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Community survey identifies health needs
by Jennifer Jenks
Bob Otley has resigned from the Harney District Hospital (HDH) Board of Directors. Citing his differing views from the chief executive officer and the chairman of the board inhibiting his ability to serve the people of Harney County in a fair and honest manner, Otley submitted his resignation in a letter read by board chair Sam Caizza at the Jan. 23 board meeting.
A motion was made to accept the resignation, and Caizza seconded it “with regret.” The motion carried, with all except Tim Smith voting aye. The board will be taking applications for a replacement and hopes to review them before the next board meeting.
At the same meeting, Health Information Services Coordinator Toni Siegner and Outreach Coordinator Sonni Svejcar updated the board on the status of the Community Health Needs Assessment they’ve been working on for the last couple of months. The assessment is required by the Patient Protection and Affordable Care Act to preserve not-for-profit status for the hospital, but will also serve to determine changing demographics and needs that, Siegner said, would help them better serve the community.
Several people in the community from many different backgrounds (not just those in health care) were asked to join a council to review data and information and identify and prioritize the health needs of the community.
The members were also asked to participate in surveys and facilitate their completion by others in the community, the results of which will be used to make recommendations to HDH and HEAL (from whom HDH received a $10,000 grant to complete this survey and help with healthy eating programs). The assessment must be done every three years, Siegner reported, and there is a hefty fine if they don’t.
Siegner reported the top points revealed from the data collected so far were the decreasing labor force (which dropped by about 78 from 2011 to 2012), decreasing annual unemployment (down from 12.4 percent in 2011 to 10.9 percent in 2012), decreasing seasonally adjusted unemployment (from 13.8 percent to 12.4 percent) and increasing monthly unemployment (up from 9.6 percent in September 2012 to 10.9 percent in October 2012). Another top point, Siegner noted, was that average pay was reported to be lower than both the state and the country as a whole. Harney Countians make about $12,000 per year less than others in Oregon and about $27,000 per year less than the rest of the country.
While the population is not changing by a tremendous amount, Siegner said what is changing is where the county is losing people, which is from those age 44 and under, which includes a lot of working-age people and children. The county is gaining in those over age 45. The population is decreasing in the cities, but gaining in rural areas.
Another statistic Siegner noted was that about 50 percent of the population are government employees (compared to 18 percent in the rest of the state). “It stands to reason,” Siegner said, “because about 77 percent of our lands are public.”
Some other statistics Siegner noted were the large amount of people without dental or health insurance (24.5 percent; Oregon 19.4 percent), “incredibly high” abuse and neglect rates (25 per 1,000 children; Oregon 13), higher population of Native Americans compared with the rest of the state, higher population of those below poverty level and the working poor and double the state average of abused and neglected children.
The average inadequate prenatal care rate is lower than the state, Signer reported, and, although the teen birth rate is currently higher than the state, it has improved over the past three years.
The five leading causes of death are about the same as the rest of the state, with heart disease being number one for Harney County and cancer number one for the state. The others in the top five are cerebrovascular disease (stroke), chronic lower respiratory disease and unintended injuries. Interestingly enough, Siegner noted that although survey respondents reported they were in good or very good general health, there is a disconnect between how healthy they feel and how healthy they actually are because Harney County has higher rates for most diseases.
The percentage of the population classified as overweight or obese is about 50 percent, Siegner said, but data shows there are more people who are overweight than obese now.
The percentage of people who currently smoke has been cut by about half in the last couple of years; however, asthma rates are higher now. Since the smoking rate has decreased so dramatically, Siegner said, the higher asthma rates must not be due to smoking, but she did not know what else might be causing it.
The next step in the assessment process is to go over the survey results (which will be collected in February), identify community needs and make recommendations on the services and resources needed to fulfill those needs.
Svejcar reported the hospital had held four Melt Downs to date and had many individuals return. She felt people were becoming more physically active, but had heard complaints about limited physical fitness activities in the area.
She noted not everyone can afford to go to the gym or drive to town from rural areas, and they were anxious to hear the survey results to see what types of activities (such as better sidewalks, continuous trails, and indoor pool or a bowling alley) might best benefit the community. “It’s amazing what kind of impact exercise can have on your life,” she said.
Svejcar proceeded to play part of a YouTube video, called “23 1/2 Hours” for the board, which she thought was a great presentation encouraging daily exercise and showing how low fitness is the biggest determinor of early death. The video asserts, “The best thing you can do for your health is to get one-half to one hour of exercise per day.”
The video can be viewed online at:
CEO Jim Bishop updated the board on the status of the Swing Bed program. Bishop explained they were considering increasing the staff, as they have times they can’t accept more patients, not because there are no beds, but because they don’t have the staff. He noted it would need to be done carefully, since it will take several months to get the staff level up, but if the census then goes down, they will have to let people go.
Board member Buck Taylor brought up an incident that he was called about in which someone coming back to Burns from Bend thought a bed was available through the Swing Bed program and did not find out that a bed was not available until the day they were supposed to return.
He said someone had taken the day off work to transport the patient, only to find out there was no bed. The explanation given, he said, was that the bed was given to someone else with lower care.
Swing Bed coordinator and discharge planner Cheryl Norton explained that, in that particular incident, the bed became unavailable that same day, and they notified the patient as soon as they found out. She said it had been explained to the patient that the bed may not be available the day before, due to staffing issues (it takes less staff to care for someone deemed lower care).
In other business,
• Clinic Manager Stacie Rothwell updated the board on the new Saturday clinics, noting the schedules have been full, and they have had scheduled appointments, walk-ins and referrals;
• Chief of Staff Dr. Kevin Johnston reported Dr. Sharon King will be the new chief of staff and will start reporting to the board next month. He noted he appreciated Dr. Sarah Laiosa for starting work a month early while he was out due to back surgery. He thanked King and Dr. Oleg Reznik for both stepping up to help out during that time, as well. He said they are trying to put together a program to help the county and police with their needs (i.e., medical examiners, sexual assaults) and were coming up with a plan. He also said the hospital had been very busy, and he wanted to make sure they had enough staff and beds, especially for the obstetrics patients.
The next meeting will be held Wednesday, Feb. 27, at 6 p.m. in the HDH board conference room.