St. Luke's Cornwall Hospital Community Service Plan 2016-18 Review & projection

ST. LUKE’S CORNWALL HOSPITAL

70 Dubois Street | Newburgh, NY 12550

Community Service Plan Liaison | Brian Gunning, Marketing Manager

(845) 784-3849 | bgunning@slchospital.org

The SLCH geographic coverage area serves a population of approximately 400,000 people. In 2013, SLCH provided healthcare services to 14,000 Medicaid patients. As a safety net provider, SLCH serves a population that has been designated as a medically underserved area (MUA). The hospital’s Primary Service Area includes the City of Newburgh, the most densely populated portion of SLCH’s Primary Service Area, with more than 1,500 people per square mile. St. Luke’s Cornwall Hospital’s market is defined by 36 neighboring zip codes mainly in Orange County and including Ulster and Dutchess counties.

This plan was created using data compiled and prepared by the Orange County Department of Health.

Jackie Lawler, MPH, CIC, CPH | Epidemiologist

124 Main Street | Goshen, NY 10924

(845) 615-3884 | jlawler@orangecountygov.com

EXECUTIVE SUMMARY

St. Luke’s Cornwall Hospital (SLCH), with main campuses in Cornwall and Newburgh and off-site facilities throughout the community, is a 345-bed acute care hospital dedicated to providing for the health care needs of the community. SLCH has participated in a community health needs assessment (CHNA) and developed an implementation plan with strategies to address identified needs within the community. The assessment was conducted using survey data from the 2016 Community Health Assessment from Orange County Department of Health.

Using this data, SLCH has determined that it should continue working on its Prevention Agenda priorities selected in 2013 – Preventing Chronic Diseases and Promoting Healthy Women, Infants and Children.

The latest survey shows an increase from 2013 in the reported prevalence of certain chronic diseases, including diabetes, high blood pressure, reported overweight or obesity and heart disease. The survey also indicated the other most commonly reported chronic diseases as hyperlipidemia (25.8%), depression or anxiety (17.5%) and chronic pain (12.5%) In addition two of the top five health priorities identified by 2016 survey respondents were Routine Care for Children and Women’s Health.

In order to address these Prevention Agenda items, St. Luke’s Cornwall Hospital continues to work with a broad spectrum of community partners. SLCH leads the Population Health Coalition, a group formed in 2014 that includes more than 30 local organizations focused on improving the health of the population served. The group is comprised of disease specific advocacy, local health care providers, including primary and specialty care practices, rehabilitation centers, emergency medical services, and federally qualified health centers, as well as organizations that focus on housing, the aging population, employment, mental health, and special needs. The Population Health Coalition strives to identify gaps in care, consolidate resources and information, and collaborate on projects that serve the community.

One recent example of this cooperation was an educational seminar titled, Aging 101. More than 60 community members attended the event that included presentations from PHC members, including St. Luke’s Cornwall Hospital. Additional topics, such as access to care, have been identified for future education events.

POPULATION HEALTH COALITION MEMBERSHIP

Ability Beyond, Access: Supports for Living, Alzheimer’s Association, American Cancer Society, American Lung Association of the Northeast, Bon Secours Charity Health System, Inc., Good Samaritan Hospital of Suffern, Village of Campbell Hall, Cancer Resource Center of the Hudson Valley City of Newburgh, Community Solutions, Cornerstone Family Healthcare, Dominican Sisters Family Health Services, Elant, First Light, Fresenius, First Light, Greater New York Hospital Association, Hamaspik Choice MLTC, HealthLinkNY, Helen Hayes Rehabilitation Center, Horizon Family Medical Group, Hospice of Orange & Sullivan Counties, Hudson Valley Asthma Coalition, Hudson Valley Community Services, Inc., Independent Living, Inc., Inspire, IPRO, Manor at Woodside and Independent Living, Mental Health Association of Orange County, Montefiore Hudson Valley Collaborative, Montgomery Nursing Home and Rehabilitation Center, Mount Saint Mary College, Nathan Kline Institute, Occupations, Inc., Orange County Health Department, Orange County Office for the Aging, Orange AHRC, Orange County Department of Social Services, Premier Home Health Care, Rehabilitation Support Services, St. Luke’s Cornwall Hospital, SUNY Orange, The Pines at Poughkeepsie, United Healthcare, Willcare, Wingate, YMCA

In addition to working with the Population Health Coalition, St. Luke’s Cornwall Hospital has its own community education program that reaches a wide variety of audiences on a number of topics related to its two Prevention Agenda items. Education is provided at a number of local senior groups, workplace wellness programs, local businesses, food pantries, soup kitchens, and public events. In 2016, SLCH provided more than 100 education and screening events to the community. Future plans will build upon this existing model by identifying other audiences in need of educational programming, as well as utilizing digital outreach through the internet and social media. The Population Health Coalition has also succeeded in compiling an interactive directory of local community resources that can be utilized to better connect the population to appropriate services to best fit their needs.

Another focus has been to decrease exacerbation of chronic diseases and preventing unnecessary hospitalization through work that has been completed in our Care Transitions Program. With this program, high risk patients (COPD, CHF and Diabetes) are managed by members of our team. The Coleman Model of Care is used with each patient, ensuring that they receive the proper follow up care when discharged from the hospital. Our team works closely to continue to manage the patients’ needs in the community, ultimately preventing them from returning to the hospital for chronic illness.

St. Luke’s Cornwall Hospital’s selected Prevention Agenda items are also in line with its participation in the Delivery System Reform Incentive Payment Program (DSRIP). SLCH is part of the Montefiore Hudson Valley Collaborative and is represented on its Leadership Steering Committee. The hospital is involved in nine out of 10 DSRIP projects and some special projects such as the Accelerated eXchange Series Program (MAX) and Asthma Management Project, all aimed at improving outcomes and decreasing hospitalizations. Through collaboration with community partners, these projects are designed to engage patients in order to help them manage chronic diseases in more appropriate settings and reduce hospital utilization for issues better dealt with through community-based resources.

To assist in the promotion of healthy women, infants and children, SLCH has worked to increase support for breastfeeding by giving patients greater access to Certified Lactation Counselors through certification training to Neonatal Intensive Care Unit and Birthing Center Staff. SLCH is participating in the New York State Breastfeeding Quality Improvement in Hospitals (BQIH) Collaborative. Every member of the Birthing Center and NICU staff who are not Certified Lactation Counselors will be required to complete 20 hours of training through he BQIH. We have also partnered with the Maternal Infant Services Network to house pre-natal breastfeeding classes and a new moms support group.

Along with the efforts to increase the breastfeeding rates, SLCH has taken an active role in the prevention of Neonatal Abstinence Syndrome, a consequence of the abrupt discontinuation of chronic fetal exposure to substances such as heroin, prescription medication, methadone or buprenorphine, used and abused by a mother during pregnancy. Utilizing education and intervention, SLCH and the Cornerstone Family Health Center’s Center for Recovery are working together to target expectant mothers who have been identified by the Center for Recovery’s Opiod Treatment Program and enhance current practices by adding a comprehensive treatment program which includes obstetric care, counseling and educational services with the goal of giving babies a healthier start while minimizing the financial burden to state and federal social service programs.

There are also internal initiatives being put in place in order to ensure the best possible outcomes for newborns at St. Luke’s Cornwall Hospital. Any member of the NICU and Birthing Center staff who reads a fetal monitor as part of their duties will be required to achieve Certification in Electronic Fetal Monitoring (C-EFM) through the National Certification Corporation. In addition, two NICU nurses have completed training to become S.T.A.B.L.E. (Sugar & Safe Care, Temperature, Airway, Blood Pressure, Lab Work, Emotional Support) Program instructors in order to train other members of the NICU and Birthing Center staff. This neonatal education program focuses on the post-resuscitation/pre-transport stabilization care of sick infants in order to help reduce infant mortality. The program will eventually be expanded to Emergency Department Staff.

Progress and improvement on all these initiatives is tracked in a variety of ways. Feedback and evaluation forms have been developed for use at community education events that ask attendees about the overall effectiveness of the program, their likelihood of following up with a medical intervention and what lifestyle changes they will make as a result of the information. We are also tracking the number of cancer screening events held in partnership with community partners and the number of individuals navigated to and/or through cancer screening, as well as hospital readmission rates for chronic diseases both overall and for Care Transitions patients. To monitor the progress of our health women, children and infants program, we will track the number of women reached by policies and practices to support breastfeeding, the number and percent of women/families who participate in family education programs (e.g., pre-natal breastfeeding and a new mom support group), as well as the number and percent of NICU/birthing center professionals who receive lactation counselor certification.

ST. LUKE'S CORNWALL HOSPITAL GEOGRAPHY

The SLCH geographic coverage area serves a population of approximately 400,000 people. In 2013, SLCH provided healthcare services to 14,000 Medicaid patients. As a safety net provider, SLCH serves a population that has been designated as a medically underserved area (MUA). The hospital’s Primary Service Area includes the City of Newburgh, the most densely populated portion of SLCH’s Primary Service Area, with more than 1,500 people per square mile. St. Luke’s Cornwall Hospital’s market is defined by 36 neighboring zip codes mainly in Orange County and including Ulster and Dutchess counties.

SLCH is a not-for-profit community hospital that provides dedicated care to more than 250,000 patients per year. SLCH is a 345-bed acute care hospital with main campuses in Cornwall and Newburgh as well as several off-site facilities throughout the community.

ST. LUKE’S CORNWALL HOSPITAL DEMOGRAPHICS

According to estimates from the United States Census Bureau, Orange County’s —

  • Population grew by 1.3% between 2010 and 2015.
  • Median household income between 2011 and 2015 was $70,848 (measured in 2015 dollars).
  • Percentage of persons 65-and-older was 12.9%, an increase of nearly two percent since 2010.
  • 12.1% of the population lives in poverty.

According to results from the Orange County Department of Health’s Community Health Assessment Survey —

  • 73.8% of respondents described their overall health as either healthy or very healthy, and 80.8% described their overall mental health as either healthy or very healthy.
  • 50.1% described their weight as being normal, 42% reported being overweight, while only 4.1% rated themselves as obese. However, when using a self-reported calculated BMI, only 28.7% were categorized as normal weight (BMI of 18.5-24.9), 28% were overweight (BMI of 25.0-29.9) and 30.2% were obese (BMI above 30).
  • Nearly 90% of respondents visited their doctor for a routine physical or check-up in the last two years.
  • While a lack of financial resources made up the highest percentage for not getting a routine physical or check-up, 66.4% said there was nothing preventing them from receiving medical care.
  • 84% of the respondents do not smoke, which is in line with the County Health Rankings (85%).
COMMUNITY HEALTH CONCERNS PREVENTION AGENDA PRIORITIES

A number of data points were reviewed in order to determine the health issues of the community served by St. Luke’s Cornwall Hospital. SLCH partnered with the Orange County Department of Health to distribute the 2016 Community Health Assessment survey. The information from this survey included information about the health and demographics of community. For example, as noted above, there is a large disconnect between how residents perceive their weight and their actual calculated BMI. This issue may be a contributing factor to a rise in chronic diseases such diabetes, high blood pressure, and heart disease compared with the 2013 CHA survey. Utilizing the Prevention Agenda Dashboard, SLCH also found there was no significant change in Orange County for the rate of adult obesity and the emergency department visit rate for asthma, while the rate of hospitalizations for short-term complications of diabetes worsened. These numbers show that there is much work to be done in the Prevention of Chronic Disease agenda.

Additionally, the dashboard showed that the county rate of infants exclusively breastfed in the hospital is well above the state average and exceeds the prevention agenda 2018 objective. We will continue to focus on these initiatives as part of the Promote Healthy Women, Children and Infants agenda.

Community engagement methods used to confirm the continuing work on these two priorities include community/town forums and meetings, medical education seminars, physician presentations and health screening events.

MAINTAINING ENGAGEMENT

St. Luke’s Cornwall Hospital is committed to continuing our work with local partners. Active participation in local coalitions and ongoing outreach efforts will be used in order to remain engaged, track our progress and be able to make any necessary adjustments.

The hospital has established an internal Community Action Committee which meets regularly to discuss and coordinate community education efforts. Members of the committee are assigned to report on various partnership and activity within community organizations in which the hospital is engaged. These include local chapters of national groups such as the American Cancer Society, American Heart Association and Habitat for Humanity, as well as city, county, and state-based organizations such as The City of Newburgh, Newburgh’s Empire State Poverty Reduction Initiative, and the Food Bank of the Hudson Valley.

In addition, St. Luke’s Cornwall Hospital has broad representation on, and takes a leading role in facilitating, the local Population Health Coalition that includes more than 30 local organizations focused on improving the health of the population served. The group is comprised of disease specific advocacy, local health care providers, including primary and specialty care practices, rehabilitation centers, emergency medical services, and federally qualified health centers, as well as organizations that focus on housing, the aging population, employment, mental health, and special needs. The Population Health Coalition strives to identify gaps in care, consolidate resources and information, and collaborate on projects that serve the community.

SLCH will also –

  • Maintain positive relationships and contacts with local businesses and organizations in our database.
  • Record the number events and type of event in order to track progress and make mid course corrections.
  • Include effective ways to communicate with diverse audiences. Such as multi- language literature and bilingual staff.
  • Utilize digital resources such as Facebook, Twitter, www.stlukescornwallhospital.org as an interactive way of communicating with the SLCH community.
  • Actively engage local media outlets in print and online in order to serve the adult demographic.
2016 COMMUNITY ENGAGEMENT MASTER LIST

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