Comprehensive CommunityService Plan

2013

St. Luke’s Cornwall Hospital (SLCH), with main campuses in Cornwall and Newburgh and offsite 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 2010-2013 Community Health Assessment from Orange County Department of Health, Demographic and Economic profile prepared by Siemens and other data sources. After reviewing the data, SLCH developed a comprehensive implementation plan.

Overview:

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Community Health Assessment

Description of the Community:St. Luke’s Cornwall Hospital’s primary market is defined by 36 neighboring zip codes mainly in Orange County and including Ulster and Dutchess counties. The City of Newburgh is the most heavily populated portion of SLCH’s primary service area, with more than 1,500 people per square mile. The hospitals primary and secondary service areas includes more than 400,000 people total.

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Primary Service Area Demographic Snap Shot:(All data has been taken from the New York State Department of Health at https://health.data.ny.gov/ and SLCH’s information database)

• The overall population is growing moderately between 2% to 3% through 2016; two fastest growing zip codes in the county are within 5 to 12 miles of the Hospital.

• Nearly 57.5% of the overall population is 50 years of age and older.

• $77, 421 is the average household income.

• In 2011, the estimated unemployment rate was slightly lower than New York’s average at 7.9%

• In 2008, provisional data indicated that 19.7% of Orange County adults reported disabilities and 5.9% reported health problems that required the use of special equipment such as a cane, wheelchair, special bed or telephone.

• SLCH along with Community Health Centers have been working to access eligibility for Medicaid Managed Care, Child Health Plus and Family Health Plus.

• During the period of 1990-2000, approximately 9,000 immigrants established residency in Orange County, with over one-third of that number settling in the city of Newburgh, NY. The Census estimates that Orange County has experienced a 28% increase in foreign-born population from 2000-2005 compared to 16.3% nationwide.

• The Orange County Department of Health has determined that housing units within the county increased 11% from 1990-2000 to 122,754. The DOH found that the majority of housing units in the county are owner occupied- 67%.

• Overall, the perception of health is very high; 72% of respondents claim to have good or very good health.

• Nearly 50% of the population feels that they are at normal weight.

• Though the population feels as though they are at normal weight, 32% of SLCH’s service area is obese and 28% is overweight.

• While the lack of access to primary care is due to financial resources or employment, 86.9% of survey respondents claim to have medical insurance.

• 81% of the population claims to be aware of no or low cost health insurance programs available to children.

• 81% of SLCH’s service area does not smoke.

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Primary Service Area Demographic Snap Shot (continued):(All data has been taken from the New York State Department of Health at https://health.data.ny.gov/ and SLCH’s information database)

Age Distribution

Income Distribution

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Primary Service Area Demographic Snap Shot (continued):(All data has been taken from the New York State Department of Health at https://health.data.ny.gov/ and SLCH’s information database)

Education Level Distribution

Race/Ethnicity Distribution

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Primary Service Area Demographic Snap Shot (continued):(All data has been taken from the New York State Department of Health at https://health.data.ny.gov/ and SLCH’s information database)

(Data charts have been taken from the Orange County Department of Health)

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Main Health Challenges:According to the Orange County Department of Health, in the last 6 months, residents have seen a health care provider for the following health issues:

• Diabetes- 76% of population • High Blood Pressure- 77% of population • High Cholesterol- 62% of population • Cancer or Cancer Screenings- 61% of population • Heart Disease- 74% of population

Based on this information, SLCH has identified several health challenges that face the community of which our healthcare services extend to. Included with these challenges are associated risk factors which have been identified by the Department of Health. The main challenges are:

• Heart disease • Cancer • Stroke

Within these health challenges, there are other obstacles that are leading causes of these challenges including diabetes and obesity. These obstacles greatly contribute to SLCH’s main health challenges. Other risk factors have a role in these diseases as well. These risk factors are below.

• Behavioral Risk Factors: The leading overall cause of death in Orange County has been linked to numerous behavioral risk factors. Individuals residing in the St. Luke’s Cornwall Hospital/Newburgh communities generally have a high rate of death caused by specific behaviors including: alcohol and substance abuse, risky sexual behavior, diet and lack of activity and the lack of consistent medical care, including lack of primary and preventative care. Behavioral and Environmental risk factors account for about 70% of premature deaths in the US overall.

• Environmental Risk Factors: Factors such as tobacco smoke, pollutants and environmental allergens (ex. House dust mites, cat and dog dander) are environmental health risk factors associated with the challenged addressed by SLCH. These factors in addition to a lack of access to quality medical care and a lack of financial resources allow a disease to become difficult to manage on a long term basis.

• Socioeconomic Factors: According to Healthy People 2010, NYSDOH, socioeconomic status, particularly poverty, appears to be an important contributing factor to asthma illness, disability and death. In 2008-2009, an EBRFSS was conducted for Orange County. This indicated that a total of 19.2% of those who participated were uninsured. There was a higher rate of uninsured males (22.7% as opposed to 15.6% of females). Those between the ages of 18-34 had the highest rate of all, with 31.7% uninsured. The lack of insurance in a community proves for a higher risk of mismanagement of a chronic disease.

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• Policy Environment: (smoke free parks, menu labeling, zoning for walkable communities, etc.) A variety of programs and organizations work to provide health information to the community. Of these programs include, Healthy Neighborhoods Program, which provides public health services to specific geographic areas identified with a high rate of environmental health needs and Healthy Orange which has implemented several worksite wellness programs which focus on healthier eating and physical activity. Events for the programs include walking events and clubs.

According to the New York State Department of Health, Chronic diseases are among the leading causes of death, disability and rising health care costs in New York State. They account for approximately 70 percent of all deaths in NYS and affect the quality of life for millions of New Yorkers, causing major limitations in daily living for about one in ten residents. Additionally, the rate of chronic diseases is rising steadily, increasing from 24 percent in 2001 to 28 percent in 2006, and in 2009 to 58 percent.

Due to the long duration and generally slow progression of chronic diseases such as cancer, diabetes, heart disease, stroke and asthma, consistent delivery of high-quality chronic disease preventative care and management proves to be the main challenge in relation to chronic diseases.Though chronic diseases are among the most prevalent in NYS, they are often the most preventable. The World Health Organization has estimated that if the major risk factors for chronic disease were eliminated, at least 80 percent of all heart disease, stroke and type-2 diabetes would be prevented, and more than 40 percent of cancer cases would be avoided.

The area of which SLCH will focus on for the Preventing Chronic Diseases Action Plan will be:

• Increase access to high-quality chronic disease preventive care and management in clinical and community settings.

Summary of the Assets and Resources that can be utilized to Address Health Issues:

SLCH has identified several resources that will be used to aid in addressing the health issues stated above. The resources that will be implemented include:

• SLCH Community engagement efforts for heart disease include thirteen engagements. Those events include medical staff speaking engagements, blood pressure screenings, conferences, and EMS respondent speaking engagements.

• SLCH is very active within the preventative cancer spectrum and annually carries the responsibility for providing; four breast screenings, one prostate screening, two colon screenings, two smoking cessation education, and two skin cancer screenings.

• SLCH provides two educational sessions per year about stroke and one general program on stroke.

• SLCH provides three programs regarding diabetes and educational information about healthy eating, diabetes prevention as well as obesity prevention.

• SLCH offers other programs including fall prevention, health maintenance screenings, information on Lyme disease, advancements in physical therapy, neck and back injuries, orthopedic emergencies, nutrition, etc.

Documents and sources used to conduct the assessment: • Orange County Department of Health Assessment 2010-2013 • Orange County Department of Health Assessment results- 2012, accessed on October 1, 2013 • Data pulled from SLCH data files, accessed on October 1, 2013 • Information gathered from the new York State Department of Health at ny.health.gov, accessed on October 9, 2013

- Partners for the assessment include: • Orange County Department of Health • Orange County Regional Medical Center • Bon Secours Charity Health System

- Methods to seek community input included: • Community/town forums and meetings • Medical education seminars • Physician presentations •Health screening events

Community Health Improvement Plan:Chronic Disease Prevention is the prevention agenda priority that has been identified. The priority was determined through a community health survey, conducted by the Orange County Department of Health among other findings from the New York State Department of Health, and SLCH’s compiled data reports. Participating organizations include St. Luke’s Cornwall Hospital, Bon Secours Charity Health System, and Orange Regional Medical Center.

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Prevention Area: Chronic Disease Prevention

Long Term Goal: • Increase screening rates for cardiovascular disease, diabetes and breast and cervical cancers, ultimately to decrease the percentage of adults with cardiovascular disease, diabetes and breast and cervical cancers.

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Prevention Area: Chronic Disease Prevention

Long Term Goal: • Promote use of evidence-based care to manage chronic diseases, ultimately to reduce hospital stay in adults with short term chronic disease complications.

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Prevention Area: Chronic Disease Prevention

Long Term Goal: • Promote culturally relevant chronic disease self-management education, ultimately to reduce amount of adults within SLCH’s primary service area who have chronic diseases or are aware of preventative measures for chronic diseases.

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Hospital Community Service Plan:

Hospital Mission Statement:

St. Luke’s Cornwall Hospital is dedicated to providing excellent health care services to our community.

Vision: Our Vision is to be a leader in clinical and service excellence, working in partnership with our medical staff, employees, and area health providers to improve the health of our community. Definition and brief description of the community served:

St. Luke’s Cornwall Hospital (SLCH), with main campuses in Cornwall and Newburgh and offsite 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 2010-2013 Community Health Assessment from Orange County Department of Health, Demographic and Economic profile prepared by Siemens and other data sources. After reviewing the data, SLCH developed a comprehensive implementation plan.

St. Luke’s Cornwall Hospital’s primary service area includes the City and Town of Newburgh and 7 additional towns in Orange County and one town in Ulster County. The secondary service area represents a considerably larger area and encompasses additional towns (15 zip codes) in Orange, Dutchess and Ulster Counties. The hospital’s immediate service area is classified as the “only Federally Designated Medically Underserved Municipality in Orange County.”

Public Participation:

a. Participants involved in assessing community health needs and their roles include:

• Community-based organizations such as the Greater Hudson Family Health Center, the Unity Center and the Town of Newburgh Recreation Center. • Faith-based organizations • Local health department • Employers and businesses

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b. Throughout 2012 and 2013, each community education event has surveyed participants on the lecture. The survey asks for participant suggestions regarding what they did or did not like about the lecture and what specific topics they would have liked to have learned about. The information is then documented and utilized for scheduling future education and outreach activities. The priorities selected represent existing programs that will be supplemented by input and support from clinical staff and community partners.

c. Describes how public notification of these sessions was accomplished: • Invitations • Flyers distributed to public, displayed at the hospital, on our website and on social media • Emails to past participants and local community centers • Collaboration with Greater Newburgh Partnership • Distribution of news to community calendars and local news outlets which will appear on-line and in print • Notifications to appear on SLCH’s public website and the internal website

Assessment and Selection of Public Health Priorities:

Community Education and Health screenings:SLCH understands that early detection and prevention is a key component in identifying and managing disease. SLCH is dedicated to helping community

members live longer and stronger by providing risk reduction interventions to improve health outcomes.

SLCH has provided over 25 community health education lectures and presentations on cardiovascular disease, stroke, diabetes, prostate cancer and breast health to increase

awareness of risk factors and increase recognition of warning signs. SLCH’s educational programs are held in faith and community based organizations to establish effective techniques that will cultivate behavior changes that influence healthy living.

Many of the individuals within the SLCH service area are at risk for particular diseases. Early detection and preventive health screenings are one of the most effective ways to identify ones risk to a disease. SLCH offers free screenings to the community for blood pressure, and breast, skin and colon cancers on our campuses and community sites to provide a larger reach and greater resident participation.

Throughout 2013, SLCH’s outreach and education initiative has reached over 1,000 community members in the hospital’s primary and secondary markets.

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Stroke Education

Cardiac Education

Cancer Education

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Men’s Health

Home Care

Diabetes Education

EMS Education

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Other

Other (Continued)

All community partners above were coordinated one month ahead of time. SLCH plans to continue working with these partners for 2013-2017. In addition to the partners above, SLCH has strong partnerships with:

Greater Newburgh Partnership (GNP)

• SLCH has participated in the GNP Summit, held in March of 2013.

• The GNP Summit supported the gathering of over 60 individuals from 40 not for profit organizations within the City of Newburgh, NY.

• The Summit gathered information under the conversation, “Together, We’re Better”.

• Organizations brainstormed resources that are being duplicated among the community with the goal to eliminate efforts that are being provided by various groups.

• SLCH was responsible for leading a discussion with several other health organizations about diabetes/obesity, physician tools and education and chronic diseases.

Times Herald Record- Not One More Forum

• SLCH employee, Kathy Sheehan, ED Educator/Clinical Coordinator presented as a panelist on May 21, at Cornwall High School, as part of The Times Herald Record’s Not One More Campaign.

• Not One More was created by The Times Herald Record in efforts to prevent distracted teen driving crashes. The forum is presented to teenagers at local high schools in the area during the spring with hopes that fewer teens will take part in distracted driving behaviors such as texting, loud noises, driving under the influence of drugs or alcohol, driving while fatigued, or driving with multiple individuals in the car.

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• Over the past few years, Orange County Stop DWI/Traffic Safety has partnered with Cornwall High School to present this program aimed at putting an end to fatal car crashes involving local teens.

Teddy Bear Clinic

• SLCH hosts several “Teddy Bear Clinics” each year which welcomes local kindergarten students to the SLCH emergency department in efforts to reduce the anxiety children have when visiting the emergency room. Quality Care: The primary priority at SLCH is providing quality health care services to our community. We are committed to meeting the needs of our community and aspire to excellence in the delivery of comprehensive health care services. To achieve this goal, we partner with our medical staff, are committed to customer satisfaction and seek continuously to improve our services. We strive to be your first choice when seeking health care services. SLCH achieves the highest in quality care through achievements and accreditations with:

• The American College of Radiology • The American Association of Cardiovascular and Pulmonary Rehabilitation • The American Diabetes Association • The College of American Pathologists • The National Accreditation Program for Breast Centers • The Aetna Institutes of Quality • The Joint Commission • The American Heart and Stroke Association. • The Commission on Cancer Accreditation by the American College of Surgeons Community Preparedness:St. Luke’s Cornwall Hospital fosters a ‘culture of preparedness’ not only within our hospital but with the entire Newburgh community. Extensive interaction with emergency services – including annual drills, bi-monthly meetings, and everyday phone conversations – help the hospital prepare and assist in community resiliency. Within the region, St. Luke’s has built a strong coalition with other hospitals through equipment sharing, training and exercises, and mutual aid agreements in which staff and gear can seamlessly be called upon. Our EMS personnel must complete requirements of two educational sessions per year about stroke and our program on stroke.

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The Three year plan of Action: St. Luke’s Cornwall Hospital’s planning process to meet the identified needs listed above included addressing increased cancer rates in the region and an increased rate of chronic disease. The hospital analyzed extensive demographic data on the health care status of the community. The goal of these programs is to improve access to education, prevention, care and treatment. SLCH has identified previous successes and include connecting with members of the community by way of education and outreach. SLCH has hosted over 45 free educational lectures and presentations with more than 1,000 community members in attendance. Presentations have been given at health fairs, churches, hospital campuses, senior centers and community sites. There is an anticipated overlap in our action plan efforts. For example, strategies which will promote healthy eating and exercise/physical activity will positively affect those with heart disease, diabetes, and obesity. Moreover, an increase in healthy behaviors as a result of our efforts will essentially have a positive “snow ball” effect for all health issues identified in the CHNA. Dissemination of the Plan to the public: St. Luke’s Cornwall Hospital’s Community Service Plan will be displayed on the hospital’s website and given out at community events. In order to serve the community and provide the best quality care, the plan will be a living document and additions to the plan will be made as the needs for our community change. A brief description of the process:

The processes that will be used to maintain engagement with local partners over the three years of the Community Service Plan include:

• Maintaining positive relationships and contacts with local businesses and organizations in our database.

• Recording 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.

• SLCH has expanded communications efforts, implementing social media sites, such as Facebook and Twitter. These sites serve as an interactive way of communicating with the SLCH community.

• SLCH also actively engages local media outlets in print and online in order to serve the adult demographic.

2013 Community Service PlanProduced by the Office of Community Relations(845) 784-3849

The CSP was made available to the public by being placed on the hospital website:http://stlukescornwallhospital.org/community_service_plan.php

70 Dubois StreetNewburgh, NY 12550