FORT KENT, Maine — Changing incentives under the Affordable Care Act (ACA) and value-based reimbursement to keep people healthy and out of acute care settings have prompted discussion of the state’s top health priorities.
The Maine Centers for Disease Control, local hospitals and partners set goals to improve rural health, including the development of health improvement plans. To obtain public input, a series of public engagement sessions was held in Aroostook County from October 2015 through March 2016.
The process identified The County’s top three health concerns: obesity, drug and alcohol abuse and cardiovascular health.
The process began in May 2014, when the Maine CDC sought national public health accreditation to best position it for future federal funding. As a result, staff developed several new plans, including a state health assessment, a state health improvement plan, and an agency-wide strategic plan.
To maintain public health accreditation, the Maine CDC and local health departments are required to conduct community health assessments and to develop health improvement plans every five years. Hospitals are also required to conduct a community needs assessment every three years and to use that information to develop plans to address top health concerns.
The CDC, hospitals and partners throughout the state developed a Shared Health Needs Assessment and Planning Process (SHNAPP) with four phases, which became the first statewide public/private partnership of its kind in the nation. The four phases included data collection and analysis, needs assessment reporting, community engagement and health improvement plans.
Central Maine Health System, Eastern Maine Health System, Maine CDC, MaineGeneral Health and MaineHealth developed a memorandum of understanding, with input from other healthcare and public health agencies, to share resources and ensure the health needs of the people of the state are met.
According to Dr. Rachel Albert, professor of nursing at the University of Maine at Fort Kent and chair of the Aroostook District Coordinating Council (DCC) for Public Health, “During the third phase of the SHNAPP process, from October 2015 through March 2016, the DCC held several successful community engagement sessions with local public representatives, including diverse healthcare consumers, community leaders, educators, businessmen, and healthcare and hospital administrators in northern, central and southern Aroostook County to obtain broad stakeholder input on identifying significant health needs based on review of the SHNAPP data, solicit stakeholder feedback and prioritize significant health needs, and identify gaps and local assets and resources that could potentially address local health priorities for The County.
“The community engagement forums provided the momentum to bring together public and healthcare stakeholders and find alignment in the next steps of the planning process and prioritize goals and strategies for the next district public health improvement plan,” said Albert. “The broad experiences and knowledge of health consumers and healthcare providers, and resources and services contributed by hospitals and community agencies, helped to highlight collective solutions to barriers impacting the rural health of our communities.”
During the forums held at Northern Maine Community College in Presque Isle, the University of Maine at Fort Kent and Houlton Regional Hospital, Stacy Boucher, Maine CDC district liaison, shared the survey results of the overall Maine Public Health SHNAPP.
Discussions focused on the three top health issues for Aroostook County based on information provided by 110 County respondents on the stakeholders’ survey. People were asked to rank health issues from 1 to 5, where 1 was not at all a problem and 5 was a critical problem.
Obesity was identified as the most important health issue in Aroostook County by 85 percent of the respondents, compared to 78 percent in the rest of Maine.
Drug and alcohol abuse was identified as the second leading health priority in Aroostook County by 80 percent of the respondents, the same as in the state overall.
The third priority in Aroostook County, reported by 80 percent of the respondents, was cardiovascular health, which was reported by 63 percent statewide. The critical issues affecting where people live, work, learn and play in Aroostook County included access to behavioral and mental health care (70 percent); poverty (69 percent); and employment/healthcare insurance (63 percent). The top three factors reported for the entire state by 1,639 respondents were poverty (78 percent), access to behavioral and mental health care (67 percent), and transportation (67 percent).
The feedback received during the SHNAPP public forums was summarized to foster discussion and to facilitate the development of the 2016 District Health Improvement Plan.
According to both Albert and Boucher, “Championing the health of our communities calls for Aroostook District action that links public health strategies to the reduction of avoidable hospitalizations. Shared ownership for health is currently underway through the development of DCC ad hoc committees with diverse experts for each health priority who will collaborate on identifying a course of action and critical strategies to address the top health issues in Aroostook County via the development of a District Community Health Improvement Plan.”
The district plan will inform the Maine State Health Improvement Plan.
The full report is available at www.maine.gov/SHNAPP.
