St Clair Hospital 2016 Community Health Needs Assessment Report

C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T 2 0 1 6

Ourvision: A healthy community

C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

Introduction

T

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he story of St. Clair Hospital is one of vision,

A community is alive; it’s a network of people, families,

commitment and growth. It’s also a story of

homes, businesses, and organizations as well as public

relationships — of people and organizations in

spaces and institutions. It’s where people come together,

partnership. That spirit persists today, and is reflected

meet and form relationships, and develop a sense of obli-

in the numerous relationships that the Hospital has

gation to each other. St. Clair was born of this community,

cultivated within the community, relationships that build

where there is a strong sense of ownership and pride in

and strengthen ties, facilitating progress in identifying

the Hospital. To the residents, it is “their” hospital, where

and meeting the healthcare needs of the community.

many were born, where they may work, and where they

St. Clair Hospital

encounter neighbors and friends. It’s where the people of the region turn in times of crisis, with a deep feeling of belonging and trust.

St. Clair Hospital strives to earn that trust every day.

Deeply rooted in our mission, we have nurtured a culture of

TABLE OF CONTENTS Our History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Continued Growth . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

excellence that encompasses the highest quality care, safety,

St. Clair Hospital’s Economic Development Impact . . . . . . . . . . . . . . . . 7

cordiality and clinical advancements. We honor our proud past

Community Health Needs Assessment . . . . . . . . . . 9

and are inspired by it as we work to create a vibrant future.

Chronology of Our Assessment . . . . . . . . . . . . . . . 10 Part of the Solution . . . . . . . . . . . . . . . . . . . . . . . . . 11

ST. CLAIR HOSPITAL MISSION STATEMENT

”To provide highly valued, service-oriented healthcare to the community.”

The Community We Serve . . . . . . . . . . . . . . . . . . . . 12 Gathering Information . . . . . . . . . . . . . . . . . . . . . . . 13 To Better Understand and Serve . . . . . . . . . . . . . . 14 Ways We Give Back to the Community . . . . . . . . . 15 Addressing the Critical Issues of 2016 . . . . . . . . . . 16 Top Six Priority Health Issues . . . . . . . . . . . . . . . . . 18 A Collective Effort: Resources and Relationships . . . . . . . . . . . . . . . . . 24 Thank You to Our Community Partners . . . . . . . . . 26

If you have additional questions or would like to receive a paper copy of our Community Health Needs Assessment, please e-mail us at Community@stclair.org.

Community Benefit Programs

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COMMUNITY BENEFIT PROGRAMS

S T. C L A I R H O S P I TA L’ S B E G I N N I N G S

Our history

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St. Clair Hospital

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he history of St. Clair Hospital is distinctive. It is not a hospital that was built solely by banks, foundations and corporations, but by ordinary people who wanted a hospital of their own, close to home. It was built by volunteers who went door-to-door

soliciting donations, children who sold flowers, women’s groups who united to form an extraordinarily effective auxiliary, and business leaders who volunteered their expertise.

Spurred by a communitywide effort, St. Clair opened in 1954 as a small community hospital offering medical-surgical, maternity and emergency care. For over 60 years, St. Clair Hospital has been part of the fabric of the South Hills community. Most importantly through six decades of expansions, innovations and improvements, the physicians, nurses and caregiving staff never wavered from their dedication to patient care.

Community Benefit Programs

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COMMUNITY BENEFIT PROGRAMS

ST. C LAI R HOSPITAL IN 20 1 6

St. Clair’s commitment to quality outcomes

Continued growth

and excellence in patient care has earned

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Hospital holds the region’s only ‘A’ grade

oday, St. Clair Hospital is a highly honored, independent,

four years in a row for hospital safety from

acute care medical center with 328 beds and five

the Leapfrog Group, is consistently rated

satellite locations, offering advanced, high quality care

as one of the 100 Top Hospitals in the

in multiple specialties, including heart, oncology, orthopedics,

nation for outstanding performance

psychiatry and mental health, women’s and children’s

in clinical outcomes, patient safety,

services, stroke care and more.

patient satisfaction and efficiency, and

Healthcare services are provided to more than 480,000 residents of southwestern Pennsylvania at the main campus

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numerous accolades for the Hospital. The

is recognized by Comparion Medical Analytics as a leader in medical excellence.

in Mt. Lebanon, Pa., two comprehensive outpatient centers

These accolades inspire us to greater excellence. During the

in nearby Bethel Park and Peters Township, and at three

60-plus years of expansions, innovations, improvements and

satellite locations, bringing together primary care services,

awards, St. Clair has continued its dedication to excellence and

physician specialty care and comprehensive diagnostic

its responsiveness to community need. These factors, plus the

services. With 2,300 employees and 550 physicians, St. Clair

humanity of its physicians, nurses and care-giving staff have

is the largest employer in the South Hills of Pittsburgh.

shaped its history and will ensure its future.

St. Clair Hospital

S T. C L A I R H O S P I TA L’ S

Economic development impact St. Clair Hospital plays a pivotal role in the economic health and vitality of the community, with a direct and indirect impact on the area’s economy.

DIRECT IMPACT

INDIRECT IMPACT

Hospital employment Hospital spending Emergency Department capacity Regional vitality Community health

Non-Hospital employment Regional spending State and local tax revenues State economic development support

TOTAL SPENDING HOSPITAL

$251.7 MILLION ECONOMIC RIPPLE EFFECT

$252.7 MILLION

TAXES PAID TO THE COMMUNITY

$7.16 MILLION

COMMUNITY BENEFIT PROGRAMS • Community Health Improvement Services & Community Benefit Operations • Health Professions Education • Subsidized Health Services • Cash and In-Kind Contributions • Community Support • Community Health Improvement Advocacy

$ 3.68 MILLION

TOTAL BENEFIT

$504.3 MILLION SALARIES HOSPITAL

$92.9 MILLION ECONOMIC RIPPLE EFFECT

CHARITY, DISCOUNTED AND UNCOMPENSATED CARE • Charity Care • Discounts to Uninsured/ Underinsured • Unpaid Patient Expenses • Unreimbursed Medicare • Unreimbursed Medical Assistance

$43.23 MILLION

$69.6 MILLION TOTAL

$162.5 MILLION Source: The Hospital and Healthsystem Association of Pennsylvania

VALUE OF QUANTIFIABLE SERVICE TO THE COMMUNITY

$46.91 MILLION

Community Benefit Programs

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COMMUNITY BENEFIT PROGRAMS

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St. Clair Hospital

FISCAL YEAR 2016

COMMUNITY HEALTH NEEDS ASSESSMENT St. Clair Hospital has always worked to assure a strong, healthy community. Indeed, identifying and addressing unmet needs has been part of the St. Clair mission since our founding in 1954, and remains so today. Through remarkable growth and expansion, we have never lost sight of our origins or strayed from our vision.

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n 2014, under the astute leadership of Joseph B. Smith,

In preparing this report, the Community Benefit

chairperson of the St. Clair Hospital Community

Committee drew upon the expertise of St. Clair

Benefit Committee and Senior Vice-President,

clinical leaders, business leaders, health and human

Marketing, Dollar Bank, and Andrea L. Kalina, Vice

services representatives, and members of the

President of Human Resources and Organizational

community. They conducted extensive research to

Advancement at St. Clair, the Hospital endeavored to

acquire the most accurate and complete picture of

gain a deeper understanding of the unmet health needs

the health-related problems we face as a community.

of people living in the neighborhoods that constitute

They are complex problems, and while there are no

the St. Clair community. The culmination of this effort,

quick and easy answers, we have also developed

the 2016 Community Health Needs Assessment (CHNA),

an implementation plan that will guide our initiatives

aligns perfectly with our mission and enables us to

to address the unmet needs. All of this information

truly know the community we serve — to not only

is provided in the following pages.

recognize unmet needs and vulnerabilities, but also to identify strengths and resources. In doing so, we are part of a national effort to improve healthcare all across the United States.

Community Health Needs Assessment

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C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

Chronology of our assessment In an effort to maximize the opportunity presented by the Patient Protection and Affordable Care Act, we invited experts from within and outside of the region to share their expertise regarding the healthcare needs of the community. The three-year process to complete the Community Health Needs Assessment (CHNA) began in January 2013 and is presented in the timeline below.

2013

JANUARY

>

The St. Clair Hospital Board of Directors approved the Fiscal Year 2013 Community Health Needs Assessment (CHNA) and Implementation Strategy.

JUNE

>

The final Community Health Needs Assessment (CHNA) report was created and made widely available to the public, via the St. Clair Hospital website. A hard copy version of the report was also made available for community members, which they can receive upon request.

JULY

> St. Clair staff and leadership began implementing initiatives outlined in the Implementation Strategy to help

address the community’s health needs.

AUGUST 2013–JUNE 2016

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An interdisciplinary group of St. Clair staff members — with expertise in oncology, prenatal education, mental health, access and community education — executed the initiatives outlined in the Implementation Strategy. The group met quarterly with Senior Leadership and the Community Benefit Board to discuss the progress of the programs and identify alternative initiatives for programs that did not reach the targeted outcomes.

2014

DECEMBER

2015

JANUARY

> St. Clair Hospital selects Verité Healthcare Consulting to conduct its Fiscal Year 2016 Community

Health Needs Assessment (CHNA) based on their extensive expertise and knowledge in this field.

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Verité begins conducting qualitative research, analyzing other publicly available Community Health Needs Assessment (CHNA) documents, available public data, and St. Clair Hospital discharge and Emergency Department data.

> Focus groups were conducted with key community stakeholders and nonprofit partners.

OCTOBER–DECEMBER > Public input surveys were conducted online.

AUGUST

2016

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FEBRUARY A comprehensive review of information and statistics surrounding the pervasive health needs in St. Clair’s service region was presented to the Community Benefit Board by Verité.

MARCH

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After reviewing the results of the Fiscal Year 2013 Community Health Needs Assessment (CHNA) and taking into consideration the updated findings of the Fiscal Year 2016 report, the Community Benefit Board prioritized the initiatives that best aligned with the Hospital’s core competencies.

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APRIL–MAY An implementation strategy was developed by St. Clair Senior Leadership and staff. Specific action plans were developed (including the identification of key community partners) to execute and implement strategy initiatives.

JUNE

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The Implementation Strategy was approved by the Community Benefit Board. A final Community Health Needs Assessment (CHNA) report was created and made widely available to the public, via the St. Clair Hospital website. A hard copy version of the report was also made available for community members, upon request.

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St. Clair Hospital

Part of the solution Like the community it serves, a hospital is always growing. New services are opened, the most advanced technology is acquired, and new programs are developed to prevent and treat diseases and conditions. All of this happens in order to meet the emerging needs of the people within the community, and those needs are identified in various ways.

One of the most effective ways that a hospital understands the needs of the community is through a Community Health Needs Assessment, or CHNA — a comprehensive and systematic exploration of the community’s entire healthcare environment.

A CHNA studies the entire region for a period of three years, looking closely at every geographic area and demographic group, seeking to learn where there are gaps in services and underserved groups of people. It identifies and prioritizes the unmet needs and considers strategies to address them, working to find solutions that will ultimately improve the health and well-being of the community as a whole.

By conducting a CHNA, we seek to answer several essential questions:

WHO is vulnerable in terms of health or access to healthcare?

WHAT are the unique needs of these people?

WHERE do these people live in the community?

WHY do these problems exist?

HOW do we address these problems?

To find answers to these questions, we conduct surveys and interviews, and collaborate with organizations and individuals throughout the region who provide us with information and insights. With their valuable feedback, we learn about the problems and needs facing the community. We also review assessments prepared by other regional organizations in recent years.

At St. Clair Hospital, this is a constant, ongoing endeavor. We embrace this process with enthusiasm, engaging deeply with our community partners as we search for the most effectual and efficient approaches to meet the health needs of our residents.

Community Health Needs Assessment

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C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

Carnot Coraopolis

Moon

A growing need In 2015, the total population Imperial

The population between 2015 and 2020 is expected to change,

Pittsburgh

Crafton

Santiago Rosslyn Farms

with an increased growth of 1.4%

Oakdale

and a 14.9% increase in the 65+

Region 2

population. There is expected to

Green Tree

Mount Oliver

Carnegie Dormont

Baldwin

be a decreasing white population population, specifically Asian

West Park

Coraopolis Heights

of this community was 482,000.

and an increasing non-white

Groveton

Region 6

McDonald Midway

and Hispanic.

Bridgeville

Gladden Heights

Southview

Mount Lebanon

St. Clair Hospital

Bethel Park

Region 1

Cecil

Castle Shannon Pleasant

Upper St Clair

Region 4 Hickory

Library

Thompsonville

Region 3 Houston

Jefferson Borough

Boyer

Cool Valley

Canonsburg Strabane

Finleyville

Linden Ginger Hill

The community we serve St. Clair Hospital is located in the South Hills region of Pittsburgh, Pennsylvania. The St. Clair Hospital community is defined by the geographic origins of the Hospital’s patients. The area includes parts of Allegheny and Washington counties, covering a total of 34 ZIP codes, and is broken down into six regions.

(Please refer to map above.)

The community is comprised of a Primary Service Area (PSA), which is the geographic area from which the majority of the Hospital’s patients originate. The PSA is comprised of Regions 1 and 2 and is home to 48% of the community’s population. A Secondary Service Area (SSA) consists of Regions 3, 4, 5 and 6, and is home to 52% of the population.

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St. Clair Hospital

Region 5 West Elizabeth

McMurray Bower Hill Venetia

Clairton

PROCESS AND METHODS

Gathering Information To conduct the CHNA, St. Clair Hospital engaged the services of Verité Healthcare Consulting, LLC, a leading healthcare consulting firm with expertise in improving healthcare services and access, based in Alexandria, Virginia. With Verité, the Hospital was able to garner the perspectives and experience of numerous partners and collaborators who represent the broad interests of the community and were eager to participate in the process.

The results of the CHNA were achieved by using surveys and in-depth interviews with key community leaders, public health experts, medical staff, internal hospital staff and representatives from numerous agencies and organizations. These individuals and organizations provided valuable, expert information.

Data from secondary sources, including demographic,

Benchmarking and trend analysis are essential to the

economic, health status and health status indicators

prioritization of community health needs. Therefore,

from local, state and federal sources, were also studied.

statistics for several health status, healthcare utilization

Analysis of the primary and secondary data was conducted

by St. Clair Hospital administrators and by Verité’s presi-

and healthcare access indicators were also analyzed and compared to state and national benchmarks.

dent and senior level staff, with support from associates

No information gaps have affected the Hospital’s ability

and research analysts. The methodologies included quanti-

to reach reasonable conclusions regarding community

tative analysis, benchmarking, and trend analysis. Verité

health needs.

applied a ranking methodology to help prioritize the health needs identified by the assessment.

Review of other recent community health needs assessments In developing this CHNA, the Hospital reviewed other community health needs assessment documents for this region that have been published since 2013, in order to make comparisons. A total of 11 such CHNA documents were reviewed.

About Verité Because of their national expertise with Community Health Needs Assessment projects, St. Clair selected Verité Healthcare Consulting, founded in 2006, as the firm to assist with the Hospital’s process. Verité’s

Allegheny County Health Department

The Washington Hospital

Pittsburgh Mercy Health System

UPMC Passavant

Children’s Hospital of Pittsburgh

UPMC Magee Womens Hospital

Ohio Valley General Hospital

UPMC McKeesport

benefit regulations. Hearle continues to

Plan for a Healthier Allegheny

UPMC Shadyside

work closely with these initiatives, even

(Allegheny County Health Department)

The Children’s Institute of Pittsburgh

president, Keith Hearle, MBA, has worked in healthcare consulting for over 30 years, and has extensive expertise with community

today, bringing expert guidance to organizations working to improve health needs.

Verité Healthcare Consulting is dedicated to optimizing the planning, organization, financing and delivery of health services for vulnerable people and communities.

Community Health Needs Assessment

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C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

To better understand and serve Every three years, a CHNA is conducted by St. Clair Hospital in order to gain a better understanding of the unmet healthcare needs of the community, including current residents and a growing, diverse population. The St. Clair Hospital 2016 assessment also enables us to identify resources and strengths within that community. We then develop an implementation plan, detailing the initiatives that we will put in place to address unmet health needs.

The overall goal of the CHNA is to improve community health in order to enhance the quality of life and well-being of all those who live within the community we serve.

St. Clair Hospital is committed to serving the community through adherence to our mission, providing services that prevent disease, promote healthy lifestyles, and offer state-of-the-art diagnostic and therapeutic care.

This report is a summary of our findings and our plans to meet the high-priority needs identified by our CHNA.

The 2013 CHNA report spotlighted the following problems that impact the overall health of our community: ACCESS TO CARE | INADEQUATE PRENATAL CARE CHRONIC AND LIFESTYLE-RELATED HEALTH CONDITIONS In preparing the 2016 CHNA, we reviewed the 2013 CHNA, which identified and prioritized several key unmet health needs: access to care, inadequate prenatal care, and chronic and lifestyle-related health conditions. In the ensuing three years, the Hospital has achieved much progress in reaching those at-risk for these problems. Programs have been developed that facilitate early detection of cancer through free screenings; health fairs have been conducted to provide health education and screenings to reduce the incidence of chronic diseases; and the Hospital partnered with community agencies to offer prenatal care, prenatal education and smoking cessation education. These initiatives, and many others, were the direct result of the findings of the 2013 CHNA.

The Courtesy Van Program increased ridership in low-access/high-need communities by 14%.

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St. Clair Hospital

The Free Mammography & Women’s Wellness Day screened over 150 uninsured women for breast cancer and detected an incidence of breast cancer in a patient.

St. Clair provided free health screenings and education to an additional 600 residents by expanding health fairs into the region.

Ways we give back to the community St. Clair is a community-based hospital, and has always had the goals of promoting health, improving access to healthcare and providing benefits to the community as a whole. St. Clair envisions our community as a place where healthful lifestyles are the norm, where residents of any neighborhood have access to health education, disease prevention, screenings and primary care. By engaging in partnerships with established non-profit agencies and charitable organizations who share our values and goals, St. Clair Hospital expands its reach into the community, building on existing strengths and enhancing services to improve health and quality of life.

CHARITY, DISCOUNTED AND UNCOMPENSATED CARE

YOUTH PROGRAMS In a variety of ways, St. Clair Hospital regularly sponsors

As a non-profit organization, St. Clair cares for everyone

Youth Programs in the community, including those offered

who enters our doors, regardless of their ability to pay.

by the 14 school districts within our service area. These

Last year, St. Clair provided $43.23 million worth of

programs provide opportunities for children and teens to

charity, discounted and uncompensated care.

socialize with their peers, engage in the arts, and participate

DONATIONS

in sports.

St. Clair regularly makes donations to partnering

GREEN TEAM

agencies in the form of monetary donations and

St. Clair Hospital believes that our commitment to the

in-kind contributions.

community means a commitment to a healthy environment.

We have created a Green Team of employee volunteers

NEEDLE DISPOSAL PROGRAM

who work in partnership with Adopt a Highway and Keep

In the interest of safety and disease prevention, St. Clair

Pennsylvania Beautiful.

has a needle disposal program for those who utilize needles, syringes and other sharps in managing conditions

SPEAKERS BUREAU

such as diabetes. This free service enables people to

Recognizing that our employees possess a wealth of

exchange containers of contaminated needles for new

knowledge and experience, St. Clair Hospital has developed

empty ones.

a Speakers Bureau that any community group can call upon.

MENTORSHIP FOR HEALTH PROFESSIONS STUDENTS St. Clair opens its doors to health professions students from the region’s many training programs and universities, who come to the Hospital to gain clinical experience. Medical students, residents, nursing students and others rotate through our clinical departments as they prepare for careers in healthcare, and often times, returning to communities in need.

Community Health Needs Assessment

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C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

ALLEGHENY AND WASHINGTON COUNTIES

Addressing the critical issues of 2016 Poor health is nearly always multifactorial, due to a convergence of medical, social, economic, environmental and behavioral issues. Access to care is a complicating factor, and may include lack of insurance, unaffordable co-payments and deductibles, transportation challenges and even issues such as child care or eldercare. Lack of access often means delays in seeking care, until the problem becomes urgent or critical.

To improve morbidity and mortality, and improve a community’s overall health and quality of life, these root causes of poor health must be addressed. There are likely connections between behavioral, social and economic factors and health status; for example, poor dental health has been linked to higher rates of cancer.

PRIORITY NEEDS IN ALLEGHENY COUNTY

PRIORITY NEEDS IN WASHINGTON COUNTY

Allegheny County contains areas designated by St. Clair

Washington County contains areas designated by

as service area Regions 2 and 6 and portions of Regions

St. Clair as service area Region 3 and portions of

1, 4 and 5. In comparison to Washington County,

Regions 1, 4 and 5. Washington County is more rural

Allegheny County has higher proportions of low-income

than Allegheny County and is expecting more growth

and uninsured residents living in an urban environment.

of the Hispanic population between 2015 and 2020.

This contributes to the area’s unique health needs.

Allegheny County ranks unfavorably on a number of

health; high rates of cancer; high rates of diabetes;

health status and access indicators, including high

high rates of maternal smoking during pregnancy;

rates of suicide and mental illness; poor community

and high rates of ambulatory care sensitive conditions.

safety, including homicide rates; unsafe sex practices; high rates of communicable diseases, including chlamydia and gonorrhea, and high HIV mortality rates; higher poverty, lower per capita incomes and poorer health outcomes among black and Hispanic populations; high rates of infant mortality; high incidence of low birthweight infants; and high rates of stroke, coronary heart disease, ischemic heart disease, and cancer.

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Washington County ranked unfavorably for poor dental

St. Clair Hospital

Health issues identified by the 2016 CHNA as critical for St. Clair Hospital to address (in alphabetical order) ACCESS Lack of Affordable and Accessible Care Lack of Dental Services Lack of Services and Care for Seniors BEHAVIORAL HEALTH Insufficient Access to Mental and Behavioral Conditions Poor Mental Health Status HEALTH BEHAVIORS Alcohol Abuse Substance Abuse HEALTH CONDITIONS Diet and Exercise-Related Conditions

MORTALITY RATES High Rates of Cardiovascular Disease Mortality High Rates of Cancer Mortality High Rates of Diabetes Mortality High Rates of Cirrhosis Mortality High Rates of Injury PHYSICAL ENVIRONMENT Poor Air Quality SOCIAL & ECONOMIC FACTORS Low and Moderate Income Populations Unable to Meet Basic Needs Increasing Diversity within the Community

INFANT & MATERNAL HEALTH Insufficient Access to Prenatal Care

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C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

St. Clair Hospital has prioritized the following six health issues in the community: C O M M U N I T Y H E A LT H N E E D

#1

Access to Care The value of access in healthcare cannot be overstated. Access means that you are able to get the screening exam that facilitates early detection of cancer and prompt treatment. Access means that you consult your primary care physician about a symptom that may be an indication of a pre-morbid condition, enabling you to reverse the trajectory of the problem. It means you get vital prenatal care. Access to regular healthcare services keeps people healthier and helps them manage healthcare problems; it means better outcomes, fewer admissions and lower costs.

Lack of access is still a major problem, however. It takes many forms and is a major obstacle for many, especially seniors, low income residents and those who are chronically ill. It can range from lack of insurance to lack of transportation; it may mean overwhelming logistical obstacles that confront a person with disabilities who needs a diagnostic test.

For some, a lack of resources translates into reduced access, when there are no funds for gas or parking fees, or an unexpectedly high co-payment. Limits on the insurance plans

ACTION

accepted by physicians may limit access to specialists.

When access is problematic, health problems go untreated; chronic conditions worsen and complications develop — leading to emergencies and hospital admissions.

Access issues for seniors are critically important, as the senior population in our community is projected to increase significantly and seniors are opting to “age-in-place” in their own homes.

TO ADDRESS LACK OF ACCESS TO CARE, ST. CLAIR HOSPITAL WILL TAKE THE FOLLOWING ACTIONS: Collaborate with other non-profits in the region that provide services to seniors and facilitate coordination among them. St. Clair will act as an advocate for the senior population; Free van transportation services will continue, with increased marketing of the service in areas of high need, and increased “batching” of rides; and In conjunction with the Hospital’s strategic plan, St. Clair Medical Services will continue to expand its physician practices and their locations.

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St. Clair Hospital

C O M M U N I T Y H E A LT H N E E D # 2

Behavioral Health An insufficient number of qualified mental health care providers is a key dimension of this multifaceted problem.

There is a great need for providers, particularly psychiatrists, who can treat children and adolescents with mental health issues, and for those who can address the growing and pervasive problem of substance abuse. There is also a need for detoxification services and substance abuse rehabilitation services in the community. Mental health services for the elderly are also inadequate to meet present and anticipated needs, as the number of seniors will increase in the region.

With the closing of mental health facilities over the past two decades, families turn to the police and the emergency department to respond to mental health crises, taxing their resources.

TO ADDRESS BEHAVIORAL HEALTH NEEDS, ST. CLAIR HOSPITAL WILL TAKE THE FOLLOWING ACTIONS:

ACTION

Continue the community-based mental health support groups in collaboration with other non-profit mental health providers; Pursue the recruitment of a clinical provider in order to better meet the demand for more mental health services in the community; and Integrate mental health services into the St. Clair Medical Services

>

Primary Care Physician offices.

St. Clair plans to collaborate with the following community organizations in executing these initiatives: Chartiers Mental Health

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Greenbriar Treatment Center

Christ United Methodist Church

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Brookline 3 FOR 1

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| Bridgeville Public Library St. Clair Medical Services

Gateway Rehab

Community Health Needs Assessment

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C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

C O M M U N I T Y H E A LT H N E E D

#3

Health Behaviors Substance abuse and addiction have reached epidemic proportions across the country, and our community is no exception. St. Clair recognizes that this is a significant issue within our own community.

Substance abuse, including the misuse of alcohol, prescription medications, especially opioids, and illicit drugs, including heroin, is increasing in the region and is a problem in our schools, workplaces and homes, affecting all segments of the population. In 2016, substance abuse in some form touches nearly every family.

High rates of cirrhosis exist in the community, as a consequence of excessive alcohol consumption, and binge drinking is increasing among teens and young adults.

ACTION

TO ADDRESS HEALTH BEHAVIOR NEEDS, ST. CLAIR HOSPITAL WILL TAKE THE FOLLOWING ACTIONS: Continue to provide community support for the Narcan opioid reversal program, training first responders in the recognition of overdose and administration of Narcan, and expand this initiative by providing education and supplies to local school districts and non-profits.

St. Clair anticipates collaborating with local EMS providers, police departments and fire departments as well as local school districts and non-profit human service organizations to realize this initiative.

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St. Clair Hospital

C O M M U N I T Y H E A LT H N E E D

#4

Health Conditions Poor nutrition, overeating, and lack of physical activity lead to obesity and potentially to the many adverse consequences of obesity: diabetes, cardiovascular disease, arthritis, sleep apnea and other chronic conditions.

Poor diet and exercise behaviors are common throughout our community. Health education in nutrition, as well as increased awareness of the relationship between obesity and sedentary lifestyles to illness and disability, are effective preventive measures that can motivate residents to make better choices and live healthier lifestyles.

ACTION

TO ADDRESS HEALTH CONDITIONS NEEDS, ST. CLAIR HOSPITAL WILL TAKE THE FOLLOWING ACTIONS: Continue to host and participate in community health fairs and senior expos to provide free health education and health screenings to the community.

To achieve this, St. Clair will partner with local non-profits who work with underserved populations and local government officials.

Community Health Needs Assessment

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C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

C O M M U N I T Y H E A LT H N E E D

#5

Infant and Maternal Health High rates of low birth weights and infant mortality are red flags for any community. Infants are among the most vulnerable residents, and when they begin life with the disadvantage of low birth weight or prematurity, they are far more likely to encounter health and developmental challenges as they grow older. Improving the health of infants and mothers is a priority in 2016, as it was in 2013, when St. Clair initiated interventions to improve access to prenatal care. In recent years, St. Clair partnered with Tobacco Free Allegheny and Sto-Rox Neighborhood Health Center to improve prenatal education and offer smoking cessation, recognizing that maternal smoking is associated with low birth weight. We also partnered with OB/GYN practices at St. Clair to subsidize prenatal education classes for low-income families. These measures have proven helpful, but there is much more to be done.

ACTION

TO ADDRESS INFANT AND MATERNAL HEALTH NEEDS, ST. CLAIR WILL UNTERTAKE THESE INITIATIVES: Host prenatal education videos on the Hospital website and YouTube page to reach those women who are unable to attend classes in person; Subsidize existing prenatal classes for low income families; continue to provide support to the Sto-Rox Neighborhood Health Clinic, through prenatal education and smoking cessation classes.

To achieve this, St. Clair will partner with Hospital OB/GYN practices and Sto-Rox Neighborhood Health Center.

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St. Clair Hospital

C O M M U N I T Y H E A LT H N E E D

#6

Mortality Rates Within the community served by St. Clair Hospital, cardiovascular disease (heart disease and stroke) is the leading cause of death. High mortality also exists for prostate, breast, lung, ovarian and colon cancer. Rates of mortality associated with diabetes is higher in Washington County than in Allegheny County, but is significant throughout the region. Cirrhosis of the liver is another leading cause of mortality. In addition, deaths due to injuries are high.

ACTION

TO ADDRESS THESE NEEDS, ST. CLAIR WILL UNTERTAKE THESE INITIATIVES: Continue to provide free cancer screenings to the community for prostate, breast and skin cancers; The St. Clair Diabetes Center will continue to serve as a resource to the community, assisting with the needs of newly diagnosed patients and those dealing with the condition long-term. This includes offering free support groups for both sets of patients.

Collaborations to achieve this goal are planned with St. Clair Hospital physician practices that specialize in urology, breast surgery, radiology and dermatology, and with the physicians who specialize in endocrinology.

Community Health Needs Assessment

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C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

A COLLECTIVE EFFORT

Resources and relationships St. Clair Hospital stands as the strong center of a network of organizations and agencies throughout our community that share our values and aspire to similar goals. These are social service agencies, other hospitals, home healthcare providers, civic organizations, community institutions and many types of non-profits. The people of these organizations are experts, advocates, consumers and leaders; they are knowledgeable about their fields and committed to the people who need them. They are resources that provide invaluable feedback to the Hospital and collaborate with us on a regular basis, not only in the preparation of a CHNA, but in providing daily services to people whose care we often share.

Our relationships with these community partners are based on mutual respect and a belief in each other’s missions.

When we join forces to meet the needs of our community, we gain power and are far more effective in meeting the unmet needs identified in this CHNA. Through these relationships, we build and strengthen community.

WITHIN THE ST. CLAIR COMMUNITY, THERE ARE FOUR FEDERALLY QUALIFIED HEALTH CENTERS Hilltop Community Healthcare Center, located in

Sto-Rox Neighborhood Family Health Center is a

Beltzhoover, a satellite of the Sto-Rox Neighborhood

full-service medical center that treats patients of all

Family Health Center, providing pediatrics, women’s

ages. It is open six days per week with some extended

health and family medicine.

hours. It is in partnership with Focus on Renewal,

McDonald Family Medicine provides family medicine services. It is part of a large physicians’

an organization focused on health and social services needs in the McKees Rocks community.

group of 19 medical practices that provide family

West End Health Center provides primary mental

medical care.

health, women’s health, and dental care.

OTHER HOSPITALS WITHIN THE ST. CLAIR COMMUNITY

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Southwood Psychiatric Hospital, Upper St. Clair

Kindred Hospital–Pittsburgh, Oakdale

Canonsburg General Hospital, Canonsburg

Ohio Valley Hospital, Kennedy Township

St. Clair Hospital

PROG RAM S AN D SERVICES There is a wide range of programs to assist in meeting community health and social services needs in the St. Clair Hospital service area. These resources are provided by multiple agencies, coalitions, and organizations.

There are several different types of community resources available to help community members.

The chart below lists the approximate number of resources available within each category to serve residents of Allegheny and Washington counties: County

Organization/Agency

ALLEGHENY COUNTY

WASHINGTON COUNTY

Basic Needs

184

84

Consumer Services

43

12

Criminal Justice and Legal Services

71

17

Education

65

7

Environment and Public Health/Safety

5

3

Healthcare

114

60

Income Support and Employment

82

11

Individual and Family Life

305

74

Mental Health and Substance Abuse Services

126

19

Organizational/Community/International Services

117

33

Target Populations

78

13

RESOURCE

A comprehensive 2-1-1 service is available through the 2015 United Way of Allegheny County, which is accessible by phone, text, and online to help connect members of the community to the essential health and human services they need.

Community Health Needs Assessment

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C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

Thank you to our community partners…

St. Clair Hospital gathered information through interviews and surveys of dozens of persons who are invested in the health of the community. Also, St. Clair Hospital interviews were conducted in August 2015. The web-based survey was conducted from October–December of 2015. These included external stakeholders — those not affiliated with St. Clair — as well as members of our medical and Hospital staff. These persons shared their perspectives and expertise on community health needs and their ideas for interventions and innovative programs to meet those needs.

St. Clair Hospital acknowledges the following leaders for their valuable feedback and ideas.

ST. CLAIR HOSPITAL COMMUNITY BENEFIT COMMITTEE MEMBERS Joseph B. Smith Senior Vice President, Marketing, Dollar Bank Chairman, Community Benefit Committee Board of Directors, St. Clair Hospital Frank Arcuri, Esq. Law Office of Frank Arcuri Board of Directors, St. Clair Hospital

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Andrew R. Hays Senior Director, Elk Lake Capital Emeritus, Board of Directors, St. Clair Hospital David R. Heilman Chairman, St. Clair Hospital Board of Directors

Karl E. Bushman, M.D. Mt. Lebanon Internal Medicine Board of Directors, St. Clair Hospital

Andrea L. Kalina Executive Liaison, Community Benefit Committee Vice President of Human Resources and Organizational Development, St. Clair Hospital

James M. Collins President & Chief Executive Officer, St. Clair Hospital Board of Directors, St. Clair Hospital

Joan R. Massella Administrative Vice President and Chief Nursing Officer, St. Clair Hospital Board of Directors, St. Clair Hospital

St. Clair Hospital

John P. Meegan Executive Vice President and Chief Operating Officer, Heffren-Tillotson, Inc. Board of Directors, St. Clair Hospital Melvin D. Rex Former Chairman, St. Clair Hospital Board of Directors G. Alan Yeasted, M.D. Sr. Vice President & Chief Medical Officer, St. Clair Hospital Board of Directors, St. Clair Hospital Mark Zacur Vice President and General Manager Thermo Fisher Scientific, Fisher Healthcare Board of Directors, St. Clair Hospital

COMMUNITY LEADERS AND EXPERTS Michael Bowersox, LPC Program Director, Our Clubhouse Rachael Burdette Outreach Specialist, Greenbriar Treatment Center Venard Campbell EMS and Emergency Communications Coordinator, St. Clair Hospital Richard Chesnos Senior Vice President and Chief Financial Officer, St. Clair Hospital Susan Coyle Chief Executive Officer, Chartiers Community Mental Health Katie Devine Director of Human Resources, Mt. Lebanon School District Mary Duranti Librarian, Heritage Public Library Michael Flanagan Senior Vice President and Chief Operating Officer, St. Clair Hospital

Christina Hostutler, LCSW Clinical Director, Outreach Teen and Family Services

Todd R. Pritchard Operations Director, Medical Rescue Team South Authority

David Kish Executive Director, Emergency Services, St. Clair Hospital

Casey Rich Service Coordinator, South Hills Interfaith Movement

Janice Klein Director of Business, Mt. Lebanon School District

Tom Salerno Jr. Director of Operations/EMS Chief, Scott Township EMS

Michelle Kurta, PhD, MPH Epidemiology Research Associate, Allegheny County Health Department

Stephanie Samolovitchm, MSW Director of Support Services, Cancer Caring Center

Tracy Lahew Public Health Nurse, Washington County

James Secrete Police Chief, Scott Township Police

Aaron Lauth Chief of Police, Mt. Lebanon Police

Richard Sieber Executive Director, Marketing & Development, St. Clair Hospital

Heather Martorella Oncology Nurse Specialist, St. Clair Hospital Linda McIntyre Director, Women and Children’s Services, St. Clair Hospital Casey Monroe, MSW Executive Policy Advisor, Allegheny County Health Department

Liz Style Project Coordinator for Safer Together, City of Pittsburgh Denis Valentine Director, Southbridge EMS Brian White Superintendent, Chartiers Valley School District

Harry Fruecht Police Chief, Peters Township Police

Grace Muller Navigator, Casa San Jose

Jim Guffey Executive Director, South Hills Interfaith Movement

Kathe Niznik Director, Psychiatry and Mental Health, St. Clair Hospital

Nora Helfrich EMS Director, Tri-Community South EMS

Marianne Olschesky Community Outreach & Marketing Specialist, St. Clair Hospital

Rebecca Whitlinger Executive Director, Cancer Caring Center Joseph Wissel Jr. EMS Chief, Kirwan Heights EMS

Community Health Needs Assessment

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1000 Bower Hill Road |

Pittsburgh, PA 15243

|

412.942.4000

|

stclair.org

Our vision of a healthy community endures

W

ithin every community, there are people who are

in our community. We gained often profound insights and deeper

vulnerable, and some who are nearly invisible.

understanding of the roots and complexities of these problems.

These people may be the very youngest and the

St. Clair Hospital’s mission has always been to provide highly

very oldest among us; they may those who are alone, or those

valued, service-oriented healthcare to the community. To us, this

struggling with basic needs and health challenges; they may

CHNA is more than a document or a collection of data and graphics;

be people who are disconnected from the larger community

it is more than an obligation. It is an expression of our commitment

because of language barriers or cultural differences. All of

to our mission. It is a living, dynamic blueprint for the future that

them are our neighbors; all of them need healthcare.

At St. Clair, we believe that health means more than the absence of disease. It means physical and emotional wellbeing,

inspires us to improve, to innovate and to advance. We approach the task it sets before us with a genuine sense of passion, eager to move forward and help wherever we can.

quality of life, mobility sufficient to meet social and practical

As the community continues to grow, St. Clair Hospital’s

needs, and a sense of safety and connectedness. We believe

commitment is to grow with it. We are a unique, mission-driven

that a healthy community is one that cares about everyone

organization and that mission is reflected in the many ways

within it, in recognition of our common humanity. We believe

that we serve this community in response to identified needs.

that healing happens within relationships.

Historically, this has always been true of St. Clair Hospital,

As we prepared this Community Health Needs Assessment (CHNA), we engaged deeply with the problems that affect people

and it remains true in 2016.