Community Health Needs Assessment

Oconee Regional Medical Center
Community Health Needs Assessment Report
2013
ORMC Community Health Needs Assessment Report 2013
INDEX
Topic:
Page Number:
Our History
3
CHNA Needs Assessment Background and Methodology
4
Community Served
5
Data Assessment-Secondary Data
6
Sources Used in Data Assessment Process
7
Data Assessment Highlights and Findings
8-9
County Health Rankings Chart
10
Statistical Information Related to Health and Socio-Economic Indicators:
Access to Care
11
Clinical Preventative Services
12
Environmental Quality
12
Injury and Violence
12
Maternal Infant and Child Health
13
Mental Health
14
Nutritional, Physical Activity and Obesity
15
Reproduction and Sexual Health
16
Substance Abuse/Tobacco
16
Community Input
17
Community Based Survey Results
18-21
Community Informants/Stakeholder Interviews
22
Community Focus Groups
23
Inventory of Services Addressing Community Needs
24
Prioritization of Needs
25-26
Board Approval
26
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ORMC Community Health Needs Assessment Report 2013
Our History
Oconee Regional Medical Center (ORMC) is located in Milledgeville near the geographic center
of Georgia, providing advanced healthcare technologies to the 130,000 residents living in the
seven surrounding counties.
The hospital offers a wide range of medical services - from specialized treatment centers for
cancer and wound care -- to advanced imaging technologies that include digital mammography
and high-speed CT scanning. In addition to its 24/7 Emergency Department, the hospital also
offers a number of outpatient treatment programs, same-day surgery, health education
programs, and a state-of-the-art laboratory for diagnostic testing. For inpatient treatment, the
hospital is licensed for 140 acute care beds and for 15 beds in its Skilled Nursing Unit, which
serves patients requiring extended care.
ORMC's roots date back to March 1957, when it opened as Baldwin County Hospital. In the
1990s, the hospital's name was officially changed to Oconee Regional Medical Center and
Oconee Regional Health Systems, Inc. was formed as a non-profit 501 (c) (3) organization to
serve as a holding company to operate the hospital. Today, the system also encompasses a
number of other healthcare subsidiaries, including Jasper Health Services which operates Jasper
Memorial Hospital and The Retreat Nursing Home, both located in Monticello, Georgia.
As part of its mission to provide high quality, safe, compassionate and patient-focused
healthcare, ORMC continues to make substantial investments each year in new medical
technologies, equipment and upgrades to its facilities. During the past decade, this has included
the addition of Park Tower, a four-story complex which houses the Education Center, a
Medical/Surgical unit, Cardiopulmonary Services, a Post-Surgical Unit, Same Day Surgery,
Ambulatory Care, Outpatient Lab, Administration, and "A Place for Women," the hospital's
maternity and obstetrics care unit. Other enhancements to its facilities have included renovation
and expansion of the Emergency Treatment Center, which added 4,157 square feet to the unit,
a Cancer Treatment Center, a Wound Care Healing Center, and a Sleep and Wellness Center.
ORMC is committed to patient-centered care and is focused on quality improvements at every
level of the patient experience. Through programs like Quality Works, every process from
admission to discharge is reviewed to ensure that each patient receives care that is safe,
compassionate and personalized to their specific illness or injury.
Oconee Regional Medical Center is fully accredited by The Joint Commission, the nation's oldest
and largest independent, non-profit standards-setting and accrediting body in health care. In
addition, all our Radiologists are board certified by the American College of Radiology, and all of
our Radiologic Technologists are certified by the American Registry of Radiologic Technologists.
Laboratory services at the hospital are accredited by the College of American Pathologists.
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ORMC Community Health Needs Assessment Report 2013
Community Health Needs Assessment Background and Methodology
CHNA Background – With the passage of the Affordable Care Act, changes in major
entitlement programs such as Medicare, along with a challenging economy, it is important to
utilize existing resources while minimizing costs associated with starting and creating new
programs. Recent changes to federal laws governing not-for-profit hospitals now require Oconee
Regional Medical Center (ORMC) to participate in a Community Health Needs Assessment
(CHNA), following specific guidelines and develop an implementation plan with strategies to
address identified needs. This must be done every three years and the completion of the
assessment must be reported to the Internal Revenue Service as a part of the corporate tax
filing. According to this IRS mandate, the implementation strategy must be adopted by the end
of the same taxable year in which the CHNA was conducted. Oconee Regional Medical Center’s
Community Health Needs Assessment recognized the disparity in health status and health risk
between those in the highest income levels and the lowest, as well as between the insured and
uninsured in the primary service area (Baldwin County).
CHNA Methodology – Oconee Regional Medical Center began the planning process for the
community health needs assessment in November 2012. Kristy Johnson, Community Outreach
Coordinator at ORMC was chosen to oversee the assessment process with the assistance of
Jean Aycock, President/CEO of ORHS, Brenda Qualls, Vice President of Finance/CFO of ORHS
and various community members, leaders and organizations. ORMC obtained the services from
an outside vendor, Dixon Hughes Goodman LLP, to serve as consultants on this project. The
CHNA consists of five key elements: 1) Data Assessment, 2) Community Input, 3) Community
Need Prioritization, 4) Reporting, 5) Monitoring.
The first step in the CHNA process was a secondary data assessment that was conducted on
Baldwin County. This included analysis from 15-20 different external sources, as well as
internal sources, which gathered not only demographic information, but data specific to the
service area on health factors and health outcomes. In addition to the secondary research
compiled in the data assessment phase, the CHNA process requires input from persons
“representing the broad interests” of the community. This input was gathered by multiple
methods including surveys, interviews and focus groups. The secondary data from state and
federal sources was reviewed and compared to the primary data that was gathered. Identified
needs were prioritized through that process and developed into an implementation plan that
was presented to the Board of Directors for review. It is important to note that community
assessments not only focus on documented or perceived community health issues/problems,
but they focus on the positive aspects of the community also known as assets. Since this
assessment is an initiative that must be completed again every three years, Oconee Regional
Medical Center will continue to monitor any data updates and key measurements in the
implementation plan.
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ORMC Community Health Needs Assessment Report 2013
The assessment process consists of five steps pictured below:
Community Served
Oconee Regional Medical Center serves residents in seven surrounding counties. The primary
service area accounts for 65% of the admissions, which consists of Baldwin County. The
secondary service area accounts for only 30% of the admissions, which includes Jasper,
Putnam, Greene, Hancock, Wilkinson and Washington counties. According to the Nielsen
Claritas, the 2013 population for Baldwin County is 42,829. That population is expected to
decrease by 7.5% over the next five years.
Oconee Regional Medical Center
2013 Population
Baldwin County
42,829
Georgia
9,815,210
Source: Nielsen Claritas
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ORMC Community Health Needs Assessment Report 2013
Data Assessment – Secondary Data
The data assessment phase was completed during February and March 2013. In order to
present the data in a way that would tell a story of the community and also identify needs, the
framework of Healthy People 2020 was selected to guide secondary data gathering and also
community input. This framework was selected based on its national recognition as well as its
mission listed below:

Identify nationwide health improvement priorities.

Increase public awareness and understanding of the determinants of health, disease, and disability and the
opportunities for progress.

Provide measureable objectives and goals that are applicable at the national, state, and local levels.

Engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the
best available evidence and knowledge.

Identify critical research, evaluation, and data collection needs.
Within this framework, 12 topics were chosen as “Leading Health Indicators.” These topics
guide discussion and research related to this CHNA.
Clinical
Preventive
Services
Environmental
Quality
Injury and
Violence
Maternal, Infant
Child Health
Mental Health
Nutritional,
Physical Activity
and Obesity
Oral Health
Reproduction
and Sexual
Health
Social
Determinants
Substance Abuse
Tobacco
Access to Health
Services
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ORMC Community Health Needs Assessment Report 2013
Sources Used in Data Assessment Process
Nielsen Claritas: Nielsen Claritas demographics were used to create maps and tables of total
population and breakdowns of certain other population segments. This information was pulled
for Baldwin County and the state of Georgia. 2013 and 2018 demographics were included.
Nielsen Claritas also provided certain education and income level data used in the social
determinants section.
2013 County Health Rankings: This source is a collaboration between the Robert Wood
Johnson Foundation and the University of Wisconsin Population Health Institute. It gives a
general snapshot of how healthy each county is in relation to others in the same state. It
measures and ranks both health outcomes and health factors that lead to those outcomes.
Each indicator is weighed, standardized, and ranked in order to come up with an overall ranking
of health for each county in Baldwin. Ranking areas included:
Health Outcomes: Mortality and Morbidity
Health Factors: Tobacco Use, Diet and Exercise, Alcohol Use, Sexual Activity, Access to
Care, Quality of Care, Education, Income, Family and Social Support, Community Safety
Health Indicators Warehouse: The HIW is a collaboration of many Agencies and Offices
within the Department of Health and Human Services. The HIW is maintained by the CDC’s
National Center for Health Statistics. HIW has many county level statistics that allow for
comparison to state and national benchmarks.
The Advisory Board Company- The Oncology Roundtable Cancer Incidence Estimator was
used at a county level to estimate % growth in cancer incidence by site over the next five and
ten years.
Kids Count Data Center- This source houses state and county level data. For Georgia, some
data elements are provided by the Children’s Trust of Georgia, while others are provided by
National Kids Count.
Truven Health Analytics: The population based Physician Need tool was used to discover
possible physician shortages by specialty. Also, various ICD-9 based outpatient volume
estimators were used to show increased demand over the next five years
United States Department of Agriculture: Food desert locator data was used to identify
areas that may have income and/or access issues to healthy food options. This analysis was
done at a census tract level.
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ORMC Community Health Needs Assessment Report 2013
Data Assessment Highlights and Findings
The data assessment piece of the CHNA process included data tables, graphs, and maps from
various sources widely available. These data elements were used to identify at-risk populations,
underserved populations, health need areas, and professional shortage areas. A summary of
findings was then created to highlight areas of need within the service area.
Pop 2013
Pop 2018
Net Growth Total
Pop 2013-2018
% Growth Total
Pop 2013-2018
Age 00-04
2,646
2,500
-146
-5.52%
Age 05-09
2,541
2,388
-153
-6.02%
Age 10-14
2,374
2,295
-79
-3.33%
Age 15-17
1,305
1,169
-136
-10.42%
Age 18-44
17,579
15,938
-1,641
-9.34%
Age 45-54
5,612
4,578
-1,034
-18.42%
Age 55-64
5,145
4,821
-324
-6.30%
Age 65-74
3,391
3,572
181
5.34%
Age 75-84
1,634
1,735
101
6.18%
602
615
13
2.16%
42,829
39,611
-3,218
-7.51%
Age 85+
Total
Source: Nielsen Claritas
Race/Ethnicity
1%
1%
1%
White
African American
41%
56%
Asian
**Baldwin County’s overall population is
estimated to decrease by 7.5% over the next
five years. The only age group expected to
grow is those over the age of 65**
Two or more races
Other
Source: Nielsen Claritas
% Families Below Poverty Line
Avg. Median
HH income
2013
20%
15%
10%
5%
2011
Baldwin
County
$33,515
2012
Georgia
$45,069
2013
0%
USA
Georgia
Baldwin
County
Source: Nielsen Claritas
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ORMC Community Health Needs Assessment Report 2013
% Adults (25+) with no high school diploma
USA
Some high school,
no diploma
Georgia
<9th Grade
Baldwin County
0%
5%
10%
15%
% Unemployment
14%
12%
10%
8%
6%
4%
Baldwin County
Georgia
USA
2%
0%
Source: US Bureau of Labor Statistics
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ORMC Community Health Needs Assessment Report 2013
The following chart displays the Baldwin County Ranking of various indicators as compared to
the other 159 counties in Georgia:
Health and Socio-Economic Indicators
Focus Area
Tobacco use (10%)
Diet and exercise
(10%)
Alcohol use (5%)
Sexual activity (5%)
Measure
Health Behaviors (30%)
Weight
Adult smoking (percent of adults that
smoke)
Adult obesity (percent of adults that report
a BMI >= 30)
Physical inactivity (percent of adults that
report no leisure time physical activity)
Excessive drinking (percent of adults who
report heavy or bringe drinking)
Motor vehicle crash deaths per 100,000
population
Sexually transmitted infections (chlamydia
rate per 100,000 population)
Teen birth rate (per 1,000 females ages 1519)
Focus Area
Measure
Uninsured (percent of population < age 65
without health insurance)
Ratio of population to primary care
physicians
Ratio of population to dentists
Quality of care (10%) Preventable hospital stays (rate per 1,000
Medicare enrollees)
Diabetic screening (percent of diabetics
that receive HbA1c screening)
Mammography screening
Focus Area
Education (10%)
Employment (10%)
Income (10%)
Family and social
support (5%)
Community safety
(5%)
Focus Area
Environmental
quality (4%)
Built environment
(6%)
Georgia
National
Rank
Benchmark (of 159)
10%
17%
19%
13%
31%
28%
25%
90
2.5%
28%
24%
21%
14%
14%
7%
13
16
10
693
466
92
35
50
21
2.5%
2.5%
58
2.5%
2.5%
Baldwin
County
Georgia
72
National
Rank
Benchmark (of 159)
5%
20%
21%
11%
1407:1
2756:1
1611:1
2249:1
1067:1
1516:1
80
68
47
85%
84%
90%
69%
Social and Economic Environment (40%)
Measure
Weight
Baldwin
County
High school graduation
5%
68%
Some college (Percent of adults aged 25-44
5%
49%
years with some post-secondary education)
Unemployment rate (percent of population
10%
age 16+ unemployed)
13.7%
Children in poverty (percent of children
10%
under age 18 in poverty)
36%
Inadequate social support (percent of adults
2.5%
without social/emotional support)
N/A
Percent of children that live in single-parent
2.5%
household
52%
Violent crime rate per 100,000 population
5%
64%
73%
26
3%
2%
5%
2.5%
48
2.5%
854
Physical Environment (10%)
Measure
Weight
Baldwin
County
Daily fine particulate matter (average daily
2%
measure in micrograms per cubic meter)
Drinking water safety (percent of population
exposed to water exceeding a violation limit
in the past year)
2%
Access to recreational facilities (rate per
100,000 population)
Limited access to health foods (percent of
population who lives in poverty and more
than 1 or 10 miles from a grocery store)
Fast food restaurants (percent of all
restaurants that are fast food)
2%
Source: County Health Rankings
25
7.5%
Clinical Care (20%)
Weight
Access to care (10%)
Baldwin
County
Georgia
National
Rank
Benchmark (of 159)
67%
N/A
77
59%
70%
9.8%
5.0%
146
27%
14%
100
21%
14%
36%
20%
437
66
Georgia
137
156
National
Rank
Benchmark (of 159)
12.7
12.0
8.8
0%
2%
0%
11
8
16
9%
8%
1%
52%
50%
27%
79
2%
41
2%
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ORMC Community Health Needs Assessment Report 2013
Statistical Information Related to Health and Socio-Economic
Indicators:
Access to Care
35,000
28,963
30,000
25,000
2010 %
uninsured
20,000
Insured
15,000
Uninsured
10,000
7,316
Baldwin
County
20.2%
Georgia
21.9%
5,000
0
Baldwin County
Source: SAHIE//State and County by Demographics and Income Characteristics
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
85% 84%
35%
85%
81%
83% 84%
29%
12% 10%
% Adults Diabetes
% Adults High
blood pressure
% Diabetic patients % Females over 50
receiving HbA1c
receiving
mammogram
Baldwin County
% Females
receiving pap
smear
Georgia
Source: County Health Rankings Health Indicators Warehouse
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ORMC Community Health Needs Assessment Report 2013
Clinical Preventative Services
Heart Disease Death Rates (per 100,000 pop.)
300
252.9
254.7
250
228.9
213.3
204.5
200
196.7
2004-2010
150
2006-2010
100
2008-2010
50
0
Baldwin County
Georgia
Source: Health Indicators Warehouse
Environmental Quality
15
10
Baldwin County
5
Georgia
0
Particulate Matter Days
Ozone Days
Source: County Health Rankings
Injury and Violence
Violent Crime
Rate (per
100,000)
Motor Vehicle
Death (per
100,000)
Unintentional Injury
(per 100,000)
Baldwin
County
854
18.9
41.2
Georgia
437
17.5
43.6
Baldwin County is ranked 156 out of 159 counties in the state of Georgia with the highest violent crime rate (159
being the worst)
Source: County Health Rankings Health Indicators Warehouse
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ORMC Community Health Needs Assessment Report 2013
Maternal, Infant and Child Health
60
47.7
50
40.1
40
32.9
30.1
30
20
14.9
10.1
10
8.3
6.3
0
Infant Mortality Rate Births to teen mothers
(per 1,000)
(per 1,000)
Baldwin County
STDs to teens (per
1,000)
Substantiated
Incidents of child
abuse and/or neglect
(per 1,000)
Georgia
90%
83%
76%
80%
70%
58%
60%
50%
40%
48%
42%
33%
30%
20%
13%
10%
9%
0%
% Children living with
single parent
% Low birth weight
Baldwin County
% Babies born to % Births to unmarried
mother with prenatal
mothers
care
Georgia
Baldwin County has a rather low rate for births to teen mothers compared to Georgia, but rates
higher in the other area of maternal, infant and child health
Source: Kids Count Data Center Health Indicators Warehouse
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ORMC Community Health Needs Assessment Report 2013
Mental Health
In 2007, Baldwin County reported 31 mental health providers; mainly localized at Central State
Hospital. In 2012, the state of Georgia began shutting down many divisions at CSH, eliminating
hundreds of jobs and beds for patients with behavioral and mental health issues. Currently, CSH
only houses a skilled nursing home unit and a forensic unit. The nursing unit provides skilled
and intermediate nursing home care for clients with significant medical and nursing needs in
addition to mental illness or developmental disabilities. The forensic unit serves clients who are
referred for psychiatric evaluation and treatment from various components of the state's
criminal justice and corrections systems. With the decrease in services and change in
infrastructure at Central State Hospital in the last few years, some of the data could be skewed.
Mentally
unhealthy
days/month
% monthly
unhealthy
days/month
Baldwin
County
5.5
18.3%
Georgia
3.4
11.3%
Suicide deaths per
100,000
population
Baldwin
County
11.0
Georgia
10.5
Source: County Health Rankings
Source: Health Indicators Warehouse
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ORMC Community Health Needs Assessment Report 2013
Nutritional, Physical Activity and Obesity
A rather large percentage of Baldwin County residents live in a food desert. The Healthy Food
Financing Initiative (HFFI) Working Group considers a food desert as a low-income (poverty rate
of at least 20%) census tract where a substantial number or share of residents have low access
to a supermarket or large grocery store. Also, at least 33 percent of the tract’s population or a
minimum of 500 people in the tract must have low access to the store.
Baldwin
County
Georgia
Food desert
population
11,604
1,190,267
Pop. with low
access
8244
561,145
% pop. of food
desert with low
access
71.0%
47.1%
The chart above shows an estimated number of people in the census tract that live more than
one mile from a supermarket or large grocery store (urban tracts) or more than 10 miles from a
supermarket or large grocery store (rural tracts). The total number of people in each grid cell
that is either 1 or 10 miles from a supermarket or large grocery store was aggregated at the
tract level to produce the census tract total. (ERS definition)
Source: USDA – Economic Research Service
%
Population
Obese
% Children
Eligible for
Free Lunch
Baldwin
County
31.3%
66%
Georgia
28.4%
51%
14% of preschoolers in Baldwin County are obese
Source: County Health Rankings
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ORMC Community Health Needs Assessment Report 2013
Reproduction and Sexual Health
800
700
600
500
400
Baldwin County
300
Georgia
200
100
0
Chlamydia Rate (per
100,000)
HIV Prevalence Rate
(per 100,000)
Source: County Health Rankings
Substance Abuse/Tobacco
20%
18%
16%
14%
12%
Baldwin County
10%
Georgia
8%
6%
4%
2%
Sample respondents age
18+ who drank more than
two drinks per day on
average (men) or more
than one drink on average
(women) or who drank 5
or more drinks during a
single occasion (men) or 4
or more drinks during a
single occasion (women)
0%
% Excessive Drinking
% Adults Smoking
Source: Health Indicators Warehouse
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ORMC Community Health Needs Assessment Report 2013
Community Input
This portion of the Community Health Needs Assessment process included face to face
interviews, written questionnaires, and focus groups with those with knowledge/expertise in
public health and those either serving or a member of the underserved and chronic disease
population. The community input phase of the assessment gave respondents the opportunity to
comment and discuss general community health issues in the specific service area. Through
these numerous interviews, surveys, and focus groups, a summary of community input was
created. This summary would eventually be used to help focus in on priorities and ultimately,
implementation strategies.
The list below includes respondents who participated in this phase, excluding those that
completed the survey. They included experts in the field of public health, community outreach
programs, and other local organizations. All input was collected in April, May and June 2013.
Respondents included:









Members of Vaughn Chapel Missionary Baptist Church
Area citizens and members of Flipper Chapel AME Church
Oconee Regional Healthcare Foundation contributors and donors
Wendy Harris, RN, and staff nurses – Baldwin County Health Department
Jean Boone, Program Director – River Edge Behavioral Health
Chris Smith, RN – Baldwin County Bd. Of Education – elementary school nurse
Nicole Ingram, RN – Baldwin County Bd. Of Education – high school nurse
Janet Cavin, Coordinator – Baldwin Family Connection
Jeanne Starr, Director – Baldwin County School Nutrition
Community-Based Surveys
Oconee Regional Medical Center distributed surveys to the community in three difference ways;
a link on the ORMC webpage and a link on the ORMC Facebook page where both took you
directly to an online survey through Survey Monkey. The third type of the survey was a paper
form that was either given out to the various focus group participants or filled out at the
outpatient registration areas throughout the hospital and placed in the questionnaire box. ORMC
received 157 completed surveys through all avenues. There was not a specific list of people that
the survey was sent to; therefore, there is not a calculated response rate. Respondents were
given 8 multiple choice questions asking what they viewed as the top health issues facing
Baldwin County, as well as some preventative screenings/education that would be helpful to
address these issues. Also, there were two open-ended questions where the respondents could
elaborate on these issues and strategies to address these needs. The following is a summary of
the results:
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ORMC Community Health Needs Assessment Report 2013
There are three main health issues that emerged from the surveys as being the main areas of
concern in Baldwin County. The main issues are mental health, access to health services and
obesity. These three areas account for 63.6% of the respondents answers with drug/alcohol
abuse and physical activity and exercise coming in a far fourth with only 7.5% of respondents
stating they are the major health issue.
There were two main reasons that emerged from the surveys that keep people from receiving
medical treatment in Baldwin County and they are lack of insurance and that medical treatment
is too expensive
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ORMC Community Health Needs Assessment Report 2013
There was an overwhelming consensus that economic factors created the greatest barrier in
receiving healthcare in Baldwin County
The majority of the respondents agreed that more job opportunities were needed in order to
improve the health of Baldwin County. However, wellness services and other services to target
nutrition and physical activity were stated as being needed in Baldwin County
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ORMC Community Health Needs Assessment Report 2013
The above chart show what screenings or education services are needed in Baldwin County
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ORMC Community Health Needs Assessment Report 2013
Which of the following preventative services have you had in the past 12 months?
Yes
No
Flu shot
70.1%
29.9%
Blood pressure check
92.3%
7.7%
Blood sugar check
82%
18%
Skin cancer screening
21.1%
78.9%
Cholesterol screening
82%
18%
Vision screening
60.1%
39.9%
Hearing screening
14.3%
85.7%
Cardiovascular screening
35.7%
64.3%
Bone density test
22%
78%
Dental cleaning/exam
64.5%
35.5%
Physical Exam
72.6%
27.4%
Do you follow these health practices?
Yes
No
N/A
46.5%
14.5%
17.3%
7.3%
36.2%
78.2%
If female over 40, do you have annual
mammograms?
51.2%
12.6%
36.2%
If female, do you have a pap smear every other
year?
61.9%
19.4%
18.7%
Do you get 2.5 hours exercise each week?
56.1%
43.9%
0.0%
Do you get at least 7 hours of sleep a night?
57.1%
42.9%
0.0%
Do you make healthy meal choices?
72.7%
27.3%
0.0%
If over 50, have you had a colonoscopy?
If male over 50, do you have annual prostate
exams?
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ORMC Community Health Needs Assessment Report 2013
Community Informants/Stakeholder Interviews
During the community input portion of the CHNA, there were interviews held with six different
community members that are informed with the health issues in the community. Their areas of
expertise include childhood health and nutrition, public health, and mental health. During the
interviews, each stakeholder shared their thoughts on the main health issues in Baldwin County
and opinions on how to address these issues. Each also discussed the barriers that they see in
community members accessing their services.
The following issues emerged as being viewed as the greatest health issues in Baldwin County:


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Non-compliance
Obesity/lack of physical activity
STDs
Oral health
Access to care
Mental health
Lack of knowledge and/or health education
No insurance
The following were seen as barriers in accessing community health services:
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Lack of support system at home
Budget cuts within the various organizations
Economy (low income)
Lack of transportation
Unaware of resources and/or services offered in community
Lack of understanding of healthcare
The different community leaders had various specific responses on how to address these health
needs. However, the main consensus was that there needs to be more community health
educations programs, as well as screening and preventative measures.
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ORMC Community Health Needs Assessment Report 2013
Community Focus Groups
During the months of April, May and June, three different focus groups were held with
community members. Two of the focus groups were held at African American churches and
were comprised of all minorities. One of these focus groups consisted of community members
that were all over the age of 65, with the majority of them being a part of the underserved
population and low income. The second group involved mostly senior citizens as well, with a
few members under the age of 65, but from various economic backgrounds. The last focus
group was held at Oconee Regional Medical Center and included community members that have
given monetarily and/or volunteered time to ORMC. The demographics of this group varied from
the other two focus groups in that there was a broad age range and that all of the respondents,
minus one, were Caucasian. Also, this group represented a higher income level. In each of the
focus groups, there was discussion on the biggest viewed health issues and barriers to receiving
healthcare in Baldwin County, as well as some thoughts on how to address these issues.
A “healthy community” means:
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Good healthcare system
Good overall mental and physical health
High employment rate
Good school system
Clean environment
Good family values
Caring for the community and everyone in it
Helping each other out
Low crime rate
The following issues emerged as being viewed as the greatest health issues in Baldwin County:
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Heart disease
Diabetes
Stroke
High cholesterol
Arthritis/joint and back pain
Cancer
Obesity
Mental health
The following were seen as barriers in accessing community health services:






Transportation
Lack of knowledge/education on available resources
Do not understand healthcare
Financial ( no insurance, can’t afford )
Mistrust of medical community
Cultural barriers
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ORMC Community Health Needs Assessment Report 2013
Inventory of Services Addressing Community Needs
External Resources
in Baldwin County
Access to Care
Obesity/Nutrition and
Physical Activity
Mental Health
- Family Medical of Milledgeville
(FQHC)
- Compassionate Care Clinic
- Community Health Care Systems –
services Baldwin County
- Baldwin Transit (Transportation)
- Financial Assistance/sliding
scale program
-
-
Meals on Wheels
Live Healthy Baldwin
Baldwin Family Connection
Community Gardens
Greenway Farmers Market/Fall Line
Farmers Market/Milledgeville
Farmers Market
- Oconee River Greenway
- Collins P. Lee Community Center
Walking Track
Wellness Center
Medical Nutrition Therapy
Diabetes Self-Management
Education
- Annual Old Capitol 5K/Fun
Run
- River Edge Behavioral Health
- Oconee Center
- Maranatha Mission
- Breastfeeding Classes
Health Education
Prevention/Screenings
Sexual Health (STDs)
Internal Resources
within ORMC
-
Smoking Cessation
Health Fairs
Diabetes Support Group
Heart Fest
- Baldwin County Health Department
- Crossroads Pregnancy Center
- The HOPE Center – services Baldwin
County
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ORMC Community Health Needs Assessment Report 2013
Prioritization of Needs
In July 2013, a priority session was held at Oconee Regional Medical Center. The purpose of
this session was to discuss data and input that had been collected and to prioritize the needs of
the hospital’s defined community. Criteria used to prioritize these needs included importance to
the service area, relevance of the health issues to the population served, and the ability of
ORMC to effectively impact and improve the health issue. Also discussed in this session were
those needs that were already being addressed by other community partners or organizations.
A prioritization grid was created that compared ORMC’s ability to impact the need to how
significant the need was in the community. Those needs identified in the upper right sectors of
the grid were viewed as the most significant needs that ORMC’s leadership team felt they had
the ability to impact. These are the needs that would ultimately be chosen as priorities. A
sample is shown below:
Based on this grid, the following issues were identified as priorities:
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Access to Care (Uninsured, Physician Need and Transportation)
Obesity/Nutrition
Physical Activity/Wellness
Mental Health
Health Education
Prevention and Screenings
Sexual Health (STDs)
Infant Mortality
Quality of Care
Local Economy
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ORMC Community Health Needs Assessment Report 2013
Many of these issues were chosen as the framework of Oconee Regional Medical Center’s
implementation strategies. Also, in accordance with IRS proposed regulations, the team also
identified which of these priorities would not be addressed in the implementation strategy and
why. After discussing these priorities in depth and examining ORMC’s expertise, the expertise of
other community organizations and outreach, and ORMC’s services currently available, the
following issues were chosen for implementation:
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Access to Care (Uninsured and Physician Need)
Obesity and Nutrition
Prevention and Screenings
Health Education
Physical Activity and Wellness
Oconee Regional Medical Center’s Community Assessment Team will initiate the development of
implementation strategies for each health priority identified above. This Implementation Plan
will be rolled out over the next three years. The team will work with community partners and
health issue experts on the following for each of the approaches to addressing health needs
listed:
 Identify what the other local organizations are to address the health priority
 Develop support and participation for these approaches to address health needs
 Develop specific and measurable goals so that the effectiveness of these approaches can
be measured
 Develop detailed work plans
 Communicate with the assessment team and ensure appropriate coordination with other
efforts to address the issue
The team will develop a monitoring method at the conclusion of the Implementation Plan to
provide status and results of these efforts to improve community health. Oconee Regional
Medical Center is committed to conducting another health needs assessment in three years. In
addition, ORMC will continue to play a leading role in addressing the health needs of those
within our community. As such, community benefit planning is integrated into our Hospital’s
annual planning and budgeting processes to ensure we continue to effectively support
community benefits.
Board Approval
This Community Health Needs Assessment Report for fiscal year end September 30, 2013 was
approved by the Oconee Regional Medical Center/Oconee Regional Health Systems, Inc. Boards
of Directors at its meeting held on September 18, 2013.
______________________________________
Cay Quattlebaum; Chairman, ORMC, Inc. Board
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