Peninsula / Williamsburg Community Needs Assessment

1. Peninsula / Williamsburg Community Needs Assessment December 2013

2. Four New IRS Requirements for Charitable 501(c)(3) Hospitals With The Affordable Care Act (ACA) • Section 501 (r) of the ACA requires each 501(c)(3) hospital organization on a facility-by-facility basis to • Establish written financial assistance and emergency medical policies • Limit amounts charged for emergency or other medically necessary care to individuals eligible for assistance under the hospital’s financial assistance policy. • Make reasonable efforts to determine whether an individual is eligible for assistance under the hospital’s financial assistance policy before engaging in extraordinary collection actins against an individual and • Conduct a Community Health Needs Assessment (CHNA) at least once every three years. • This CHNA requirement is effective for tax years beginning after March 23, 2012. • Must adopt a written implementation strategy to address identified community needs • Include input from persons who represent the broad interest of the community • Include input from persons having public health knowledge or expertise • Make assessment widely available to the public • Failure to comply is $50,000 fine per tax year

3. CHNA Benefits • Identify key opportunities for clinical offerings. • Identify opportunities for community health outreach. • Solidify population health understanding during transition to ACO markets. • Provides opportunity to connect with community health leaders during throughout the market.

4. Who and How… • Riverside commissioned Community Health Solutions to conduct a community health needs assessment for Riverside Regional Medical Center. • The following counties and cities were included in the assessment: Hampton, Newport News, Williamsburg, Poquoson, York, Isle of Wight, James City. King William and New Kent. • Methodology: Two Prong Approach • Community Insight Profile • Qualitative analysis from survey of community stakeholders • Community Indicator Profile • Quantitative analysis from community health status indicators

5. Community Insight Profile • Survey sent to 158 community stakeholders • Response rate of 53% (83) • Survey participants were asked to provide viewpoints on: • Important health concerns in the community; • Significant service gaps in the community; and • Ideas for addressing health concerns and service gaps.

6. Organizational Affiliations of Survey Respondents • Abbitt Management • An Achievable Dream • Angels of Mercy Medical Clinic • Area Health Education Center • Avalon: A Center for Women & Children • Ball Metal Beverage Packaging Division, Americas • BOSH Global Services • Canon Virginia, Inc • Child Development Resources • Christopher Newport University • City Council of Newport News • City of Newport News • City of Newport News, Department of Human Services • City of Williamsburg • City of Williamsburg – Fire Dept (2) • Civic Leader • Colonial Behavioral Health • David, Kamp and Frank, LLC • Dixon Hughes Goodman • Emmanuel Baptist Church / Emmanuel House In. • Foodbank of the Virginia Peninsula • Greater Williamsburg Chamber and Tourism Alliance • Greg Garrett Realty • Hampton Department of Human Services • Hampton Division of Fire & Rescue (2) • Hampton HELP, Inc • Hampton Police Division • Hampton Roads Prostate Health Forum • Hidenwood Presbyterian Church • Isle of Wight Chamber of Commerce • Isle of Wight Social Services • James City County Board of Supervisors • James City County Community Services / Social Services • James City County Police Department • Lackey Free Clinic (6) • Monarch Bank • Newport News Fire Department (2) • Newport News Police Department • Newport News Public Schools • Newport News Shipbuilders • Olde Towne Medical Center • PBMAres • Peninsula Agency on Aging • Peninsula Airport Commission • Peninsula Emergency Medical Services • Peninsula Fine Arts Center • Peninsula Health District • Poquoson City Schools • Project CARE of the Greater Virginia Peninsula • RAMPS Across America, Inc • Riverside Family Medicine Residency • Riverside Health System Foundation • Riverside Life Long Health Division • Riverside Regional Medical Center • Riverside Wellness and Fitness Center (2) • Surry Area Free Clinic • Surry Chamber of Commerce / School Board • The Arc of the Virginia Peninsula • The Colonial Williamsburg Foundation • The Community Free Clinic of Newport News • The Mariners Museum • Virginia Peninsula Chamber if Commerce • Walsingham Academy • West Point Public Schools • West Point Public Schools – Middle School • Williamsburg Christian Academy • Williamsburg Community Chapel • Williamsburg Community Foundation • Williamsburg Community Health Foundation • Williamsburg Landing • Williamsburg / James City County Schools • York – Poquoson Social Services • Unknown Organization

7. Important Community Health Concerns Identified by Survey Respondents Top Health Concerns Identified: High Blood Pressure Adult Obesity Cancer Heart Disease & Stroke Diabetes Mental Health Conditions Substance Abuse – Illegal Drugs

8. Important Community Service Gaps Identified by Survey Respondents Top Service Gaps Identified: Aging Services (Health Care related) Community Services for the Elderly (Meals, Transportation, etc) Behavioral Health Services Homeless Services Adult Day Care Services Dental Care / Oral Health Health Care Coverage 81 of 83 respondents answered this question

9. Action Plan Recommendations There are three “buckets” of recommendations: • Those action items that are the full responsibility of Riverside Health System (RHS). • Those action items that are solved through collaborative relationships with community and not necessarily led by RHS. • Those action items that are resolved in community without the involvement of RHS.

10. Developing the Action Plan • The review of findings fell under four broader categories: • Services for the Elderly • Healthy Lifestyle / Nutrition / Wellness • Awareness & Navigation of Resources • Behavioral Health • The individual proposed actions were developed from these categories with assignments noted for the responsible facilities.

12. The Action Plan Services for the Elderly: Increase awareness of and access to existing medical and community resources and create plan to determine and address service gaps in the community. • Partner with area organizations to identify current resources, create master directory of resources and identify ways to communicate those resources with area organizations and community members. • Perform a gap analysis on current availability of services vs. projected demand for services in the region. Then develop specific action plan to address any identified issues.

13. The Action Plan Healthy Lifestyle, Nutrition and Wellness: Improve community members’ long-term health through education of healthy lifestyle choices. • Develop Healthy Lifestyle Program for use in multiple environments • Area health departments • Employers • Schools • Church and community groups • Inventory and collaborate with local communities to preserve and promote recreational spaces for healthy activities for community members of all ages and abilities.

14. The Action Plan Awareness & Navigation of Resources: Increase awareness of existing resources. • Partner with local groups to identify current resources, create master directory of on-line resources and identify ways to communicate those resources with area organizations and community members. • Develop a plan for ongoing collaboration.

15. The Action Plan Behavioral Health: Increase awareness of and access to existing behavioral health resources and create plan to determine and address behavioral health service gaps in the community. • Partner with area CSBs, health systems, clinicians and other stakeholders to identify current resources, create master directory of resources and identify ways to communicate those resources with area organizations and community members. • Perform a gap analysis on current availability of behavioral health services vs. projected demand for services in the region. Then develop specific action plan to address any identified issues.

16. Questions?