Dodge County Hospital Community Health Needs Assessment and Implementation Plan - July 2015
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About Dodge County Hospital Dodge County Hospital is a progressive 94-bed healthcare facility, located in Eastman, Georgia dedicated to meeting the challenges of the changing healthcare environment and is committed to providing healthcare for the valued citizens of Dodge County and surrounding communities. Dodge County offers an array of services that include an Emergency Department staffed 24 hours a day by in house physicians, and a Critical Care Unit with state of the art equipment. Additional services include Medical/Surgical Unit, Obstetrics, Nursery and Pediatric Unit, Geriatric Behavioral Health Unit, a Surgery Center, Gastro-intestinal Laboratory, Ophthalmology, Laboratory, Radiology, Pharmacy, Respiratory Therapy, and Sleep Studies. Dodge County Hospital is a DNV Healthcare Accredited facility. As an accredited facility, Dodge County Hospital demonstrates its commitment to safety by complying with the Centers for Medicare and Medicaid Studies conditions of participation and all applicable DNV requirements. Achieving DNV accreditation clearly communicates to patients and other key stakeholders that Dodge County Hospital’s personnel, care practices and facilities are compliant with clear, consistent performance standards. With all the other concerns patients and families may have about their health, the basic confidence in the quality and safety of the services provided should not be in doubt. As an accredited facility, Dodge County Hospital undergoes an unannounced accreditation visit by DNV Healthcare on an annual basis. These visits use multiple methods of assessment, such as interviews, document reviews and on-site visits to ensure the ability to capture a complete and thorough understanding of the organization.
Contents About Dodge County Hospital 2 Acknowledgements 4 Contributors 4 A Letter from the Chairman to the Community 5 Introduction 6 Purpose and Scope 6 Approach and Process 7 Dodge County Hospital’s Community 8 Dodge County Hospital’s Community Demographics 9 FAQs – Frequently Asked Questions 10 Community Health Needs Assessment 11 Community Health Needs vs. Other Community Needs 11 Process of Identifying & Prioritizing Community Health Needs 11 2015 Community Health Need Priorities 12 Dodge County Hospital’s Implementation Strategy 12 DCH’s Community Health Needs Implementation Plan 2015-2018 13 DCH’s Programs & Services Addressing Community Health Needs 20 Appendix: Community Inventory - Health Facilities & Resources 22 3 DODGE COUNTY HOSPITAL
Acknowledgement Dodge County Hospital’s Community Needs Assessment and Implementation Plan was developed by Dodge staff with the assistance of LEGACY CONSULTING GROUP and generous input from a broad group of people representing the health interests of residents of Eastman and Dodge County, Georgia and nearby communities. The individuals listed below contributed immeasurable value in the formation of this report, providing professional knowledge, expert medical information, and community input regarding health need advocacy. Dodge County Hospital would like to acknowledge these individuals and thank them for their generous time and contributions to this assessment. Cecil Barden Lou Barker, MD Board Member, Dodge County Hospital Authority Obstetrician/Gynecologist Maintenance Supervisor, Eastman Housing Authority Dodge County Hospital Kevin L. Bierschenk Miranda Bush, RN Chief Executive Officer Nurse Manager, Emergency Services Dodge County Hospital Dodge County Hospital Sandra Campbell, RN, MSN Ricky Coleman Chief Nursing Officer EMS Director Dodge County Hospital Dodge County Debbie Connell Lawton C. Davis, MD Executive Director South Central Health District Director / District 5-1 / Dublin Dodge Connection-Communities in Schools of Dodge County Georgia Department of Public Health Chief Executive Officer, Dodge County Board of Health Melinda M. Dennis, Ph.D. Jan Hamrick Superintendent Chief Financial Officer Dodge County Schools Dodge County Hospital Dan Harrell, DMD Paul Jones, CPA Dentist Board Chair Eastman Family Dental Dodge County Hospital Authority Dan McCrane Bart S. Milner, MPA-C Chairman Physician Assistant Dodge County, Georgia Board of Commissioners Southwest Georgia Health Care Blake Milner, MD Johnny Peeples, MD Family Medicine Pediatric and Adolescent Medicine Dodge County Hospital Eastman Pediatric Clinic Charles Williams President Eastman Dodge County Chamber of Commerce Development Authority
A Letter from the Chairman to the Community Board of Directors Dear Friends, Paul Jones Chairman Dodge County Hospital is pleased to present this Community Health Needs Assessment and Implementation Plan. Wilbur Garrett Secretary/Treasurer With input from a broad range of truly remarkable people, we have Minister Cecil Barden identified and prioritized community health needs to help advance the health and wellness of residents of Eastman, Dodge County, and nearby Mitchell Coffee communities. Mimi Daniels Dennis These contributors provided expert knowledge, experience, and guidance in helping DCH review and plan programs and services to work with other Mandel Trent Mullis community-based organizations to enhance health education, injury and illness prevention, and promotion of a healthy lifestyle and wellness. James H. Tison, MD Reggie Sheffield Our Board of Directors has adopted the 2015-2018 Community Health Needs Implementation Plan and is committed to leveraging our existing Patricia Patterson, MD* programs, services, and resources to assist area residents develop and Chief of Medical Staff maintain their highest level of health and wellness. Kevin L. Bierschenk* Dodge County Hospital’s primary focus will be to work with other Chief Executive Officer organizations to address the health need priorities of persons residing in the communities of Dodge County. When possible and financially feasible, DCH will play a supportive role in assisting other community health need efforts in nearby communities. Please visit us at www.dodgecountyhospital.com for more information and * Ex-officio members follow our progress. Warm Regards, SigPlus1 Paul Jones 07/10/2015 01:56:08 pm Chairman Dodge County Hospital Authority Board of Directors 5 DODGE COUNTY HOSPITAL
Introduction Quality healthcare and exceptional service awaits you at Dodge County Hospital, located in Eastman, Georgia. The Hospital is a progressive, not-for-profit, acute care facility serving the needs of the residents of Eastman, Rhine, Chauncey, Chester and Milan in Dodge County and nearby communities in the heart of Georgia. Our Mission The employees, medical staff and Board of Trustees of Dodge County Hospital will deliver the highest quality healthcare services to our patients, families and visitors by managing the fiscal, human, physical and information resources in an efficient, effective and ethical manner. Our Vision Dodge County Hospital will mirror the needs of the community and surrounding areas and become the provider of choice, the employer of choice and the most clinically efficient, cost-effective healthcare system. Our Values Dodge County Hospital considers the patient and family to be the nucleus of the healthcare delivery system and is committed to the mission and vision by enhancing these values: communication, loyalty, honesty, morality, compassion, dignity, confidentiality, innovation and continual performance improvement. Purpose and Scope The purpose of Dodge County Hospital’s community health needs assessment (CHNA) and implementation plan is to enhance the health and wellness of individuals living in the communities of Dodge County. When possible and financially feasible, DCH will play a supportive role in assisting other community health need efforts in nearby communities.
Approach and Process Dodge County Hospital’s approach to achieving community health improvement priorities follows a six-step process designed to be updated every three years to assess progress in addressing the health needs of the community. It begins with defining DCHs target community, and then assessing the health needs of the community using available health data and input from a broad range of advocates representing the health interests of the residents within the community. After the health needs are identified, individuals representing the target community establish the health improvement priorities for their community. Assess Health Needs of the Community Evaluate Set Outcomes & Health Progress Improvement Toward Target Target Goals Priorities Report Plan Targeted Targeted Initiatives & Health Benefits to Improvement the Public Initiatives Implement Specific Health Improvement Strategies From the list of health improvement priorities developed by advocates of the target community, the leadership at Dodge County Hospital met to develop strategies and plans to address the identified health need priorities. These strategies and plans were then implemented and reported to the public via the hospital’s website as Dodge County Hospital’s Community Health Needs Assessment and Implementation Plan. As part of the implementation plan, DCH will evaluate progress toward achieving goals and report the results on the hospital’s website. 7 DODGE COUNTY HOSPITAL
Dodge County Hospital’s Community In 2014, 66% of Dodge County Hospital’s admissions came from within Dodge County and another 31% of admissions came from the surrounding counties of Telfair, Bleckley, Wilcox, Laurens, Pulaski and Wheeler Counties in south central Georgia. Dodge County Hospital’s Primary and Secondary Service Area
Based on the residence of admissions, Dodge County Hospital defines its primary service area community as Dodge County. The Hospital’s secondary service area encompasses Telfair, Bleckley, Wilcox, Laurens, Pulaski and Wheeler counties in south central Georgia. Dodge County Hospital’s 2014 Admissions Service Area County Admissions % of Admissions Cumulative Admissions Primary Dodge 1,077 65.9% 65.9% Secondary Telfair 337 20.6% 86.5% Secondary Bleckley 64 3.9% 90.4% Secondary Wilcox 42 2.6% 93.0% Secondary Laurens 30 1.8% 94.8% Secondary Pulaski 18 1.1% 95.9% Secondary Wheeler 15 0.9% 96.8% All other 52 3.2% 100.0% Total Admissions 1,635 100% Sources: Dodge County Hospital & Legacy Consulting Group analysis. Dodge County Hospital’s Admission Demographics In 2014, Dodge County Hospital admitted 1,635 patients with 75% of admissions for medical/surgical services, 17% requiring intensive care services, 7% for obstetrical services, and 1% geriatric psychiatry admissions. Patients with Medicare accounted for 48% of admissions, Medicaid 28% of admissions, third-party payment 17% and self-pay 7% of admissions. Over the same period, Dodge County Hospital has 12,482 Emergency Department visits, which led to 77% of the Hospital’s admissions. In addition, the Hospital had 1,172 surgical patients of which 75% were performed on an outpatient basis. Admissions by Service Admissions by Payment Source 1,400 1,223 1,200 1,000 Third- party Self pay 800 17% Medicaid 7% 600 28% 400 270 120 200 22 0 Medicare 48% 9 DODGE COUNTY HOSPITAL
Access to Health Indicators What do we mean by access to health services? Professionally Active Physicians Access to health services means the timely use of personal health services to achieve the best outcomes. (1) It requires three distinct (Population to Physician Ratio – Smaller Number is Better) steps: 1,500 1,311 1) Gaining entry into the health care system. 1,104 2) Accessing a health care location where needed 892 873 1,000 services are provided. 744 680 3) Finding a health care provider with whom the patient can communicate & trust. 500 What are the barriers to health services? 0 Barriers to health services include: Sources:Primary “2015 Care Physicians County Specialty Health Ranking: Georgia” Care Phsyicians County Health Rankings & Roadmaps, A Dodge collaboration County between the Robert WoodStates Johnson Foundation and Lack of availability Georgia United the University of Wisconsin Population Health Institute. High cost Lack of insurance Access to Health Indicators Poverty & Lack of Health Insurance What do barriers to health services lead to? Barriers to health services and health care lead to: Unmet health needs 30% 26.0% Delays in receiving appropriate care 25.3% Inability to get preventive services 21.5% 19.8% 18.8% 18.2% Hospitalizations that could have been prevented 20% 15.4% 16.3% 14.5% Sources: “Healthy People 2020” U.S. Department of Health & Human Services, December 2010. (1) Institute of Medicine, Committee on Monitoring Access to Personal 10% Health Services, National Academies Press, 1993 0% Population Below Poverty Children Below Poverty Without Health Insurance Selected Behavioral Health Indicators (Ages 0-17) (Ages 0-64) Dodge County Georgia United States 40% 35.0% Sources: The Henry J. Kaiser Family Foundation, March 2015, Georgia Composite State 32.0% 31.0% 29.0% Board of Medical Examiners, June 2015, 2009-2013 American Community Survey 5 –Year 30% 24.0% 25.0% 19.0% 18.0% 18.0% Estimates, U.S. Census Bureau. 20% 10% 0% What is obesity & overweight? Obesity Physical Inactivity Smoking Obesity has been defined as a condition in which excess body fat has Dodge County Georgia United States accumulated to an extent that health may be adversely affected. Adults with a Body Mass Index (BMI) of 30 or higher are classified as Sources: “2015 County Health Ranking: Georgia” County Health Rankings & Roadmaps, A obese. Adults with BMI between 25 and 29.9 are classified as collaboration between the Robert Wood Johnson Foundation (RWJF) and the University of Wisconsin Population Health Institute. overweight. What are the health risks of obesity? In addition to diabetes, heart disease, and hypertension, obesity is Teen Births, Ages 15-19 related to many serious health problems. (Births per 1,000 Women) Approximately 20% of cancers in women and 15% of cancers 71.6 73.3 64.3 72.8 75.0 in men are attributable to obesity. 52.3 55.0 46.7 41.3 An estimated 34% of kidney disease cases in women and 24% 37.9 34.2 37.9 31.3 33.6 29.4 30.3 26.6 of cases in men are attributable to overweight and obesity. 35.0 Overweight and obesity at midlife independently increase the 15.0 risk of dementia, Alzheimer’s disease and vascular dementia. -5.0 2009 2010 2011 2012 2013 Obese adults are more likely to have depression, anxiety and Dodge County Georgia United States other mental health problems. Sources: National Vital Statistics Reports, Vol.63, No.4, August 20, 2014; Georgia DPH – Sources: The State of Obesity: 2014, Trust for America’s Health, RWJF. OASIS, 2015; Kids County- A Project of the Annie E. Casey Foundation, 2015. Teen Mothers Giving Birth to another Child Before Age 20 (Ages 15-19) What is the impact of teen childbearing? Teen childbearing is associated with negative consequences for the 37.0% 40.0% adolescent parents, their children, and society.(1) Children born to 26.8% 30.0% adolescents face particular challenges – they are more likely to 19.6% 20.6% 19.6% 20.7% 19.6% 19.7% 19.1% 20.1% 20.0% have poorer educational, behavioral, and health outcomes throughout their lives, compared with children born to older 10.0% parents. (1) 0.0% 2008 2009 2010 2011 2012 Sources: The Office of Adolescent Health, U.S. Department of Health & Human Services. (1) Hoffman, S. D., & Maynard, R. A. (Eds.). (2008). Kids Having Kids: Economic Costs and Dodge County Georgia Social Consequences of Teen Pregnancy (2nd Ed.) Washington, DC: Urban Institute Press.
Community Health Needs versus Other Community Needs Individuals have multiple needs within a community including available, accessible, and affordable food, housing, educational, social, recreational, and transportation services as well as employment opportunities. These needs are real, growing, and frequently unmet within many communities; however, they are beyond the scope of our assessment. This assessment is specifically focused on identifying, prioritizing and addressing health needs within the community. While Dodge County Hospital receives patients from multiple communities in south central Georgia, it is not practical or realistic for the Hospital to address the community health needs of all of the patients it sees when they leave and return to their home communities. Thus, Dodge County Hospital will focus its efforts on identifying, prioritizing and addressing the community health needs of residents who live in its primary service area of Dodge County. Process of Identifying and Prioritizing Community Health Needs The community health needs of residents within Dodge County were identified through in-depth interviews with a broad range of advocates representing the interests of the community including public health representatives, community leaders, physicians, school health, mental health and other health care providers. Based on the collected interviews, expertise, and feedback from this group of advocates representing the interests of Dodge County a list of community health needs was developed. There was significant consensus around eight specific community health needs, based on the unprompted frequency that these needs were identified by participants. From this list of eight specific community health needs, each participant was asked to rank community health need priorities on an ordinal scale with 1 being the highest priority and 8 being the lowest priority. The community health needs assessment was completed from March to May 2015. A 94% response rate was achieved, resulting in the following ranking of community health need priorities within the communities of Dodge County. 11 DODGE COUNTY HOSPITAL
Dodge County, Georgia 2015 Community Health Need Priorities #1 Need for community-based partnerships to enhance access to behavioral health services. #2 Need for community-based partnerships to reduce the prevalence of teen pregnancy. #3 Need for community-based programs to support a reduction in the prevalence of overweight and obesity. #4 Need for community-based programs to enhance educational outreach to promote healthy lifestyle choices. #5 Need for community-based partnerships to enhance access to non-emergency transportation assistance for residents in getting to medical appointments. #6 Need for community-based partnerships to enhance access to cardiology services for local residents. #7 Need for community-based partnerships to enhance access to recreational and fitness facilities to promote healthy, active lifestyles. #8 Need for community-based partnerships to enhance access to Telehealth services for nurses in local schools. Dodge County Hospital’s Community Health Needs Implementation Strategy Due to limited resources and the high cost of maintaining state-of-the-art medical diagnostic and treatment services to meet the needs of its inpatient and outpatient populations, Dodge County Hospital’s community health needs implementation strategy is focused on leveraging existing programs, services, and resources to address community health needs. In addition, the Hospital will focus its efforts on addressing health need priorities of residents of Dodge County. Whenever possible and financially feasible, Dodge County Hospital will work to address health need efforts in partnership with community, regional, and statewide organizations.
Dodge County Hospital’s 2015-2018 Community Health Needs Implementation Plan Community Health Need Priority #1: Need for community-based partnerships to enhance access to behavioral health services. There is broad consensus from advocates representing the interests of the community, that Dodge County lacks adequate behavioral health resources to address the needs of individuals with psychiatric and/or substance abuse problems. Furthermore, at this time there are no licensed psychiatrists in Dodge County according to the Georgia Composite Medical Board. In October 2014, Dodge County Hospital opened a 10-bed inpatient psychiatric service exclusively for geriatric patients to address this growing service need for its senior residents. No child, adolescent or adult inpatient, partial hospitalization, day program, residential short-term, residential long-term, halfway house or detoxification services are available within the community. The nearest adult inpatient mental health and substance detoxification unit is 31 miles away at The Community Mental Health Center in Dublin, Georgia. The Dublin Center does not offer child or adolescent inpatient services. The Community Service Board of Middle Georgia operates Eastman Mental Health Center in Eastman. EMHC serves five counties in south central Georgia: Dodge, Telfair, Bleckley, Wilcox and Pulaski Counties. EMHC is an outpatient facility with special groups and programs for adolescents and persons with co-occurring mental and substance abuse disorders. Outpatient substance abuse treatment services include classes, visits, group meetings, and buprenorphine services to manage opioid dependence including heroin and oxycodone. On a monthly basis, EMHC sees approximately 700 adults and 300 children/adolescents. Dodge County Hospital will continue to provide emergency stabilization services as necessary to ensure patient safety when individuals with acute psychiatric and/or substance abuse issues present in the emergency department. These patients are transferred to psychiatric facilities in Dublin, Macon or Savannah if inpatient services are required. Dodge County Hospital leadership will meet with local, regional and statewide advocates for behavioral health services to identify potential opportunities for increasing access to psychiatric and substance abuse services within the service area. Dodge County hospital will provide partnership support when financially feasible to community organizations dedicated to increasing access to behavioral health services within the local community. 13 DODGE COUNTY HOSPITAL
Community Health Need Priority #2: Need for community-based partnerships to reduce the prevalence of teen pregnancy. Based on the consensus opinion of physicians, school health nurses, and public health officials interviewed as part of the community health needs assessment, reducing teen pregnancy continues to be a community health need priority within Dodge County. Teen childbearing is associated with negative consequences for all parties involved: the adolescent mothers/parents, their children, and society as a whole. A study by Saul Hoffman and Rebecca Maynard, “Kids Having Kids: Economic Costs and Social Consequences of Teen Pregnancy” (2008 2nd Edition), notes that “Children of teen parents have poorer cognitive and educational outcomes, such as a lower likelihood of completing high school and lower test scores; more behavioral problems, including higher levels of fighting, delinquency, and early sexual experience; and poor health outcomes, such as low birth weight”. In addition, The Office of Adolescent Health of the U.S. Department of Health and Human Services notes, “Adolescents who have a baby are more likely to be poor as adults, and are more likely to rely on public assistance than those who do not have a teen birth”. From 2009 through 2013, while Georgia and the United States as a whole saw a dramatic drop in the prevalence of teen births, Dodge County continued to have an extremely high number of teen births. In 2013, births to teen mothers in Dodge County was 52.3 per thousand, almost twice the national average of 26.6 per thousand, and substantially higher than the 30.3 per thousand rate across Georgia. In addition, 37% of teen mothers give birth to another child before age 20 in Dodge County compared to 20% of teen mothers in the same age group (15-19 years) across Georgia. Dodge County Hospital will access local, regional, statewide and national organizations to provide educational information to local teens about the impact of teen pregnancy and opportunities to reduce the prevalence of teen pregnancy. Dodge County Hospital will coordinate its outreach efforts to reduce the prevalence of teen pregnancy with the Georgia Department of Public Health’s comprehensive approach to teen pregnancy prevention through: o Coordinated district adolescent health services o Abstinence and comprehensive sexuality prevention o Parent education and involvement o Faith/health community partnerships o Best practices for teen prevention programs Dodge County Hospital will meet with representatives of DPH’s Adolescent Health and Youth Development Program (AHYD) and Youth Development Coordinators (YDC) at the local level to coordinate efforts between the Dodge County Health Department and the (Dublin) South Central District Health Department to form critical partnerships with afterschool programs and county and community agencies to foster collaboration around adolescent and youth development issues with particular emphasis on reducing teen pregnancy. Dodge County Hospital will continue to provide information outreach to pregnant teens regarding prenatal care, the importance of full term pregnancy, and breast feeding for the first six months of life.
Community Health Need Priority #3: Need for community-based programs to support a reduction in the prevalence of overweight and obesity. The 2013 Behavioral Risk Factor Surveillance System (BRFSS) reports that 35.4% of Georgia adults are overweight and 30.3% are classified as obese. Nationally 29.4% of adults are obese. For children, the 2011 National Survey of Children’s Health ranks Georgia 41 st in the nation in overall prevalence of overweight and obesity with 35.0% of Georgia’s children considered either overweight (18.5%) or obese (16.5%). Community Health Need Priority #4: Need for community-based programs to enhance educational outreach to promote healthy lifestyle choices. The Institute for Health Metrics and Evaluation (IHME) at the University of Washington analyzed the performance of all 3,143 U.S. counties and county-equivalents in terms of alcohol use, life expectancy, smoking prevalence, obesity, and poverty using novel small area estimation techniques and the most up- to-date county-level information. The following is a comparison of six lifestyle choice findings for Dodge County in comparison to the national average for 2012 and Dodge County’s national ranking. Selected Lifestyle Activity Indicators National Dodge County Performance Dodge County Lifestyle Activity Sex Average % National Rank Compared to All % of Population of Population (of 3,143 Counties) Counties Heavy Drinking Male 7.6% 9.9% 414 Best 25% Female 2.5% 6.7% 312 Best 10% Binge Drinking Male 16.0% 24.5% 160 Best 10% Female 6.2% 12.4% 400 Best 25% Smoking Male 29.0% 22.2% 2,425 Worst 25% Female 20.4% 17.9% 1,129 Middle 50% Obesity Male 42.6% 33.8% 3,022 Worst 10% Female 44.3% 36.1% 2,689 Worst 25% Recommended Physical Activity Male 49.7% 56.3% 2,264 Middle 50% Female 39.6% 52.6% 2,830 Worst 10% Life Expectancy Male 72.8 years 76.5 years 2,512 Worst 25% Female 77.2 years 81.2 years 2,807 Worst 25% Sources: The Institute of Health Metrics and Evaluation at the University of Washington, 2012, www.healthdata.org The IHME data clearly supports the need identified by community representatives for community-based programs to enhance educational outreach promoting healthier lifestyles for residents of Dodge County. Community Health Need Priority #7: Need for community-based partnerships to enhance access to recreational facilities to promote healthy, active lifestyles. The 2015 County Health Rankings for Georgia and Dodge County developed through a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, indicates that 31% of Dodge County residents are physically inactive compared to 24% of the population throughout Georgia. Furthermore, it indicates that only 48% of residents in Dodge County have access to exercise opportunities versus 75% of Georgians overall. 15 DODGE COUNTY HOSPITAL
We believe these three community health need priorities can most effectively be addressed by combining partnership initiatives with local, regional, and statewide organizations that provide education about and addresses the collective issues related to overweight/obesity, supports healthy nutritional and lifestyle choices, and promotes access to recreational facilities for residents in the community. Dodge County Hospital will identify and recruit local, regional and statewide partners to develop a Wellness Task Force for Dodge County to facilitate development of local community initiatives to address issues related to good nutritional practices, weight management, stress management, and physically active lifestyle choices, and work with these organizations to enhance access to recreational programs in the community. Dodge County Hospital will identify target organizations within Dodge County where Wellness Programs can be successfully implemented utilizing existing communication channels and social support networks (schools, worksites, faith-based, and community organizations). Dodge County Hospital will develop an educational program for leaders of community organizations to communicate “Why Wellness is Important” and how these organizations can support its members with lifestyle changes associated with healthy nutrition, weight management, stress management, and physically active lifestyles. Dodge County Hospital will develop and implement a Wellness Program for its own employees and volunteers that support lifestyle changes associated with healthy nutrition, weight management, stress management, and physically active lifestyle. Dodge County Hospital will establish an on-going program for evaluating local progress in implementing Wellness Programs and provide peer support to help individual organizations improve and sustain their programs.
Community Health Need Priority #5: Need for community-based partnerships to enhance access to non-emergency transportation assistance for residents in getting to medical appointments. Multiple community representatives, interviewed as part of the community health needs assessment, discussed the pressing need to enhance access to non-emergency transportation services for individuals to get home from the hospital, get to follow-up medical appointments, and to local pharmacies to fill prescriptions following their visit to the hospital or doctor’s office. With inadequate access to non-emergency transportation services, many residents just forgo necessary follow-up medical appointments with their physicians. In addition, this issue was frequently cited as a major contributing factor toward poor compliance with routine health checks for individuals with chronic health conditions like diabetes, high blood pressure, heart disease, and psychiatric disorders. As a consequence, some of these individuals become “frequent flyers” when their medical conditions become exacerbated, and local emergency medical services are called in for repeat visits to Dodge County Hospital’s Emergency Department via ambulance. Dodge County Transit provides limited rural public transportation services with two wheelchair accessible vans and one regular van for local residents. Residents who need a ride from rural areas of the county to Eastman are eligible for curb-to-curb services at affordable rates. However, clients must be able to enter and/or exit their destination without assistance from the driver, and clients need to schedule an appointment at least three days and up to a week in advance. Heart of Georgia Community Action Council is the third party operator for Dodge County Transit. Dodge County Hospital will evaluate proposed new rules from the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services regarding local safe harbor non- emergency transportation protections, and will develop hospital policies and procedures regarding non-emergency transportation assistance for patients in getting to medical appointments. Dodge County Hospital will seek to identify local, state or philanthropic organizations that can assist in expanding access to non-emergency medical transportation services for individuals who live within Dodge County Hospital’s service area and need to get to medical appointments within the Hospital’s service area. 17 DODGE COUNTY HOSPITAL
Community Health Need Priority #6: Need for community-based partnerships to enhance access to cardiology services for local residents. From 2009 through 2013, coronary heart disease was the leading cause of death (33.5%) in Dodge County, which is significantly higher than Georgia (29.5%), the United States (23.7%), and worldwide (13.2%). (1) Georgia Department of Public Health, OASIS, Centers for Disease Control & Prevention, World Health Organization. In terms of age-adjusted hospital discharge rates (hospital discharges per 100,000 population), Dodge County residents have a substantially higher hospitalization rate for cardiovascular diseases at 2,139.6 discharges per 100,000 compared to 1,387.6 discharges per 100,000 across Georgia. (2) Georgia Department of Public Health, OASIS. According to the Centers for Disease Control and Prevention, high blood pressure, high LDL cholesterol, and smoking are key heart disease risk factors with 49% of Americans having at least one of these three risk factors. Several other medical conditions and lifestyle choices can also put people at a higher risk for heart disease, including: diabetes, overweight and obesity, poor diet, physical inactivity and excessive alcohol use. At present, there is not a full time cardiologist in Dodge County. On Tuesdays and Thursdays, Dr. Tehrani, a cardiologist from Perry, Georgia travels 41 miles to see cardiology patients in Eastman. Most patients travel to Macon, Georgia which is 56 miles northwest or an hour drive from Eastman if they need access to cardiovascular services. Dodge County Hospital will work with Dr. Tehrani to assist in recruiting a Nurse Practitioner to his practice to increase local cardiology coverage in Eastman 2-3 additional days per week by the fall of 2015. Dodge County Hospital will seek to identify additional local, regional, and statewide partnerships to enhance access to cardiology services in Eastman and the Hospital’s service area. Dodge County Hospital will ensure that its Emergency Department remains open 24/7 and that its physicians and nurses maintain advanced cardiac life support certification.
Community Health Need Priority #8: Need for community-based partnerships to enhance access to Telehealth services for nurses in local schools. Telehealth is the delivery of health-related services using telecommunications and related technologies in the support of patient care, health education, and administrative services. Technologies include video conferencing on a secure, private network with store and forward imaging, streaming media, and wireless communications. Telehealth is designed to increase access to care by connecting people with the specialized care they need that may not exist in their community. The Georgia Partnership for Telehealth is a charitable non-profit organization that was formed in 2008 to promote the establishment of telemedicine programs in communities throughout Georgia. In Dodge County, Telehealth is available through four school clinics located at the Dodge County - Board of Education, Dodge County - Achievement Center, Dodge County High School, and Dodge County - Pre- Kindergarten. This service significantly reduces absenteeism, as students can be connected to specialized patient care and health education services without having to travel out of the county for these services and miss a day of school. The original Telehealth Grant money that provided for the Dodge County school-based clinic programs is running out, and new community-based partnerships are needed to continue funding Telehealth in Dodge County Schools. Dodge County Hospital will seek to provide support to the Georgia Partnership for Telehealth, to help maintain access to Telehealth services in Dodge County school clinics based on the availability of the Hospital’s financial resources. Dodge County Hospital will seek to identify local, regional, and statewide partnerships to provide funding to help maintain access to Telehealth services in Dodge County school clinics. Dodge County Hospital will provide opportunities for school nurses to connect with peers at the Hospital for professional development opportunities, and will fund pediatric advanced life support certification classes for Dodge County school nurses. 19 DODGE COUNTY HOSPITAL
Dodge County Hospital Programs & Services Addressing Community Health Needs Dodge County Hospital currently provides several programs and services to meet community health needs. The following is a description of existing programs and services that address community health needs identified and prioritized by individuals presenting the interests of the community. #1 Need for community-based partnerships to enhance access to behavioral health services. Dodge County Hospital Programs/Services In October 2014, DCH opened a dedicated 10-bed inpatient psychiatric service exclusively for geriatric patients to address this growing need for its senior residents in the community. The Hospital will continue to provide emergency stabilization services as necessary to ensure patient safety when individuals with acute psychiatric and/or substance abuse issues present in the emergency department. #2 Need for community-based partnerships to reduce the prevalence of teen pregnancy. Dodge County Hospital Programs/Services DCH does not have specific programs and services to reduce the prevalence of teen pregnancy, but does provide information outreach to pregnant teens regarding prenatal care, the importance of full term pregnancy, and breast feeding for the first six months of life. #3 Need for community-based programs to support a reduction in the prevalence of overweight and obesity. Dodge County Hospital Programs/Services DCH does not provide specific programs or services to reduce the prevalence of overweight and obesity, but discusses with individuals the consequences of being overweight and/or obese when patients present for treatment, and discuss sources for help in weight reduction. #4 Need for community-based programs to enhance educational outreach to promote healthy lifestyle choices. Dodge County Hospital Programs/Services DCH does not have specific programs or services to promote education and outreach promoting a healthy lifestyle, but does provide periodic reduced priced testing for individuals to have heart health and lipid profile evaluations. #5 Need for community-based partnerships to enhance access to non-emergency transportation assistance for residents in getting to medical appointments. Dodge County Hospital Programs/ Services Due to issues surrounding federal Anti-Kickback Laws, DCH is not able to provide non-emergency transportation assistance to residents in getting to medical appointments.
#6 Need for community-based partnerships to enhance access to cardiology services for local residents. Dodge County Hospital Programs/Services DCH is working with Dr. Tehrani, a cardiologist from Perry to assist in recruiting a Nurse Practitioner to his practice to increase local cardiology coverage in Eastman from twice a week to four to five days a week. The Hospital ensures that its Emergency Department remains open 24/7 and that its physicians and nurses maintain advanced cardiac life support certification. #7 Need for community-based partnerships to enhance access to recreational and fitness facilities to promote healthy, active lifestyles. Dodge County Hospital Programs/Services DCH does not provide specific programs and services to enhance access to recreational and fitness facilities to promote healthy, active lifestyles in the community, but does encourage its employees and volunteers to exercise regularly. #8 Need for community-based partnerships to enhance access to Telehealth services for nurses in local schools. Dodge County Hospital Programs/Services DCH does not provide specific programs or services that enhance access to Telehealth services for nurses in local schools, but does provide continuing medical education opportunities for local school nurses. 21 DODGE COUNTY HOSPITAL
APPENDIX Community Inventory – Healthcare Facilities & Resources Available to Respond to Identified Community Health Needs ACUTE HEALTH CARE FACILITIES Dodge County Hospital is an accredited, not-for-profit, progressive, 94-bed general hospital proving a broad array of health care services including: Critical Care Unit Emergency Department 24/7 Gastro-intestinal Laboratory Geriatric Behavioral Health Unit Laboratory Medical/Surgical Unit Nursery & Pediatric Unit Obstetrical Unit Ophthalmology Pharmacy Physical Therapy Radiology Respiratory Therapy Surgery Center Sleep Disorders Center 901 Griffin Avenue Eastman, Georgia 31023 (478) 448-4066 Chief Executive Officer: Kevin Bierschenk BEHAVIORAL HEALTH Georgia Department of Behavioral Health & Developmental Disabilities is the state authority for behavioral health and developmental disabilities. DBHD is administered through six regional offices and 26 community service areas. Each regional office operates a community-based system of care for the clients it serves. The community-based system allows clients to receive care in the least restrictive setting possible while helping them to obtain a life of independence and recovery. Dodge County is located in Region Five and CSA 23: Community Service Board of Middle Georgia. 1915 Eisenhower Dr., Bldg. 7, Savannah, GA 31406 (912) 303-1670 Behavioral Health Reg. Services: Ted Schiffman Community Service Board of Middle Georgia provides quality, innovative behavioral health care in a therapeutic environment for those they serve. The CSBMG is located in Dublin and serves residents of Bleckley, Dodge, Johnson, Laurens, Montgomery, Pulaski, Telfair, and Treutlen, Wheeler, and Wilcox counties. The CSBMG provides the following mental health and substance abuse services through its offices in Dublin: Adult Mental Health & Substance Abuse Services: Residential Services and Day Services Access Unit - Child & Adolescent Services: Admission, Evaluation, Initial Treatment Planning Community Support – Individual Services: Case Coordination Services Adult Outpatient Mental Health Services Adult MH Services Mental Health Supportive Living Services MH Support Living Supportive Living Program: Supportive Living Services Dublin Adult Day Services: Psychosocial Rehabilitation Services Step One Recovery Center: Adult MH & SA Services, Residential/Day Services, Temporary Assistance for Needy Families (TANF)- Ready For Work (RFW), SA Outpatient Services Quentin’s Place: Detoxification Services, Crisis Stabilization Unit Abundant Life: SA Residential Services for females & their children 600 N. Jefferson Street, Dublin, GA 31021 (478) 275-6811 2121A Bellevue Road, Dublin, GA 31021 (478) 275-6811
Eastman Mental Health Center is a community mental health center operated by CSBMG providing outpatient mental health and substance abuse services to clients in Dodge, Bleckley, Pulaski, Telfair, and Wheeler counties. EMHC provides the following mental health and substance abuse services: Access Unit Triage: Mental Health, Mental Retardation, Substance Abuse, Child and Adolescent Services Substance Abuse Outpatient Services: Classes, Visits, Group Meetings, Buprenorphine Services to manage opioid dependence. 621 Plaza Avenue, Eastman, GA 31023 (478) 448-1040 Contact: Dean Selph Georgia Regional Hospital at Savannah is a state-funded multi-service facility that provides quality care to mentally ill adults, emotionally disturbed children and adolescents, and individuals living with developmental disabilities from its 24-county catchment area in Southeast Georgia. The hospital provides evaluation and treatment to clients needing care. The hospital’s admitting office is a psychiatric emergency receiving facility open 24 hours a day. 1915 Eisenhower Drive, Savannah, GA 31406 (912) 356-2011 Georgia Crisis & Access Line is a 24/7 crisis call center hotline operated by Behavioral Health Link that providing clinical screening, triage, and service linkage by emotional support specialists to determine the level of service needed for individuals with mental health and substance abuse issues. Georgia Crisis & Access Line (800) 715-4225 www.mygcal.com Southeast Georgia Treatment Center is a private, outpatient, narcotics treatment program that provides substance abuse treatment, detoxification, methadone maintenance, and methadone detoxification. 816 Professional Center Drive, Eastman, GA 31023 (478) 374-0390 Contact: W. Buford Rogers DIABETES Georgia Diabetes Coalition is a non-profit membership organization that serves as a unified voice for those members dedicated to improving the quality of life for those affected by diabetes. GDC’s Mission is to increase awareness and implement programs addressing primary and secondary prevention strategies of diabetes, its complication, disabilities and burdens. P.O. Box 162160, Atlanta, GA 30321 (678) 310-4432 email@example.com Georgia Diabetes Prevention & Control is coordinated through the Georgia Department of Public Health’s evidenced-based diabetes prevention programs, and diabetes self-management education programs. The Diabetes Self-Management Program (DSMP) consist of seven management behaviors: healthy eating, being active, monitoring blood glucose levels, problem solving, taking medications as prescribed, coping in a healthy way, and reducing risks of developing complications. GDPH 2 Peachtree St. NW 15th Floor, Atlanta, GA 30303 (404) 657-2700 www.dph.georgia.gov American Diabetes Association is the leading organization heading the fight against the deadly consequences of diabetes and fight for those affected by diabetes. 233 Peachtree St, Suite 2225 Atlanta, GA 30303 (404) 320-7100 www.diabetes.org END STAGE RENAL DISEASE TREATMENT CENTERS Fresenius Medical Care Eastman Dialysis Center is a 21-station end stage renal disease treatment center. 1078 Plaza Avenue, Eastman, GA 31023 (478) 374-4777 Facility Manager: Tina McDaniel FEDERALLY QUALIFIED HEALTH CENTERS Southwest Georgia Health Care is a federally qualified health center with two locations in Dodge County. Eastman Medical Center 1111 Griffin Ave, Suites A & B, Eastman, GA 31023 (478) 374-0020 Middle Georgia Pediatrics 817 Griffin Ave, Eastman, GA 31023 (478) 374-1801 23 DODGE COUNTY HOSPITAL
FINANCIAL ASSISTANCE Georgia Medicaid is a state/federal program that pays for medical and long-term care services for low-income pregnant women, children, certain people on Medicare, individuals with disabilities and nursing home residents. These individuals must meet certain income and other requirements. The Georgia Department of Community Health administers Georgia’s Medicaid program. Dodge County DFCS, 1111 Plaza Ave, Eastman, GA (478) 274-3004 County Director: Natalie Conley PeachCare for Kids is a comprehensive health care program for children through the age of 18 who do not qualify for Medicaid and live in households with income at or below 247% of the federal poverty level. This means a family of three can earn $49,656 a year and a family of four can earn $59,904 a year. PeachCare for Kids health benefits include: Care from a doctor when your child is sick Preventive services such as immunizations and regular check-ups Specialist care Dental care Vision care, including vision screening and eyeglasses Hospitalization Emergency room services Prescription medications Mental health care Each child will have a choice of a Georgia Families Care Management Organization (CMO), a private health plan that is responsible for coordinating your child’s health care. You will also be able to choose your child’s primary care provider. The Georgia Department of Community Health administers the PeachCare for Kids program. PeachCare for Kids PO Bix 2583, Atlanta, GA 30301 (877) 427-3224 GEORGIA DEPARTMENT OF PUBLIC HEALTH DPH is the lead agency in preventing disease, injury, and disability; promoting health and well-being; and preparing for and responding to disasters from a health perspective. At the state level, DPH functions through numerous divisions, sections, programs and offices. Locally, DPH funds and collaborates with Georgia’s 159 county health departments and 18 public health districts. Today, DPH’s main functions include: health promotion and disease prevention, maternal and child health, infectious disease and immunization, environmental health, epidemiology, emergency preparedness and response, emergency medical services, pharmacy, nursing, volunteer health care, the Office of Health Equity, Vital Records, and the State Public Health Laboratory. Department of Public Health 2 Peachtree Street NW 15th Floor, Atlanta, GA 30303 (404) 657-2700 Commissioner: Brenda Fitzgerald, M.D. South Central Health District 2121-B Bellevue Road, Dublin, GA 31021 (478) 275- 6545 District Director: Lawton C. Davis, M.D. Dodge County Board of Health 1121 Plaza Avenue, Eastman, GA 31023 (478) 374-5576 CEO: Lawton C. Davis, M.D. GEORGIA FAMILY CONNECTION Dodge Connection- Communities in Schools of Dodge County is the local decision-making body, bringing community partners together to develop, implement, and evaluate plans that address the serious challenges facility Georgia’s children and families. Dodge Connection is the local Georgia Family Connection Collaborative Organization (GFC). Using a communities in school, family-centered approach, schools, health and human services agencies, business, the faith community, law enforcement, nonprofit organizations, civic clubs, and others work together with families, focusing on academics, physical and mental health, nurturing parenting, economic success, and community service. GFC’s overarching goal is for all children to succeed in school and life. 1400 Dr. Martin Luther King Jr Drive, Eastman, GA 31023 (478) 374-1997 Contact: Debbie Connell
HEALTHY LIFESYTLE GAL (Get a “Healthy” Life) is a program created to educate, enlighten, and inspire women to take time out for themselves and get healthy. The GAL program addresses physical activity, healthy eating, visits to your doctor, problems with smoking, drugs, and alcohol, Text4baby a free mobile information service that provides pregnant women and new moms with information to help them through their pregnancy and the baby’s first year, having a plan for your family budget, education plan, career plan, and preparing to start a family. It also provides resources and downloads to help women “get a healthy life.” www.adph.org/gal Worksite Wellness Program is a program of the Georgia Department of Public Health that advocates physical activity and healthy food choices as part of our daily environment. The DPH hosts workshops during March to engage active employees in additional health and fitness programming and to encourage those not as active to find healthy habits they can begin to implement. www.dph.georgia.gov The Partnership for a Healthier America (PHA) is devoted to working with the private sector to ensure the health of our nation’s youth by solving the childhood obesity crisis. PHA brings together public, private and nonprofit leaders to broker meaningful commitments and develop strategies to end childhood obesity. Supporting the PHA’s effort is honorary chair First Lady Michelle Obama. www.healthy-america.org HEART DISEASE / HYPERTENSION The Georgia Cardiovascular Health Initiative (CVHI) works diligently to refine and improve the CDC’s four areas of the Heart Disease and Stroke Program: prevention of the risk factors associated with CVD, detection and treatment of CVD risk factors, early identification and treatment of CVD, prevention of recurrent CVD events. The CVHI relies on successful partnerships with the Georgia Coverdell Acute Stroke Registry, the Stroke and Heart Prevention Program, the American Heart Association, Georgia’s 18 public health districts, Emory University, Georgia Medical Care Foundation, Georgia Hospital Association, CDC, and participating hospitals. www.dph.georiga.gov HOME CARE SERVICES Asmart Senior Care is a licensed private home care company providing nursing services, personal care tasks, and companion sitter services. 410 Griffin Avenue Suite A, Eastman, GA 31023 (478) 374-5115 Administrator: Leo Anyanwu ResCare is a licensed private home care company providing nursing services, personal care tasks, and companion sitter services. 5450 Oak Street, Eastman, GA 31023 (478) 374-4322 Administrator: Laurie Dent-Smith Three Rivers Home Care is a licensed private home care company providing nursing services, personal care tasks, and companion sitter services. 208 Foster Street, Eastman, GA 31023 (478) 374-6729 Administrator: Kaye Smith Three Rivers Home Health Services is a full-service, Medicare certified home health agency serving Dodge, Bleckley, Laurens, Wheeler, Telfair, Wilcox, and Pulaski counties in the Hospitals primary and secondary service area. 131 Main Street, Eastman, GA 31023 (478) 374-2027 Administrator: Hal Smith HOSPICES Hospice Care Options of Georgia is an in-home hospice provider. 715 Legion Drive, Eastman, GA 31023 (478) 374-4888 Administrator: Jane Howard Quality Health Services Hospice is an in-home hospice provider. 830 Professional Center Drive, Eastman, GA 31023 (478) 374-0609 Administrator: Brandy Groff 25 DODGE COUNTY HOSPITAL
NURSING HOMES Eastman Healthcare & Rehab is a 100-bed Medicare/Medicaid certified skilled nursing facility. 556 Chester Highway, Eastman, GA 31023 (478) 374-4733 Administrator: Jeremy Locklear Heart of Georgia Nursing Home is a 100-bed Medicare/Medicaid certified skilled nursing facility. 815 Legion Drive, Eastman, GA 31023 (478) 374-5571 Administrator: Paul Milner OVERWEIGHT/OBESITY Georgia Nutrition and Physical Activity Strategic Plan 2011-2021 is a practical guide in Georgia’s obesity control effort facilitated by the Georgia Department of Public Health with input from more than seventy stakeholders with the long term goal of controlling obesity and preventing the onset of other chronic diseases by encouraging a prevailing environment of wellness throughout the entire state. To that end, the plan identifies practical and measurable long-term and mid-term objectives. The South Central Health District in Dublin is the partner organization representing Dodge County. www.beproactivefoundation.org/media/6a9a857bc6e14cbdffff8020ffffd523.pdf See also “Healthy Lifestyle” PERSONAL CARE HOMES Dogwood Gardens Senior Living is a 24-bed licensed personal care home. 1222 Plaza Drive, Eastman, GA 31023 (478) 374-3303 Administrator: Susan Coffee Golden Personal Care Home is a 30-bed licensed personal care home. 257 Golden Road, Eastman, GA 31023 (478) 374-2483 Administrator: Jan Smith Home Place Senior Living is a 15-bed licensed personal care home. 345 Pearl Bates Avenue (478) 374-0600 Administrator: Susan Coffee TEEN PREGNANCY PREVENTION Office of Adolescent Health is dedicated to improving health and well-being for adolescents to enable them to become healthy, productive adults. First funded in 2010, OAH supports and evaluates evidenced-based teen pregnancy prevention (TPP) programs and implements the Pregnancy Assistance Fund; coordinates efforts related to adolescent health promotion and disease prevention; and communicates adolescent health information to health professionals and groups, those who serve youth, parents, grantees, and the general public. OAH is the convener and catalyst for the development of a national adolescent health agenda. www.hhs.gov/ash/oah Teen Pregnancy Resource Center is an initiative of the Office of Adolescent Health and provides training materials and resources for TPP grantees and organizations working to reduce teen pregnancy in the United States. It offers: E-Learning modules, informative podcasts, webinars, and training materials. www.hhs.gov/ash/oah/oah-inititatives/teen_pregnancy Georgia Teen Pregnancy Prevention is facilitated by the Georgia Department of Public Health in partnership with the Georgia Department of Human Services and Georgia Department of Family and Children Services using a comprehensive approach to address teen pregnancy through evidenced-based programs and best practices. www.dph.georgia.gov/teen-pregnancy-prevention TRANSPORTATION Dodge County Transit is a rural public transportation service with two wheelchair accessible vans and one regular van for local residents operated by the Heart of Georgia Community Action Council. Residents who need a ride from rural areas of the county to Eastman are eligible for curb-to-curb service at affordable rates. However, clients must be able to enter and/or exit their destination without assistance from the driver, and clients need to schedule an appointment at least three days and up to a week in advance. 112 2nd Avenue, Eastman, GA 31023 (478) 374-2261
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