Maine Shared Community Health Needs Assessment 2018 Community Events

1. Maine Shared Community Health Needs Assessment2018 Community Events York County Region: Saco

2. Welcome and Introductions

3. Thank you to the following sponsors of this forum!

4. Forum Agenda

5. Why are we here?

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

7. Maine Shared CHNA Governance

8. Health Improvement Process Partners Partners Partners Partners Partners Partners

9. Local Activities and Accomplishments

10. York County AccomplishmentsCommunity priority areas of work since the 2016 Shared CHNA • Substance Use Prevention • Tobacco Use Prevention • Obesity Prevention • Oral Health

11. 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 • 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 Southern Maine Health Care 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) • Trainstaff 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.

12. York County Accomplishments Priority: Tobacco Hospital/Health System Strategies/Activities Southern Maine Health Care • 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 withvarious sectors such as lodging, landlords, municipalities and schools. York Hospital • Created policy and protocol in Electronic Medical Record (EMR) for York Primary Care Providers to refer patients to QuitLink for tobacco cessation • Implemented EMR changes to support the use of brief interventions and referrals for tobacco users

13. York County Accomplishments Priority: Obesity Hospital/Health System 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 Southern Maine Health Care York Hospital • 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 York Public Health District • 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

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

15. How to Read County Health Profile EXAMPLE

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% Maine 11% 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 YPLL measures premature death, or the years of potential life lost before the age of 75. 10,000 Maine 6529.2

23. Social Determinants of Health York County: Individuals Living in Poverty • Unemployment rate (2012-2016) 15% Maine 14%

24. Social Determinants of Health • Adverse Childhood Experiences, 2017

25. Health Behaviors - Obesity • York County: Obesity (Adults) • York County: Obesity (High School) 35% 35% Maine 30% Maine 15% 2011 2017 2011 2017

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 E-Cigarette Use (High School) 25% 25% Maine 15%

28. Health Behaviors – Alcohol and Marijuana • York County: Past 30-day Alcohol and Marijuana Use (High School) 35%

29. Health Outcomes - Cancer All Cancer Deaths, 2016

30. Health Outcomes - Adult Chronic Disease York: Diabetes Prevalence York: Asthma Prevalence 15% 15% Maine 12% Maine 10%

31. Health Outcomes-Adult Chronic Disease York County: High Cholesterol York County: High Blood Pressure Maine 40%

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

33. Health Outcomes - Mental Health York County: Seriously Considered Suicide (High School) 20% Maine 15%

34. Health Outcomes - Substance Use York County: Unintentional/Undetermined Intent Poisoning Deaths Per 100,000 Population Overdose Deaths Per 100,000 2012-2016 25 2017 114 Maine 17.6 2012-2016 2007-2011

35. Health Outcomes - Injury York County: Injury Deaths Per 100,000 Population York County: Fall-Related Deaths (Unintentional) Per 100,000 Population 80.0 80.0 Maine 67.9 Maine 9.6 36

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

37. Facilitated Discussion

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

39. Assets/Resources and Needs Put sticky notes with assets/resources and needs on the corresponding Priority Area sheet. 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 Adam.Hartwig@maine.gov • Meets quarterly - 1st 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 Manninensmanninen@yorkhospital.com • UNE – Coastal Healthy Communities Coalition • Contact: Sarah Breulsbreul@une.edu