Seton Medical Center Harker Heights Community Health Implementation Strategy

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Seton Medical Center Harker Heights Community Health Implementation Strategy Prepared by the Seton Family of Hospitals in collaboration with Seton Medical Center Harker Heights Formally adopted by the Seton Medical Center Harker Heights Board of Directors on November 14, 2016. For questions or comments on this report, please visit https://www.seton.net/chna-feedback/

Overview Seton Family of Hospitals is a 501(c)(3) nonprofit organization with a long-standing history of serving Central Texas, not only as a health care provider, but as a leader and advocate for improving the health of the population as a whole. Its parent company, Ascension Health Texas (d/b/a Seton Healthcare Family) is a minority owner of Seton Medical Center Harker Heights. These organizations collaborated to prepare this implementation strategy (IS) report and the term Seton refers to both Seton Family of Hospitals and Central Texas Rehabilitation Hospital in this report. The 2010 Patient Protection and Affordable Care Act included an IRS mandate that changed Community Benefit reporting. Non-profit hospitals must now engage in a three-year cycle of addressing community health needs, beginning with a Community Health Needs Assessment (CHNA) for the communities it serves. Once CHNA is complete, each hospital must create and adopt an Implementation Strategy that describes the actions the hospital plans to address the health needs identified in the Community Health Needs Assessment. These mandates are required as a condition of maintaining the hospital s federal tax exemption. Community Health Needs Assessment (CHNA) In 2016, Seton and its partners conducted eight CHNAs for the communities served by the Seton Healthcare Family. The methodology for conducting the CHNAs included two main components: (1) Analysis of demographic and health data using primary sources such as the U.S. Census and the Behavioral Risk Factor Surveillance System and; (2) Collection of secondary data from community stakeholders (including residents, public health officials, nonprofit organizations, government and business stakeholders) through focus groups, community forums and surveys. A detailed description of the methodology Seton used to conduct the 2016 CHNAs is included in the CHNA reports, which are posted on the hospital websites of the communities they address. Community Health Implementation Strategy This plan identifies the actions the Seton Medical Center Harker Heights, with the support of the Seton Healthcare Family, plans to take to address the prioritized needs identified in the Bell County CHNA of its service area. As required by the IRS, the Implementation Strategies also address any needs that will not be met. 2

Seton Harker Heights Medical Center Community Health Implementation Strategy About Seton Harker Heights Medical Center Seton Medical Center Harker Heights is a full-service acute care that opened in June 2012 near Killeen. Services offered at the 83-bed facility include emergency care, women s services, orthopedics, an intensive care unit, cardiology (including a cath lab) and imaging and diagnostics. Seton Medical Center Harker Heights is a joint venture between the Austinbased Seton Healthcare Family and LHP HH/Killeen, LLC. About the Bell County CHNA Seton Medical Center Harker Heights is located in Bell County and serves its residents. Seton collaborated with Baylor, Scott & White to gather data and community input for the 2016 Bell County Community Health Needs Assessment. Prioritized Health Needs for Bell County After carefully reviewing the data and community input, Seton prioritized five main health needs for Bell County in the 2016 CHNA: Need 1: Mental and Behavioral health. Need 2: Primary and Specialty Care. Need 3: Chronic Diseases. Need 4: Social Determinants of Health. Need 5: System of care. Seton recognizes that the five needs listed above are inter-connected and that many Bell County residents, especially the poor and vulnerable, have cross-cutting needs. The needs prioritized in the 2016 plan are similar to the needs identified in the 2013 Bell County Community Health Needs Assessment. The 2013 CHNA highlighted priorities including access to care, behavioral health, chronic diseases, accidents and obesity. 3

Implementation Strategy for Seton Medical Center Harker Heights The following Community Health Implementation Strategy for Seton Harker Heights addresses the above needs. For each category of need prioritized in the 2016 CHNA for Bell County, Seton has provided information below that describes: Key actions to address the need and their anticipated impact, Available resources, and Potential collaborations. Since many of the needs identified in 2016 reflect needs from the 2013 CHNA, many efforts to address needs in this implementation strategy are continuations of previous work. There is one community health need SMCHH does not intend to address and there is additional information provided below. Initiatives Addressing Community Health Needs: 1. Mental and Behavioral Health Initiative: Collaboration with Central Counties Mental Health Mental Retardation (MHMR) agency. Action: Behavioral health referrals, assessment and treatment. Need Addressed: Mental and behavioral health Increased access to needed mental health assessments and treatment. Telepsychiatry will improve care for behavioral health patients to begin earlier intervention for their care. Psychologists, nurses, social worker/case managers. Central Counties MHMR 2. Primary and Specialty Care Initiative: Collaboration with Greater Killeen Free Clinic Action: Primary care and preventive screenings for low-income residents. Needs Addressed: Primary and specialty care, chronic diseases, mental and behavioral health Expanded access to acute care services, chronic disease management and women s health screening. More residents with a medical home. Reduced preventable or inappropriate emergency room visits. Partnership with Freedom and urgent care setting in Killeen, which will be a more cost-effective setting to prevent misuse of the Emergency department. Physicians, nurses, assistants.. Greater Killeen Free Clinic Wellstone Physicians, Partnering with Freedom Express Urgent Care Note: Seton Harker Heights also helps individuals enroll in health insurance through enrollment in the Affordable Care Act Marketplace plans (ObamaCare). 4

3. Chronic Diseases Initiative: Seton Food and Fitness Forum (formerly Diabetes Lunch Bunch Academy) Action: Educate community members on healthy eating and exercise habits. Need Addressed: Chronic diseases Better health outcomes for all patients, including those with chronic diseases. Lower obesity rates and the public understanding healthy nutritional habits. Dietician, space, education materials, Armed Services YMCA (ASYMCA) teaching kitchen ASYMCA Initiative: Education for patients with chronic diseases including heart disease, congestive heart failure, chronic obstructive pulmonary disease, renal disease and prevention of accidents. Action: Educate the community on symptoms and how to self-manage their diseases and reduce risks of hospitalization Need Addressed: Chronic Diseases Increased use of self-management tools by patients with chronic illness. Improved health of patient that have chronic diseases. Increased awareness of safety precautions in life activities. Physicians, nurses, Dietician, Case Management, Clinical Pharmacist, medication Teach back tools, Community Plan of Care form EMS, Fresenius Initiative: Stroke & Hypertension Prevention and Recognition Education Action: Educate community members on the prevention of stroke and recognition using BE FAST (Balance Eyesight, Facial Drooping, Arm weakness, Speech slurred, Time to act fast) Model Need Addressed: Chronic Diseases Increased awareness of what a stroke looks like. Early detection leading to improved health outcomes. Physicians, Neurologist, Nurses, Staff education material, BE FAST model EMS, ASYMCA 4. System of Care SMCHH is not addressing this prioritized health need. Resource constraints and limited expertise in this area restrict SMCHH s ability to adequately address this community health need. 5

5. Social Determinants of Health Background: The Centers for Disease Control and Prevention define social determinants of health as conditions in the places where people live, learn, work and play that affect a wide range of health risks and outcomes. During the CHNA process, when asked to identify the most pressing health needs facing Bell County, community members frequently cited social determinants of health such as transportation, affordable housing and poverty. Actions: Seton acknowledges the impact environmental and life factors have on a person s health outside health care settings. Seton executives, physicians and associates are both leaders and active participants in strategic discussions about many of the most pressing social and economic issues impacting communities we serve. This includes many of the social determinants of health raised by the community during the 2016 CHNA process, such as transportation and housing. SMCHH plans to address this need through collaboration with local organizations serving community needs. Anticipated Impact: In working with other agencies the health needs can be met in the most cost effective manner with achieving the best results through partnerships with other leaders in the community. By building internal capacities, partnering with different agencies and providing leadership in the community, Seton anticipates our efforts will work toward addressing social determinates of health and have a positive impact on the communities we serve. We will identify initiatives that align with our mission and strategic plan, have measurable outcomes, demonstrate social and economic impact, and meaningfully address social determinates of health. Resources: Seton plans to continue to identify partnerships and invest with monetary donations in community organizations and nonprofits to address social determinants of health and other community health needs. Planned Collaborations: Through collaboration with different local agencies such as EMS, Armed Services YMCA, and involving our community groups such as churches, and schools, the identified health needs of the community can be met in many different settings. SMCHH s community partnerships and financial investments will maximize community impact in addressing social determinants of health. Conclusion Developing this Community Health Implementation Strategy was a collaborative effort of many areas within Seton. Seton views this document as dynamic and evolving plan of how we serve our communities. As we learn more from our community and build new investments and capabilities, this plan will change and grow. Substantive modifications and additions to this plan will be brought to our board for review and approval. 6