Hoopeston Regional Health Center

Hoopeston Regional Health Center Copyright 2012 by the Illinois Critical Access Network (ICAHN). All rights reserved. The contents of this publication may not be copied, reproduced, replaced, distributed, published, displayed, modified, or transferred in any form or by any means except with the prior permission of ICAHN. Copyright infringement is a violation of federal law subject to criminal and civil penalties. Hoopeston Regional Health Center 1

TABLE OF CONTENTS Process Purpose....3 Scope of Assessment...3 Methodology and Gaps Discussion...4 Community Geographic Assessment Area Defined....5 Demographic Profile...6 Economic Profile...7 Input Health Profiles from Existing Studies and other Secondary Data...10 Primary Source Information...14 Prioritization Reconciliation of Primary Source Information with Secondary Data...17 Summary of Findings and Recommendations...17 Resource Inventory Hoopeston Regional Health Center...19 Area Health Services Review...25 Remarks ICAHN Remarks...26 Appendix Key Informant Interview Participants...27 Collaborators....28 Hoopeston Regional Health Center 2

I. PROCESS Purpose Hoopeston Regional Health Center (HRHC) is dedicated to providing the residents of Hoopeston and surrounding communities with quality, dependable health services. In the past, HRHC has employed many different methods to assess the health needs of the communities it serves and has adjusted its services to meet those identified needs. Recent changes to federal laws governing not-for-profit hospitals now require HRHC to conduct local community health needs assessments, following specific guidelines, every three years and to report the completion of the process as part of their corporate tax filings with the Internal Revenue Service. Assessing community health needs through a review of available health data and discussion with area health care partners, community leaders and representatives of the many groups currently or potentially served by the hospital give Hoopeston Regional Health Center and its health care partners the opportunity to identify and address the area s most pressing health care needs. Scope of Assessment Hoopeston Regional Health Center elected to conduct a community health needs assessment in 2011 and 2012. The HRHC community health needs assessment was developed and conducted by a consultant provided through the Illinois Critical Access Hospital Network (ICAHN). ICAHN is a not-for-profit 501(c)(3) corporation, established in 2003 for the purposes of sharing resources, education, promoting operational efficiencies and improving health care services for member critical access hospitals and their rural communities. ICAHN, with 51 member hospitals, is an independent network governed by a ninemember board of directors with standing and project development committees facilitating the overall activities of the network. ICAHN continually strives to strengthen the capacity and viability of its members and rural health providers. HRHC is a member of the Illinois Critical Access Hospital Network. The community health needs assessment will serve as a guide for planning and implementation of health care initiatives that will allow the hospital and its partners to best serve the emerging health needs of the Hoopeston area. The assessment identifies and assesses the health needs of, and takes into account input from persons who represent the broad interests of, the community served by HRHC. Hoopeston Regional Health Center is dedicated to providing quality, dependable health services. Hoopeston Regional Health Center 3

Methodology and Gaps Discussion The community health needs assessment was conducted through a consulting arrangement with the Illinois Critical Access Hospital Network. Terry Madsen, an ICAHN consultant, attorney and former educator and community development specialist, met with hospital executive staff to define the community, scope of the project and special needs and concerns. Possible local sources for secondary data and key external contacts were identified and a timeline was established. Potential avenues for gathering primary data were reviewed and it was determined to proceed with key contact interviews representative of community leaders and health care professionals. Information gaps exist in the service area because of the absence of population concentrations in Hoopeston and the HRHC service area that may be target groups of concern in other locations. This assessment has addressed those gaps by including input from community members that are charged professionally with advancing the health and education of the community and all its members, including school officials dealing daily with youth and families, and representatives of the area s multi-services agency. As with many rural areas, secondary data is often a year or more out-of-date, which highlights the importance of historic trends in that data in the service area. Secondary data from state and federal sources, which are cited in text, was reviewed by the consultant and compared to the primary data gathered. Identified needs were prioritized through that process and presented to hospital administration for review. Hoopeston Regional Health Center 4

COMMUNITY Geographic Assessment Area Defined The geographic assessment area was determined to be the primary hospital service area, which includes all or portions of six zip codes. The service area, as defined by hospital staff and an independent consultant on a prior project, surrounds the city of Hoopeston and includes the additional communities of Milford, Cissna Park, Wellington, Rankin, Rossville, East Lind, Stockland, Goodwine and Henning. The geographic area definition of community is well-suited to Hoopeston Regional Health Center, a designated critical access hospital providing basic care through inpatient care, ancillary services, clinics and specialty clinics to residents of a rural area. The hospital is located on the northern edge of the Danville Metropolitan Statistical Area, although the demographics of its service area much more closely reflect the rural nature of neighboring Iroquois County than those of the City of Danville. Illustration 1. Hoopeston Regional Health Center Service Area ESRI - 2012 Hoopeston Regional Health Center 5

Demographic Profile Table 1. Population by Race HRHC Service Area RACE 2010 2016 White 95.2% 94.7% Black 0.7% 0.8% American Indian 0.3% 0.3% Asian 0.3% 0.3% Other 2.4% 2.7% Tw o or More Races 1.1% 1.3% Hispanic Origin (any race) 6.1% 7.3% (ESRI - 2012) As with many rural locations, census data suggests the hospital service area is predominantly white with no large identified clusters or concentration of any minority population. Illinois State Board of Education data indicates that eight percent of the demographic of Rossville Elementary School District is Hispanic. The Hoopeston school district is eleven percent Hispanic and eight percent multiracial. The Cissna Park junior high school is eight percent Hispanic and six percent Asian. Table 2. Population by Age HRHC Service Area 18.0% 16.0% 14.0% 12.0% 10.0% 2011 2016 15.3% 13.8% 14.8% 14.0% 11.8% 10.6% 10.5% 10.6% 10.0% 9.7% 8.0% 6.0% 4.0% 6.0% 6.6% 6.7% 6.9% 6.4% 6.6% 5.9% 6.3% 4.4% 4.2% 6.2% 6.1% 3.4% 3.2% 2.0% 0.0% 0-4 5-9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Category (ESRI - 2012) The age of residents within the service area is projected to increase in all age groups over 55 and to decline slightly in lower ages, except for the 25-34 bracket, which is expected to show a small increase. The stability of the age profile at lower and middle age levels is better than is often seen in rural Illinois communities. Hoopeston Regional Health Center 6

Table 3. Population Summary and Trends HRHC Service Area SUMMARY 2000 2011 2016 Population 13,409 13,455 13,398 Households 5,524 5,548 5,559 Families 3,640 3,652 3,614 Average Household Size 2.41 2.41 2.39 Ow ner Occupied Housing Units 4,059 4,036 4,072 Renter Occupied Housing Units 1,465 1,512 1,487 Median Age 43.2 43.5 44.9 TRENDS: 2011-2016 Annual Rate AREA STATE U.S. Population -0.09% 0.00% 0.67% Households 0.04% 0.00% 0.71% Families -0.21% 0.00% 0.57% Ow ner Households 0.18% 0.00% 0.91% Median Household Income 3.13% 0.00% 2.75% (ESRI - 2012) The overall population of the service area is trending downward with expected related drops in most demographic categories. The median age is rising steadily and is projected to continue to increase over the next five years to 44.9 years of age. Hoopeston is located over 20 miles from the nearest interstate. Economic Profile Table 4. Household Income Profiles HRHC Service Area HOUSEHOLD INCOME BRACKET 2011 2016 <$15,000 17.3% 17.2% $15,000-$24,999 13.7% 11.0% $25,000-$34,999 13.5% 10.5% $35,000-$49,999 17.4% 15.4% $50,000-$74,999 19.1% 21.2% $75,000-$99,999 10.7% 14.3% $100,000-$149,999 6.1% 7.7% $150,000-$199,999 1.0% 1.3% $200,000+ 1.2% 1.4% (ESRI - 2012) A snapshot of Hoopeston s sales tax revenue shows a recovery for the August 2011 report over past years after a sharp decline between 2008 and 2009. The 2011 amount for the August report (June payment) was $47,428.41. This pattern is very typical of that found throughout rural Illinois. In 2010, the occupational distribution of the local employed population was: 51.4% in white collar jobs, compared with 61.6% of U.S. employment 17.7% in service jobs, compared with 17.3% of U.S. employment 30.9% in blue collar jobs, compared with 21.1% of U.S. employment Hoopeston Regional Health Center 7

Agriculture and construction jobs are included in the blue collar category, reflecting the rural character of the service area. According to the Illinois Department of Economic Opportunity Community Profile for 2011, Hoopeston Regional Health Center is the largest employer in Hoopeston. The graduation rates at Milford and Cissna Park exceed the state level, yet Hoopeston s rate remains below Illinois. In 2010, the educational attainment of the population aged 25 years or older in the area was distributed as follows: 16.4 percent had not earned a high school diploma, compared with 14.8 percent in the U.S. 43.2 percent were high school graduates only, compared with 29.6 percent in the U.S. 8.3 percent had completed an Associate s degree, compared with 7.7 percent in the U.S. 8.1 percent had obtained a Bachelor s degree, compared with 17.7 in the U.S. 4.1 percent had earned a Master s, Professional or Doctorate degree, compared with 10.4 percent in the U.S. (ESRI 2012) Table 5. Education Environment 100% 80% 74.5% 69.6% 95.1% 93.0% 89.7% 100.0% 85.1% 82.6% 87.8% 60% 58.5% 55.9% 59.4% 40% 36.4% 28.0% 30.5% 40.7% 36.9% 36.7% 45.4% 20% 12.8% 21.1% 0% Hoopeston Area Milford Elementary Milford High School Cissna Park Rossville Illinois Low Income - 2000 Low Income - 2010 Graduation Rate - 2000 Graduation Rate - 2010 (ISBE - Interactive Illinois Report Card 2011) Low-income students are pupils ages 3 to 17, inclusive, from families receiving public aid, living in institutions for neglected or delinquent children, being supported in foster homes with public funds, or eligible to receive free or reduced-price lunches. The percentage of low-income students is the count of low-income students, divided by the total fall enrollment, multiplied by 100. Hoopeston Regional Health Center 8

At Hoopeston Area School District, the percentage of low income students rose from 36% in 2000 to 58% in 2010. During the same period, Milford Elementary doubled from 28% low income students to 56%, and Milford High School rose from 30% to 41%. Cissna Park reported the lowest percent of low income students at 13% in 2000 and 21% in 2010. Rossville reported the highest percent of low income students at 37% and 59%. The state average was 45% in 2010. Table 6. 2010-2011 Unemployment Rate Trends 13.5% 12.5% Unemployment Rate 11.5% 10.5% 9.5% 8.5% 7.5% Vermilion County Iroquois County Illinois U.S. 2010 12.2% 9.5% 10.1% 9.5% 2011 10.3% 8.1% 9.5% 9.1% (Illinois Department of Employment Security 2011) Unemployment in Vermilion and Iroquois counties remains high; however, the unemployment rate in both counties dropped in the period 7/10 7/11. The jobless rate in Iroquois County fell below both the state and national rates while Vermilion County remained above both rates. Slowly recovering employment numbers and sales tax revenue, increasing numbers of children eligible for free or reduced lunch, and modest incomes and housing values paint the service area as similar to many rural communities in Illinois today. Hoopeston Regional Health Center 9

INPUT Health Profiles from Existing Studies and other Secondary Data The Illinois Behavioral Risk Factor Surveillance System provides health data trends through the Illinois Department of Public Health in cooperation with the Center for Disease Control and Prevention, Office of Surveillance, Epidemiology and Laboratory Services. Table 7. Health Risk Factor Trends 35% 30% 25% 20% 15% 10% 5% 0% Smoker 2006 Smoker 2009 Obese 2006 Obese 2009 Vermilion 31% 28% 27% 30% Iroquois 22% 25% 29% 30% Illinois 20% 19% 25% 27% (Illinois Behavioral Risk Factor Surveillance System 2011) Table 8. Incidence by Disease Type Iroquois County 50.0% Percentage of Population 45.0% 40.0% 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 42.0% 42.0% 39.0% 38.0% 37.0% 36.0% 34.0% 34.0% 34.0% 32.0% 29.0% 26.0% 12.0% 10.0% 8.0% 8.0% 5.0% 0.0% Diabetes Arthritis High Blood Pressure High Cholesterol 2001-2003 2004-2006 2007-2009 State 2009 (Illinois Behavioral Risk Factor Surveillance System 2011) Hoopeston Regional Health Center 10

Table 9. Incidence by Disease Type Vermilion County 50.0% Percentage of Population 45.0% 40.0% 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% 10.0% 9.0% 8.0% 7.0% 36.0% 34.0% 34.0% 35.0% 30.0% 30.0% 28.0% 29.0% 26.0% 25.0% Diabetes Arthritis High Blood Pressure 2001-2003 2004-2006 2007-2009 State 2009 43.0% 37.0% High Cholesterol (Illinois Behavioral Risk Factor Surveillance System 2011) Both counties reflected reasons for attention to incidence of diabetes, arthritis, high blood pressure and high cholesterol. In Iroquois County, all four categories showed irregular reporting patterns over the period 2001 to 2009, but in each case, the 2009 levels in Iroquois County exceeded those reported statewide. In Vermilion County, all categories also exceeded statewide levels but diabetes, high blood pressure and high cholesterol also indicated a consistent pattern of increased incidence reported over the period. (IBRFSS 2011) Table 10. Activities limited by Impairment 2009 100% % of Population 90% 80% 70% 60% 50% 40% 30% 18.0% 82.0% 22.0% 78.0% 16.1% 83.9% 20% 10% 0% Iroquois County Vermilion County Illinois 2009 Not Limited by Impairment Limited by Impairment (Illinois Behavioral Risk Factor Surveillance System 2011) Hoopeston Regional Health Center 11

The National Cancer Institute rates Vermilion County at Priority 4 out of 9 levels on death rates for all cancer, with Priority 1 being highest and Priority 9 lowest. Priority 4 indicates stable rates over time that are above the U.S. rate. Vermilion County is rated as Priority 8 (similar to U.S. rate and falling) for breast cancer and colon/rectal cancer, and Priority 6 (similar to U.S. rate and stable) for leukemia and stomach cancer. Iroquois County is rated at Priority 6 for all cancers. Priority 6 indicates stable rates over time that are similar to the U.S. rate. (National Cancer Profiles, State Cancer Profiles, 2011 data collected through 2009) While the percentage of reported smokers declined in both counties in the service area from 2006 to 2009, both counties remained above the statewide level. Reported obesity also exceeded the state level and rose in both counties during the period. (IBRFSS 2011) According to the U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions (January 2011), Hoopeston is a designated health professional shortage area for primary care physicians. There are more than 30 state and federal programs available to HPSAs to help meet local health care needs. The Iroquois and Vermilion County Health Departments work actively with hospitals and other health care providers in their counties. The Departments conduct a community health planning process under the Illinois Project for Local Assessment of Needs (IPLAN) every five years. The IPLAN conclusions are: Vermilion County IPLAN 2007-2012 Three Major Health Indicators Teen pregnancy Diseases of the heart Violence Ford-Iroquois Counties IPLAN Objectives 2010 Priority Objectives Gateway drug abuse Alcohol use among youth Mental health issues in senior citizens (depression/isolation) Obesity in children and adults The IPLANs that overlap the HRHC service area differ, reflecting perhaps the larger population and the inclusion of the Danville area in the Vermilion County plan process. The Illinois Youth Survey, 2010, is referred to in the Iroquois report in support of the Priority 1 and 2 objectives. A review of the IYS for Vermilion County suggests a low countywide participation. An aside of that report is that it does document a small gang presence and possession of weapons by high school age members, which also supports the violence goal of that report. Synthesized Secondary Data Hoopeston Regional Health Center 12

Hoopeston area demographics reflect overall lower income and housing values than statewide comparisons but in levels that are not inconsistent with other rural areas of the state. The population has declined in the past ten years and is projected to continue to decline slowly over the next five years, while increases are seen statewide during the same periods. Vermilion County unemployment fell slowly over 2010-2011 but has been above state and U.S. levels over the period. Iroquois County has also been declining but has been slightly lower than state and federal rates. The population of low income students has increased steadily over ten years in every school in the service area, more than doubling in one instance. The risk for smoking declined from 2007 to 2009 in Vermilion County and rose slightly in Iroquois. Both remain slightly higher than the state overall. Obesity also increased slightly in both counties and marginally exceeds the state level. Iroquois County reports patients diagnosed with diabetes, arthritis, high blood pressure and high cholesterol at higher than state levels, although all but cholesterol have been trending downward. Vermilion County also reports patients diagnosed with diabetes, arthritis, high blood pressure and high cholesterol at higher than state levels and also indicates all but arthritis have been trending upward for several years. Persons with activities limited by impairments also exceed state levels in both counties. Vermilion County s level exceeds Iroquois. The IPLANs drew local emphasis to teen pregnancy, heart disease, violence, gateway drugs, alcohol use by youth, mental health issues with the elderly and obesity. Summary The secondary data and previous planning conclusions draw attention to several common issues or rural demographics and economies of the day and draw emphasis to health issues related to the elderly, risky behavior with regard to substances and obesity, and related issues, including diabetes. Hoopeston Regional Health Center 13

Primary Source Information Key Contact Interviews Hospital staff identified thirty potential key contacts representing local government, community services, health care professionals and local leaders. Nine of these, representative of each of the groups included, were selected for personal one-on-one telephone interviews. They included Dr. Jay Colbert, DO, Family Practice; Julie Clark, Tobacco Coordinator/FOIA and OMA Officer, Iroquois County Health Department; Chalmers Flint, Director, Multi-Agency Service Center; Susan Redden, Administrative Secretary, Multi-Agency Service Center; Hank Hornbeck, Superintendent, Hoopeston Area Schools; Dr. Dan Hylbert, Superintendent, Cissna Park Community Unit School District No. 6; Scott Strausser, Director, Hoopeston Area Emergency Management Agency; Mark Drollinger, Chief, Hoopeston Police Department; and Megan Deck, Grant Township Supervisor. Dr. Colbert identified recent positive developments as the expansion of services at both HRHC satellite clinics and the main clinic in Hoopeston, more physical therapy resources and the ongoing improvements of the emergency room. Dr. Colbert identified the need for more specialists generally and specifically, a Cardiologist, and greater access to orthopedic services as area health delivery needs. He also noted while ultrasound access has improved greatly in the past three to five years, greater access to imaging resources would be beneficial. Finally, he expressed that some post-referral transportation to out-of-town specialists would be helpful. Julie Clark has led the Iroquois County IPLAN process. She expressed the belief there was a lack of adequate teen parent and family planning services in the area. She also suggested a school nurse at Cissna Park could be helpful. She reported that she perceives youth obesity as a health concern and believes smoking may be high in the Millford area. Chalmers Flint is the Director of the Hoopeston Multi-Agency Service Center which provides local access to federal, state, county and private social service agencies for residents of northern Vermilion County. Access to social service agencies is accomplished through information and referral. The Multi-Agency Service Center makes available office space and other supportive services for various agency representatives, such as counselors and caseworkers, to provide social services in northern Vermilion County. The Multi-Agency Service Center also provides an afterschool program and transportation for senior citizens and disabled citizens five days a week, year-round on an on-demand basis. Flint identified obesity, diabetes, blood pressure and emergency care as primary health care needs of the clients of his agency. He was complimentary of Hoopeston Hospital for its efforts to address local health needs and reported it has grown recently and is performing an important job in the overall health care delivery system. Hoopeston Regional Health Center 14

Susan Reddle, the administrative secretary for the Multi-Agency Service Center was interviewed separately. She works with seniors and single mothers and spends much of her effort on the Circuit Breaker program and attempting to assist with access to prescription drugs. She offered the same health needs as Mr. Flint (obesity, diabetes, blood pressure and emergency care) and added care for the uninsured. She reported that she believes the new walk-in clinic is going a long way to ease the problem with needs of the uninsured. She also identified a need for smoking cessation classes and possibly more EMS and community CPR training. Hank Hornbeck is the superintendent of Hoopeston Area Schools. He reported several positive developments in area health care delivery, including the Rossville clinic and many recent improvements at the hospital. He also spoke very favorably of the sports medicine program, which put an athletic trainer on-site at the schools. He believed the hospital enjoyed a much improved reputation in the community overall and particularly for its emergency services. Hornbeck identified education outside of school for teen pregnancy issues and expectant mother wellness as related needs facing the local health care community. He also expressed the need for more convenient access to low income care. He suggested extending clinic hours to nights and weekends as possible resolution of this concern. He also reported the biggest health care issue facing the schools is lice. He said a comprehensive community education approach is needed for that issue. He reported that he had, very recently, joined the hospital board. Dr. Dan Hylbert, Superintendent, Cissna Park Community Unit School District stated a need for wellness programs for obesity and healthy lifestyles and a network or alliance for persons interested in those issues. He cited the new clinic as a positive development. He also identified the presence of EMTs at sporting events as a big positive. Scott Strausser is the Director of the Hoopeston Area Emergency Management Agency. He identified health care needs specific to emergency/disaster services, including a need for emergency shelters and warming centers and a plan for home health care during emergencies or extended shelter circumstances. He believed an updated emergency plan may help address these issues. He noted the increased services from the ambulance service were a recent positive development. Mark Dollinger, Chief of Police in Hoopeston, stated the area had issues with substance addiction, particularly with alcohol and prescription drugs. He noted that while Prairie Center in Danville does work in the community, there is a need for additional counseling resources. He also cited obesity, diabetes and the absence of a local dentist as additional health concerns. He offered the opinion that the hospital has become more responsive to local needs in the past few years. Megan Deck is the Grant Township Supervisor. Grant Township includes Hoopeston and surrounding areas. She assists people in poverty with various needs and Hoopeston Regional Health Center 15

volunteered the opinion that charity care at the hospital is amazing. She reported that she assists with prescription needs and deals with a few requests a month with general success. She reported a recent awareness of a need for medical equipment and has found that it is difficult to find assistance for persons with the need for equipment. Hoopeston Regional Health Center 16

PRIORITIZATION Reconciliation of Primary Source Information with Secondary Data The primary information gathering process resulted in the disclosure of concerns over local numbers of persons with obesity, diabetes, high blood pressure and in need of emergency care. Lice was also raised as a significant concern by a school official. Risky behaviors were identified as substance addiction, including alcohol, teen pregnancy and smoking. More specialists generally and specifically, a cardiologist, and greater access to orthopedic services, dental services, increased access to imaging services, increased access to medical equipment, post-referral transportation to out-of-town specialists and providing care to an increased number of uninsured, were also raised as needs by the key informants. One key informant raised concerns over adequacy of planning for health response to needs generated by emergency or disaster situations, including providing for persons with home care needs isolated by weather or other events. The issues raised by key informants were largely consistent with the needs identified from the secondary information collected, which included evidence of risky behavior with alcohol and smoking, obesity, diagnosis of diabetes, arthritis, high blood pressure and high cholesterol, all at higher levels than statewide occurrence rates. Secondary sources drew additional attention to specific issues as they related to the elderly. Summary of Findings and Recommendations The items set forth below are those which found consistent identification and, ultimately, prioritization in the primary information gathering process, and which are supported by the secondary information related to demographics and health status. 1. Health Education / Risk Education The need for health education was identified both in the discussions with primary sources as well as in the secondary information. Education and community organizations around elderly populations, teen pregnancy and parenting, lice, dietary and general health, and risk for smoking, alcohol and other substance abuse, were supported by both primary and secondary sources. Emergency planning, although not evident from secondary health data was identified by the local director of the Emergency Management Agency and warrants inclusion in education planning. 2. Obesity / Diabetes Obesity-related issues are more prevalent in the service area than statewide. Primary information sources recognized and prioritized this subject. The Iroquois County Health Department s current IPLAN priority objectives call for addressing obesity. This is an area where coordination and collaboration among communities, schools, health care partners and HRHC on education and opportunities for healthy living and health care could reduce numbers in both risk and disease. Hoopeston Regional Health Center 17

3. Physician Recruitment and Replacement Planning According to the U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions (January 2011), both counties are designated health professional shortage areas for primary care. Key informant inquiry led to a specific call for access to additional specialists. 4. Mental Health Resources for the Elderly Iroquois County indicated this as an IPLAN priority. Other data and the key informant process leads to indications of increased numbers of persons with activities limited by impairments and issues locally with obtaining medical equipment and transportation to out-of-area medical care, all issues of concern to senior populations. This, again, presents HRHC with the opportunity to work with other health care providers toward a collaborative resolution. 5. Improved Access to Dental Care This area was identified through the key informant process as a need. Hoopeston Regional Health Center 18

RESOURCE INVENTORY Hoopeston Regional Health Center Hoopeston Regional Health Center is a critical access hospital serving Hoopeston, Vermilion County and the surrounding area. Employing more than 250 staff members, with 18 physicians and mid-level providers, the 25-bed HRHC is committed to providing quality, dependable health services. The hospital has clinics in Hoopeston, Rossville and Cissna Park. Activities Department The Activities Department at Hoopeston Regional Health Center offers residents the daily and special activities that address their needs and interests. Swing bed patients are included in the activity programs. Each resident is evaluated upon admission, and frequently thereafter, to ensure the activities offered and participated in meet his/her individual preferences and needs. Upon admission, the family is interviewed so the staff can gain valuable insight into what activities the resident will enjoy and benefit from the most. In addition, the activities staff participates in the care plan conferences, held monthly with other staff and the resident s family member(s). Special events are frequently scheduled that allow the residents to be away at times. A new van was purchased in 2007 which has increased the frequency of trips and in the number of residents who are able to participate in those trips because of expanded seating. Special internal activities are an important part of the facility s activity program calendar. The staff has developed strong relationships with area schools, churches and social groups to allow for increased community participation in the activities offered. Ambulance Service The Hoopeston Ambulance Service is recognized by the Illinois Department of Public Health as an Advanced Life Support (ALS) ambulance service. An ALS ambulance service means the ambulance is staffed with a licensed paramedic who is certified to diagnose illnesses or injuries, administer medications, provide cardiac monitoring and perform many other emergency procedures. The units are ready and available 24 hours a day, 365 days a year. Each ambulance is equipped with state-of-the-art emergency cardiac support equipment and advanced airway equipment, in addition to a vast array of pediatric and adult medical equipment. The ambulance staff uses their special skills and training to quickly stabilize and transport patients to Hoopeston Regional Health Center, where board certified emergency medicine physicians and specially trained nurses will be waiting. Hoopeston Regional Health Center 19

The Hoopeston Ambulance Service operates under the medical direction of Carle Regional EMS System. Airlife, an aero-medical team based at Carle Hospital in Urbana, provides service to the area. The Hoopeston Ambulance Services provides Advanced Life Support for Hoopeston and the surrounding areas including Rankin, Reilly, East Lynn, Wellington (by request) and Ambia, IN (by request). Mutual aid service is also provided to Rossville, Milford, Paxton and Cissna Park, IL. Infection Control The Infection Control Department plays a critical role within the facility. The staff in this department performs ongoing monitoring and education to prevent hospital-acquired infections. The Hoopeston Regional Health Center rates of hospital-acquired infections are significantly below the national infection rates. While controlling infections within the hospital and nursing home settings is something in which everyone plays a role, the Infection Control Department is the driving force in this process. Ongoing training with employees works to keep proper infection control techniques fresh in their minds. The Infection Control Practitioner does monthly training for departments so that proper infection control is an ongoing focus for everyone in the facility. Those traveling throughout the facility will see handwashing stations throughout the clinical areas. Visitors are encouraged to use these stations upon entering and exiting where patient care is provided, including the Surgery, Medical/Surgical and Emergency Departments. Signage throughout the facility also reminds patients and visitors to use standard precautions when sneezing or coughing. The Infection Control Department also oversees a community education program called Scrubby Bear, which teaches grade school children the proper handwashing technique and why it is important. Laboratory Services Convenient hours, quick results and a highly qualified staff are three reasons for choosing Hoopeston Regional Health Center for laboratory service needs. The facility s laboratory staff are on-site 24 hours a day, 7 days a week. The process to get results to providers begins the moment a sample is taken. Upon receipt of a sample, laboratory staff immediately begin the analysis process. Once complete, usually within 24 hours, staff will immediately fax results to providers. The experienced staff at the Hoopeston Regional Health Center laboratory manages more than 86,000 tests each year. Staff members have more than 110 years of combined laboratory experience. The laboratory staff has been trained to process samples using state-of-the-art technology, including sophisticated analyzers. Hoopeston Regional Health Center 20

Medical/Surgical Unit Hoopeston Regional Health Center s Medical/Surgical Unit provides a caring and compassionate environment for patients who are recovering from an illness or injury. The unit provides a low patient-to-nurse ratio. This low ratio provides staff members more time with each patient. The facility is committed to maintaining this low ratio in order to maintain additional time with the staff. The facility offers an open visitor policy with flexible hours. Meals served in the Medical/Surgical Unit are prepared by a talented dietary staff that makes it a priority to provide a tasty variety of meals. The facility s housekeeping staff provides cleaning service each day to ensure a sanitary environment for patients. The unit has an on-site physician 24 hours a day, 7 days a week. This type of physician coverage is often referred to as a hospitalist. This type of program provides patients with immediate physician care should the need arise. Pharmacy Services To ensure that any patient or resident medication needs or questions can be answered quickly, Hoopeston Regional Health Center has a pharmacy contract to provide off-site coverage with 24-hour call. The pharmacy is automated and safeguarded to ensure that medications are distributed in the safest manner possible. Medications are available for dispensing through a process that calls for prescriptions to be faxed to the registered pharmacist and reviewed immediately. After the review, medications are administered by appropriate nursing staff. Radiology Department The radiology department at Hoopeston Regional Health Center provides the most current radiology testing close to home. Staff of the facility are trained, experienced and licensed or certified to perform routine radiology tests, mammography, MRI studies, CT scans, ultrasounds, bone density and echocardiograms. Staff members perform radiology services under the supervision of a radiologist. The facility s radiologist reads the completed tests and communicates the results to the provider 24 hours a day, 7 days a week for the emergency room. Primary care providers usually receive reports with 24 hours. For specialty tests like mammography, ultrasounds and MRI tests, patients can rest assured knowing the staff managing your test(s) hold advanced certifications which allow them to perform those tests. Social Services Department The Social Services Department at Hoopeston Regional Health Center is a valuable resource for the community. A trained and knowledgeable staff provides needed resources during what can often be challenging situations. Hoopeston Regional Health Center 21

The Social Services staff can assist or provide the following: Information on the facility s nursing home Information on Medicaid and the process to follow for applying Managing a nursing home placement Information about home care needs whether it is from a community member or someone being discharged from the hospital, swing bed program or nursing home settings Surgery Department Hoopeston Regional Health Center has a surgery department that routinely performs a wide range of general surgeries including gall bladders, hernias, colonoscopies and gastroscopies. In addition to general surgery procedures, the facility also has specialty surgeons that perform procedures in ophthalmology, urology and podiatry. The facility s surgeons all have extensive experience in their field of expertise and the clinical surgery staff has been skillfully trained, with an average of 20 years experience per employee. Most surgical consultations are available at the Charlotte Ann Russell Medical Center. Health Alliance, Personal Care, PHCS, Medicare, Medicaid, BC/BS and other insurance are accepted. Swing Bed Care Program Hoopeston Regional Health Center offers rehabilitative services allowing patients to return back home near their family, friends and loved ones while they recover from an illness, injury or surgery. By obtaining services locally, a patient can maintain ongoing contact with their friends and loved ones. This ongoing contact and support can be an important part of making what could be a difficult situation easier for the patient and their caregivers. The swing bed program allows patients to stay in their own community while receiving the on-site therapy and healthcare services they need to return to their home or transition to a new living environment. The low staff-to-patient ratio provides for more personal contact during the recovery process. The scope of services offered to swing bed patients includes skilled nursing care, physical and occupational therapy, social services and activities, nutrition review and the availability of outpatient lab and radiology testing. Swing bed patients are provided physician care by hospitalists, which are board certified medical doctors. Therapy Services Recovering from an injury or illness that has comprised one s mobility can be difficult; however, the highly trained and compassionate therapy staff at Hoopeston Regional Health Center can make the healing process easier. Hoopeston Regional Health Center 22

Services offered locally can range from assisting those with hip and knee replacements, stroke recovery and other conditions that have limited your mobility, including muscle injuries and overall uncontrolled pain. Every therapy staff member is highly trained and a certified physical therapist oversees each patient s therapy program, from their initial evaluation to meeting their maximum level of mobility and function. A wide range of therapy methods are available to the therapy team and the selected method will be based on the patient s unique needs. Whatever method is selected, the patient can be assured that a qualified staff member will be overseeing the treatment. Some of the most common modalities offered to patients include hot and cold compress, ultrasound, electrical stimulation, TENS and specifically targeted exercises. There is no need to leave the area for highly successful therapy. Ask your primary care provider for a local referral at the time your therapy order is written. The convenient hours and location make it easy to get started on the recovery process. Hoopeston Community Memorial Nursing Home A caring and compassionate staff provides the highest level of care possible in a manner that preserves a resident s right to choose. Pioneering is a word that employees, residents and family members will likely hear or experience while in the nursing home. Pioneering is a concept based on providing residents the opportunity to make choices about their care and their life within a homelike setting. An important element of the facility s Pioneering Program is the buffet style dining experience in which the residents participate at each meal. Residents are provided a wide variety of choices during each meal and they work with a staff member to make their selections fresh off the buffet cart. During the breakfast meal, residents can choose items from the buffet cart or request to have their eggs cooked fresh to their specific tastes. The most crucial piece to a successful Pioneering Program is the unique opportunity that all levels of staff have been given to freely interact with the residents to keep the environment as homelike as possible. From the housekeeper to the certified nursing assistant to the maintenance technician, each staff member becomes an important part of each resident s life and each of them interacts and gets to know more than just the resident s name. The facility works diligently to keep the same caring staff whenever possible to promote the development of a caring relationship between the residents and staff. By maintaining consistency in this area, staff members get to know the resident s family, learning their likes and dislikes and the way they wish their home to be. Hoopeston Regional Health Center 23

The Pioneering Program also promotes resident choice. The facility s talented employees within the activity department continuously strive to meet each resident s specific activity needs and desires, taking into account each resident s own personal preferences. Special activities occur throughout each day to provide residents numerous opportunities to socialize with other residents and with the employees. Special one-on-one activities are also planned for those residents that prefer or require that setting. In addition to providing a more homelike and less clinical setting, the 75-bed facility is connected to the hospital. This close proximity to a hospital provides extra assurance to the resident and their families that if needed, acute care services are just a few feet away. Bridgeway Unit Bridgeway, a program unlike any in the area, provides much needed mental health services for senior adults struggling in their daily lives. This is accomplished through an intensive program of individual and group therapy sessions designed to help with the many mental health issues that are prevalent for the elderly. This program has a two part system individual sessions combined with multiple group therapy sessions. During the group therapy sessions which are held two separate times in the morning, Monday through Friday seniors are able to share their grief and start to believe they are not alone. The sessions are also designed to help show seniors how to begin and continue to make changes in their lives. Criteria for participation include loss of interest in what he/she normally enjoys doing, isolation, lack of participation in social events, frequent episodes of sadness, having a difficult time with grief or a loss or having a difficult time adjusting to a medical issue. Referrals to Bridgeway can come in many forms. Family members, friends, clergy, neighbors, nurses, physicians, assisted living facility staff and nursing home staff can all refer someone to the program. The only main criteria are willingness and ability to participate in a group and the ability to retain and benefit from the information gained. Bridgeway can provide transportation as needed. They have a handicapped accessible vehicle and a minivan as well as a driver on staff. Country Terrace Independent Living Apartments Country Terrace Apartments are located on the southeast area of the Hoopeston Regional Health Center campus. The apartments overlook a parklike setting and landscaped flower beds are nestled throughout the grounds. Running fountains, bird feeders and a beautiful gazebo offer residents the opportunity to interact with nature just like they did in their own home. The Country Terrace apartment community was designed specifically for older adults wanting to maintain their independence. The apartment complex is small enough Hoopeston Regional Health Center 24

where everyone knows your name, but large enough to offer many of the services needed to make your life worry-free. Those living at Country Terrace maintain their independent living lifestyle with the occasional helping hand and friendly smile. The menu is unique and caters to a wide variety of tastes, with each meal offering several choices. The menu offers standard favorites and new experiences something to appeal to everyone s tastes. Two full meals are served each day in the cozy dining room atmosphere. A full activities program is also an important part of Country Terrace. Daily activities and special events are planned and the staff works diligently to ensure there is something for everyone s particular tastes and interests. In addition, special individual time is available for those who have that need. The facility offers studio and one bedroom units. Both units offer a private outside door to a patio for enjoying those cool evening breezes and an inside door to the common hall. The all-inclusive monthly rate provides meals, housekeeping, utilities, cable TV, transportation, laundry facilities and maintenance. Area Health Services Review The Family Health Care Center of Hoopeston The Family Health Care Center of Hoopeston is open on weekdays from 8:00 a.m. until 5:00 p.m. and provides services through a medical doctor and a family health nurse practitioner. Hoopeston Regional Health Center 25

REMARKS The Hoopeston Regional Health Center Community Health Needs Assessment began in spring 2011 and continued through April 2012. During the process, interim IRS guidelines were released allowing for a more confident focus of effort and resources. ICAHN is grateful to HRHC staff for their participation in the development of this project, which will benefit many of their ICAHN partners in the years to come. ICAHN and HRHC are grateful to the health care professionals, community leaders and citizens who offered their thoughtful input for the assessment. This report was submitted to the Administration of Hoopeston Regional Health Center in May 2012, subject to further revision reflecting data updates or changes in local circumstances prior to widespread publication. Hoopeston Regional Health Center 26

APPENDIX Key Informant Interview Participants Dr. Jay Colbert, DO Family Practice Julie Clark, Tobacco Coordinator/FOIA and OMA Officer Iroquois County Health Department Chalmers Flint, Director Multi-Agency Service Center Susan Redden, Administrative Secretary Multi-Agency Service Center Hank Hornbeck, Superintendent Hoopeston Area Schools Dr. Dan Hylbert, Superintendent Cissna Park Community Unit School District No. 6 Scott Strausser, Director Hoopeston Area Emergency Management Agency Mark Drollinger, Chief Hoopeston Police Department Megan Deck Grant Township Supervisor Hoopeston Regional Health Center 27

Collaborators The Hoopeston Regional Health Center Community Health Needs Assessment was developed and conducted by a consultant provided through the Illinois Critical Access Hospital Network (ICAHN). ICAHN is a not-for-profit 501(c)(3) corporation, established in 2003 for the purposes of sharing resources, education, promoting operational efficiencies and improving health care services for member critical access hospitals and their rural communities. ICAHN, with 50 member hospitals, is an independent network governed by a ninemember board of directors with standing and project development committees facilitating the overall activities of the network. ICAHN continually strives to strengthen the capacity and viability of its members and rural health providers. HRHC is a member of the Illinois Critical Access Hospital Network. Terry Madsen, M.A., J.D., former University of Illinois Extension educator and community development specialist, was the lead collaborator for this project. Mr. Madsen is a member of the City Council and Commissioner for Public Health and Safety for the City of Princeton, Illinois, which owns a critical access hospital. He has participated in specialized training in community needs assessment, community organization, diversity, ethics, community and youth development and project evaluation. Through ICAHN, Mr. Madsen has direct access to data services and specialized production equipment as well as educational, management and marketing support from in-house staff and consultants. Curt Zimmerman, Director of Business Services and Development at ICAHN, provides technical support, design/layout direction, proofreading and editorial support for the community health needs assessments projects provided through ICAHN and Mr. Madsen. Hoopeston Regional Health Center 28