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CommunityHealth
Pickens County, South Carolina
NeedsAssessment 2013
TABLE OF CONTENTS
445
56
89
1213162021
Purpose
Description of Community
Methodology / Assessment Partners
Secondary / Qualitative Statistical Data Sources
Primary / Qualitative Data
1. Surveys
2. Focus Groups
3. Forums
4. Partners
Summary
Supporting Statistical Data
Limitations
Existing Healthcare Resources
Recommendation
Reference
Appendix
A. Community Leader Input / Expertise
B. Needs Assessment Survey
C. Implementation Matrix
DATA COLLECTION
4
BAPTIST EASLEY & CANNON MEMORIAL HOSPITALSCOMMUNITY HEALTH NEEDS ASSESSMENT (CHNA)
The resulting CHNA will be used to document community needs, link those needs to community benefit efforts, and assist the two hospitals in planning and prioritizing community benefit investments.
COMMUNITY SERVED-PICKENS COUNTY
The population identified as Pickens County encompasses the following eight cities and zip codes: Pickens (29671), Easley (29640, 29641, 29642), Liberty (29657), Central (29630), Clemson (29631, 29632, 29633, 2934), Norris (29667), Six Mile (29682) and Sunset (29685). These zip codes represent the primary market for both hospitals. The following map (fig. 1) identifies the targeted areas in the county for this assessment.
MAJOR HEATLH CONCERNSQUALITATIVE DATA
PURPOSE
In compliance with the provisions of the Health Care Bill, Baptist Easley (BE) and Cannon Memorial Hospital (CMH) partnered to conduct a Community Health Needs Assessment (CHNA) during FY2012 and FY2013. The results of the assessment will be filed on the 2013 IRS form 990.
The one survey meets the requirement for both BE and CMH and is conducted every three years. The results of the survey are made available on both hospital websites.
Baptist Easley www.baptisteasley.orgCannon Memorial Hospital www.cannonhospital.org
The assessment has three main objectives:
1. Assess/Identify top health-related needs/ issues in the community.
2. Assess the underlying factors of these identified top related health needs/issues in the community.
3. Assess resources available in the community to address these issues with possible solutions.
FIG. 1
COMMUNITY SERVED PICKENS
COUNTY MAP
Central
Liberty
Clemson
Easley
Norris
Pickens
Six Mile
Sunset
As of 2010, the total Pickens County population totaled 119,224 (fig. 2), which has grown 7.64% since 2000. The population growth rate is much lower than the state average rate of 15.29% and is lower than the national average rate of 9.71%. Pickens County median household income was $41,898 in 2006-2010 and has grown by 15.70% since 2000.
The income growth rate is higher than the state average rate of 13.31% and is lower than the national average rate of 19.17%. Pickens
County median house value was $123,500 in 2006-2010 and has grown by 28.51% since 2000. The house value growth rate is much lower than the state average rate of 45.52% and is much lower than the national average rate of 50.42%. As a reference, the national Consumer Price Index (CPI) inflation rate for the same period is 26.63% (U.S. Census, 2012).
Pickens County, South Carolina - Overview Total Population
Population by RaceAmerican Indian and Alaska Native alone
Asian alone
Black or African American alone
Native Hawaiian and Other Pacific Native alone
Some other race alone
Two or more races
White alone
Population by Hispanic or Latino Origin (of any race)
Persons of Hispanic or Latino Origin
Persons Not of Hispanic or Latino Origin
2010 Census Counts119, 224
230
1,913
7,854
14
1,690
1,776
105,747
3,743
115,481
100.00%
0.19%
1.60%
6.59%
0.01%
1.42%
1.49%
88.70%
3.14%
96.86%
FIG. 2
6
METHODOLOGY
Baptist Easley Hospital (BE) conducted the assessment in conjunction with Cannon Memorial Hospital (CMH). Both systems serve the same population and are in close geographic proximity of approximately seven miles. Because of this factor, and a long history of partnerships between both hospitals as well as all Health and Human Service (HHS) agencies in the county, the decision was made to partner in the CHNA. Input from the various HHS agencies provided vital information for the assessment. Historically all of the stakeholders mentioned above have worked closely to develop and implement previous CHNA’s and other community initiatives. This partnership will conserve resources, increase efficiency, and promote optimal outcomes in community benefits. Both hospital’s administration and Board of Directors (BOD) were in agreement with the partnership.
A community-based approach was taken to complete the community health needs assessment. A collaborative partnership already in existence as described above, and with much input from local and regional Public Health professionals, community leaders, and community boards facilitated the process (see appendix A for list).
Efforts were made to ensure that research was conducted in a manner representative of the communities within the primary service area of both hospitals. National, state, regional, and county-specific data was collected from a broad set of data sources. Primary and secondary research was gathered from various sources including statistical data collected by the State of South Carolina.
Research methods were conducted in an approach that incorporated both quantifiable and qualitative data to obtain a well-rounded view of the state of the community’s health.
1) Collection of statistical (secondary, quantitative) data at national, state, regional and local levels—key data sources included Pickens County Health Partners, Vision 2025, Pickens County Access Health, County Health Rankings, National Health Indicators Warehouse, CDC and South Carolina DHEC biostatistics, and hospital discharge data. Dates of data collected ranged from 2000– 2011. For each indicator, data was obtained for the most recent year available. In addition, data was obtained, when available, from previous years to assess progress and identify trends.
2) Collection of qualitative data through a variety of community and stakeholder focus groups and surveys.
The qualitative portion of the CHNA consisted of surveys and focus groups to obtain input from community leaders and stakeholders, as well as general community populations. The collection of surveys began July 2012 and continued through October 2012 (see appendix B for survey).
A total of 1328 surveys were administered to the general population. Surveys were collected at church congregations, physician offices, YMCA programs, random community surveys, Samaritan’s Health Clinic, United Christian Ministries, two community church food pantries, Centering Pregnancy programs, chronic disease management classes, and community health education programs. Seven of the survey sites provide programs for uninsured/underinsured persons. Survey results were broken down into age categories and payment source for healthcare services (fig. 3 & 4).
Forums were also conducted simultaneously with general population groups to confirm the information gathered from written surveys. The groups identified to participate in the forums included two Centering Pregnancy groups, SHINE soup kitchen, and chronic disease management classes.
Community leaders were encouraged to participate in the survey. One hundred and sixty-five surveys were collected from key leaders representing the following: Behavioral Health Services, United Way Staff and Board, Samaritan Health Clinic, United Christian Ministries, School District of Pickens County School Nurses, Pickens County Health
18-35
36-50
51-62
62+
26
2725
22
PVT Insurance
Medicare
Medicaid
Uninsured
31
2217
30
FIG. 3
FIG. 4
AGE OF PARTICIPANTSQUALITATIVE DATA
UNINSURED VS. INSURED QUALITATIVE DATA
8
Department, First Steps Board and Staff, Rape Crisis, BEH Community Services Staff, BEH Voice of the Customer Board, BEH Board of Directors, Abundant Living pastors, parish nurses and lay health leaders, Joseph Sullivan Center, and City Council Members. The Pickens County School District school nurses were surveyed in a forum setting and input was obtained from local and regional Public Health officials and community health experts (see appendix A).
RESULTS/SUMMARYThe purpose of the surveys and forums was to determine the general perception of Pickens County and leaders of community organizations’ perception of the top health concerns for the area.
Top Health Concerns Concluded from Surveys and Focus Groups (fig. 5)
1. Cardiovascular Diseases (includes stroke)2. Diabetes3. Obesity4. Cancer (all types)5. Hypertension
Participants were also queried on barriers to accessing healthcare services and suggestions for meeting both the health and system needs which they identified.
Top System Concerns Concluded from Surveys and Focus Groups
1. Transportation2. Affordable Healthcare/gaps for under
and uninsured3. Education and Awareness
The top five health concerns identified in the survey and focus group process mirrors the statistical data described below. While there is no statistical data available to support the top three system issues concluded from the survey and focus groups, the identified issues are common knowledge among all health and human service agencies in the county. In the collaborative partnership described earlier, the decision was made to address the top five identified health needs and the health education and awareness system needs identified by the community. The collaborative partnership has the capacity to directly impact these issues individually and collectively.
FIG.5
32
25
16
14
13
Cardiovascular Disease
Diabetes
Obesity
Cancer
High Blood Pressure
MAJOR HEATLH CONCERNSQUALITATIVE DATA
SUPPORTING STATISTICAL DATA
In 2007 a community health needs assessment identified a need to preserve healthy lifestyles, grow healthcare resources, work to guarantee affordable healthcare, and increase affordable dental care (Pickens County Vision 20/25, 2007). Again, five years later and now 10 years after the initial CHNA (PCHP, 2003) we see a common thread in Pickens County that mirrors state and national statistics in access to care and increasing healthy lifestyles. Statistics in the original assessment and the recent assessment reveal cardiovascular disease (CVD) as the number one cause of death and morbidity in Pickens County for individuals over 65 years of age. It is the 2nd leading
cause of death in residents 45-65 years of age (fig. 6). Heart disease diagnoses also make up the top inpatient chronic conditions for both CMH and BE. Of those individuals surveyed, 32% responded they thought cardiovascular disease was the top health problem in our community (SCDHEC, 2012).
HEART DISEASE COUNTY
Total Blacks Whites Males Females
STATE
Number of hospitalizations
Crude rate of hospitalization (per 100,00)
Median age of hospitalized patients
Total cost of hospitalizations ($)
Average length of hospital stay (days)
Number of ER visits
Crude rate of ER visits (per 100,000)
Median age of ER patients
Total cost of ER visits ($)
Number of deaths
Age-adjusted death rate (per 100,000)
1,860
1,574
68
93,632,500
4
670
567
63
3,507,700
236
189.7
113
1,040
60
4,268,100
4
59
543
61
258,600
15
209.6
1,719
1,601
68
87,861,600
4
598
557
63
3,195,700
220
188.4
1,112
1,875
66
60,872,200
4
362
610
62
1,855,500
113
165.3
748
1,217
70
32,760,300
4
308
524
65
1,652,200
123
165.3
55,893
1,225
67
2,767,780,900
5
16,905
371
63
91,625,400
9,253
188.9
FIG. 6
10
COUNTYSTROKE
Total Blacks Whites Males Females
STATE
Number of hospitalizations
Crude rate of hospitalization (per 100,00)
Median age of hospitalized patients
Total cost of hospitalizations ($)
Average length of hospital stay (days)
Number of ER visits
Crude rate of ER visits (per 100,000)
Median age of ER patients
Total cost of ER visits ($)
Number of deaths
Age-adjusted death rate (per 100,000)
369
312
70
12,050,100
4
137
116
66
1,244,400
56
45.7
33
304
61
1,278,100
5
3
28
65
28,400
5
67.3
332
309
71
10,427,100
4
134
125
66
1,216,000
50
43.5
181
305
68
6,241,800
4
67
113
63
584,700
27
52.4
188
320
73
5,808,300
4
70
119
73
659,700
29
38.7
14,471
317
69
539,875,300
5
4,283
94
67
31,243,700
2,285
47.7
OBESITY
When adults in Pickens County were asked to rate their overall health as part of the 2010 South Carolina Behavioral Risk Factor Surveillance System (BRFSS), 86% reported having excellent, very good, or good health compared to the SC total of 82%. However, 57% of Pickens County residents are considered overweight or obese compared to South Carolina’s 67%. When surveyed,
16% of our response group felt that obesity was one of the major health concerns for our community. Obesity is one of the leading risk factors related to morbidity and mortality in South Carolina. Contributing factors to the obesity rate in our county is the percentage of adults not meeting the recommended physical activity and fruits and vegetables intake (SCDHEC/BRFFS, 2012).
FIG. 6
IMPACT OF DIABETES IN THE SOUTH CAROLINA AND THE UNITED STATES
Diabetes affects 25.8 million Americans and contributes to approximately 231,000 deaths each year. Approximately 371,476 adults in South Carolina are diagnosed with Diabetes. Diabetes is the seventh leading cause of death in South Carolina, claiming 1,114 lives in 2009. African Americans have nearly twice the prevalence as Whites. The direct and indirect costs of Diabetes in the U.S. were nearly $174 billion in 2007.
DIABETES IN PICKENS COUNTY
Twenty-five percent of our survey group felt that diabetes was one of the top health concerns for our community. The following points verify this perception:
• An estimated 7,180 adults (7.9% of adults) in Pickens County suffer annually from Diabetes.
• In 2010, there were 153 hospitalizations for Diabetes in Pickens County for all ages.
• There were an additional 2,522 hospital discharges with Diabetes-related conditions in Pickens County.
• The total direct costs of hospitalizations and emergency room visits were over $4.1 billion in 2010.
• In 2010, there were 296 emergency room (ER) visits for Diabetes as the primary diagnosis, among which 53 (18%) were by African American patients.
• A total of 31 people in Pickens Countydied of Diabetes in 2009
• The following graph compares national, state, and local data (fig. 7).
(SCDHEC, 2012).
US SC Pickens
PREVALENCE OF SELF-REPORTEDDIABETES AMONG ADULTS
2001
0
2
4
6
8
10
12
2002 2003 2004 2005 2006 2007 2008 2009 2010
FIG. 7
% o
f Pop
ulat
ion
12
• Hospitalization and ER data for individuals diagnosed with diabetes indicate that 50% are at least 62 years old. This is consistent with state and national data reporting seniors are at greater risk for chronic diseases such as Diabetes (fig. 8)
CANCER IN PICKENS COUNTY
Lung cancer is one of the most prevalent types of cancer in Pickens County and caused approximately one third of all cancerdeaths in 2011. The number of hospitalizations related to lung cancer and colorectal cancer far outweighs the number of all other cancers combined during this same time frame. In 2011 the percentage of Pickens County residents admittedly smoking cigarettes was slightly higher than the state average of 23.14% (SCDHEC, 2012).
The American Lung Association and other national health authorities have identified tobacco use and as the number one risk factor for lung cancer. Second-hand smoke also poses a major health risk.
LIMITATIONS
The primary research for the community at large was based on surveys and group forums. We realize this limits participation from those community members who were not part of the targeted groups; however, surveys were made available to any public member who utilized Cannon Memorial Hospital, any of its practices, and by community random sampling. The assessment did not conduct town hall meetings in the community. The expectation was each community was well represented by the community leaders identified.
The appending table (fig. 10) is a list of organizations and existing healthcare facilities available in Pickens County with assets for meeting collaborative CHNA implementation strategies. There may be others inadvertently omitted who provide some form of healthcare service to our community.
50
733
9
FIG. 8
Medicare
Medicaid
PVT Ins
DIABETES ER & HOSPITALIZATION
CHARGES, PICKENS COUNTY,
2010
Self/ Indigent
FIG. 9EXISTING HEALTHCARE FACILITIES & OTHER RESOURCES
AnMed Women’s Care, Liberty
Behavioral Health Services
Clemson Community Care
Clemson Free Medical Clinic
Foothills Community Health Center
Clemson University Joseph Sullivan Center
DESCRIPTION & ASSETS TOWARD IMPLEMENTATION STRATEGIES FOR TOP FIVE IDENTIFIED NEEDS:
Obstetrical and gynecological services regardless of payer source.CVD / DM / CA / OB / HTN
BHS of Pickens County is a non-profit organization that focuses on prevention, intervention, and treatment of drug, alcohol, and other addictive substances. CVD / DM / CA / OB / HTN
Provides assistance for food, heat, and rent. This agency also provides referral and support services.
Provides healthcare and prescriptions, at no cost, to residents who have no insurance and who cannot pay for services. CVD / DM / CA / OB / HTN
Federal grant funding received, but not currently operational at this time. Once the clinic is operational, efforts will be made to collaborate with this community partner. The clinic will provide healthcare, on a sliding scale fee, to residents who meet specified criteria based on income. CVD / DM / CA / OB / HTN
Provides comprehensive healthcare for faculty members and community residents. Also seeks to bring healthcare to underserved populations thru partnerships and grant funded initiatives. CVD / DM / CA / OB / HTN
Cardiovascular Disease
Diabetes Mellitus
Cancer
Obesity
Hypertension
CVD
DM
CA
OB
HTN
LEGEND
14
Mountain View OB/GYN/Centering Pregnancy Program
Parish Nurse Program
Pickens County Health Department
Pickens County Mental Health Center
Pickens County School Nurse Programs
Samaritan Health Clinic
Provides comprehensive obstetrical care for residents regardless of payer source. This program includes a nationally recognized Centering Pregnancy program which improves immediate and long-term outcomes for women and infants. CVD / DM / CA / OB / HTN
Baptist Easley and area churches partner to provide health education and wellness programs to congregants and surrounding neighborhoods. CVD / DM / CA / OB / HTN
Provides both adult and child health services. The health department also seeks to improve safety, quality of life, and empower residents to improve health/wellbeing. CVD / DM / CA / OB / HTN
Provides Mental Health services to the residents of Pickens County based on identified needs and state mandates. Referral.
Each school in Pickens County has a minimum of one nurse on staff. Nurses dispense medications to children while at school, become a referral source forparents/children, provide support services, and have the ability to bill Medicaid for specific services. CVD / DM / CA / OB / HTN
Provides healthcare and prescription, at no cost, to residents who have no insurance and cannot pay for services. CVD / DM / CA / OB / HTN
United Christian Ministries
United Way of Pickens County
Baptist Easley Hospital Wellness Programs
Cannon Memorial HospitalWellness Programs
YMCA
Provides assistance for food, heat, and rent. This agency also provides referral and support services. Referral.
The United Way partners with every agency in Pickens County to provide grant funding and/or support services. The United Way currently has grant funding to assist individuals with prescription assistance, hunger, and homeless issues. One of the largest initiatives in 2012 is the Hunger/Homeless Coalition. This coalition is well underway to establishing a comprehensive and structured system to ensure family units are empowered and assisted in life-sustaining needs, education, and gainful employment. Referral.
Baptist Easley provides free/ low-cost wellness screenings and education targeting cardiovascular disease, Diabetes, and other identified health concerns. Evidence-based chronic disease management classes are also offered free of charge. CVD / DM / CA / OB / HTN
Cannon Memorial provides free/ low-cost wellness screenings and education targeting cardiovascular disease, Diabetes, and other identified health concerns. CVD / DM / CA / OB / HTN
Provides physical fitness and healthy lifestyle programs in a wholistic approach of mind, body, and soul for all age groups. CVD / DM / CA / OB / HTN
Cardiovascular Disease
Diabetes Mellitus
Cancer
Obesity
Hypertension
CVD
DM
CA
OB
HTN
LEGEND
16
RECOMMENDATION
BE recognizes the devastating burden of Chronic Disease in Pickens County and across the nation. Cardiovascular Disease (CVD) and Diabetes are now considered co-morbidities and the top two identified health concerns in Pickens County. With this in mind, BE made the decision to combine health education and awareness efforts to maximize positive outcomes as described below.
BE will implement six initiatives for education and risk reduction in CVD, Diabetes, and cancer. All six of these initiatives are immediate for FY2013 with plans to expand and enhance strategies in subsequent years.
Targeting risk reduction provides an avenue for addressing the top five and several other identified health concerns on the survey, because the same risk factors are common to most chronic health issues. For example, obesity and tobacco use are risk factors for CVD, Diabetes, and cancer. Hypertension is a risk factor for CVD and Diabetes. The education in the following initiatives will focus on all common risk factors and provide the community with information on access to available services.
Initiative 1: Increase knowledge in CVD and decrease risk factors BE has designed a standardized curriculum for use in community forums and train-the-trainer options for replication in various settings. Participants in each session will be surveyed after the presentation to determine if knowledge was increased and/or a commitment was made to reduce oneCVD risk factor. This initiative teaches risk reduction and goal setting around heart healthy numbers, hypertension, weight control, nutrition, tobacco reduction, and physical activity. Therefore this initiative will address the top five health concerns identified in the assessment.
Initiative 2: Decrease Diabetes risk factors
BE initiated the Start Now program. This is a standardized program taught by Diabetes Educators and focused on risk factor reduction. By the end of each session participants contemplate and report willingness to reduce at least one risk factor and incorporate lifestyle changes. This initiative teaches risk reduction and goal setting around consistent blood sugar numbers, heart healthy numbers, hypertension, weight control, nutrition, tobacco use, and physical activity. Therefore this initiative will address the top five health concerns identified in the assessment.
Initiative 3: Increase knowledge and self-efficacy in Diabetics and their caregivers
BE initiated the Diabetic Maps program. This is an interactive standardized program facilitated by healthcare providers and lay health advocates. Small group sessions are conducive for participation in hands on activities and learning scenarios. At the end of each session, participants take away knowledge and skills for increased Diabetes self-management. This initiative teaches risk reduction and goal setting around nutrition, consistent blood sugar numbers, hypertension, weight control, and physical activity. Therefore this initiative will address four of the five health concerns identified in the assessment.
Initiative 4: Increase knowledge of harmful effects of tobacco and increase the number of tobacco-free Church campuses
BE was awarded a Healthy South Carolina grant to fund this initiative. BE designed a standardized curriculum and provided train-the-trainer sessions for Parish Nurses in 25 churches committed to partner in the grant process. The commitment includes providing educational sessions for both adult and youth congregants, developing and implementing a tobacco-free campus policy, and posting tobacco-free campus signs. Many of the churches are also committed to opening the
educational components to the community as well. At the end of each educational session, individuals are more aware of harmful effects of tobacco and informed about the new items on the market which contain nicotine. This initiative will meet the identified health concern of cancer and address the increased incidence of lung cancer deaths in Pickens County. Reduced tobacco use and avoiding second-hand smoke will also reduce the risk for other identified health needs such as CVD, Diabetes, and hypertension.
Initiative 5: Reduce tobacco use
BE provides Fresh Start classes free of charge for the community. This standardized curriculum focuses on benefits of being tobacco-free and offers suggestions in tobacco cessation. During the four week session, participants are asked to start reducing the amount of daily tobacco consumed using the techniques and strategies learned in class. By the end of the fourth week, participants are asked to select a quit date and determine to become tobacco-free. This initiative will meet the identified health concern of cancer and address the increased incidence of lung cancer deaths in Pickens County. Reduced tobacco use will also reduce the risk for other identified health needs such as CVD, Diabetes, and hypertension.
18
Initiative 6: Increase self management skills in individuals diagnosed with chronic disease
BE designed a standardized curriculum to assist individuals and their caregivers to navigate the numerous issues in dealing with any chronic illness. This curriculum focuses on several issues that are common to all chronic illnesses such as fatigue, pain, difficult emotions, and the disease process. The curriculum also instills hope and encouragement by advocating for action plans and goal setting. At the end of each session participants learn skills and techniques to improve self-management. Chronic disease includes but is not limited to, CVD, Diabetes, cancer, and hypertension. Therefore this initiative will address four of the five health concerns identified in the assessment.
During FY2013 BE will engage community partners in meeting the six initiatives described above. These initiatives will address six of the top ten identified health concerns. The FY2014 plan is a continuation of these initiatives with expansion and enhancement of the strategies and partner involvement which will drive positive outcomes. Obesity, one of the top five identified needs will be addressed and integrated into the initiatives for CVD, Diabetes, and chronic disease management described above. On a broader
scale, childhood obesity is already addressed in collaboration with the Pickens County School District, Clemson University Department of Agriculture, Zest Quest, Youth Learning Institute, and SCDHEC Farm to School initiatives. The United Way, Leadership Pickens County, YMCA, BE, CMH, City of Easley, City of Pickens, and City of Liberty have initiated the following to increase physical activity opportunities: Initiating and refurbishing walking and bike trails, providing safe bike and walking areas downtown, and sponsoring family fun events that highlight physical activity. Pickens County is a rural area with a large number of farms which produce fresh fruit and vegetable options during the Spring, Summer, and Fall. BE currently supports the local Farmers Market with Registered Dieticians providing healthy cooking demonstrations and recipes for fresh fruits and vegetables. BE also advocates Farm to Table activities and educates food pantries in economical options for providing fresh fruits and vegetables for clients. BE employees serve on the Hunger Coalition for Pickens County, educate underserved populations in healthy eating options, and advocates resource awareness to meet this need. BE is also leading the way in healthy workplace initiatives by providing healthy meal and snack machine options as well as promoting physical activity options for employees. In FY2011, 2012 and 2013, BE was awarded the American Heart
Association Gold Fit Friendly Worksite award. BE strives to lead the way in worksite health and wellness with a desire to be a model for the community.
Three of the top 10 identified health issues in the assessment will not be addressed at this time by BE. However, county-wide partnerships are in place to continue analyzing options to meet these needs and BE will continue to serve as leaders and team players. These include access to dental care for uninsured citizens, access to mental health care, and substance abuse issues. Funding is the main barrier in moving forward with these particular identified health needs. Budget cuts for the Medicaid program in the area of dental care and federal cuts in the area of mental health are crippling at this time. However, the newly formed, Pickens County Drug Task Force is focusing on prescription narcotic drug abuse. This is a collaboration between Pickens County School District, Law Enforcement, Behavioral Health Services, BE and CMH. Recent data indicates that Pickens County has a higher than average incidence of teen and young adult deaths attributed to prescription drug overdose. Pickens County was also identified as a Red Zone for the number of narcotics prescribed for Medicaid recipients. Public awareness campaigns, rallies for youth and young adults, and prescription drug take-back days are coordinated through
this task force (personal interview, Cliif Collie, PharmD-Task Force Member). In addition, the top two non-medical system issues identified in this assessment will not be addressed at this time by BE. These include Healthcare cost/gaps for underinsured and uninsured, and transportation issues. However, at this time BE is working internally and with other health systems to reduce healthcare costs especially in the area of purchasing. BE continues to find ways to provide services for the underinsured and uninsured. Charity care and community benefit resources continue to increase each year. Transportation is a long standing issue with little opportunity for change because of funding. County government and county-wide partnerships continue to seek and review opportunities to improve the need for transportation. Currently, Seniors Unlimited provides transportation to Medicare and Medicaid recipients for medical appointments. BE is seeking partnerships with local private transportation companies to assist with medical follow-up after patients are discharged. BE is also working in partnerships to provide chronic disease management courses at senior housing centers and other strategic places in the community to decrease transportation issues, decrease readmissions, and improve outcomes.
20
REFERENCE
Pickens County Vision 20/25. (2007). Retrieved from http://pickenscountyvision2025.org
Pickens Health Partners. (2003). Retrieved from http://pchp.org
South Carolina Department of Health and Environmental Control. (2012). Retrieved from http://www.scdhec.gov
South Carolina Department of Health and Environmental Control. (2012). Retrieved from http://www.scdhec/BRFFS.gov
U.S. Department of Health and Human Services. (2012). Retrieved from http://www.cdc.gov
U.S. Census Bureau. (2012). Retrieved from http://www.census.gov
Broad Interest IntervieweesAlex Levy, Director, Rape Crisis CouncilAmanda Dow, Cannon Memorial Hospital, Manager Community ServicesAngela Reid, Baptist Easley Hospital, Manager Community ServicesBob Hiott, Director, Behavioral Health ServicesCarol Cinnamon, Director of Health and Counseling Services, Southern Wesleyan UniversityCathy Breazeale, Youth Services Director, Behavioral Health ServicesGeorge Sutter, MD, Samaritan Health ClinicJulie Capauldi, Director, United WayNikki Dunn, Assistant Director, Samaritan Health ClinicParish Nurses—total of 42Pickens County School District, 26 School Nurses and First Steps Board MembersRegina Reece, Director, Samaritan Health ClinicTeresa Nash, Director, United Christian MinistriesLocal Pastors—Total of 23 pastors from all denominations and faith backgrounds representing:
Congregants from disparate to affluent populations; Caucasian, African American, and Latino races.
BEH Board of DirectorsBEH Voice of the Customer Board Members—comprised of 15 community representatives
Individuals with special knowledge or expertise in Public Health Jane Yates, Region 2 DHEC, County Nurse Manager, Pickens County Health Department, Lilly Hall, Region 2 DHEC, Public Health/CHNA LiaisonKathleen Meyer, Clemson University, Professor, Department of Public Health SciencesDr. Paula Watt, Clemson University, Director, Joseph Sullivan Center/
Community Health Initiatives
Representative IntervieweesRepresentative David HiottSenator Larry MartinLiza Holder, Pickens Chamber of Commerce Board MemberTiffany Martin, Easley Chamber of Commerce Board Member
APPENDIX A | COMMUNITY LEADER INPUT/EXPERTISE
22
COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY
Please feel free to write comments on the back if additional space is needed.
Age
Payment Source for Health Care Services:○ Medicare ○ Medicaid ○ Private Insurance ○ Self Pay ○ None
1. What are the major health concerns in our county?
2. Are services available in Pickens County to address these concerns?
3. Do you have problems accessing services?
4. Do you have suggestions in addressing these issues?
APPENDIX B | SURVEY
24
Com
mun
ity R
esou
rce
/Rol
e
FY 2
013
Bapt
ist E
asle
y H
ospi
tal—
teac
hBa
ptist
Ups
tate
Phy
sicia
n--r
efer
Can
non
Mem
oria
l Hos
pita
l--re
fer
Beha
vior
al H
ealth
Ser
vice
s--r
efer
Cle
mso
n C
omm
unity
Car
e--r
efer
Cle
mso
n Fr
ee M
edic
al C
linic
--re
fer
Cle
mso
n U
nive
rsity
Jose
ph S
ulliv
an C
ente
r--r
efer
Foot
hills
Com
mun
ity H
ealth
Cen
ter-
-ref
erPa
rish
Nur
se P
rogr
am--
teac
hPi
cken
s Cou
nty
Hea
lth D
epar
tmen
t--re
fer
Pick
ens C
ount
y Sc
hool
Hea
lth N
urse
s--r
efer
Pick
ens C
ount
y YM
CA-
-ref
erSa
mar
itan
Hea
lth C
linic
--re
fer
Uni
ted
Chr
istia
n M
inist
ries-
-ref
erU
nite
d W
ay o
f Pic
kens
Cou
nty-
-ref
er
FY20
14Ad
d th
e fo
llow
ing
addi
tiona
l tea
chin
g sit
esBu
sines
s & In
dustr
y—ho
st te
achi
ng si
tes
Can
non
Mem
oria
l--te
ach
Jose
ph S
ulliv
an C
ente
r--te
ach
Foot
hills
Com
mun
ity H
ealth
Cen
ter-
-teac
hPi
cken
s Cou
nty
Libr
ary—
host
teac
hing
site
Pick
ens C
ount
y YM
CA—
host
teac
hing
site
Sam
arita
n H
ealth
Clin
ic—
host
teac
hing
site
FY20
15To
be
asse
ssed
and
des
igne
d in
201
4
Impl
emen
tatio
n St
rate
gies
• D
esig
n a
stand
ardi
zed
curr
icul
um
cond
uciv
e to
teac
h/re
plic
ate
in
mul
tiple
setti
ngs i
n th
e co
mm
unity
• S
olic
it co
mm
unity
par
tner
s to
teac
h cu
rric
ulum
in o
rgan
izatio
nal
setti
ngs
• D
esig
nate
hos
pita
l sta
ff fo
r Sp
eake
r Bur
eau
in v
ario
us
com
mun
ity se
tting
s
• P
rovi
de tr
ain-
the-
trai
ner s
essio
ns in
sta
ndar
dize
d cu
rric
ulum
• S
olic
it pa
rtne
rs n
ot te
achi
ng th
e cu
rric
ulum
for r
efer
ral o
f in
divi
dual
s int
o co
mm
unity
cla
sses
• I
nitia
te e
duca
tiona
l pre
sent
atio
n
• A
sses
s pro
gram
fide
lity
and
revi
ew
part
icip
ant s
urve
ys m
onth
ly
• R
evise
cur
ricul
um/p
roce
ss
as in
dica
ted
Goa
l
Redu
ce ri
sk fa
ctor
s fo
r Car
diov
ascu
lar
Dise
ase
Incr
ease
kno
wle
dge
and
awar
enes
s in
Car
diov
ascu
lar
Dise
ase
Eval
uatio
n M
etho
d
Surv
ey u
pon
com
plet
ion
of
educ
atio
nal
pres
enta
tion
Mea
sure
men
t
• %
of a
ttend
ees
repo
rtin
g a
com
mitm
ent t
o de
crea
se a
t lea
st on
e ris
k fa
ctor
• %
of a
ttend
ees
repo
rtin
g in
crea
se
in k
now
ledg
e
Initi
ativ
e 1
APPENDIX C | IMPLEMENTATION MATRIX
26
Com
mun
ity R
esou
rce
/Rol
e
FY 2
013
Bapt
ist E
asle
y H
ospi
tal—
teac
hBa
ptist
Ups
tate
Phy
sicia
n--r
efer
Can
non
Mem
oria
l Hos
pita
l--re
fer
Beha
vior
al H
ealth
Ser
vice
s--r
efer
Cle
mso
n C
omm
unity
Car
e--r
efer
Cle
mso
n Fr
ee M
edic
al C
linic
--re
fer
Cle
mso
n U
nive
rsity
Jose
ph S
ulliv
an C
ente
r--r
efer
Foot
hills
Com
mun
ity H
ealth
Cen
ter-
-ref
erPa
rish
Nur
se P
rogr
am--
refe
rPi
cken
s Cou
nty
Hea
lth D
epar
tmen
t--re
fer
Pick
ens C
ount
y Sc
hool
Hea
lth N
urse
s--r
efer
Pick
ens C
ount
y YM
CA-
-ref
erSa
mar
itan
Hea
lth C
linic
--re
fer
Uni
ted
Chr
istia
n M
inist
ries-
-ref
erU
nite
d W
ay o
f Pic
kens
Cou
nty—
refe
r
2014
Add
the
follo
win
g ad
ditio
nal t
each
ing
sites
Busin
ess &
Indu
stry—
host
teac
hing
site
sC
anno
n M
emor
ial--
teac
hFo
othi
lls C
omm
unity
Hea
lth C
ente
r—ho
st sit
ePi
cken
s Cou
nty
Libr
ary—
host
teac
hing
site
Pick
ens C
ount
y YM
CA—
host
teac
hing
site
Sam
arita
n H
ealth
Clin
ic—
host
teac
hing
site
FY20
15To
be
asse
ssed
and
des
igne
d in
201
4
Impl
emen
tatio
n St
rate
gies
• I
nitia
te S
tart
Now
pro
gram
sta
ndar
dize
d cu
rric
ulum
• T
augh
t by
cert
ified
D
iabe
tes E
duca
tor
• S
olic
it pa
rtne
rs fo
r ref
erra
l of
indi
vidu
als i
nto
com
mun
ity c
lass
es
• I
nitia
te e
duca
tiona
l pre
sent
atio
n
• A
sses
s pro
gram
fide
lity
and
revi
ew
part
icip
ant s
urve
ys m
onth
ly
• R
evise
cur
ricul
um/p
roce
ss
as in
dica
ted
Goa
l
Dec
reas
e D
iabe
tes
risk
by c
hang
ing
lifes
tyle
beh
avio
r
Eval
uatio
n M
etho
d
Surv
ey u
pon
com
plet
ion
of
educ
atio
nal
pres
enta
tion
Mea
sure
men
t
• %
of a
ttend
ees
repo
rtin
g in
crea
se in
kn
owle
dge
• N
umbe
r of
Chu
rche
s co
mm
ittin
g to
a
toba
cco-
free
cam
pus
with
doc
umen
ted
polic
y.
Initi
ativ
e 2
Com
mun
ity R
esou
rce
/Rol
e
FY20
13Ba
ptist
Eas
ley
Hos
pita
lPa
rish
Nur
ses
FY20
14Pa
rtne
r with
follo
win
g to
teac
h cu
rric
ulum
Can
non
Mem
oria
l Hos
pita
lFo
othi
lls C
omm
unity
Hea
lth C
ente
rSa
mar
itan
Hea
lth C
linic
FY20
15To
be
asse
ssed
and
des
igne
d in
201
4
Impl
emen
tatio
n St
rate
gies
• I
nitia
te D
iabe
tes M
aps p
rogr
am
stand
ardi
zed
curr
icul
um
• S
olic
it Pa
rish
Nur
ses t
o te
ach
curr
icul
um in
con
greg
atio
nal
setti
ngs
• P
rovi
de tr
ain-
the-
trai
ner s
essio
ns in
sta
ndar
dize
d cu
rric
ulum
• I
nitia
te e
duca
tiona
l pre
sent
atio
n
• A
sses
s pro
gram
fide
lity
and
revi
ew p
artic
ipan
t sur
veys
mon
thly
• R
evise
cur
ricul
um/p
roce
ss
as in
dica
ted
Goa
l
Incr
ease
kno
wle
dge
and
awar
enes
s in
Dia
bete
s
Incr
ease
in se
lf-m
anag
emen
t ski
lls
Eval
uatio
n M
etho
d
Surv
ey u
pon
com
plet
ion
of
educ
atio
nal
pres
enta
tion
Mea
sure
men
t
• %
of a
ttend
ees
repo
rtin
g in
crea
se
in k
now
ledg
e
• %
of a
ttend
ees
repo
rtin
g an
in
crea
se in
se
lf-effi
cacy
Initi
ativ
e 3
28
Com
mun
ity R
esou
rce
/Rol
e
FY20
13Ba
ptist
Eas
ley
Gra
nt sp
ecifi
c to
Chu
rch
Cam
puse
sPa
rish
Nur
ses—
teac
hC
hurc
h Ad
min
istra
tion
–Dev
elop
Tob
acco
Fre
e C
ampu
s Pol
icy
FY20
14Pa
rtne
r with
follo
win
g to
teac
h cu
rric
ulum
Can
non
Mem
oria
l Hos
pita
lBe
havi
oral
Hea
lth S
ervi
ces
Foot
hills
Com
mun
ity H
ealth
Cen
ter
FY20
15To
be
asse
ssed
and
des
igne
d in
201
4
Impl
emen
tatio
n St
rate
gies
• D
esig
n a
stand
ardi
zed
curr
icul
um
cond
uciv
e to
teac
h/re
plic
ate
in
mul
tiple
setti
ngs i
n th
e co
mm
unity
• S
olic
it Pa
rish
Nur
ses w
ho w
ill te
ach
curr
icul
um in
con
greg
atio
nal
setti
ngs
• P
rovi
de tr
ain-
the-
trai
ner s
essio
ns in
sta
ndar
dize
d cu
rric
ulum
• I
nitia
te e
duca
tiona
l pre
sent
atio
n
• A
sses
s pro
gram
fide
lity
and
revi
ew
part
icip
ant s
urve
ys m
onth
ly
• R
evise
cur
ricul
um/p
roce
ss
as in
dica
ted
Goa
l
Incr
ease
kno
wle
dge
and
awar
enes
s in
harm
ful e
ffect
s of
toba
cco
Incr
ease
num
ber o
f to
bacc
o-fre
e ch
urch
ca
mpu
ses
Eval
uatio
n M
etho
d
Surv
ey u
pon
com
plet
ion
of
educ
atio
nal
pres
enta
tion
Mea
sure
men
t
• %
of a
ttend
ees
repo
rtin
g in
crea
se in
kn
owle
dge
• N
umbe
r of
Chu
rche
s co
mm
ittin
g to
a
toba
cco-
free
cam
pus
with
doc
umen
ted
polic
y.
Initi
ativ
e 4
Com
mun
ity R
esou
rce
/Rol
e
FY20
13Ba
ptist
Eas
ley
Hos
pita
l—te
ach
smok
ing
cess
atio
n cl
asse
sBa
ptist
Eas
ley
Gra
nt sp
ecifi
c to
Phy
sicia
n O
ffice
s-Ba
ptist
Ups
tate
Phy
sicia
ns—
refe
r to
SC Q
uit L
ine
FY20
14Pa
rtne
r with
follo
win
g to
teac
h cu
rric
ulum
Beha
vior
al H
ealth
par
tner
ship
Busin
ess &
Indu
stry
Can
non
Mem
oria
l Hos
pita
lFo
othi
lls C
omm
unity
Hea
lth C
ente
r
FY20
15To
be
asse
ssed
and
des
igne
d in
201
4
Impl
emen
tatio
n St
rate
gies
Initi
ate
two
stand
ardi
zed
toba
cco
cess
atio
n pr
ogra
ms
1. T
obac
co c
essa
tion
clas
ses
• S
tand
ardi
zed
curr
icul
um f
or
toba
cco
cess
atio
n ta
ught
by
Amer
ican
Can
cer S
ocie
ty
cert
ified
trai
ner
• S
olic
it pa
rtne
rs f
or re
ferr
al o
f in
divi
dual
s to
clas
ses
• In
itiat
e ed
ucat
iona
l pre
sent
atio
n•
Ass
ess p
rogr
am fi
delit
y an
d re
view
pa
rtic
ipan
t sur
veys
qua
rter
ly•
Rev
ise c
urric
ulum
/pro
cess
as
indi
cate
d
2. P
hysic
ian
office
refe
rral
to S
C
Q
uit L
ine
• S
olic
it Ph
ysic
ians
and
offi
ce
man
ager
s to
part
icip
ate
• P
rovi
de tr
ain-
the-
trai
ner s
essio
ns
in st
anda
rdize
d cu
rric
ulum
•
Initi
ate
refe
rral
syste
m•
Ass
ess p
rogr
am fi
delit
y an
d re
view
pa
rtic
ipan
t num
bers
eac
h m
onth
• R
evise
cur
ricul
um/p
roce
ss
as in
dica
ted
Goa
l
Redu
ce to
bacc
o us
e
Eval
uatio
n M
etho
d
Reco
rd #
peo
ple
atte
ndin
g Ba
ptist
Ea
sley
smok
ing
cess
atio
n cl
asse
s Su
rvey
pre
an
d po
st
cess
atio
n cl
ass t
o ob
tain
cur
rent
to
bacc
o us
e
Obt
ain
num
ber
of re
ferr
ed
indi
vidu
als w
ho
cont
act t
he S
C
Qui
t lin
e
Mea
sure
men
t
• #
indi
vidu
als
acce
ssin
g lo
cal
avai
labl
e re
sour
ces
for T
obac
co
Ces
satio
n
• %
of i
ndiv
idua
ls re
port
ing
cess
atio
n
or re
duce
d to
bacc
o us
e a
fter a
cces
sing
lo
cal t
obac
co
cess
atio
n cl
asse
s
• #
refe
rral
s to
SC
Qui
t Lin
e
Initi
ativ
e 5
30
Com
mun
ity R
esou
rce
/Rol
e
FY20
13Ba
ptist
Eas
ley
Hos
pita
l—te
ach
Bapt
ist U
psta
te P
hysic
ian-
-ref
erC
anno
n M
emor
ial H
ospi
tal--
refe
rBe
havi
oral
Hea
lth S
ervi
ces-
-ref
erC
lem
son
Com
mun
ity C
are-
-ref
erC
lem
son
Free
Med
ical
Clin
ic--
refe
rC
lem
son
Uni
vers
ity Jo
seph
Sul
livan
Cen
ter-
-ref
erFo
othi
lls C
omm
unity
Hea
lth C
ente
r--r
efer
Paris
h N
urse
Pro
gram
--te
ach
Pick
ens C
ount
y H
ealth
Dep
artm
ent--
refe
rPi
cken
s Cou
nty
Scho
ol H
ealth
Nur
ses-
-ref
erPi
cken
s Cou
nty
YMC
A--r
efer
Sam
arita
n H
ealth
Clin
ic--
refe
rU
nite
d C
hrist
ian
Min
istrie
s--r
efer
Uni
ted
Way
of P
icke
ns C
ount
y--r
efer
FY20
14Ad
d th
e fo
llow
ing
addi
tiona
l tea
chin
g sit
esBu
sines
s & In
dustr
y—ho
st te
achi
ng si
tes
Can
non
Mem
oria
l--te
ach
Jose
ph S
ulliv
an C
ente
r--te
ach
Foot
hills
Com
mun
ity H
ealth
Cen
ter-
-teac
hPi
cken
s Cou
nty
Libr
ary—
host
teac
hing
site
Pick
ens C
ount
y YM
CA—
host
teac
hing
site
Sam
arita
n H
ealth
Clin
ic—
host
teac
hing
site
FY20
15To
be
asse
ssed
and
des
igne
d in
201
4
Impl
emen
tatio
n St
rate
gies
• D
esig
n a
stand
ardi
zed
curr
icul
um
cond
uciv
e to
teac
h/re
plic
ate
in
mul
tiple
setti
ngs i
n th
e co
mm
unity
• S
olic
it Pa
rish
Nur
ses t
o te
ach
curr
icul
um in
con
greg
atio
nal
setti
ngs
• P
rovi
de tr
ain-
the-
trai
ner s
essio
ns
in st
anda
rdize
d cu
rric
ulum
• I
nitia
te e
duca
tiona
l pre
sent
atio
n
• A
sses
s pro
gram
fide
lity
and
revi
ew p
artic
ipan
t sur
veys
mon
thly
• R
evise
cur
ricul
um/p
roce
ss a
s in
dica
ted
Goa
l
Incr
ease
self-
man
agem
ent s
kills
in
indi
vidu
als w
ith
diag
nose
d C
hron
ic
Dise
ase
Eval
uatio
n M
etho
d
Surv
ey u
pon
com
plet
ion
of
educ
atio
nal
pres
enta
tion
Mea
sure
men
t
• %
of a
ttend
ees
repo
rtin
g an
in
crea
se in
se
lf-effi
cacy
Initi
ativ
e 6
32
baptisteasley.org
200 Fleetwood DriveEasley, SC 29640864.442.7200