Library Services for Blind and Physically Handicapped National Mental Health Association (TTY) Pawnee Mental Health State Mental Health Agency KS Department of Social and Rehabilitation Services 915 SW Harrison Street Topeka, KS Suicide Prevention Hotline SUICIDE [ ] American Dietetic Association American Dietetic Association Consumer Nutrition Hotline Department of Human Nutrition KansasStateUniversity 119 Justin Hall Manhattan, KS Eating Disorders Awareness and Prevention Food Stamps Kansas Department of Social and Rehabilitation Services (SRS) or Local SRS office Kansas Department of Health and Environment 1000 SW Jackson, Suite 220 Topeka, KS Road and Weather Conditions 66

68 Senior Services Kansas Road Conditions KDOT Alzheimer's Association American Association of Retired Persons (AARP) OUR-AARP ( ) Americans with Disabilities Act Information Line or [TTY] American Association of Retired Persons Area Agency on Aging Eldercare Locator Home Buddy Home Health Complaints Kansas Department of Social and Rehabilitation Services (SRS) Kansas Advocates for Better Care Inc. Consumer Information Kansas Department on Aging or (TTY) Kansas Foundation for Medical Care, Inc. Medicare Beneficiary Information Kansas Tobacco Use Quitline KAN-STOP ( ) Older Kansans Employment Programs (OKEP) Older Kansans Hotline Older Kansans Information Reference Sources on Aging (OKIRSA) Senior Health Insurance Counseling for Kansas SHICK Social Security Administration or (TTY) SRS Rehabilitation Services Kansas (TTY) Suicide Prevention Veterans Suicide Prevention Services FederalInformationCenter U.S. Department of Veterans Affairs Helpline Education (GI Bill) HealthResourceCenter InsuranceCenter Veteran Special Issue Help Line Includes Gulf War/Agent Orange U.S. Department of Veterans Affairs Mammography Helpline Other Benefits Memorial Program Service [includes status of headstones and markers] Telecommunications Device for the Deaf/Hearing Impaired 67

69 (TTY) Veterans Administration Veterans Administration Benefits Testing Life Insurance Education (GI Bill) Health Care Benefits Income Verification and Means Mammography Helpline Gulf War/Agent Orange Helpline Status of Headstones and Markers Telecommunications Device for the Deaf Benefits Information and Assistance Debt Management Life Insurance Information and Service Welfare Fraud Hotline Welfare Fraud Hotline Index 68

70 V. Detail Exhibits [VVV Research & Development, LLC] 69

71 Patient Origin & Access [VVV Research & Development, LLC] 70

72 Ellis County IP 2015 FFY2012 FFY2013 FFY2014 Trend 1 Total Discharges Total IP Discharges-Age 0-17 Ped Total IP Discharges-Age Total IP Discharges-Age Total IP Discharges-Age Total IP Discharges-Age Psychiatric Obstetric Surgical % 27.1% 25.1% 28.4% # KS Hospital Assoc PO103 Hays Medical Center (Only) FFY2012 FFY2013 FFY2014 Trend 1 Total Discharges Total IP Discharges-Age 0-17 Ped Total IP Discharges-Age Total IP Discharges-Age Total IP Discharges-Age Total IP Discharges-Age Psychiatric Obstetric Surgical % 24.8% 24.0% 27.1% # KS Hospital Assoc PO103 # Kansas Hospital AssocOP TOT223E FFY2012 FFY2013 FFY2014 Trend 1 ER Market Share - Hays Reg 92.8% 93.3% 92.5% 2 OPS Market Share - Hays Reg 70.9% 88.0% 88.6% 3 OP Market Share - Hays Reg 81.9% 78.9% 77.1% 71

73 Town Hall Attendees Notes & Feedback [VVV Research & Development, LLC] 72

74 Ellis County, KS Town Hall Roster N=30 Date: 03/11/15 First Name Last Name Organization Address/City/ST/Zip Regina Borthwick HaysMed 2220 Canterbury Hays KS Bryan Brady First Care Clinic FQHC 105 W. 13, Hays, KS Erica Burges United Way of Ellis County 205 East 7th, Suite 106, Hays, KS William Cadoret HaysMed 2220 Canterbury Hays KS Bill Davis Turning Point 124 E. 12th, Hays, KS Sarah Dreiling HaysMed 2220 Canterbury Hays KS Grace Evans Via Christi Village 2225 Canterbury, Hays, KS Sandra Gottschalk North Central Kansas Tech School 2205 Wheatland Ave, Hays KS Ruth Heffel HaysMed Foundation 2200 Canterbury, Hays, KS Stephanie Howie HaysMed 2220 Canterbury Hays KS JoBeth Jackson Regional Prevention Center 209 E. 7th Hays, KS John Jeter HaysMed 2220 Canterbury Hays KS Kristin Koster Hays Rec. Commission 1105 Canterbury Drive Hays, KS Rich Kramer Insurance Planning 3006 Broadway Ave., Hays, KS Jackie Loos USD 489 Hays High School 2300 East 13th Hays, KS Kerry McCue Ellis Co EMS 1009 Cody Ave. Hays Ks Monica Ptacek Early Childhood Connections 2300 East 13th Hays, KS Dave Quillin Hays Rec. Commission 1105 Canterbury Drive Hays, KS Dr. Richard Rajewski Hays Family Medicine 2509 Canterbury Dr. Hays, KS Robert Schyler Public Health Department 601 Main, Hays, KS Mary Ann Shamen Hays Middle School 201 W 29th St, Hays, KS Terry Siek HaysMed 2220 Canterbury Hays KS Jodi Sproul Regional Prevention Center 209 E. 7th Hays, KS Kent Steward City of Hays PO Box 490 Hays KS Shae Veach HaysMed 2220 Canterbury Hays KS Aaron White Ellis County Coalition for EcoD 2700 Vine St. Hays, KS Gayla Wichman HaysMed 2220 Canterbury Hays KS *Three Town Hall attendees did not sign the roster 73

75 Ellis County Community Health Needs Assessment Meeting n=30 County Health Rankings: Why so poor on the physical??? WATER TAB 2: Economic/Business Profile Economic Factors like Oil come into play, it is down now TAB 3: Educational Profile Screenings are required by law, they are actually doing it. Vision every 2 years, hearing every 3 years TAB 7: Risk Indicators/Factors Profile Have a big issue in Public Health with STIs, state doesn t investigate anymore because they are so commonplace (i.e. gonorrhea) TAB 8: Uninsured Profile The Supreme Court might have something to do with healthcare in the future o Don t perceive that many people here have insurance off the exchange, it is only going to affect those people o Regulatory and expansion of Medicaid will help- they do not have Medicaid o Future of FQHCs? Critical Access Hospitals? A lot at Federal level to consider STRENGTHS: Collaborative Community Walk-In Clinic at Oak Park Sound Education System Walking Club Good Acute Care Hospital Complete Healthcare Pressure of being a Regional Leader (makes them better) Safe Community Activities for Senior Population Good Community Health with Support Groups Schools are Supportive of Struggling Families Good Doctors Longevity Work Well Kanas 74

76 Access to Fitness/Wellness Strong Local Economy WEAKNESSES: Placement for Mental Health Services More Senior Care (Skilled Care) Gerontology Specialty Family Support/Infrastructure Inpatient Dementia Care Access to Dental Care for Medicaid/Uninsured Personal Responsibility in Healthcare Affordable Healthy Food Options More Primary Care Physicians Sources/Quality of Water Hays Public Transportation Affordable Rent/Housing Medical Billing Issues Homeless Shelter Drug Abuse Affordable Handicap Housing No Medical Detox Locally Isolation of Mental Health Lack of Family Planning Knowledge of Available Healthcare Services Alcohol in the Community Community Healthcare Stakeholder Communication Lack of Childcare Providers Tobacco 75

77 Public Notice & Invitation [VVV Research & Development, LLC] 76

78 HaysMed To Conduct Community Health Needs Assessment Survey Update For Immediate Release: Jan 22, 2015 HaysMed is working with other Ellis County Kansas health providers to update the 2012 community health needs assessment. Results of this update will be compiled and prioritized to help guide the hospital s implementation plans to address health care needs and fulfill both federal and state requirements. Starting the week of February 2 nd, surveys will be mailed to 2800 randomly selected Ellis county residents with a deadline of Friday Feb 27 th. (Note: If you would like to participate and do not receive a mailed survey, please go to to complete the survey online). Copies of the paper survey will also be available for pickup at HaysMed at the Information Desks in the Miller Medical Pavilion Entrance B, Main Entrance C and at The Center for Health Improvement. All Ellis County KS residents and business leaders are encouraged to participate. Included in the 2015 CHNA surveys are questions dealing with community health regarding service delivery, fitness, nutrition, and access to care. All survey responses are anonymous and completing the survey takes less than 10 minutes. VVV Research & Development, LLC, an independent research firm from Olathe, Kansas has been retained to conduct this countywide research. If you have any questions about the survey or survey process, please call

79 Hays Med LOGO Date: Feb 23, 2015 For Immediate Release NEWS In order to gauge the overall health needs of Ellis County residents, Hays Medical Center is working together with other community providers to conduct a community wide healthcare needs assessment. To ensure that all county residents have an opportunity to participant, the deadline to complete this assessment has been extended to Friday March 4th, If you would like to participate and did not receive a mailed paper survey, please either complete the assessment online by entering the following link into your browser: or drop by Hays Medical Center to pick up a paper survey. Again it is important that all assessment surveys be completed and returned by Friday March 6 th, All survey responses are anonymous and completing the survey takes less than 10 minutes. In addition, a Town Hall meeting will be held on Wednesday, March 11 th, 2015 at Hays Medical Center from 11:30am-1pm. Persons invited to the Town Hall meeting represent all segments of Ellis County s population. 78

80 DATE Firstname Lastname Organization ADDRESS CITY ST ZIP Dear Community Health Partner; To fulfill IRS Community Health Needs Assessment requirements, Hays Medical Center held a Town Hall meeting in March of During this Town Hall meeting, a list of community health needs were discussed and ranked. Now, we need to take a second step to develop an implementation plan to address each community health need cited. Hays Medical Center values your input as a community health stakeholder to promote quality health delivery. Today, we are organizing a working lunch meeting to gather community health improvement action steps and need your participation. (Note: During this meeting, we will review the list of community health needs and then brainstorm on how we will address each of these issues). The details of the meeting are as follows: May 21st, 2015 Hadley Room 1 11:30 to 1:00 p.m. Thank you for your continued support as we complete our Community Health Needs Assessment work. We truly appreciate your time & effort to participate on Thursday May 21 st Sincerely, Shae Veach VP Regional Operations Hays Medical Center 79

81 In a message dated 2/11/ :35:06 A.M. Central Standard Time, tammy.jacobs@haysmed.com writes: Re: Community Health Needs Assessment Butch, It was nice visiting with you this morning. I ve attached the link to the HaysMed website. The CHNA survey link is on the front page. Thanks for helping get the word out about the survey and encouraging folks to take it. I appreciate it! See you on March 11 th. Thanks, Tammy Tammy Jacobs Regional Health Hays Medical Center (785) phone (785) fax tammy.jacobs@haysmed.com 80

82 In a message dated 2/12/2015 3:00:49 P.M. Central Standard Time, tammy.jacobs@haysmed.com writes: Bryan, Re: Notification of Community Health Needs Assessment (Ellis County) Thanks for visiting with me about the Community Health Needs Assessment currently taking place in Ellis County. I ve attached the link to the HaysMed website. The CHNA survey link is on the front page under the Upcoming Events section. Thanks for helping get the word out about the survey and encouraging folks to take it. I appreciate it! See you on March 11 th. Thanks, Tammy Tammy Jacobs Regional Health Hays Medical Center (785) phone (785) fax tammy.jacobs@haysmed.com 81

83 Detail Primary Research Primary Service Area [VVV Research & Development, LLC] 82

84 Community Health Needs Assessment Round #2 Community Feedback Methodology A community feedback survey was created on behalf of the CHNA client to gather PSA stakeholder feedback on health perception and progress in addressing previous CHNA community needs. In addition to 2500 mailed surveys, community residents were encouraged to take the survey online by entering the following address into personal browser, where 520 responses were collected: Also, an invite letter was sent to all PSA stakeholders (i.e. Schools, County, City, Clergy, Public Health Leaders). Below is a summary of public response: 83

85 Community Healthcare Needs Assessment Demographics What is your age? CHNA NORM (23) N=8959 % Hays 2012 PSA % Hays 2015 PSA % Under 18 (omit) % 0 0.0% 0 0.0% , % % % , % % % , % % % Over % % % T otals 8, % % % Hays 2012 Hays 2015 PSA % Your gender? CHNA NORM (23) N=8959 % PSA % Ma le 2, % % % Fe ma le 5, % % % T otals 7, % % % How would you identify yourself? CHNA NORM (23) N=8959 % Hays 2012 PSA % Hays 2015 PSA % a ) Caucasian / White American 7, % % % b ) African American / Black Ame rica n % 0 0.0% 0 0.0% c) Latino / Hispanic American % 3 0.6% 4 0.9% d ) American Indian / Native Ala skan % 0 0.0% 0 0.0% e ) Asian American / Pacific Isla nd e r % 2 0.4% 0 0.0% f) Multicultural / Multiracial % 3 0.6% 2 0.4% Other (please specify) % 5 0.4% 6 1.3% T otals 8, % % % * N o rm is comp o se d o f 23 CHN A co mmunity surve ys fro m IA, KS a nd MO. Community Healthcare Needs Assessment Demographics How would you describe your household? CHNA NORM (23) N=8959 % Hays 2012 PSA % Hays 2015 PSA % Sing le 1, % % % Ma rrie d 1, % % % Married with children at home 2, % % % Married with children no longer at home 1, % % % D ivo rce d % % % Othe r % % % T otals 8, % % % Regarding your health insurance coverage.. CHNA NORM (23) N=8959 % Hays 2012 PSA N=577 % Hays 2015 PSA N=520 % Private Insurance you purchased 1, % % % Me d icare 1, % % % Me d icaid % 3 0.6% 1 0.2% Covered by Employer (employer pays total cost) % % % Covered by Employer (you & employer share cost) 3, % % % No Coverage (Uninsured) % 9 1.7% 3 0.7% Othe r % % % T otals 8, % % % * N o rm is comp o se d o f 23 CHN A co mmunity surve ys fro m IA, KS a nd MO. 84

86 Community Health Needs Assessment Hays Medical Center Service Area Hays Medical Center is conducting a comprehensive community health needs assessment update this year. In 2012 a similar community health needs survey was administered. Today we need your assistance to gather confidential feedback by Friday February 27, Thank you. Part I: HEALTHCARE PERCEPTIONS & SATISFACTION 1. In general, how would you rate the overall quality of the healthcare delivered to your community? Very Good Good Fair Poor Very Poor OVERALL Quality of Care nmlkj nmlkj nmlkj nmlkj nmlkj 2. How would you rate of the following health service...? (Check one box per row) Very Good Good Fair Poor Very Poor N/A a) Ambulance Service nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj b) Child Care nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj c) Chiropractor nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj d) Dentists nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj e) Emergency Room nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj f) Eye Doctor / Optometrist nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj g) Family Planning Services nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj h) Home Health nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj i) Hospice nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj 3. How would you rate the following services? (Check one box per row) Con't Very Good Good Fair Poor Very Poor N/A j) Inpatient Services nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj k) Mental Health Services nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj l) Nursing Home nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj m) Outpatient Services nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj n) Pharmacy nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj o) Primary Care nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj p) Public Health Dept. nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj q) School Nurse nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj r) Visiting Specialists nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj 85

87 4. Over the past 2 years, did you or your household receive health care services outside of your county? nmlkj Yes nmlkj No If Yes, please specify the healthcare services you received 5. Are there healthcare services in your community / neighborhood that you feel need to be improved and / or changed? (Please be specific) In your opinion, how much of a problem are the following causes of diseases or disability in your community? (Check one box per row) Not a Problem Somewhat of a Problem Major Problem Don't Know a) Cancer nmlkj nmlkj nmlkj nmlkj b) Diabetes nmlkj nmlkj nmlkj nmlkj c) Substance Abuse nmlkj nmlkj nmlkj nmlkj d) Heart Disease nmlkj nmlkj nmlkj nmlkj e) Sexual Transmitted Diseases nmlkj nmlkj nmlkj nmlkj f) Mental Disorders nmlkj nmlkj nmlkj nmlkj g) Obesity nmlkj nmlkj nmlkj nmlkj h) Pneumonia / Flu nmlkj nmlkj nmlkj nmlkj i) Respiratory Disease nmlkj nmlkj nmlkj nmlkj j) Stroke nmlkj nmlkj nmlkj nmlkj k) Suicide nmlkj nmlkj nmlkj nmlkj l) Trauma nmlkj nmlkj nmlkj nmlkj Other (please specify below) 86

88 7. How well do you feel our local health care providers are doing in addressing the health needs of the following age groups? (Check one box per row) Very Good Good Fair Poor Very Poor N/A Infants nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj Age 1 12 nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj Age nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj Age nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj Age nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj Age nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj Over 85 nmlkj nmlkj nmlkj nmlkj nmlkj nmlkj 8. Does our community need any additional healthcare providers? nmlkj Yes nmlkj No If Yes, please specify what is needed In your opinion, what areas need additional education or attention in our community? (Check all that apply) gfedc a) Abuse / Violence gfedc j) Neglect gfedc s) Teen Pregnancy gfedc b) Aging (Dementia) gfedc k) Nutrition gfedc t) Tobacco Use gfedc c) Alcohol gfedc l) Obesity gfedc u) Uninsured gfedc d) Alternative Medicine gfedc m) Ozone gfedc v) Vaccinations gfedc e) Child Care gfedc n) Pain Management gfedc w) Water Quality gfedc f) Chronic Diseases gfedc o) Poverty gfedc x) Wellness Education gfedc g)family Planning / Birth Control gfedc p) Preventative Healthcare gfedc y) Drugs / Substance Abuse gfedc h) Lead Exposure gfedc q)sexually Transmitted Diseases gfedc i) Mental Illness gfedc r) Suicide Other (please specify below) 5 6 PART II: YOUR HEALTH PRACTICES 87

89 10. In general, how would you best describe your health? (Choose one) nmlkj Very Good nmlkj Good nmlkj Fair nmlkj Poor nmlkj Very Poor 11. Compared to a year ago, how would you rate your overall health in general now? nmlkj Much better than a year ago nmlkj About the same nmlkj Much Worse than a year ago 12. Does your household have a provider you use for primary care? nmlkj Yes nmlkj No If Yes, Please give Physician's name / Specialty / City Have you had a physical in the past 12 months? nmlkj Yes nmlkj No If no, why not? (Be specific) Do you follow these health practices...? (Check one box per row) Yes No N/A If over 50, have you had a colonoscopy? nmlkj nmlkj nmlkj If male over 50, do you have annual prostate exams? nmlkj nmlkj nmlkj If female over 40, do you have annual mammograms? nmlkj nmlkj nmlkj If female, do you have a pap smear every other year? nmlkj nmlkj nmlkj Do you get 2.5 hours a week of moderately intense physical activity? nmlkj nmlkj nmlkj 15. Please complete sentence below. Are you...? Yes No N/A a) Eating right (Daily5+servings fruits/veg/wheat) nmlkj nmlkj nmlkj B) Using tobacco products weekly nmlkj nmlkj nmlkj c) Exercising 2 3 times weekly nmlkj nmlkj nmlkj d) Consuming alcohol (more than 1 drink daily) nmlkj nmlkj nmlkj e) Receiving an annual flu shot nmlkj nmlkj nmlkj 88

90 Part III: A LITTLE MORE ABOUT YOU 16. What is your age? nmlkj Under 18 nmlkj nmlkj nmlkj nmlkj Over Your gender? nmlkj Male nmlkj Female 18. How would you identify yourself? nmlkj a) Caucasian / White American nmlkj e) Asian American / Pacific Islander nmlkj b) African American / Black American nmlkj f) Multicultural / Multiracial nmlkj c) Latino / Hispanic American nmlkj g) Other nmlkj d) American Indian / Native Alaskan 19. How would you describe your household? nmlkj Single nmlkj Married with children no longer at home nmlkj Married nmlkj Divorced nmlkj Married with children at home nmlkj Other 20. Regarding your health insurance coverage... What type of health coverage is your primary plan? (Choose one) nmlkj Private Insurance you purchased nmlkj Covered by Employer (employer pays total cost) nmlkj Medicare nmlkj Covered by Employer (you & employer share cost) nmlkj Medicaid nmlkj No Coverage (Uninsured) Other (please specify below) 89

91 21. Thinking back over the past few years, would you say you are more or less likely to go to the doctor when you are sick or injured, or hasn t there been much change? nmlkj Much less likely nmlkj Not much change nmlkj Much more likely nmlkj Somewhat less likely nmlkj Somewhat more likely nmlkj No opinion 22. In the past few years, what is the likelihood you or someone in your household went without medical treatment you thought was needed because of the cost? nmlkj Much less likely nmlkj Not much change nmlkj Much more likely nmlkj Somewhat less likely nmlkj Somewhat more likely nmlkj No opinion 23. What is your 5 digit zip code? 24. What is the name of your County? You have just completed the Community Health Needs Assessment Survey. Thank you for your participation. By hitting "Next" you are submitting your responses and giving others an opportunity to complete the same survey. Again, thank you for your participation. 90

92 KEY - CHNA Open End Comments CODE Physician Specialty NEUS Neurosurgery ALL Allergy/Immunology OBG Obstetrics/Gynecology (Delivery) AES Anesthesia/Pain ONC Oncology/RADO CARD Cardiology OPTH Ophthalmology DERM Dermatology ORTH Orthopedics EMER Emergency ENT Otolaryngology (ENT) ENDO Endocrinology ** PATA Pathology FP Family Practice (General) PEDS Pediatrics GAS Gastroenterology PHY Physical Medicine/Rehab SUR General Surgery PLAS Plastic/Reconstructive GER Gerontology PSY Psychiatry IFD Infectious Diseases PUL Pulmonary IM Internal Medicine RAD Radiology NEO Neonatal/Perinatal * ABP 06 RHE Rheumatology NEP Nephrology ** VAST Thoracic/Cardiovascular/Vascular NEU Neurology URL Urology KEY - CHNA Open End Comments Code HC Themes Code HC Themes VIO Abuse / Violence EMRM Emergency Room ACC Access to Care EMS EMS AGE Aging (Senior Care / Assistance) EYE Eye Doctor / Optometrist AIR Air Quality FAC Facility ALC Alcohol FAM Family Planning Services ALT Alternative Medicine FEM Female (OBG) ALZ Alzheimers FINA Financial Aid AMB Ambulance Service FIT Fitness / Exercise ASLV ASSISTED LIVING ALL General Healthcare Improvement AUD Auditory GEN General Practioner BACK Back / Spine GOV Government BD Blood Drive HRT Heart Care BRST Breastfeeding HEM Hemotologist CANC Cancer HIV HIV / AIDS CHEM Chemotherapy HH Home Health KID Child Care HSP Hospice CHIR Chiropractor HOSP Hospital CHRON Chronic Diseases MAN Hospital Management CLIN Clinics (Walk-in etc.) INFD INFIDELITY COMM Communication IP Inpatient Services CORP Community Lead Health Care LEAD Lead Exposure CONF CONFIDENTIALITY BIRT Low Birth Weight DENT DENTIST LOY LOYALTY DENT Dentists MAMO Mammogram DIAB Diabetes MRKT MARKETING DIAL Dialysis STFF Medical Staff 91

93 DUP Duplication of Services BH Mental Health Services ECON Economic Development MDLV MID-LEVELS Code HC Themes SANI Sanitary Facilities NURSE More Nurse Availibility SNUR School Nurse NEG Neglect STD Sexually Transmitted Diseases NP NURSE PRACTIONER SMOK Smoking NH Nursing Home SS Social Services NUTR Nutrition SPEC Specialist Physician care OBES Obesity SPEE Speech Therapy ORAL Oral Surgery STF STAFFING ORTHD ORTHODONTIST STRK Stroke OTHR Other DRUG Substance Abuse (Drugs / Rx) OP Outpatient Services/Surgeries SUIC Suicide OZON Ozone SURG SURGERY PAIN Pain Management TPRG Teen Pregnancy PARK PARKING TEL TELEMEDICINE PHAR Pharmacy THY Thyroid DOCS Physicians TOB Tobacco Use FLU Pneumonia / Flu TRAN Transportation FOOT Podiatrist TRAU Trauma POD PODIATRIST TRAV TRAVEL POV Poverty ALCU Underage Drinking PNEO Prenatal INSU Uninsured/Underinsured PREV Preventative Healthcare URG Urgent Care/After Hours Clinic PRIM Primary Care: VACC Vaccinations PROS Prostate VETS VETERANS CARE DOH Public Health Department WAG Wages QUAL Quality of care WAIT Wait Times REC Recreation H2O Water Quality RESP Respiratory Disease WELL Wellness Education/Health Fair NO Response "No Changes," etc. WIC WIC Progam 92

94 ID ZIP CHNA Round #2 Community Feedback Ellis Co, KS N=499 Community Health Status c1 c2 c3 Q4 Are there healthcare services in your community / neighborhood that you feel need to be improved and / or changed? Access on a day-to-day basis. Convenient Care is good start just too small Good ACC URG CLIN Very Good ACC Assistance for the working poor Good ACC WAIT doctors you can get in to see Very Good ACC WAIT faster service; wait time is to long Good ACC PEDS WAIT HARD TO GET AN APPOINTMENT IN A TIMELY MANNER FOR SOME TYPES OF CARE, LIKE PEDIATRICS, AND THEN NO GUARANTEE YOU WILL SEE YOUR NORMAL PROVIDER, WHO YOU TRUST, MAY JUST BE THE PA YOU DON'T KNOW AT ALL Very Good ACC HDEPT WAIT Health department needs to have evening and weekend hours. They function like departments did years ago...not progressive Good ACC COST I just wish healthcare wasn't so expensive Very Good ACC DOCS I went to Plainville cause no doctor in Hays would take me. I also needed to apply for a doctor back in Fair ACC making sure can provide services to local and surrounding communities before acquiring farther away places Good ACC WAIT Need more staff at the hospital, as a paitent had to wait a long time to even see a professional Very Good ACC WAIT Shorter wait time to see a doctor. Some wait times are several weeks Fair ACC WAIT Waiting periods in doctor's office Very Good AGE HH QUAL Government and regulatory burdens on nursing home and home health seriously impair the facilities and their employees as well as their physicians from providing effective care Good AGE More and better options in nursing home care Good AGE nursing homes Fair ALC There needs to be a better relationship between professional healthcare providers and alcoholics anonymous. People who need help are not being sent to good groups Good BH EMER WAIT community mental health services are too restrictive and tied to HPMH unfortunately. ER service is terrible...long waiting Very Good BH Community mental health services need to be improved Fair BH IP Inpatient Mental Health Good BH DOCS Mental health care - not enough workers to provide care to all patients who need meds BH DOCS SPEC Mental Health in Hays/Ellis County needs more physicians Fair BH AGE OPTH Mental health services for young children are limited. Eye professionals that know how to work with very young children with special needs are needed. Nursing home facilities charge exorbitant prices and provide poor care - They have high staff turnover and continuity and quality of care is extremely poor Good BH PSY THER Mental health services need to be more acessible to all people in the community. More psychiatrists, psychologists and therapists are needed to better care for the population Good BH We need more inpatient mental health and more help for dementia patients Good CLIN URG Convenient Care Clinic - need one in Victoria Good CLIN CARD SPEC Debakey Heart Clinic - they make appointment and then charge them and that not right Fair CLIN URG First Care Clinic 93

95 ID ZIP CHNA Round #2 Community Feedback Ellis Co, KS N=499 Community Health Status c1 c2 c3 Q4 Are there healthcare services in your community / neighborhood that you feel need to be improved and / or changed? For the longest time Hays had no walk in clinics, closet was Plainville. Scheduling times to get looked at was a hassle. FHSU campus clinic is great for students. I was pleased with care i received there while in school. But walk in clinics is something i know needs addressed. I have heard nothing good about Hays Medical Center. If i had a choice I would choose to receive in/out patient treatment elsewhere. I have recommend people to specialist in KC area. I rarely visit a doctor or seek attention but was fairly happy with one Emergency room visit treatment i received. Was not timely but i felt it was quality care. I have heard great things about the PT and Chiropractic clinics in town and we have amble practices to choose from. Dental Care is also quality. I think we have enough choice in treatment as well. Mental health care and Good CLIN URG ACC special needs (home care) are adequate in my opinion. DSNWK, High Plains, and other traveling nursing treatments are great services Very Good CLIN URG WAIT Hays recently opened a walk-in clinic. I can't believe a town this size has gone this long without one. I do think they may need to open one that me closer down to the college Good CLIN URG More walk-in clinic access Good CLIN ENDO URG The addition of the walk-in clinic was huge and meets a large need in our community. Would like to have access to an endocrinologist/hormonal expertise, whether through visiting resource or other Fair CLIN URG ACC Used to have walk in but now closed Good CLIN URG Very impressed with the Convenient Care Clinic Good CLIN EMER WAIT With the opening of the walk in clinic I feel people will not have to visit the emergency room for a minor issue which in turn will make the wait time in the emergency room lessen. We were frustrated that it took 3 hours for our 2 year old to be stitched up when he got a cut on his head. When the doctor finally came it took him 15 minutes to finish the procedure. After our experience we heard from many of our community friends about there experience with the long wait time in the emergency room Very Good CLINC URG The walk-in clinic great addition, feel it will need to grow! Big need Very Good COMM DOCS ACC better communication at Doctors office, very hard to access the doctor or his nurse, the timeliness of them returning calls is terrible, Very Good DAY SANI Daycare - some seem so dirty or cramped Good DAY COST WAIT daycare needs improvement its expensive, with limited availability with part-time, evenings and weekends Fair DAY Daycares for parents working 12 hour jobs Fair DENT INS Dental care to persons who are on Medicaid! Very Good DENT Dentists Poor DENT WAIT INS Dentists opened on Friday, Saturday, and Sunday - more doctors for medicaid Fair DENT Dentists Good DENT INS more access for dentist to the hospital for sedation dentistry for patients with Medicaid Good DENT BH Not enough access to adult dental (low income) or mental health Very Good DENT Number of dentists Fair DENT PEDS CLIN There is only one dentist that caters to children, so it's nearly impossible to get in. We take our children to Wichita because they have full practices dedicated to children. Additionally, the pediatric clinic in Hays is terrible. They won't see more than 2 children at a visit, so if you want to schedule well child checks for all of your children at one time it's impossible. Instead, you have to make seperate visits which as a working parent is time consuming and unrealistic. Heaven forbid more than 2 of your children get sick at the same time. 94

96 ID ZIP CHNA Round #2 Community Feedback Ellis Co, KS N=499 Community Health Status c1 c2 c3 Q4 Are there healthcare services in your community / neighborhood that you feel need to be improved and / or changed? Good DENT INS WELL This community needs more dentistry providers for medicare and medicaid patients. Also, the monthly fee for the Center for Health Improvement is outrageous and people who desperately need to go cannot afford it. A personal trainer to help people learn to exercise safely is also way out of affordability. We need nutrition consultation and classes for the public instead of only those geared towards diabetic patients. Lastly, mental health services that people can afford is lacking. We need more public education in the area of mental health DENT SANI Would like to see fewer x-rays taken by dentists. Stricter germ protection at Hays Med - too many patients infected while in hospital DIAB SPEC DOCS Diabetes doctor - URGENT Very Good DIAB SPEC Need diabetic specialist Good DOCS Hays Med needs Dr M. Biring Very Good DOCS NURSE NO I am very pleased with Hays Medical Center and our doctors and nurses, great care Good DOCS EMER WAIT Yes, the ER department. I rushed my child there after she sliced her finger. After 4 hours, we left and never saw a doctor Good DRUG Drug Addition Good EMER Be seen quicker in the emergency room Fair EMER PRIM WAIT Better ER services...more caring. Less of a wait. More primary care physicians. People can't find a doctor to take them Good EMER WAIT Emergency room - Service is too slow! EMER Emergency Hays Med- Unacceptable EMER WAIT Emergency room it takes too long! 1307 EMER Emergency room services Good EMER WAIT Emergency room wait time Good EMER Emergency room Good EMER COMM ER - communication Fair EMER WAIT ER - no reason to have to be taken to room and sit 4-5 hours before seeing doctor Poor EMER SPEC DOCS ER - no special doctors. Don't need hospitalist in hospital Good EMER DOCS ER - very unprofessional, uncaring ER doctors Good EMER Er is horrible EMER WAIT ER needs to be improved a lot. takes hours to see someone and hours to get to a room when you have to stay Very Good EMER WAIT ER wait time is horrible at times Good EMER DENT WAIT ER wait times, Dental Access EMER WAIT ER wait too long to be dismissed or admitted Good EMER Hays Emergency room Poor EMER HMC - ER services Very Good EMER CARD SPEC I hear a lot of complaints regarding locum tenens and their lack of detailed care. I had an experience with one in the emergency room when I thought I was having a heart attack. His diagnosis was I was depressed and gave me an antidepressant despite my protests. After seeing a cardiologist it was determined I have mitral valve prolapse Good EMER WAIT LESS WAIT TIME IN ER Good EMER WAIT COST Should not have a long wait at ER or cost Good EMER COMM WAIT The emergency room at the hospital has a horrible reputation for not taking any emergency serious. A friend recently partially severed a finger on his hand and they allowed him to sit in the emergency room for 15 minutes bleeding on himself and on the floor of the waiting room. I would call that awful attention to what is going on. When is an emergency and emergency? EMER The emergency room services Fair EMER HOSP COMM The ER and Hospital are beyond horrible, but nobody listens/cares that customer service needs to change drastically 95

97 ID ZIP CHNA Round #2 Community Feedback Ellis Co, KS N=499 Community Health Status c1 c2 c3 Q4 Are there healthcare services in your community / neighborhood that you feel need to be improved and / or changed? Fair EMER AGE The ER at Hays Med and both nursing home facilities at Via Christi Fair EMER The ER in hays is a huge joke Fair EMER COMM QUAL Trego County Hospital. My 80 year old mother was very ill. Went to her doctor and they wouldn't give antibiotic. Took her to emergency room in Wakeeney and they did testing and she had sepsis poisoning. We almost lost her. They even knew that she takes treatment for her cancer. Very disappointed in Hays Med Good EMER WAIT Waiting time in emergency room was very, very long Good EMER SPEC ACC Yes - ER, need specialists, i.e. neurology, GI, and rheumatology Fair ENDO SPEC add endocrinologist Good ENDO SPEC endocrinologist needed Fair ENDO EMER HH Offer endocrinology Improve ER efficiency Increase hospice consults Increase availability of Home Health Increase coordination of care in hospital--physicians consult together and be aware of what each specialist orders/requires Family awareness of condition and physicians in hospital setting FAM PHARM Family Planning Options. Need a local pharmacy Very Good FAM Non-governmental family planning Good FINA BH More financial assistance for mental health services Good FP Family doctors Very Good FP DENT SPEC General family practitioners--it's really difficult for a family moving into the community to find a good practitioner accepting patients. Likewise with dental care. More qualified specialists are needed so families do not need to travel to other communities, e.g., gastroenterologist, asthma specialist, ENT specialist Very Good FP IM BH More family medicine or internal medicine doctors needed. It's hard to find a physician if you are new to the community. Would also like to see better mental health services. If you need the service, it can take weeks to get in and sometimes the patient needs the help sooner than that Good FP IM DERM We need more family practice physicians and skin/internal med specialists Good GAS SPEC DOCS Gastroenterologist Good GAS FAM DERM Gastroenterology, fertility specialists, dermatology - greater access to these services in our community Fair GAS FAM STAFF Need gastroenterologist on staff here - not from Salina! Planned Parenthood for low income/female care, birth control, etc Very Poor GEN DOCS PHY Hays Med doctors and hospitalist!! Can't keep the good doctors in town and Hays Med hosptialist haven't a clue on pt treatment or good pt care. Alot of misorder exams or exam order and no idea what type of exam they order Fair GEN FP MDLV My family has NEVER seen an actual doctor, only mid-level providers GENIMP Everything GENIMP Hays Med. Care Very Good GENIMP HDEPT I feel the health department needs to be more involved with building the health infrastructure in Ellis County. The health department is unaccredidated, does not work to apply for grants in disease prevention and seems to take a very "hands off" approach to building partnerships with other health organizations across the community Good GENIMP Improved Fair GENIMP YES! Poor GENIMP Yes, all in Hays Fair GENIMP ACC yes, I would rather drive to Plainville to receive services then receive them in Hays Good HH Home health care providers are hard to locate Fair HH Rest home visits to residents and seriously looking at their needs. 96

98 ID ZIP CHNA Round #2 Community Feedback Ellis Co, KS N=499 Community Health Status c1 c2 c3 Q4 Are there healthcare services in your community / neighborhood that you feel need to be improved and / or changed? Poor HH Yes, home health. Girls don't know how to cook or clean house Fair HOSP IP Hospital and inpatient care has went down hill significantly in the last year Fair HOSP GENIMP Hospital service overall needs improvement Poor HOSP GEN DOCS The Doctors and Hospialist at Hays Med. Hospialist very POOR. Don't know what they are doing as far as pt treatment. What good doctors we have at Hays Med can't keep. Cheaper to let them go and bring other doctors who don't know near as much as the doctors we lose Fair INS COMM QUAL I have a big complaint. When did you begin admitting patients under observation? We pay for our insurance and when you admit us under observation, we get this huge bill in the mail. I think the patients should be informed about being admitted under observation and not a regular admit and what the difference is. Also, the patient should be informed that their insurance (Medicare) or what other insurance will not pay for everything, and the patient being left with a huge bill. This makes the hospital look very cheap, only thinking of the money they can make and not of their patient's welfare. I think you need to stop admitting patients under observation. (A patient who had surgery late in the evening and was admitted under observation for the night without anyone telling me, I didn't know there was such a thing until I got the bill.) Good INS COST Insurance is too high. Hospitalization is ridiculously expensive! Good INS COST It's just plain too expensive for the common man,,even with insurance Fair NEU RHE Need neurology and rheumatology services Good NEU Need neurology services! Good NEU GAS SPEC Neurology and gastroenterologist Good NEU SPEC DOCS We are in need of a neurosurgeon Good NEU SPEC DOCS We need a neuroligist at Hays Medical Center as we don't offer that service Good NEU SPEC DOCS We need a neurologist! Good NEU PUL SPEC We need another pulmonologist and neurologist that serves this area NEU SPEC DOCS Yes, we need a neurologist since Dr Gamboa retired and moved away Good NO Don't know Very Good NO I have always had great service and always get my questions answered Good NO n/a 1163 Good NO NA Good NO No Very Good NO No Very Good NO No Very Good NO No 1388 Very Good NO no Very Good NO No Very Good NO no Very Good NO no Very Good NO No! I feel that they are adequate Very Good NO No Very Good NO None that I can think of at this time Very Good NO Not that I am aware Good NO Not that we are aware of Poor NURSE HH Nursing staff HMC, home health care Good NURSE school nursing - each school really needs a full time nurse on staff Very Good NURSE We need a nurse more readily available at my child's school Good OBG SPEC DOCS OB/GYN care could be improved. There is a limited amount of time to spend with the provider and a limited amount of resources provided to expecting mothers Very Poor OBG SPEC The OB unit 97

99 ID ZIP CHNA Round #2 Community Feedback Ellis Co, KS N=499 Community Health Status c1 c2 c3 Q4 Are there healthcare services in your community / neighborhood that you feel need to be improved and / or changed? Good OGB FINA BH ob services need improved in ellis county. Increased affordable, accessible mental health (besides hpmh). Medical transportation Good OP Outpatient care Fair OPTH SPEC SURG Eye surgeons Very Good ORTH SURG SPEC Better orthopedic surgeons Poor ORTH SPEC DOCS Most people travel out of town for Orthopedic surgery, Hays orthopedic is pathetic! Can't seem to keep the same doctor for more than a few years Good ORTH DOCS SCHED Ortho clinic docs need more and better scheduling. Update procedures Very Good PEDS GAS PSY Anything pediatric, GI, psych Fair PEDS EMER Child care and ER PEDS SPEC WAIT Hays Med Center- Pediatrics, Difficulty to get in if a same day need arises Very Good PEDS ACC SPEC It would be wonderful to have more pediatric specialists here or nearer to hays. So far,there are only a few in the area and many families have to travel several hours to see the providers. These families lose income from missed work/create strained-stressed health because of the travel time and treatments/and there is a loss of community support that goes with traveling outside the area for services Good PEDS lack of pediatric services and poor follow up with peds from the pediatric office Fair PEDS FP More options for pediatrics and family care providers Good PEDS DOCS More pediatric doctors. At Hays Med, when sick, I never get to see our actual doctor Good PEDS NURSE SPEC More pediatrician and nurses, more specialized areas(gastroenterologists), bigger facilities for cramped clinics Good PEDS GENIMP Need a hospital that can care for more complex pediatric needs.family support if a family member is hospitalized. Need a Ronald McDonald house or something similar Very Good PEDS BH DOCS Need more services for autistic children Good PEDS Pediatric care Good PEDS SPEC DOCS Pediatric care- you can never get an apt when you need one, when you set up your next apt I can never seem to get the primary provider my child is suppose to see. When we do get in our doctor is amazing though Good PEDS Pediatric for admissions - not sick enough for an ICU type setting but to sick to stay at home - this is not robust enough and not encouraged by our Peds docs - I would encourage a more resources or aggressive county health in options in care and resources Good PEDS SPEC DOCS Pediatrician specialists Good PEDS HOSP pediatrics - especially in the hospital Good PHAR In town pharmacy for Ellis Good PHAR STAFF Pharmacies understaffed Good PHAR Pharmacy in Ellis Good PHAR Pharmacy is needed Good PHAR Regarding pharmacy - would be nice to have a year script so when needed is available. Out of town people often have to go back to pharmacy for meds. Spend more time with patient, less computer time. A fresh glass of water, fluff pillow, back rub, etc. would be nice Very Poor PHARM WELL DOCS Yes, focus on wellness, quit prescribing drugs that do more harm and then require more drugs Good PLAS GAS NEU Cosmetic surgeon Gastroenterologist Neurologists Good PREV WELL We need more info and services for preventative health care Good PRIM PEDS ACC Availability of primary care taking new patients. Availability of seeing a pediatrician Very Good PRIM ACC BH Better access to primary care and mental health services Good PRIM ACC easier access to primary care 2017 PRIM HDEPT WELL expanded primary care and public health services 98

100 CHNA Round #2 Community Feedback Ellis Co, KS N=499 Community ID ZIP Health Status c1 c2 c3 Q4 Are there healthcare services in your community / neighborhood that you feel need to be improved and / or changed? Very Good PRIM More primary care doctors - so hard to get in Good PRIM More primary care options Very Good PRIM More Primary Care Physicians Good PRIM more primary care physicians More primary care physicians, expand Convenient Care ability to Very Good PRIM ACC URG serve more patients Good PRIM More primary care physicians Poor PRIM More primary care physicians. Hospital needs to work with the good physicians to get them to stay in Hays instead of leaving Fair PRIM PEDS INS more primary care/family practice doctors, very few are accepting new patients. Pediatric unit at HMC is terrible!!!! Only one experienced nurse and none of the other pediatric nurses know what they are doing. I know several people that said they will never bring their children to HMC for their childs needs, they will go all the way to Salina if needed because the care at HMC is so poor. The lactation services at HMC are amazing and I feel that we need more employees focusing on this area, it is core measures and as of now all we have is a part time employee. ER physicians know nothing about taking care of pediatric or newborn patients. Mental heath facilities are good in the area but very few people are able to get the help they need because of limitations with insurance companies. The hospital insurance is terrible and very few mental health facilities in the Hays area accept it. The health department needs to be more community involved and educate better on breastfeeding instead of just always giving formula Good PRIM NEU PUL More primary. Neurologist pulmonologist. icu. er Good PRIM WAIT Need more primary care and physicians that actually will take new patients. HaysMed is slow to provide this Very Good PRIM Need more primary care physicians Good PRIM CLIN PEDS Often there are not enough primary care physicians. They aren't accepting new patients. The walk-in clinic has helped relieve some of these issues. I've often been told it's impossible to get into the peds clinic with issues PRIM Our primary care doctor does not have opening when we need them Good PRIM primary care PRIM Primary care Very Good PRIM We need more long term primary physicians Very Good PUL SPEC DOCS Need a lung specialist doctor at Hays Medical Center Fair PUL SPEC DOCS Pulmonary medicine Good PUL NEU SPEC Pulmonology is a speciality that needs to be added back into HMC. Neurology is another specialty that needs to be at HMC Good QUAL NURSE GENIMP I spent 5 days in HMC in 2014 and not one nurse offered me a towel or washcloth to clean up or shower. I wore same gown those 5 days! Very Poor QUAL DOCS GENIMP Need doctors who aren't arrogant and listen to the concerns of their patients. Also, would be helpful if they knew a little bit about healthcare QUAL PRIM NP Need more educated, knowledgeable primary care providers/physicians! Newer doctors ARNPS suck! Good QUAL Need to be more friendlier Good QUAL NURSE HH Overall I hear that they like the fact that they can be seen and treated for so many things (including specialties) local but the quality of care for inpatient is a complaint for Hays Med. They feel like either nurses are spread too thin or they just don't care. Many people tell me that they asked to get sent home early from hospital stays because they feel they will get better care and their medicines on time at home. 99

101 CHNA Round #2 Community Feedback Ellis Co, KS N=499 Community ID ZIP Health Status c1 c2 c3 Q4 Are there healthcare services in your community / neighborhood that you feel need to be improved and / or changed? Professionalism and customer service in the HaysMed Emergency room - it is extremely poor. The people working there do not treat Good QUAL EMER others with kindness and respect. Providers that want to be there. Staff that have a personality and empathy. Treat each patient like it might be your own family, not like crap, it's them - and you'd rather not be bothered. Empathy and compassion. People that want to be the best at what they do. ER - need specialty doctor and ones that take calls. And if it was an emergency, we've been taught since young who to call, please, it is ridiculous or at least push this button if it isn't an emergency Very Poor QUAL EMER COMM Communication is vital Fair QUAL Quality of care - concern for patients versus the bottom line. service delivery is a concern at HMC; been inpatient several times and care was below standard of attention -- long waits for answering the call light, behind on medication schedule. Either understaffed or passive? Would be extremely beneficial to have traveling specialists from other areas in the fields of gastroenterology, endocrinology and rheumatology... Our community would greatly benefit in having competent nursing homes. Neglect and unskilled care serious issues in both. From personal experience, our family called the state many times while Good QUAL NURSE SPEC Via Christi has been in the new facility. Need neurosurgeon and need neurologist for sure and a physician Good RESP NEURO SPEC for respiratory care Having a Rheumatologist serving through HaysMed would be very Good RHE SPEC helpful Fair RHE SPEC No rheumatologist Fair SPEC ARTH Anything special have to leave Hays. Specialized for arthritis Good SPEC PEDS DOCS More specialists, better pediatrics - need more providers SPEC RHE Specialty areas - rheumatology. We need neurologists, endocrinologists, immunologists,allergists, Good SPEC ACC ALL pulmonologists, and primary care Poor SPEC DIAB NEU Yes, diabetic and neurology Good SPEC PEDS DOCS Yes, more pediatricians yes, we need an endocrinologist(s), GI Doctor(s), and someone like Fair SPEC ENDO GAS Dr. Benton and Dr. Kelly Good SPEC INS Yes. I feel like if Hays Med is going to bring in outside specialists, they should at least take the hospitals own insurance. This limits a huge population from being able to benefit from these specialists Good SPEC OBG QUAL Yes. I've been told to avoid the Hays area for any OBGYN care by multiple other hospitals in other parts of the state, and by friends and family members who have had bad experiences. There are also no pediatricians taking new patients within 100 miles of Hays. I don't understand how that can be possible for a town and hospital of this size Good SURG SPEC Surgeons (knee and bone in general) Good URG CLIN Urgent/non-emergency care Very Good URL SPEC DOCS Urology needs improvement Very Good WAIT DAY COST Child care in Ellis County is expensive (compared to surrounding counties) and difficult to find people willing to take part time children, and also lack of daycare available evenings/nights/weekends. I would like to see HaysMed provide a daycare facility for their employees Fair WELL AGE Fitness and health promotion for older adults Good WELL More wellness information at public events. 100

102 CHNA Report contact : Vince Vandehaar, MBA VVV Marketing & Development, LLC Adjunct Professor / Professional Healthcare Marketing & Strategic Planning Consulting Services 601 N Mahaffie, Olathe, KS (913) (C) VVV@VandehaarMarketing.com LinkedIn: vandehaar Website: VandehaarMarketing.com 101