COMMUNITY HEALTH NEEDS ASSESSMENT

Community Health Needs Assessment (CHNA) FY13 - Anderson County, TN

Ridgeview Psychiatric Hospital and Center, Inc., aka Ridgeview Behavioral Health Services, was officially organized in 1957. (Please see the history link on this home page for more detailed information.) Since that point in time, Ridgeview’s Mission - Ridgeview is committed to providing a high quality regional system of services focused on the treatment of mental illness, alcohol and drug related problems and co-occurring disorders, prevention services, and appropriate services and supports to the individuals and families we serve, has remained unchanged.

Our service continuum has continued to grow over the years and our current 16-bed adult inpatient hospital has, despite many changes at the state and federal levels, continued to be a strong component of our overall continuum. Following the closure of Lakeshore Mental Health Institute by the Tennessee General Assembly in 2012, Ridgeview entered into a contract with the state to admit those individuals who previously would have received inpatient treatment at Lakeshore. This major change has been highly effective in allowing individuals to be served closer to home.

Community Health Needs Assessment Overview

The Affordable Care Act of 2010 creates an opportunity for hospitals and public health agencies to accelerate community health improvement by conducting triennial community health needs assessments and adopting related implementation strategies that address significant health needs.

Early in 2013, Ridgeview Behavioral Health Services and Methodist Medical Center partnered to conduct a joint community health needs assessment for Anderson County. Although both organizations provide health care for multiple counties, Anderson County was selected for the assessment. Anderson County is where both institutions receive the majority of their patients and deploy the bulk of their community benefit resources.

By combining the expertise of Ridgeview Behavioral Health Services and Methodist Medical Center, the mental and physical dimensions of health have both been incorporated, offering a unique perspective in identifying the broader health needs of Anderson County.

Community Health Needs Assessment Partners

A collaborative team of community and health organizations came together to work on the 2013 Anderson County Needs Assessment. These included the following:
1. Anderson County Community Health Committee
2. Anderson County Health Department
3. Anderson County School System
4. Anderson County Head Start Program
5. Anderson County Emergency Medical Services
6. Free Medical Clinic of Oak Ridge
7. Methodist Medical Center
8. Ridgeview Behavioral Health Services
9. United Way of Anderson County
Our Assessment Process

Data Collection and Review: The health of Anderson County was researched using a variety of qualitative and quantitative data.

1. Ridgeview, Methodist Medical Center, Head Start, Anderson County School System and the health department all were actively involved in collecting data using a survey for residents of Anderson County. Survey participants were asked for their perspectives on the health and quality of life in Anderson County. Total number of surveys collected was 598.
2. Two focus groups were conducted with 24 community leaders representing social services, seniors, low-income and uninsured, and the Hispanic population.
3. Health statistics were gathered from the Tennessee Department of Health, County Health Rankings, Kids Count, hospital discharge data, and the 2010 Census.
4. Regional data collected by the Tennessee Department of Mental Health and Substance Abuse Services was also reviewed with emphasis being placed on the survey results completed by consumers, advocates, and behavioral health providers in the region.
5. A data synthesis team was formed consisting of 10 individuals representing both hospitals, the health department, the school system, the United Way, and Emergency Medical Services. This group met to identify, discuss and prioritize the findings from the assessment data sources.

Key Findings of the Community Health Needs Assessment

The significant health priorities for Anderson County, as determined by the data synthesis team, are the following:

Substance Abuse (including prescription drug abuse)
Obesity
Mental Health
Diabetes
Asthma

Strengths and Opportunities

Overall Health

Strengths

Anderson County ranks 34 out of 95 Tennessee Counties in health outcomes.
Anderson County ranks 24 out of 95 counties in health behaviors such as smoking, obesity and physical activity.

Opportunities

Anderson County ranks higher for excessive drinking (12% vs. 10%) than Tennessee overall

Quality of Life

Strengths

The violent crime rate in Anderson County is 70% less than the Tennessee state average.
81% of respondents were satisfied to very satisfied with Anderson County as a place to raise a family

Opportunities

25% of the children in Anderson County live in poverty
When asked to grade the health of Anderson County the grades ranged from a low of “F” to a high of B, the average grade being a C.

Healthy Behaviors

Strengths

Eighty seven percent of adults have been screened for diabetes.
HIV infection rates are 3 times less than the state average.

Opportunities

Deaths from motor vehicle accidents are significantly higher than the state of Tennessee average.
24% of adults smoke, 31% are obese and 33% report being physically inactive.
61% of the restaurants are fast food establishments
Prescription drug abuse is a serious issue as evidenced by the high number of drug addicted babies born in Anderson County.

Health Care

Strengths

Preventable hospital stays are significantly lower in Anderson County compared to the Tennessee rate - 55 compared to 83.
Sixty three percent of the respondents are satisfied to very satisfied with the health care resources in Anderson County.
Infant and child mortality are much lower in Anderson County compared to the state average.

Opportunities

Access to physicians accepting new TennCare/Medicaid patients continues to be a challenge in Anderson County.
Dental care access particularly for the low income is a significant issue.
The two main reasons given that keep people in Anderson County from seeking medical attention are, lack of knowledge about medical services that are available ( 36%) and inadequate transportation (35%).

Our Action Plan

The Anderson County Needs Assessment has provided a good foundation on which to build measurable community health improvement. Two of the most significant issues for Anderson County, substance abuse and mental health, are central to the core mission and purpose of Ridgeview. The other three significant issues, obesity, diabetes and asthma will be the focus of Methodist Medical Center’s action plan. Together, Ridgeview and Methodist Medical Center will synergistically address the 5 primary goals of the needs assessment, working together with other community organizations.

What follows is Ridgeview’s action plan to measurably improve the issues of substance abuse and mental health.

1. Substance Abuse

Goal A: Ridgeview will take the lead in developing educational programs and a media strategy focusing on the nature, causes and outcomes of substance use, existing available services and the recovery process.

Program Action 1: Ridgeview will structure and coordinate, with input from designated
community partners, a series of educational forums in communities in Anderson County
which will be accessible to all interested citizens. Ridgeview will also collaborate with MMC to participate in one of the Health Night on the Town series held in Oak Ridge, focusing exclusively on the nature and treatment of substance use.

Program Action 2: Ridgeview will contribute to the Healthy Lifestyles edition of The Oak Ridger, sponsored by MMC, and include information on prevention, early intervention and treatment of substance use disorders. Ridgeview will also submit similar informational articles to other local newspapers in Anderson County on a defined timely basis.

Goal B: Ridgeview will initiate routine contact with community partners, social services agencies, schools, and primary care physicians in Anderson County, in order to provide up-to-date information and new substance use programs, and how referral sources can access these treatment services.

Program Action 1: Ridgeview staff will mail out program and referral information to all of the above listed entities in Anderson County and recommend Ridgeview staff to provide in-service training programs to those entities that are interested. Ridgeview will also offer information and training, sponsored by the Tennessee Co-Occurring Disorders Collaborative, which focuses on individuals who have one or more mental health issues, along with one or more substance use or addiction issues.

Program Action 2: Ridgeview will share with the other members of the Allies for Substance Abuse Prevention of Anderson County (ASAP) anti drug coalition the findings of the Anderson County CHNA and plan strategically with them regarding identifying potential other resources that are needed to address this priority problem in the Anderson County schools.

Goal C: Ridgeview will monitor, pursue, and apply for any local, state, or federal substance use grant-funded programs that will enhance and/or complement its existing substance use continuum of care.

Program Action: Ridgeview will utilize existing internal resources and will recruit and fill the newly budgeted Director of Development position to accomplish the above stated goal.

2. Obesity: This need will be primarily addressed by Methodist Medical Center in their action
plan. Ridgeview, as indicated below, is adding a goal specific to those individuals actively receiving behavioral health services from Ridgeview. As indicated above, MMC will add other significant goals related to this health issue. Ridgeview will update this web site when the additional goals from MMC are completed.

Goal: Ridgeview is a recent recipient of a grant through the Tennessee Department of Mental Health & Substance Abuse Services called, My Health, My Choice, My Life. It is a peer led health wellness and chronic disease prevention, self management program requiring certification by the state and targeted toward individuals with mental illness, substance use disorders and co-occurring disorders.

Program Action: The certified peer wellness coach will interface with the individual’s primary care physician and Ridgeview staff to address obesity, tobacco recovery, diabetes self management programs and other chronic medical conditions of the many clients we serve. These individuals will all be active clients of Ridgeview.

3. Mental Health:

Goal A: Ridgeview will take the lead in developing educational programs and a media strategy focusing on the nature, causes and treatment of mental health issues, existing available services, and the recovery process.

Program Action 1: Ridgeview will structure and coordinate, with input from designated
community partners, a series of educational forums in each community of Anderson
County, accessible to all interested citizens. Ridgeview will also collaborate with MMC
to participate in one of the Health Night on the Town series, held in Oak Ridge, focusing
exclusively on mental heath treatment and services.

Program Action 2: Ridgeview will contribute to the Healthy Lifestyles edition of The Oak Ridger, sponsored by MMC, and include information on prevention, early intervention and treatment of mental health symptoms. Ridgeview will also submit similar informational articles to other local newspapers in Anderson County on a defined timely basis.

Goal B: Ridgeview will initiate regular contact with all community partners, social services and related helping agencies, schools, and primary care physicians in Anderson County regarding up-to-date information on referrals to existing and new mental health programs.

Program Action: Ridgeview staff will mail out program and referral information to all of the above-listed entities in Anderson County and recommend Ridgeview staff to provide in-service training programs to those entities that are interested. Ridgeview will also offer information and training sponsored by the Tennessee Co-Occurring Disorders Collaborative which focuses on individuals who have one or more mental health issues, along with one or more substance use or addiction issues.

Goal C: Ridgeview will monitor, pursue, and apply for any identified local, state, or federal mental health grant-funded programs that will enhance and/or complement its existing mental health continuum of care.

Program Action: Ridgeview will recruit and fill the newly budgeted Director of Development position to accomplish the above stated goal.

4. Asthma: This need will be addressed in the Methodist Medical Center Action Plan

5. Diabetes: This need will be addressed in the Methodist Medical Center Action Plan

Acknowledgements

Ridgeview would like to acknowledge all of the partners previously referenced including all the participants of the two community forums. Additionally, Ridgeview would like to thank the citizens of Anderson County who took the time to complete the referenced surveys and share with us their impressions of the overall health needs of Anderson County.

I also want to recognize the willingness of Methodist Medical Center and Covenant Health to partner with Ridgeview on this CHNA. This collaborative effort avoided duplication and strengthened what already is a strong relationship to better serve the needs of Anderson County.

Lastly, I want to thank the Board of Directors of Ridgeview for their involvement in this process and especially for their strong support in endorsing the action plans developed.

Robert J. Benning
Chief Executive Officer
Ridgeview Behavioral Health Services