Columbia Memorial Health Community Service Plan Update 2014-2017
New York State Department of Health (NYSDOH) requires that hospitals and local health departments collaborate with each other and community partners on the development of Community Health Assessment and hospital Community Health Improvement Plans. In keeping with the New York State Improvement Plan, the Prevention Agenda 2013-17, Columbia Memorial Health has recognized that collaboration is an essential element for improving population health in our community. Working together to develop a community health assessment and community improvement plan will reduce duplication and assist local health departments to conduct this work in an effective, efficient manner. The development of this document and the assessment has served to meet the requirements of Article 6 and Article 28 of the state public health law. In addition, the Affordable Care Act requires nonprofit hospitals to conduct a periodic community health needs assessment and adopt an implementation strategy to meet the community health needs identified in the assessment. This document is intended to facilitate responses to these requirements and promote collaboration while recognizing the role that the community plays in multi-sector planning and action to address health outcomes.
1. Mission Statement: The mission of Columbia Memorial Health is to provide our communities with safe, high quality, comprehensive health care services in a dignified and compassionate environment.
2. Community Definition:Columbia Memorial Health (Columbia Memorial) serves Columbia, Greene and parts of northern Dutchess County. For the purposes of this Community Service Plan, the service areas defined herein include the zip codes in Columbia and Greene Counties.
Columbia County is located in the northeastern region of the Mid-Hudson Valley of New York State. It is bordered on the north by Rensselaer County, on the south by Dutchess County, on the east by Berkshire County of the Commonwealth of Massachusetts and on the west by the Hudson River opposite Greene County. Columbia County comprises a total of 643 square miles or 411,520 acres. Based on the U.S. Census, Columbia County’s population is 63,096. Columbia County is basically rural in nature and includes the City of Hudson; 18 towns, including Ancram, Austerlitz, Canaan, Chatham, Claverack, Clermont, Copake, Gallatin, Germantown, Ghent, Greenport, Hillsdale, Kinderhook, Livingston, New Lebanon, Stockport, Stuyvesant and Taghkanic, and the four villages of Chatham, Valatie, Kinderhook and Philmont.
Columbia County’s local economy is diversified with small private businesses, State and municipal agencies and not- for- profit public service agencies. Many residents of both counties commute to private and public employers in the greater Albany area. Columbia County is also home to a significant community of second home owners from New York City area.
According to the U.S. Census, 15,900 Columbia County residents are under the age of 18, another 36,154 are between the ages of 18 and 65, and 11,042 are over age 65. Columbia County ranks 8th in the State for persons age 65 years and older and first in the state for persons over age 85 years.
Columbia Memorial operates 41 Family Care/ Specialty Centers located throughout Columbia, Greene Counties, and 1 Center in Dutchess County.
Greene County is situated between the mile-wide Hudson River on the east and the Catskill Mountains at the southern and western ends. Greene County is bordered by Albany County to the north, Rensselaer County to the northeast, Columbia County to the east, Ulster County to the south, Delaware County to the west and Schoharie County to the northwest. Greene County is rural in nature and covers 658 square miles with a population of 48,954 located in 15 towns and 5 villages which are scattered along the western bank of the Hudson River. Towns include: Ashland, Athens, Cairo, Catskill, Coxsackie, Durham, Greenville, Halcott, Hunter, Jewett, Lexington, New Baltimore, Prattsville, Tannersville and Windham. CMH currently operates Family/Specialty Care Centers in Cairo, Catskill, Windham and Coxsackie.
According to the U.S. Census, Greene County has 28,276 resident’s age 18-64 years and 2,257 over the age of 65.
Columbia and Greene Counties, substantially rural counties in the Northern region with nearly 115,000 residents in total, are primarily served by Columbia Memorial and its 263 clinically affiliated providers. The affiliated providers include primary and specialty care physicians who practice in solo and group settings and provide care to residents in both counties.
3. Public Participation:
a. In response the New York State’s health improvement plan, Columbia Memorial Health has developed partnerships with community agencies through a coordinated approach to community service. There are over 50 agencies and organizations working with the hospital to meet the needs of the community, including: The Columbia County Department of Health, Greene County Department of Health, Mental Health Association of Columbia and Greene County, Twin County Recovery Services, Columbia County Department of Human Services, Greene County Mental Health Services, County Sheriff’s Departments and other local, law enforcement agencies, Catholic Charities, Greene County Rural Health Network, Columbia County Healthcare Consortium, Columbia Opportunities, Columbia County Medical Society, American Red Cross, public schools in both Columbia and Greene Counties, Columbia Greene Community College, Columbia Greene Network of Healthcare Professionals, Columbia and Greene County businesses, Columbia and Greene County Departments of Social Services, Hudson River HealthCare and others. Columbia and Greene County Departments of Health along with local and regional community agencies have been working and continue to work with Columbia Memorial to develop a comprehensive community service plan.
b. Columbia and Greene County Departments of Health have been working since 2010 on a comprehensive process to identify healthcare priorities through Mobilizing for Action through Planning and Partnerships (MAPP) committees. The process includes the assessment of risks and identification of programs that support the mobilization of a wide range of services. Outcomes from the assessments for both Columbia and Greene Counties have identified key stakeholders and community support systems that address the priorities. Each county developed a list of priorities and formed committees to address the issues identified. Teams of organizations, business leaders, church groups and agencies participated in the assessment process. The MAPP meetings are held bi-monthly in both counties with Columbia Memorial representation on both the Columbia and Greene County teams. Many of the organizations have offices in both counties and currently there are no inpatient hospital services in Greene County.
c. Public notification of this process was accomplished by email, direct mail and telephonic communication. The public input process is ongoing with special attention to barriers to healthcare services within the rural community.
4. Assessment and Selection of Public Health Priorities:
Columbia Memorial’s goal is to enhance our neighbor’s health status, community by community. The goal of the Department of Columbia Memorial’s Department Community Health Services is to identify the health needs of the communities served by Columbia Memorial and work with partners to identify community health priorities. The process included a partnership with both Columbia and Greene County Departments of Health to gather input from a broad cross-section of community-based organizations and plan for the current and future needs of residents in the community. The assessment process analyzed traditional health-related indicators as well as social, demographic, economic and environmental factors. Participants included residents with broad based racial/ethnic/cultural and linguistic backgrounds as well as those with special knowledge and expertise in public health issues. In addition, educators, health related professionals, local government, human service organizations, institutes of higher learning, religious institutions and the private sector were engaged in the process. The team members developed comparisons to baseline health measures utilizing the most current validated data from sources in New York State, the U.S. Census and other government agencies. Recommendations to address the identified health needs for strategic planning served as a baseline tool for future assessments. Community stakeholders representing a cross-section of agencies and focus groups now work together to focus on two key priority community health needs in both Columbia and Greene Counties: The priority focus areas identified include: Chronic Disease and Mental Health/ Substance Abuse Prevention.
5. Three Year Plan of Action:
The assessment was obtained through the Mobilizing for Action through Planning and Partnership (MAPP) process over a two year period with 44 community partners represented. The full report can be obtained at the Columbia and Greene County Departments of Health. Participants share a community vision and common goals. Over the next three years Columbia Memorial and local departments of health in both Columbia and Greene Counties will focus on the following goals and objectives:
Chronic disease prevention:
- Goal: Increase screening rates for cardiovascular disease, diabetes and breast, cervical and colorectal cancers, especially among disparate populations.
- Objective: By December 31, 2017, increase the number of community education/ screening programs at primary care offices and within the community.
- Update as of March 2015: Screening opportunities are offered during the national calendar as well as through the Family Care Centers. A Community Health Fair held in Greene County in collaboration with the Greene County Rural Health Network provided screenings to underserved community members. CMH collaborates with the Columbia Greene Cancer Services Program throughout the calendar year.
- Goal: Promote evidence –based programs that address chronic disease prevention.
- Objective: By Dec 31, 2017, increase the number of evidence-based programs that address chronic disease prevention.
- Update as of March 2015: There are seven (7) Family Care Centers working on the NCQA/ Medical Home designation. Of those Family Care Centers one (1) has acquired level three (3) Medical Home designation and six (6) others are awaiting certification.
- Goal: Increase the number of culturally relevant chronic disease self-management programs within Columbia and Greene Counties.
- Objective: By Dec 31, 2017, implement chronic disease self- management programs in community centers and within agencies/ businesses where appropriate.
- Update as of March 2015: Currently chronic disease self-management programs are offered by private businesses and insurance plans.
Mental Health and Substance Abuse Prevention:
- Goal: Promote mental, emotional and behavioral well -being in communities.
- Objective: By Dec 31, 2017, increase the number of primary care offices with cross-disciplinary collaborations that are sensitive to behavioral health symptomology and treatment.
- Update as of March 2015: Columbia Memorial Hospital Family Care Centers offer cross-disciplinary collaborations that enhance support systems for emotional and behavioral well- being in four Primary Care offices in Greene County.
- Goal: Prevent Substance Abuse through early identification and adequate societal support systems.
- Objective:By Dec 31, 2017, increase the number of substance abuse screening tools available at primary care offices through technology.
- Update as of March 2015: Family Care Centers are working with community agencies to decrease substance abuse in both Columbia and Greene Counties in collaboration with the Columbia Greene Substance Abuse Awareness Task Force.
- Goal: Strengthen Infrastructure across systems:
- Objective: By Dec 31, 2017, utilize screening tools and referrals to services at primary care offices in Columbia and Greene Counties.
- Update as of March 2015: Screening tools and referrals are utilized in primary care offices and through collaborations with community partners. Columbia Memorial Health is continually improving the Information Systems technology infrastructure.
6. Dissemination of the Report to the Public:
This Community Service Plan will be available for public via the Columbia Memorial Health website.
7. Columbia Memorial’s administration with support from its Department of Community Health Services will be responsible to ensure engagement with local partners over the next three years of this plan. Data will be collected to track progress and address barriers to successful implementation. Columbia Memorial and its clinically affiliated partners are committed to implementing a comprehensive plan that delivers high-quality preventative care and improved management of disease for all population segments.
This report fulfills the requirements of the federal statute established within the Patient Protection and Affordable Care Act (PPACA) requiring that non-profit hospitals conduct community health needs assessments every three years.