Maine Shared Community Health Needs Assessment 2018 Community

Maine Shared Community Health Needs Assessment 2018 Community Events YORK COUNTY REGION: WELLS

Welcome and Introductions

Thank you to the following sponsors of this forum!

York Public Health District: York County Forum Agenda: Wells 8: 30 – 9: 00 p. m. Forum Agenda Registration and refreshments 9: 00 – 9: 05 p. m. Welcome and introductions Jud Knox, President York Hospital 9: 05 – 9: 20 p. m. 2016 CHNA priorities and highlights Adam Hartwig District Liaison, York Public Health District Betsy Kelly Southern Maine Health Care Sally Manninen York Hospital 9: 20 – 9: 50 p. m. Review York County Data Profile JSI 9: 50 – 10: 25 p. m. Discussion on data and health priorities JSI 10: 25 – 10: 45 p. m. Generate priorities from forum JSI 10: 45 – 11: 00 p. m. Evaluation and adjournment Adam Hartwig Betsy Kelly

Why are we here? 5

Guidance, Regulations & the Law Maine Shared Community Health Needs Assessment Images of PHAB and IRS from the internet 6

Steering Committee Program Manager Maine Shared CHNA Governance Metrics Committee Data Analysis Team Community Engagement Committee JSI Local Planning Teams 7

Health Improvement Process Community Health Needs Assessment (CHNA) Partners Evaluate Partners State Health Improvement Plan (SHIP) Partners Hospital Implementation Strategies (IS) Public Health District Health Improvement Plan (DPHIP) Partners 8

Local Activities and Accomplishments

York County Accomplishments Community priority areas of work since the 2016 Shared CHNA Substance Use Prevention Tobacco Use Prevention Obesity Prevention Oral Health

York County Accomplishments Priority: Decrease Substance Use and Addiction Strategies/Activities Hospital/Health System § Medicated Assisted Treatment provided in Biddeford & Springvale “hubs” in collaboration with Maine Behavioral Healthcare, and at the Saco Family Medicine “spoke” § Educated providers in non-opioid alternatives to treating pain, and monitored prescribing Southern Maine Health Care § Provided Narcan training to local EMS and police § Received $66, 000 in State Substance Use Prevention funding § Offering Student Intervention and Reintegration Program (SIRP) to 3 school districts § Safe Storage options for medications York Hospital § Received $244, 000 in state and federal and local grants for substance use/addiction prevention & recovery support to: § Provide Integrated Medication Assisted Treatment (IMAT) § Train staff and community in SBIRT, Stigma Reduction and Overdose Prevention § Create Opioid Prescribing Toolkit for providers § Offer Student Intervention and Reintegration Program in 5 school districts York Public Health District § Developed District Resource Guide with treatment, prevention and recovery services § Hosted educational meeting on recreational and medical marijuana, legislation and trends for health professionals and law enforcement.

York County Accomplishments Priority: Tobacco Hospital/Health System Southern Maine Health Care Strategies/Activities All Medical Assistants (MA) and Respiratory Therapists (RT) trained in Motivational Interviewing for tobacco cessation. § 100% of patients screened for tobacco use § Referrals to Quitlink through EMR § Monitored and reported implementation of tobacco cessation interventions in primary care practices, with current performance of 96. 6% on a target of 96% § Creating Policy and Environmental changes through the Maine Prevention Services Funding by working with various sectors such as lodging, landlords, municipalities and schools. § Created policy and protocol in Electronic Medical Record (EMR) for York Primary Care Providers to refer patients to Quit. Link for tobacco cessation York Hospital § Implemented EMR changes to support the use of brief interventions and referrals for tobacco users

York County Accomplishments Priority: Obesity Hospital/Health System Southern Maine Health Care York Hospital York Public Health District Strategies/Activities § § § Let’s Go! York working to increase physical activity and nutrition in various sectors: 115 Sites including childcare, schools and afterschool programs 56 School Nutrition Sites All SMHC family and Pediatric practices engaged SMHC practices working to implement the Adult Small Steps Program in all internal and family practices. § WOW- Hospital Wellness worked on re-doing and creating walking trails at each health care site § § Offer Healthy Weight Management Program 5 times/per year Offer individualized nutritional counseling for community Fund local Parks and Recreation programming annually Sponsored a series of six “Walk With the Doc” community walks with York Hospital Family Practice physicians § Provided seed money and technical assistance with Wholesome Wave to York County Community Action to develop the Fruit and Vegetable Prescription Program § Updated physical activity guide for York Guide

Accomplishments of Note Update on Selected Priorities and Activities since the 2016 Shared CHNA

How to Read County Health Profile EXAMPL E 16

How to Read County Health Profile EXAMPLE 17

Key Findings 18

Demographics York County: Age Distribution Percent of Population Living in Rural Areas, 2012 -2016 19

Demographics Change in Percent of Population Age 25+ With Associates Degrees or Higher, 2000 -2016 20

Demographics York County: Gay, Lesbian, and Bisexual High School Students 12% 11% Maine 11% 7% 2011 2017 21

Health Equity Data Handouts include selected data for: • Sex • Race • Ethnicity • Sexual orientation • Education • Income • Rurality 22

Years of Potential Life Lost York County: Years of Potential Life Lost Per 100, 000 Population 10, 000 5, 473. 7 2010 -2012 6, 010. 5 Maine 6529. 2 YPLL measures premature death, or the years of potential life lost before the age of 75. 2014 -2016 23

Social Determinants of Health Unemployment rate (2012 -2016) York County: Individuals Living in Poverty 15% Maine 14% 9% 9% 2009 -2011 2012 -2016

Social Determinants of Health Adverse Childhood Experiences, 2017 25

Health Behaviors - Obesity York County: Obesity (Adults) 35% 33% Maine 30% 27% 2011 York County: Obesity (High School) 2017 12% 13% 2011 2017 Maine 15% 26

Health Behaviors- Smoking Current Smoking (Adults), 2016 27

Health Behaviors- Smoking York County: Past 30 Day Cigarette Smoking (High School) York County: Past 30 Day ECigarette Use (High School) 25% 16 Maine 15% 12 10 9 20% 17% 2011 2013 2015 2017 28

Health Behaviors – Alcohol and Marijuana York County: Past 30 -day Alcohol and Marijuana Use (High School) 35% 29 24 27 23 25 21 23 18 Alcohol Marijuana 2011 2013 2015 2017 29

Health Outcomes - Cancer All Cancer Deaths, 2016 30

Health Outcomes - Adult Chronic Disease York: Diabetes Prevalence York: Asthma Prevalence 15% 9% 2011 -2013 10% 2014 -2016 11% 2011 -2013 2014 -2016 Maine 12% Maine 10% 31

Health Outcomes-Adult Chronic Disease York County: High Cholesterol York County: High Blood Pressure 50% 41% Maine 40% 33% 2011 & 2013 & 2015 2011 & 2013 34% Maine 34% 2013 & 2015 32

Health Outcomes - Mental Health Current Depression (Adults), 2014 -2016 York County: Sad/Hopeless 2+ Weeks in a Row (High School) 30% 27% 24% 2011 Maine 27% 2017 33

Health Outcomes - Mental Health York County: Seriously Considered Suicide (High School) 20% 14% 2011 2017 Maine 15% 34

Health Outcomes - Substance Use Overdose Deaths Per 100, 000 2012 -2016 York County: Unintentional/Undetermined Intent Poisoning Deaths Per 100, 000 Population 25 2017 114 19. 9 Maine 17. 6 10. 9 2007 -2011 2012 -2016

Health Outcomes - Injury York County: Injury Deaths Per 100, 000 Population York County: Fall-Related Deaths (Unintentional) Per 100, 000 Population 80. 0 71. 4 Maine 67. 9 55. 5 6. 4 2007 -2011 2012 -2016 2007 -2011 36 11. 8 Maine 9. 6 2012 -2016 36

Health Access and Quality Unable to Obtain Care Due to Cost, 2014 -2016 37

Facilitated Discussion 38

Small Group Discussion Questions 1. Based on your own knowledge and experiences, are there any major health issues that are not represented in the data? (10 mins) 2. Based on the data, past priorities, and your observations, what do you see as the top needs of our community? (20 -25 mins) 3. What community resources are available to address these needs, and what more may be needed? (5 -10 mins) 39

Assets/Resources and Needs 1. Put sticky notes with assets/resources and needs on the corresponding Priority Area sheet. 2. Put assets/resources and needs pertaining to other domains on the sheet marked “Other” 40

Prioritization Exercise 41

Wrap Up and Next Steps 42

Staying Involved York County Public Health District meetings: Contact: Adam. Hartwig@maine. gov Meets quarterly - 1 st Mondays at noon. Southern Maine Health Care - Partners for Healthier Communities Contact: Betsy Kelly blkelly@smhc. org York Hospital – Choose to be Healthy Coalition Contact: Sally Manninen smanninen@yorkhospital. com UNE – Coastal Healthy Communities Coalition Contact: Sarah Breul sbreul@une. edu 43