Community Health Needs Assessment and Community Health Improvement Plan

By resolution of the CCH board of directors at a meeting held on Sept. 13, 2021, the 2021 CHNA was adopted and approved by the board members, and directed to be posted on CCH's website and attached to its Form 990.

The Platte and Colfax counties CHIP planning was held Nov. 3, 2021.

By resolution of the CCH board of directors at a meeting held on Feb. 6, 2022, the 2021 CHIP Implementation Plan was adopted and approved by the board members, and directed to be posted on CCH's website and attached to its Form 990.

In 2021, Columbus Community Hospital conducted — in collaboration with the East Central District Health Department (ECDHD) and other hospital facilities — a comprehensive, joint CHNA for the participants’ shared communities of Boone, Colfax, Nance and Platte counties. The CHNA identified the five areas of greatest concern for residents in these areas:

• Mental health.
• Drug abuse and misuse.
• Ongoing diseases such as heart disease, stroke, high blood pressure, diabetes, cancer and respiratory problems.
• Finding housing that is safe and affordable.
• Bullying.

Columbus Community Hospital (CCH) has chosen to focus on addressing four of the five areas of concern. For housing that is safe and affordable, the City of Columbus, Columbus Area Chamber of Commerce and Habitat for Humanity are already working on that need, so CCH is focusing its resources elsewhere.

The hospital will work hand in hand with the ECDHD and other health- and business-related agencies to address these community needs. Specifically, CCH will take the lead in addressing the identified needs of access to mental healthcare, treatment for drug abuse and misuse, and treatment for ongoing diseases.

Mental healthcare

Platte County and the surrounding areas continue to experience an increase in mental healthcare needs — both inpatient and outpatient. Columbus Community Hospital has taken the lead in the following:

• Objective: Enhance and expand mental health resources in our community.
  • Action step: Will lead a community health inventory of what exists for mental healthcare in our area, commissioning a third-party consultant survey of access behavioral health in the general area. This survey will quantify the manpower in the area and look at lead time to appointments.

• Objective: Recruit top-level mental health physicians and other providers to the area.
  • Action step: Will continue to expand Columbus Psychiatry Clinic, which opened in 2019. The goal is to have multiple psychiatrists, nurse practitioners and licensed independent mental health providers.
  • Work with specific entities, including Bryan Telehealth, to offer telehealth options to create access to a wide variety of mental health experts.

• Objective: Create an option for top-level mental healthcare for the geriatric population.
  • Action step: Will open a 10-bed senior behavioral health inpatient unit, which will exclusively serve older adults.

• Objective: Expand options for community education on mental health initiatives.
  • Action step: Use experts from the outpatient clinic to develop educational programming for the community, including seminars on:
    • ADHD.
    • Children and screen time.
    • Stress in children.
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Drug abuse and misuse

Reduce substance abuse to protect the health, safety and quality of life for all.

• Objective: Create awareness about antibiotics use and abuse.
  • Action step: Will embark on a public education campaign to teach our community about proper antibiotics use. While antibiotics are important healthcare tools, they should only be used for treating certain infections caused by bacteria.

• Objective: Offer non-addictive options for pain relief.
  • Action step: Continue to expand our use of non-opioid pain management. The hospital’s anesthesia department was one of the first in the state to offer the iovera° treatment. This clinically proven, non-opioid pain management solution uses the body's natural response to cold to relieve pain.
  • Will continue to deliver materials and provide presentations for providers across the area related to opioid intervention.
  • Will continue to offer telemedicine options for opioid intervention.

Treatment for ongoing diseases

Diseases such as heart disease, diabetes, stroke, cancer, high blood pressure and diabetes continue to take lives and reduce quality of life. CCH has embarked on many community partnerships to tackle these diseases head-on.

• Objective: Prevent diabetes and improve advanced care for those with the disease.
  • Action step: Provide comprehensive diabetes education for members of the community. Offer specialized classes and host diabetes events for the public at least twice a year.

• Objective: Decrease incidences of heart disease in the community.
  • Action step: Open a cardiac catheterization lab at the hospital that allows doctors to perform lifesaving cardiac procedures. Concurrently, we will open Columbus Cardiology Clinic, which will educate the community about signs of heart disease and steps people can take to improve their heart health.
  • Work with local employers to offer free heart-health screenings on site so that employees can learn whether they are at risk for a heart event.

• Objective: Decrease obesity and provide options for physical activity in the community.
  • Action step: The hospital is in the process of building a 240,000-square-foot fieldhouse, which will offer the community a plethora of indoor recreational options. In an area of the country where people spend much of their time indoors for half the year, the Columbus Fieldhouse will encourage physical activity no matter the weather, which will decrease community members’ risk for heart disease, stroke and other chronic diseases.
  • Offer Walk with a Doc on a monthly basis. It is a walking program that will take place at various locations around the community. Local healthcare providers will present a health-based topic to the group, followed by a 45-50-minute walk with the provider. The purpose of the walk is to encourage physical activity and meet new and established physicians and healthcare providers from around the Columbus area.
  • Work with local restaurants, encouraging them to add healthy foods to their menus so members of the community have options when they go out to eat.
  • Work with local churches to offer the Walk to Bethlehem and the Walk to Jerusalem, walking programs that will encourage participants to walk virtually the distance from Columbus to Bethlehem and Jerusalem, respectively.

• Objective: Provide comprehensive care for cancer patients.
  • Action step: The hospital recently acquired Columbus Cancer Care, an outpatient clinic that provides radiation oncology services. This is the first step toward creating a Cancer Center concept — a facility where community members can receive all the cancer services they need in one location.

Bullying

Bullying — both in-person and online — is an ongoing problem for children of all ages. CCH plans to partner with Smart Gen Society to specifically address challenges facing children in the digital landscape.

• Objective: Decrease social media bullying.
  • Action step: Will bring in experts from Smart Gen Society, an organization that offers preventive workshops and resources for parents, teachers, sports teams and businesses. These experts will provide educational programming that focuses on decreasing bullying in the digital landscape.

The following “health priorities” were identified as recommended areas of intervention under the 2018 Community Health Needs Assessment:

• Family health and wellness.
• Behavioral health.
• Substance abuse.
• Access to care.
• Family support.

Although CCH collaborated with other organizations when conducting its CHNA and developing implementation strategies, the hospital must meet the requirement to adopt an implementation strategy with respect to its own facility.

To do this, CCH must adopt a written plan with respect to the hospital facility it operates that addresses each of the community health needs identified through the CHNA by either (1) describing how CCH plans to meet the identified health need or (2) describing the health need as one CCH does not intend to meet, along with an explanation as to why it does not intend to meet such need.

In accordance with this directive, this document is intended to constitute the implementation strategy of CCH in relation to the 2018 CHNA.

CCH will work hand in hand with the ECDHD and other health- and business-related agencies to address these community needs. Specifically, CCH will take the lead in addressing the identified needs of access to healthcare and family health and wellness by conducting the activities described below.

It will support the identified needs of family support, behavioral health and substance abuse as requested by other participants of the CHNA that have agreed to take the lead on these areas because they already have programs in place and expertise in these areas.

In accordance with this directive, this document is intended to constitute the implementation strategy of CCH in relation to the 2018 CHNA.

Access to healthcare

• Objective: Improve access to comprehensive, quality healthcare services.
  • Action step: Continued offering after-hours nurse triage line, cervical cancer screenings, Tune Up for Life screenings, mammography screening program, head and neck cancer screenings, cancer patient transportation, Diabetes Awareness Day, healthy cooking classes, therapy wellness garden, and enhanced telehealth psychiatry, geriatric psychiatry, endocrinology and pulmonary services.
  • Continued physician recruitment.
  • Launched HPV and colonoscopy campaigns, as well as a program on SIDS awareness.
  • Developed an opioid treatment program.
  • Continued working on behavioral health service line expansion.

Family health and wellness – The Family Health and Wellness Coalition evolved into the Platte County Lifestyle Coalition. It includes representatives from CCH, the city of Columbus, the Columbus Family YMCA and other local agencies. The coalition created three action teams: community, school and workplace.

• Objective: – Promote healthy weights and reduce chronic disease risks.
  • Action step: Expanded the Complete Health Improvement Program, a lifestyle intervention education program, to a wider audience. Since June 2016, CCH has completed nine CHIP sessions for a total of 157 graduates. From March through August 2018, 38 CHIP commencements have taken place for three classes.
  • With assistance from UNK, UNMC and Kansas University academia and through the Rural Futures Institute (RFI) grant obtained, the coalition is making strides in its development of action plans.
• Objective: The community action team’s goal is to increase physical activity among all Columbus residents.
  • Action step: It started researching church walking programs, such as Walk to Jerusalem — which would go on to be offered in early 2019.
• Objective: The school action team’s plan is to increase youth physical activity to improve overall lifestyle and reduce the number of children who are overweight or obese.
  • Action step: A running club was developed for school children, and the action team is working to obtain wellness policies/plans from the schools in Platte County.
  • Additional communication with local schools is ongoing.
• Objective: The workplace action team’s goal is to increase physical activity among employees, increase the number of companies who currently do not have a workplace wellness program by five companies from baseline, and to increase employee time engaged in moderate levels of activity by 15 minutes during work time.
  • Action step: The workplace action team is surveying employers in Platte County regarding their wellness programs and physical activity.

Family support – This group’s purpose is to support the family. Its plan is to increase the proportion of children who are ready for school in all five domains of healthy development. This coalition has had several activities in Platte County.

Substance abuse – Reduce substance abuse to protect the health, safety and quality of life for all, especially children in grades 6-12. The ECDHD, Columbus Police Department and Platte County Sheriff’s Department will take the lead in exploring and/or implementing the objectives and action steps. CCH will provide advice and support as requested.

Behavioral health – Improve mental health through prevention and by ensuring access to appropriate, quality mental health services. The Platte County Mental Health CHIP Group will take the lead in exploring and/or implementing the objectives and action steps. CCH will provide advice and support as requested.

Implementation strategy approval

By resolution of the CCH board of directors at a meeting held on April 1, 2019 the 2018 CHNA and 2018 CHIP implementation strategy were adopted and approved by the board members, and directed to be posted on CCH's website and attached to its Form 990.

The following “health priorities” were identified as recommended areas of intervention under the 2015 Community Health Needs Assessment:

• Access to healthcare.
• Obesity.
• Substance abuse.
• Family support.
• Mental health.

Although CCH collaborated with other organizations when conducting its CHNA and developing implementation strategies, the hospital must meet the requirement to adopt an implementation strategy with respect to its own facility.

To do this, CCH must adopt a written plan with respect to the hospital facility it operates that addresses each of the community health needs identified through the CHNA by either (1) describing how CCH plans to meet the identified health need or (2) describing the health need as one CCH does not intend to meet, along with an explanation as to why it does not intend to meet such need.

In accordance with this directive, this document is intended to constitute the implementation strategy of CCH in relation to the 2015 CHNA.

CCH will work hand in hand with the ECDHD and other health- and business-related agencies to address these community needs. Specifically, CCH will take the lead in addressing the identified needs of access to healthcare and obesity by conducting the activities described below.

It will support the identified needs of family support, mental health and substance abuse as requested by other participants of the CHNA that have agreed to take the lead on these areas because they already have programs in place and expertise in these areas.

Access to healthcare – Improve access to comprehensive, quality healthcare services. The goal is to increase the percent of people who visit a doctor in the past 12 months from 62% to 65% (which is up from 52% in 2009). The core group has been working together since late 2012, and at the June 2015 CHIP meeting, the group reenergized and recommitted to increasing access to healthcare in Platte County. One of the main goals is to increase access to preventive screenings and quality healthcare services across Platte County. CCH will take the lead exploring and/or implementing the following:

• Objective: Reduce the death rate from cancer of the uterus/cervix.
  • Action step: Staff utilized several avenues of increasing cancer prevention such as speaking at the “100 Miles in 100 Days” walking promotion, and connecting with the public at the Farm Show at Ag Park and YMCA Health Fair. Cervical cancer awareness and screening was specifically promoted during a women’s basketball game at Central Community College in Columbus.
  • A total of 647 free cervical cancer screens were completed at the area health center.
• Objective: Reduce the female breast cancer death rate.
  • Action step: Thirty-nine women in the Columbus Good Neighbor Health Center received referrals for mammograms through the Susan G. Komen grant funding.
  • Mammography funding was offered by the CCH Foundation between May 1, 2015, and April 30, 2017, and promotional materials in English and Spanish were distributed.
  • In 2017, the Good Neighbor Community Health Center continues to offer vouchers for free or reduced-price mammograms. It is expected to continue efforts to increase screenings.
  • Started working on a breast cancer survivor celebration.
• Objective: To reduce one of the barriers to care, look at the feasibility of creating volunteer transportation program for patients.
  • Action step: By June 2016, a cancer transportation van was fully operational with a combination of volunteer and paid drivers. As of the end of June 2016, the van had made 122 round trips to doctor appointments, chemotherapy or radiation visits. It had made round trips from more than 20 surrounding towns.
  • Expanded patient transportation with cab service.
• Objective: Explore other disease health screening opportunities to increase access to healthcare and develop a plan to address early screening.
  • Action step: In January 2017, the Tune Up for Life event was held, which offered numerous free screenings and educational materials. More than 200 people attended. Plans were made to change the date to October 2017 to increase participation in the event. Multiple screenings will again be offered.
  • Offered head and neck cancer screenings.
  • Offered Healthy Mobile bus health screenings.
  • Started working on a senior festival, which would offer health screenings.
• Objective: Facilitate communication opportunities between providers and patients to increase access to care.
  • Action step: CCH will continue to work with St. Elizabeth Regional Medical Center on the nurse triage telephone service. CCH is the lead for the medical resource guide. From May 1, 2016, through May 31, 2017, the nurse triage telephone service managed 1,438 calls. This nurse triage line continues to be utilized and in demand with our patients as well as our area physicians.
  • CCH launched eHealth library on CCH website.
  • Continued physician recruitment.
  • Enhanced tele-health psychiatry, geriatric, endocrinology and pulmonary services.
  • Continued working on behavioral health service line expansion.
• Objective: Provide community screenings and an information day regarding diabetes.
  • Action step: Held an annual community Diabetes Awareness Day in October 2016. Planning for October 10, 2017, for the next Diabetes Awareness Day, which will feature multiple vendors and educational sessions available to the public.

Obesity – In late 2015, the Columbus Community Hospital Coalition merged with the Platte County Lifestyle Improvement Coalition, which brought together two smaller groups of community members to move forward with the Family Health and Wellness coalition. This coalition (formally known as youth and adult obesity) developed as a direct result of the June 2012 CHIP and has worked diligently to promote healthy weights and reduce chronic disease risks. One goal of the coalition is to decrease the obesity rates in area youth in kindergarten through 6th grade and students in grades 7-12.

• Objective: Promote healthy weights and reduce chronic disease risks.
  • Action step: Reviewing the data from the pilot Complete Health Improvement Program being conducted. Using the pilot data, determine if pilot should be extended to reach larger audience.
  • Continuing to provide monthly nutrition and physical activity education electronically to businesses linked with Occupational Health Services.
  • Started offering healthy cooking classes and created a Therapy Wellness Garden that gives people access to fruit and vegetables.

Family support – This group’s purpose is to support the family. Its plan is to increase the proportion of children who are ready for school in all five domains of healthy development. This coalition has had several activities in Platte County.

Substance abuse – Reduce substance abuse to protect the health, safety and quality of life for all, especially children in grades 6-12. The ECDHD, Columbus Police Department and Platte County Sheriff’s Department will take the lead in exploring and/or implementing the objectives and action steps. CCH will provide advice and support as requested.

Mental health – Improve mental health through prevention and by ensuring access to appropriate, quality mental health services. The Platte County Mental Health CHIP Group will take the lead in exploring and/or implementing the objectives and action steps. CCH will provide advice and support as requested.

Implementation strategy approval

By resolution of the CCH board of directors at a meeting held on Aug. 27, 2017 the 2015 CHNA and 2015 CHIP implementation strategy were adopted and approved by the board members, and directed to be posted on CCH's website and attached to its Form 990.

CCH will work hand in hand with the East Central District Health Department and other health- and business-related agencies to address these needs of our communities. It will support the identified needs of family support, substance abuse and mental health, as requested by other participants of the CHNA that have agreed to take the lead in these areas in which they already have programs in place and related expertise.

Additionally, CCH agrees to take the lead in addressing the identified needs of access to healthcare and obesity by conducting the activities described below.

Access to healthcare – Improve access to comprehensive, quality healthcare services. CCH will take the lead exploring and/or implementing the following:

• Objective: Reduce the death rate from cancer of the uterine/cervix.
  
  • Action step: Explore ways to provide a free PAP smear screening event at CCH. Collaborate with the University of Nebraska Medical Center on cancer management.
• Objective: Reduce the female breast cancer death rate.
  
  • Action step: Research funding options to increase the number of uninsured/underinsured women’s access to mammography. An application was submitted on Dec. 13, 2012, for a Susan G. Komen Grant of $9,000.
• Objective: To reduce one of the barriers to care, look at the feasibility of creating volunteer transportation program for patients.
  
  • Action step: Explore programs operated by volunteers.
• Objective: Explore other disease health screening opportunities to increase access to healthcare and develop a plan to address early screening.
  
  • Action step: CCH will take the lead for Tune Up for Life Health Fair and explore options for more screenings.
• Objective: Facilitate communication opportunities between providers and patients to increase access to care.
  
  • Action step: Provide and support Nurse Triage Line to area local providers for a small fee.
• Objective: Implement a home monitoring program for patients receiving home health services.
  
  • Action step: Ensure home health tele-monitoring systems are being utilized by patients.
• Objective: Provide community screening and an information day regarding diabetes.
  
  • Action step: CCH will be the lead for Diabetes Awareness Day scheduled yearly in October.
• Objective: Explore forming a geriatric assessment team to complete patient testing and evaluation for patients.
  
  • Action Step: Collaboration with Pender Hospital and Columbus Family Practice.

Family support – To improve the stability, health and well-being of women, infants, children and families through the effective use of community resources. The Child Well-Being Work Group will take the lead in exploring and/or implementing the objectives and actions steps.

Obesity – Promote healthy weight and reduce chronic disease risk. Columbus Community Hospital’s dedication to helping create a healthier community is seen in the hospital’s commitment to building a new health and wellness center. The center will not only provide increased access to exercise and fitness opportunities, but also to registered dietitians who, through classes and individual consultations, can address lifestyle changes that can help decrease health issues associated with obesity and chronic diseases.

CCH will also take the lead exploring and/or implementing the following:

• Objective: Reduce the number of adults who are considered obese.
  
  • Action step: Include the Chamber of Commerce and meet with local HR personnel monthly to develop a worksite wellness plan that is user-friendly and can be packaged and ready for business use.
• Objective: Grow the Platte County CHIP Obesity Prevention Coalition and gather resources for public distribution.
  
  • Action steps: Have coalition members invite other community agencies and individuals to join. Gather list of available resources for physical activity and nutrition and distribute to area businesses. Regularly publish articles in newspaper and on website.

Substance abuse – Reduce substance abuse to protect the health, safety and quality of life for all, especially children in grades 6-12. The ECDHD, Columbus Police Department and Platte County Sheriff’s Department will take the lead in exploring and/or implementing the objectives and action steps. CCH will provide advice and support as requested.

Mental health – Improve mental health through prevention and by ensuring access to appropriate, quality mental health services. The Platte County Mental Health CHIP Group will take the lead in exploring and/or implementing the objectives and actions steps. CCH will provide advice and support as requested.

Implementation strategy approval – By resolution of the CCH board of directors at a meeting held Nov. 12, 2012, this implementation strategy was approved by the board members, and directed to be posted on CCH’s website and attached to its Form 990.