Prepared by: Mary Bevan, M.P.H., & Mhora Lorentson, Ph.D. Center for Healthy Schools & Communities @ EDUCATION CONNECTION

A Community Forum was held on April 28, 2014 in Danbury Connecticut to: 1) present an overview of the 2014 Community Health Improvement Action Plan for Western Connecticut, developed as a collaborative effort with diverse health, human service, and community partners in the Housatonic Valley Region; and 2) obtain input from key community stakeholders to inform future planning. The Forum Agenda follows:

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2014 Community Health Improvement Action Plan for Western ConnecticutCommunity Health Forum – April 28, 2014

Summary Report

8:30 - 8:45

Welcome and Opening RemarksScott LeRoy, M.S., M.P.H., Director, Danbury Health & Human Services Department

Michael Crespan, R.S., M.P.H., Director, New Milford Health DepartmentSally Herlihy, M.B.A., FACHE, V.P. of Planning, Western CT Health Network

8:45 - 9:30

A Guided Tour of the Community Health Improvement Action Planning Process & OutcomesMary Bevan, R.D.N., M.P.H., C.D.N., Director

Mhora Lorentson, Ph.D., Evaluation ConsultantCenter for Healthy Schools & Communities @ EDUCATION CONNECTION

9:30 - 9:45 Activity BreakRegional YMCA

9:45 - 10:30 Community Stakeholder Plan Feedback

10:30 - 11:00 Looking Forward: Healthy Connecticut 2020Donna Culbert, M.P.H., P.E., R.S., Director of Health, Newtown Health District

11:00 - 11:45 Roundtable: New Community Initiatives and Emerging Health Issues

11:45 - 12:00 Wrap-Up

The Community Forum was attended by 37 community stakeholders from the Housatonic Valley Region (HVR). This included representatives from 5 Health Departments/Districts (Danbury, New Milford, Bethel, Newtown, and Pomperaug), Western CT Health Network, Danbury EMS, the Bethel Visiting Nurse Association, the United Way of Western CT, the Regional YMCA, the Housatonic Valley Coalition Against Substance Abuse, the Mid-Western CT Council on Alcoholism, the AmeriCares Free Clinic, the CIFC Community Health Center, Doctor’s Express Urgent Care Center, the Regional Educational Service Center, the Danbury Fire Department, the New Milford Senior Center, and the Peter and Carmen Lucia Buck Foundation. Geographically, all 10 HVR municipalities were represented either directly or through regional agencies and organizations.

An overview of the Community Health Improvement Action Planning (CHIP) process was provided, including the collectively developed vision and mission statements.

Vision: Healthy People Living in Healthy Communities

A partnership of diverse individuals who, through a commitment to creativity and innovation, collaborative leadership, cultural responsiveness, and the development of

evidence-based solutions for priority health issues, strives to create a community of the healthiest people in Connecticut.

Mission: Promote Overall Physical, Social, Emotional, and Mental Health

Through collaborative and sustained action and commitment to excellence, we strive to promote and maintain the health of our community residents through prevention, education,

evidence-based interventions, and the assurance of access to quality health care.

The CHIP process began with the Community Report Card Steering Committee’s coordination of preparation of an updated community health needs assessment, the 2012 Community Report Card (CRC) for Western CT. Next, two Community Forums were held (one in Danbury and one in New Milford) to review key assessment findings and to: 1) obtain input and insight from a diverse group of stakeholders, 2) reach consensus on priority health issues (PHI) in the region, 3) identify community assets and challenges related to the priority issues, and 4) begin forming workgroups to develop action plans for each PHI. These two initial Forums provided high quality information to initiate the community health improvement action planning process in the region.

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Since the initial Community Forums, the four PHI workgroups have designated a leader and have met at least quarterly to further develop and refine their action plans. The Center for Healthy Schools & Communities @ EDUCATION CONNECTION

facilitated this process.

The April 2014 Forum provided a “Feedback Loop” to community stakeholders, many of whom were also participants in the initial Forums, to obtain their input on the key CHIP strategies selected, and additional insight about new community initiatives and emerging issues. During the Forum, evidence supporting the selection of each of the four PHIs was reviewed, as were the objectives and key strategies to be used. In addition, each workgroup lead provided a brief overview of “Early Successes” pertaining to their PHI.

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The Forum participants then divided into subgroups facilitated by each PHI workgroup leader to provide recommendations on refinement and/or expansion of the key strategies and action steps. Participants responded to the following questions:

How well do the strategies within your PHI meet the needs of the community?Are there any additional strategies you would recommend?

Are there more specific strategies to reach vulnerable groups within our community?

What are three recommendations to help us successfully implement the desired strategies and achieve key

objectives?

A summary of the discussion related to each PHI follows.

PHI#1 - Prevention/education of most prevalent chronic disease/health conditions, i.e., obesity,

diabetes & hypertension.

“Early Successes”

Receipt of YMCA Diabetes Prevention Program Grant, with implementation beginning in July 2014

Participation in National Walk Day by over 150 persons in the HVR and formation of 3 community walking groups

Training at National “5, 2, 1, 0 Let’s Go” Center in Maine

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Recommendations for Action Plan Refinement & Expansion

The workgroup stated that there is a full action plan with strategies that are currently moving forward, and made these additional recommendations: hold wellness campaigns (such as “5, 2, 1, 0 Let’s Go” and “Know Your Numbers”) in lower income areas, enhance outreach to primary care providers, and adapt current risk assessments to include more focus on diabetes. Other thoughts on reaching vulnerable groups within the community included: working with social services agencies to apply for grants, partnering with faith-based organizations and housing programs to bring wellness and screening programs onsite, offering incentives for attending prevention or chronic disease management programs, and compiling a list of clinics/health centers that provide services to the uninsured and offer a sliding fee scale. The need for materials and services in languages other than English was also noted as vital to action plan implementation.

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PHI#2 – Improve access to/utilization of quality prevention, counseling, and treatment services for substance use and abuse and co-related mental health issues.

“ Early Successes” Collaborating with 12 Local Prevention Councils, the CT Prevention Framework, and others to extend the “reach” of activities

Integration of Question-Persuade-Refer Model for Suicide Prevention

HVCEO Task Force established to address escalation in opiate overdoses

Recommendations for Action Plan Refinement & Expansion

This workgroup concluded that the current strategies address the entire continuum of care. Additional recommendations include: amplify the strategy to promote prevention efforts of Local Prevention Councils and increase the involvement of youth by broadening the workgroup to include community mental health providers and Action Councils, improve dissemination of information (including but not limited to online listservs), conduct a chronic homelessness survey to determine the best approaches to reach chronically homeless substance abusers through a community pilot program. It was noted that it is necessary to keep mental health and substance abuse issues equally at the table. The homeless are viewed as a highly vulnerable target group in need of enhanced services and supports.

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PHI#3 – Improve assessment and service planning to address older adult health, housing, and social support needs.

“Early Successes”

Collaborating with the Aging in Place initiatives funded by the Peter and Carmen Lucia Buck Foundation

As part of these initiatives, “Safe at Home” Program established to provide home safety items to seniors

Pilot FISH (free transportation for medical appointments) and Friendly Visitor Programs established in Danbury

Recommendations for Action Plan Refinement & Expansion

The workgroup agreed with the current strategies, however they would like them to be better defined. Recommendations included: identifying resources within each community, benchmarking effective programs, educating community partners and the public about the local/regional support services, and bringing resources such as wellness programs to senior housing sites. Vulnerable populations identified include the homebound elderly and immigrants. Transportation is a major obstacle and needs to be better understood and addressed. The involvement of regional (HART) and community-specific transportation providers in improvement planning was recommended.

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PHI#4 – Improve awareness and utilization of existing health and social programs and services.

“Early Successes” Working with 5 Health Access CT Assistor Sites in Region

Infoline 2-1-1 agency program and service updates converted from paper to online system

Partnership established with FamilyWize to provide promotional materials for distribution to health providers and key community sites

Recommendations for Action Plan Refinement & Expansion

This workgroup focused on additional strategies and the need for ongoing outreach/education campaigns to reach providers, consumers, office managers, and patient advocates about prescription discount programs and health insurance enrollment. Another recommendation was to collaborate with local Boards of Education/School Districts and Head Start Programs to disseminate resource information to families. A critical factor to the success of these objectives is that materials are translated into Spanish, Portuguese, and other languages. A listing of HVR area providers and services that can be easily accessed by community residents was also noted as essential, working in collaboration with Infoline 2-1-1.

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New Community Initiatives and Emerging Health Issues

The State Health Improvement Plan, Healthy Connecticut 2020, was released in March 2014. The plan is available on the CT State Department of Public Health’s (DPH) website at: http://www.ct.gov/dph/cwp/view.asp?a=3130&Q=542346&PM=1. A Power Point overview of Healthy Connecticut 2020 was presented, and a summary of participant responses to the follow-up questions follows.

Question 1: How does Healthy Connecticut 2020 inform our community health improvement process?Question 2: How can we better incorporate SHIP initiatives and emerging health issues into our CHIP?

Question 3: What additional information would be helpful to ensure our ability to move our community forward in partnership with Healthy Connecticut 2020?

#1: Stakeholders expressed the importance of knowing what the priorities are at the state level, since it supports the priority health issues that the region has identified. In particular, the chronic disease, substance abuse, and health systems focus areas of Healthy Connecticut 2020 were believed to align best with the region’s PHIs. It was suggested that many entities across the state are working on prevention and education initiatives related to health improvement in these same areas and it is important to be knowledgeable about and replicate best practices. Healthy CT 2020 also suggests other focus areas that may warrant a deeper look in future improvement planning in our region.

#2: Recommendations to incorporate SHIP initiatives locally included aligning service delivery with strategies promoted by the state when appropriate and collaborating on public messaging in common areas. It was suggested that a representative from DPH attend future Community Forums to provide feedback from a statewide perspective. Another opportunity for state-regional -–local collaboration was in “healthy community design”, keeping in mind locally-identified needs.

#3: Stakeholders would like to know about future state funding opportunities to support local initiatives that align with Healthy CT 2020. Other suggestions for moving forward in partnership with Healthy CT 2020 included: improving the availability of local and regional level health data related to each priority area to monitor progress and set realistic benchmarks, regular updates from DPH about innovative health improvement strategies being implemented across the state to build promising practices instead of “reinventing the wheel”, and ongoing communication from DPH about progress in each focus area.

Next Steps

In closing, the Forum participants universally agreed that it was important for each PHI workgroup to continue to meet to advance the planning process, document progress towards objectives, and integrate best practices and new and emerging needs at the local, state, and national level. Participants also affirmed the benefit of holding future Community Forums at least annually, to report on progress and gain insight from diverse stakeholders. A follow-up online survey was emailed to all participants to obtain individual feedback on the Forum content and organization, and to solicit suggestions on how to improve the process in the future.

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