Table of Contents Introduction and Overview................................................................................................................................. 3 Processes, Methods Used to Conduct the CHNA and External Input ................................................... 6 Existing Health Care Facilities and Resources............................................................................................... 9 Overview and Key Findings of Community Needs ................................................................................... 10 Prioritized Description of Health Needs ....................................................................................................... 13 Appendix..................................................................................................................................... 17 - 20 A. Financial Assistance Policy B. Billing and Collections Policies C. Form 990 D. Complete Results of Phone Survey
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Introduction and Overview Longmont United Hospital is a non-profit tax exempt 501(c)3 community hospital located in Longmont, Colorado. Our medical staff has approximately 280 physicians and we employ 1,270 people. The hospital has 201 licensed beds. We have several primary care clinics in surrounding communities and are currently developing Phase 1 of a four phase medical campus at a growing location within our service area. Longmont United Hospital is a formally designated Planetree Patient-Centered Hospital. This Planetree philosophy empowers patients and their families to be involved in decisions affecting their care. We listen to our patients and structure care around their needs and desires. Planning and developing our programs and services includes input from our communities, physicians, staff and patients. This input gives us the opportunity to increase the wellness of our communities and put the patient's needs first. Longmont United Hospital’s approach to community benefit is to impact areas of greatest need that closely align with our mission and improve the health of the communities we serve. We also seek to increase access and improve health status, especially for vulnerable community members in need. Outreach efforts and forming strategic partnerships with local non-profit organizations has been a cornerstone of our approach to addressing community health needs. These partner organizations are experts at working with the populations they serve and often address needs at a grassroots level. Longmont United Hospital emphasizes health education, embracing an active lifestyle and wellness, chronic disease prevention, proactive management of existing conditions and aging gracefully. We are expanding our services and primary care network to provide a greater continuum of care and address the need to focus on preventative care and wellness. Overview of the Community Health Needs Assessment The Patient Protection and Affordable Care Act (PPACA) requires 501(c)3 exempt hospital organizations to demonstrate their charitable purposes and community benefit by conducting a Community Health Needs Assessment every three taxable years. It must also adopt an implementation strategy to meet the needs identified through the assessment. In addition, the Hospital must also document the following: • • •
Financial assistance policy and policies relating to emergency medical care Billing and collections Charges for medical care
Community benefit activities or programs seek to achieve objectives, including: • Improving access to health services • Enhancing public health • Advancing increased general knowledge, and • Relief of a government burden to improve health
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The Community Benefit Standard has been established by the IRS as the basis for tax-exemption. The Standard determines if exempt organizations promote the health of a broad class of individuals in the community based on the following factors: • • • • • •
Emergency Room open to all, regardless of insurance status or ability to pay Participation in Medicare and Medicaid programs Surplus funds are used to improve quality of patient care, expand its facilities, and advance its medical training education and research programs Controlled by independent community and civic leaders All available and qualified physicians are privileged Adoption of a charity care policy designed to assist the healthcare needs of the medically indigent members of their communities
Project Objectives To complete the Community Health Needs Assessment requirements, Longmont United Hospital set out to accomplish the following: • •
• •
Conduct a Community Health Needs Assessment (CHNA) report, compliant with the Patient Protection and Affordable Care Act (PPACA) and IRS Code 501(r) requirements. Engage local leaders and representatives serving the broad interests of the community and those with special knowledge of or expertise in public health and citizens themselves to provide feedback on community health issues. We also asked for feedback on how well current health improvement efforts are working. Implement the CHNA findings into the overall Hospital Strategic Plan and incorporate the implementation strategy into future Community Benefit efforts. Produce guidelines for monitoring and improving the health of the communities served by Longmont United Hospital through better targeted efforts and addressing the highest priority health issues facing our community and also those that can be most significantly impacted by our efforts.
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Information About the Community Served The primary and secondary zip codes for Longmont United Hospital are shown in the map below. Detailed community demographics can be found in the Overview and Key Findings of Community Needs section.
The Longmont United Hospital primary and secondary service area is made up of the following ZIP codes: 80513 – Berthoud 80301 – Boulder 80516 – Erie 80621 – Fort Lupton 80530 – Frederick 80534 – Johnstown 80026 – Lafayette 80503 – Longmont 2013 Community Health Needs Assessment
80501 - Longmont 80504 - Longmont 80538 - Loveland 80537 - Loveland 80540 – Lyons 80542 – Mead 80651 – Platteville
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Processes, Methods Used to Conduct the CHNA and External Input Partnership with Local Organizations Longmont United Hospital partnered with multiple community organizations to develop and participate in a formal process to identify and address key priority areas that would improve the health and well-being of the communities we serve. To publically display our health data we partnered with the Boulder County Public Health Department. The Department has created a dashboard of community health indicators in an easy to use yet powerful interactive format. The data is shown by simple graphs and charts that can be understood among a wide range of viewers.
Source: Boulder County Public Health
This system is regularly updated to provide feedback and monitor performance and efforts to improve community health. The dashboard allows for an easy to understand public format of health, environmental, and other quality of life indicators. This web-interface will allow our community to identify key areas requiring attention, and increase the efficiency of implementing proven programs to address target problems. It will also link people to promising practices and other resources to assist with making healthier choices.
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Telephone Surveys Longmont United Hospital contracted with AccuData to perform 500 telephone surveys in its service area. AccuData is a third-party marketing and surveying firm located in Denver. There were 300 phone surveys conducted in Boulder County, 100 in Larimer County and 100 in Weld County. The participants were asked a series of 22 questions covering a self-assessment of their health status, access to care, utilization patterns and satisfaction with care received. Participants were also asked to share their demographic information and were assured their information would remain anonymous. The results of these surveys were tabulated and complete results are listed in Appendix D. Community Focus Groups AccuData also recruited participants for community focus groups held at Longmont United Hospital. Candidates were screened and selected to represent the demographics of the Hospital service area. The Executive Director of the Longmont Community Foundation served as moderator. The focus group was asked to discuss and respond to the following questions: 1. 2. 3. 4. 5. 6. 7. 8. 9.
What are the most significant problems related to health in our community? How do you see the health of our community? What ages and groups are most affected by these issues? How are each of these groups affected? Based on the problems identified, are the current programs and services offered working? Are these programs working? Have you or anyone you know used them? What are the barriers to accessing these resources? What can be done to improve the health and quality of life in the community? How can our community encourage or provide access to those who need these services the most? 10. What would you like to do to improve your health? 11. Are there any barriers preventing you from achieving these goals right now? The focus group can be viewed in its entirety at: http://www.youtube.com/watch?v=tiwLKXGWQtE&feature=youtu.be
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Other Sources of Data Boulder County Trends Report 2011 www.commfound.org/trendsmagazine County Health Rankings www.countyhealthrankings.com Community Health Status Indicators www.communityhealth.hhs.gov Boulder County Public Health Department www.bouldercounty.org/dept/publichealth Colorado Department of Public Health and Environment www.chd.dphe.state.co.us/HealthIndicators State Health Facts www.statehealthfacts.org Personal Interviews Longmont United Hospital also held interviews with specific community representatives to gain input on areas including public health, minority and indigent populations, disparities in health care, social determinants of health and health and social services. The individuals interviewed included: • • •
•
•
Boulder County Public Health Department Namino Glantz, Health Planner Weld County Department of Public Health and Environment Cindy Kronauge, Data Specialist OUR Center Edwina Salazar, Executive Director Veronica Orona, Program Director Sandy Stewart, Day Shelter Coordinator Further information on the OUR Center can be found at: http://www.ourcenter.org/ PrestigePLUS / Health Center of Integrated Therapies Michelle Bowman, Director of Patient Care Peggy Arnold, PrestigePLUS Senior Center Ruth Waukau, Senior Services Resources Coordinator Veronica Garcia, Senior Services Resource Specialist Eleanor Montour, Senior Services Resource Specialist
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Existing Health Care Facilities and Resources The following organizations represent existing health care facilities and resources within the community that serve populations in need. Indigent Care OUR Center 303.772.5529 www.ourcenter.org/ Salud Family Health Center 303.776.3250 www.saludclinic.org/Salud-english-longmont.html Clinica Family Health Services 303.650.4460 www.clinica.org/index.php Sister Carmen Community Center 303.665.4342 www.sistercarmen.org/ Boulder County Housing and Human Services www.bouldercounty.org/dept/housinghumanservices Boulder Valley Women’s Health Center 303.442.5160 www.boulderwomenshealth.org/ Senior Services Longmont Senior Services 303.651.8411 www.ci.longmont.co.us/sen_ctr/ PrestigePLUS 303.651.5080 www.luhcares.org/Services/PrestigePLUS.aspx Via Mobility Services 303.447.2848 http://viacolorado.org/ Longmont Meals on Wheels 303.772.0540 www.longmontmeals.org/ Mental Health Mental Health Partners 303.447.1665 www.mhpcolorado.org/Home.aspx Dental Assistance Dental Aid 303.645.4850 www.dentalaid.org/media/contact Salud Family Health Centers 303.772.1906 www.saludclinic.org/Salud-english-longmont.html 2013 Community Health Needs Assessment
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Disability The Center for People with Disabilities 303.442.8662 www.cpwd-ilc.org/ Via Mobility Services 303.447.2848 http://viacolorado.org/ Health / Nutrition / Wellness / Obesity / Substance Abuse Boulder County Health Department 303.441.1100 www.bouldercountyhealth.org Larimer County Health Department 970.679.4580 www.larimer.org/health/ Weld County Health Department 970.356.4010 www.co.weld.co.us/Departments/HealthEnvironment/index.html LiveWell Longmont 720.652.4721 https://about.livewellcolorado.org/livewell-longmont Tobacco Education & Prevention Program 303.413.7567 http://www.bouldercounty.org/env/healthyhome/pages/teppmain.aspx American Cancer Society of Boulder County 303.776.2689 www.cancer.org/MyAcs/index American Heart Association 303.369.5433 www.heart.org
Overview of Key Findings and Community Needs Community Profile • • •
The residents of the Longmont United Hospital primary and secondary services area are primarily White (92%) and Latinos (5%) The area has slightly higher percentages of adults ages 18-64 and lower rates of seniors than found in the State of Colorado. The area has a high median household income, but considerable disparity between income levels. The area has a higher percentage of persons below the poverty line compared to state levels.
Median Household Income Persons Below the Poverty Level (2007-2011)
2013 Community Health Needs Assessment
Boulder County
Colorado
USA
$66,479
$57,685
$52,762
13.1
12.5 14.3 Source: US Census Quick Facts
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• • •
The residents are well educated, with high rates of high school and college and/or graduate degrees. Rates of regular physical activity are high when compared to the State and USA. Colorado has the lowest levels of adult state-wide obesity, but these rates are rising quickly. Colorado ranks 29th in childhood obesity with these rates increasing as well. More alarmingly the rate of childhood obesity is increasing faster than every other state except one (Health Policy Solutions, 2011).
Access to Health Care •
• • •
The area has low rates of uninsured with 93% of adults surveyed reporting health insurance coverage. The national baseline per HealthyPeople.gov is 83.2 (National Health Interview Survey, 2008). Longmont United Hospital ER admissions have increased each year since 2009. 95% of adults report having a primary care provider. Additionally 86% report having seen a provider for a routine checkup or physical within the last 12 months. Those with children report that 94% have a primary care provider for their children. 98% of parents report their children are up to date with immunizations.
Chronic Disease •
• •
Adults in the Longmont United Hospital services area have lower rates of blood cholesterol, heart disease, high blood pressure and obesity when compared to Colorado and the United States. 13% of adults report arthritis as an impairment to their health. Arthritis is the leading cause of disability in the United States (National Health Interview Survey, 2010). 5% report having been diagnosed with diabetes. Diabetes can lower life expectancy by up to 15 years and increases the risk of heart disease by 2 to 4 times. It is also the leading cause of kidney failure, lower limb amputations and adult-onset blindness (U.S. Department of Health and Human Services, 2010).
Community Focus Group Findings • •
•
The cost of care is a problem for many, including those covered by health insurance. Participants reported they often avoid care because of the expense of co-pays and deductibles. There is a need for transparency in hospital and physician bills. Bills from providers are confusing and difficult to understand itemized charges. Patients would like to know what costs they will incur prior to receiving treatment. Access to health care services such as primary care, dental care and mental health services is a problem for the indigent and Latino populations. This can be attributed to a lack of financial resources, absence of health insurance coverage, mistrust of the system, cultural barriers, an aversion to preventative care and a high demand for charity and/or subsidized care.
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•
•
•
•
•
•
•
The OUR Center, Salud Family Health Center and Clinica Family Health Services are skilled at helping patients receive care but they are overwhelmed with requests. This is because demand exceeds their available resources as well as lack of available personnel and social workers to serve the needs of the population. Helping patients navigate the system is a time and labor intensive process. Childhood obesity and a focus on healthy eating and living were identified as a major priority in the community. While it was acknowledged that obesity rates are rising, local efforts such as LiveWell Longmont, emphasis on farmers markets, locally sourced food and community gardens are making a positive difference in terms of awareness. The city-wide trail system, municipal recreation centers and park system and growing cycling community were also noted as important components to encourage active living. Senior participants noted the increased utilization for healthcare services as we age. One couple shared that they did not anticipate the increased demand for care and onset of unavoidable health issues as they grew older. They were not prepared for this change and wish they had a better understanding and awareness of the aging process. Cuts in mental health services a lack of resources for mentally ill patients has caused a problem in the community. According to the staff at the OUR Center this is a major contributor to rates of homelessness. The need for healthcare organizations and providers to take the lead in educating their patients was discussed. Participants felt that prevention strategies and how to properly manage medical conditions were critical to improving their health. People would like the availability of more evening and weekend primary care appointments. Increasing the availability of primary care appointments might reduce urgent care and ER visits after hours. Barriers to improving one’s health include: too busy to find time to properly exercise, healthy food options are not convenient, losing weight is difficult, struggle with keeping positive mental attitude and lack of education on making healthy food choices. Source: Appendix D, Health Needs Assessment Phone Survey Results
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Prioritized Description of Health Needs The Longmont United Hospital Priority Identification and Implementation Strategy was developed based on the findings of the CHNA, our strengths, fit with the LUH’s mission and strategic plan, and a review of the organization’s existing community benefit activities. High Priority Need Criteria: • The Hospital has primary responsibility to enact change • The responsibility required for enacting change closely aligns with the mission of Longmont United Hospital • The Hospital has the expertise and resources to positively impact the change required to produce a healthier community • Evaluation of outcomes are easily measurable and can be monitored on a regular basis Low Priority Need Criteria: • • • • •
Actions required are beyond the mission of Longmont United Hospital Longmont United Hospital can be more effective overall in applying its resources to higher priority needs Longmont United Hospital does not possess the expertise to cause a substantive positive improvement Actions for improvement are judged to fall more appropriately to the responsibility of others Implementation efforts for some needs require behavior modification by individuals, rather than a response by an organization
High Priority Needs & Implementation Strategies 1. 2. 3. 4. 5.
Improve healthcare access Increase availability of mental health services Improve affordability of healthcare services Focus on preventative care and proactive management of chronic conditions Reduce childhood obesity and promote a lifelong wellness strategy
1. Improve Healthcare Access The Assessment identified strong community partners that are skilled in targeting at risk populations. It is critical that these organizations continue to receive funding and support to care for the populations they serve. Closer alignment and care coordination efforts between the Hospital and these organizations should result in improved health outcomes, increased access to care, reduced readmissions and utilization of the emergency department. These partners include the Salud Clinic, the OUR Center, the Mental Health Center of Boulder County, the Boulder Valley Women’s Health Center and others. It is the intention of Longmont United Hospital to strengthen partnerships with these organizations to further impact the populations they serve. By strengthening partnerships we avoid duplication of resources as well as continuing to promote efforts at a grassroots level utilizing the expertise of these existing organizations. Longmont United Hospital will 2013 Community Health Needs Assessment
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strengthen partnerships with these organizations by increasing and sustaining funding for operations, sharing electronic medical records and improved discharge planning. Greater care coordination and improving access to care were identified as major priorities and to respond Longmont United Hospital will continue expansion of its primary care network. The Indian Peaks Medical Center is currently being developed in response to rapid population growth at a location within the Hospital’s primary service area. Based on the 2010 Census, the current population is about 71,000 and is forecasted to exceed 146,000 by 2036. Phase 1 is currently under construction and will offer primary care services as well as convenient, after-hours care. These offerings are in response to a lack of medical services identified in the area as well as demand for extended hours, weekend appointments and greater convenience in obtaining care. The expansion of our primary care network will require an increase in the number of primary care providers. Longmont United Hospital intends to hire additional primary care providers over the next 36 months. All hospital-owned provider offices accept Medicare and Medicaid patients. These offices will continue to accept all patients regardless of the patient’s insurance status and coordinate care in close collaboration with Salud Clinic, the OUR Center and other non-profit organizations to insure the health needs of all community members are met. Longmont United Hospital has also invested in a program to target at risk patients for readmission and improve outcomes after discharge. The program is proven to reduce readmissions by 40% and helps insure patients understand their discharge instructions, and following physician orders, etc. This also reports potential trouble areas where patients might need additional assistance or more involved follow up from medical providers. In addition, the Hospital has placed Care Coordinators within the Emergency Department in effort to reduce readmissions. 2. Increase Availability of Mental Health Services Greater emphasis on improving mental health services has been identified as a high priority nationwide. Psychiatric patients requiring hospitalization are transferred to Centennial Peaks Hospital. This facility specialized in providing a full range of mental health services. The quality of care at Centennial Peaks and specialization of services allows local patients a higher quality of care. Longmont United Hospital heavily subsidizes the care of these patients and will continue a high level of funding to Centennial Peaks. Social workers specializing in mental health triage and care coordination have also been placed in the Hospital Emergency Department along with personnel from Mental Health Partners. 3. Improve Affordability of Healthcare Services Longmont United Hospital is committed to providing a more transparent consumer pricing structure. Longmont United Hospital also provides the highest volume of charity care in Boulder County. The Financial Assistance Policy and Billing and Collection Policies are listed in Appendices A and B. Milestone Medical Group, the Hospital’s employed physician practices see all patients, regardless of insurance status such as Medicare or Medicaid. Milestone also assists patients with obtaining Medicare and Medicaid benefits and offers additional financial assistance when necessary. 2013 Community Health Needs Assessment
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4. Focus on Preventative Care and Proactive Management of Chronic Conditions Engagement of an aging population and promotion of senior wellness will be a primary focus for the Hospital. In response, Longmont United Hospital will expand and refine its senior wellness program, PrestigePLUS. This program has become a community leader in providing innovative outreach programs and services for older adults to empower them to assume greater responsibility for their health and wellness. The program engages the senior community to improve their health utilizing a variety of approaches. Another unique aspect of PrestigePLUS is its partnership with the City of Longmont’s Senior Services Division. Since 2002, the program has been housed at the Longmont Senior Center (the only model of its kind in the state of Colorado). The partnership allows PrestigePLUS to reach beyond our membership to provide wellness activities and educational programs, senior health clinics, counseling and therapy services and advance planning assistance. Co-creating programs with the Senior Center staff allows us to broaden our horizons, share knowledge and skills and support each other in our common mission to enhance the well-being of older adults. By offering a large variety of programs and activities PrestigePLUS and the Senior Center seek to engage seniors – especially those living alone. The percentage of adults 65+ living alone was identified as a primary concern by the phone survey of the Hospital primary service area. The mission is further realized through partnerships and collaborations with other community groups, including: • The Business Community • Schools • Community Agencies/Programs • Faith Communities • Media • Medical Community • Senior Living Facilities In response to an advisory group request for alternative medical therapies, the Health Center of Integrated Therapies (HCIT) was created. HCIT offers treatments such as massage, acupuncture and Tai Chi. This link with an integrative medicine approach is one of the factors that make PrestigePLUS unique among senior wellness programs. Members receive discounted therapy services at HCIT, as well as other benefits. HCIT is a service subsidized by Longmont United Hospital. 5. Reduce Obesity and Promote a Lifelong Wellness Strategy Longmont United Hospital will focus on promoting community health with an emphasis on education and the development of healthy behaviors. A particular focus will be combating the growing rate of childhood obesity in Colorado. The Latino population is particularly vulnerable to this epidemic. To embark on this strategy the hospital has become the fiscal agent and sponsor of LiveWell Longmont. LiveWell Longmont is a division of LiveWell Colorado, which is a non-profit movement that focuses on policy, environmental and lifestyle changes that remove barriers and increase access to healthy behaviors. Working in partnership with obesity prevention initiatives 2013 Community Health Needs Assessment
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across Colorado, LiveWell aims to provide every citizen with access to healthy foods and opportunities for physical activity in the places they live, work, learn and play. LiveWell Longmont focuses on early childhood education in the school systems. LiveWell highlights schools as an ideal place to help children and adolescents develop healthy eating and active living habits. LiveWell has been able to place a coordinator for their Safe Routes to School program. This program creates recommended walking and bicycle routes for individual schools, interactive maps for parents and children to access these routes and purchase and installation of bike racks. They also sponsor bike rodeos which teach children bicycle safety. These efforts to remove barriers and increase access to healthy behaviors have been very successful in the school districts and received strong approval by parents and school administrators. LiveWell has also funded a school wellness coordinator as a permanent position within the St. Vrain Valley School District which covers the majority of Longmont United Hospital’s service area. The wellness coordinator focuses on improving the physical education program to help increase the levels of moderate to vigorous physical activity and to align with stricter physical education standards. The wellness coordinator also assists and provides the District to increase the number of children who consume the recommended servings of fruits and vegetables each day as well as support the development of school education gardens within the system. LiveWell has developed a nine-week healthy cooking competition for high school students to take on the challenge of healthy school meals as well as providing cooking and nutrition skills that will last a lifetime. Student teams will prepare school lunch menus that align with the standards for public school lunches, including meeting or exceeding USDA nutrition guidelines and staying within similar budgets. Ultimately, students will demonstrate to attendees the ease of preparing healthy, tasty and affordable school meals while highlighting the challenges and reform still needed. Longmont United Hospital has also formed a partnership with Healthy Learning Paths. This is a program that empowers children, parents and educators by teaching wellness strategies for success in health, learning and life. This is an evidence and science-based curriculum that utilizes medical professionals to present wellness strategies in schools with a focus on the early childhood years. Longmont United Hospital has recruited several primary care physicians, pediatric nurses, nurse practitioners and other clinical staff to be trained to present the Healthy Learning Paths curriculum. There is a considerable waiting list for the program in the St. Vrain Valley School District and priority will be given to schools with the highest percentage of free and reduced lunch students. Longmont United Hospital’s support will greatly enhance the reach of the program and allow it to focus on those students who need the most assistance.
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Appendix A. Financial Assistance Policy http://www.luhcares.org/PatientsVisitors/CharityPolicy.aspx B. Billing and Collections Policies https://luhcares.patientcompass.com/hc/guarantor/billingPolicies.do C. Form 990 http://luhcares.org/Portals/0/PDF/2012AnnualReportF.pdf
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D. Health Needs Assessment Phone Survey Results Survey Questions - Total
# Responses
%
1. What is your gender? 297 59.4% Female 203 40.6% Male 2. What community do you live in? BOULDER COUNTY 194 64.7% Longmont 39 13.0% Lafayette 33 11.0% Boulder 16 5.3% Erie 12 4.0% Lyons 4 1.3% Niwot 1 0.3% Louisville 1 0.3% Raymond LARIMER COUNTY 96 96.0% Loveland 4 4.0% Berthoud WELD COUNTY 17 17.0% Longmont 17 17.0% Fort Lupton 14 14.0% Frederick 14 14.0% Erie 12 12.0% Johnstown 8 8.0% Firestone 7 7.0% Platteville 6 6.0% Dacono 3 3.0% Berthoud 2 2.0% Mead 3. Would you say in general your health is: 152 30.4% Excellent 233 46.6% Good 82 16.4% Fair 33 6.6% Poor 4. Do you have any type of health insurance, such as private insurance, Medicaid or Medicare? 459 93.1% Yes 34 6.9% No 5. During the past 12 months, was there any time that you or anyone in your household did not have health insurance or coverage? 45 9.4% Yes 436 90.6% No 6. Was there a time during the last 12 months when you or anyone in your household needed to see a doctor but could not because of cost? 36 7.3% Yes 454 92.7% No 7. Do you have a problem getting to your health care provider? 12 2.4% Yes 478 97.6% No 7A. What is the nature of the problem? 5 33.3% Don't have a car 5 33.3% Other 3 20.0% Too far 1 6.7% No public transportation 1 6.7% Takes too long to get an apppointment
8. Do you have a primary care provider? 473 Yes 25 No 9. About how long has it been since you last visited a doctor for a routine checkup or physical? 428 0-12 months 43 1-2 years 10 3-5 years 14 Greater than 5 years 1 Never 10. Where do you normally go when you are sick or need advice about your health? 449 Primary Care doctor 33 Urgent care clinic 5 Emergency Room 1 Other 11. How many people, including yourself, live in your home? 124 1 224 2 58 3 44 4 38 5 or more 12. How many are under 18? (if 0, skip to Q14) 36 1 39 2 19 3 4 4 0 5 or more 12A. Do your children have a primary care provider? 92 Yes 6 No 12B. Are your children up to date with immunizations? 98 Yes 2 No
95.0% 5.0% 86.3% 8.7% 2.0% 2.8% 0.2% 92.0% 6.8% 1.0% 0.2% 25.4% 45.9% 11.9% 9.0% 7.8% 36.7% 39.8% 19.4% 4.1% 0.0% 93.9% 6.1% 98.0% 2.0%
13. How would you rate the care of the health you and your family receive? Choose a number where one (1) is the worst care possible and five (5) is the best care possible. 4 1 9 2 35 3 174 4 273 5 14. Do you get an annual flu shot? 330 Yes 163 No 15. Are you limited in any way in any activities because of a disability, impairment or health problem? 123 Yes 361 No
0.8% 1.8% 7.1% 35.2% 55.2% 66.9% 33.1% 25.4% 74.6%
15A. What is the major impairment or health problem that limits your activities? (check all that apply) 65 Arthritis 44 Walking problem 44 Heart / Hypertension / high blood pressure problems 42 Back or neck pain 25 Diabetes 23 Fractures, bone or joint injury 21 Respiratory / breathing problems 18 Other (please specify) 14 Eye / vision problem 14 Cancer 10 Hearing problem 6 Stroke problem 5 Depression / anxiety / emotional problems
13.0% 8.8% 8.8% 8.4% 5.0% 4.6% 4.2% 3.6% 2.8% 2.8% 2.0% 1.2% 1.0%
15B. Because of your impairment or health problem, do you need the help of other persons in handling your routine needs, such as household chores, shopping, etc.? 40 33.6% Yes 79 66.4% No 16. Do you do moderate activities for at least 10 minutes at a time, such as walking, jogging, bicycling or anything else that generally qualifies as exercise? Yes No 16A. How often do you do these activities? Daily 2-3 times / week 3-4 times / week 5+ times / week 17. What is the best way for you to receive health information? Healthcare providers in person Internet Informational pamphlets at Doctor's office Television Other Community Classes 18. What is your age range? 18-64 65+ 19. What would you consider to be your race or ethnicity? White Latino Asian African American American Indian Other 20. What language is spoken most often in your home? English Spanish Other 21. What is the highest grade or year in school you completed? High School or less College Degree Masters Degree or higher
431 63
87.2% 12.8%
293 78 38 25
67.5% 18.0% 8.8% 5.8%
258 149 74 46 23 7
46.3% 26.8% 13.3% 8.3% 4.1% 1.3%
249 246
50.3% 49.7%
453 25 7 5 2 1
91.9% 5.1% 1.4% 1.0% 0.4% 0.2%
492 9 1
98.0% 1.8% 0.2%
210 185 83
43.9% 38.7% 17.4%