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M I N U T E S
Public Health Advisory Board Meeting April 10, 2017 – 8:30 A.M.
Southern Nevada Health District, 280 S. Decatur Boulevard, Las Vegas, NV 89107 Red Rock Trail Room A and B
BOARD: Michael Collins – Member, Registered Nurse (Present) Timothy Jones – Member, Environmental Health
LeQawn McDowell – Member, City of Las Vegas Kenneth Osgood – Member, Physician
(Absent): Matthew Anderson – Member, City of North Las Vegas Tina Coker – Member, City of Henderson
Tim Marleau – Member, City of Mesquite Rich Shuman - Member, City of Boulder City
ALSO PRESENT: None (In Audience) LEGAL COUNSEL: Annette Bradley, Esq. EXECUTIVE SECRETARY: Joseph P. Iser, MD, DrPH, MSc, Chief Health Officer STAFF: Tony Fredrick, Andrew Glass, Mike Johnson, Fermin Leguen, Michelle Nath, Ruchi Pancholy, Zuwen Qiu-Shultz, Jacqueline Reszetar, Allison Schnitzer, Adele Solomon, Prut Udomwattawee, Leo Vega, Hans Weding, Jacqueline Wells
I. CALL TO ORDER
Chair Jones called the Public Health Advisory Board Meeting to order at 8:30 a.m. He noted a quorum of members had not been attained and the meeting would begin with the pledge and move to informational items not requiring action.
II. PLEDGE OF ALLEGIANCE
III. PUBLIC COMMENT: A period devoted to comments by the general public about those items appearing on the agenda. Comments will be limited to five (5) minutes per speaker. Please step up to the speaker’s podium, clearly state your name and address, and spell your last name for the record. If any member of the Board wishes to extend the length of a presentation, this may be done by the Chairman or the Board by majority vote. Seeing no one, the Chair closed this portion of the meeting.
IV. ADOPTION OF THE APRIL 10, 2017 AGENDA (for possible action)
A motion was made by Member Osgood seconded by Member Coker and unanimously carried to adopt the April 10, 2017 agenda as presented. There was no action taken on this item due to lack of quorum.
V. CONSENT AGENDA: Items for action to be considered by the Public Health Advisory Board which
may be enacted by one motion. Any item may be discussed separately per Board Member request before action. Any exceptions to the Consent Agenda must be stated prior to approval. 1. Approve Minutes/Advisory Board Meeting: January 9, 2017; direct staff accordingly or take other
action as deemed necessary (for possible action)
Public Health Advisory Board Meeting Minutes Page 2 of 3 October 10, 2016
A motion was made by Member Osgood seconded by Member McDowell and carried unanimously to approve the consent agenda as presented. There was no action taken on this item due to lack of quorum.
VII. REPORT/DISCUSSION/ACTION
1. Review/Discuss Community Health Improvement Plan (CHIP) Semi-Annual Report; direct staff
accordingly or take other action as deemed necessary (for possible action) Adele Solomon provided the Board with the semi-annual update. (Attachment 1) There was no action taken on this item.
2. Review/Discuss Southern Nevada Antibiogram; direct staff accordingly or take other action as deemed necessary (for possible action) Zuwen Qiu-Shultz, Epidemiologist and Prutt Udomwattawee, Public Health Informatics Scientist, presented “Clark County 2016 Antibiogram.” (Attachment 2) There was no action taken on this item.
3. Review/Discuss County Healthy Rankings; direct staff accordingly or take other action as deemed necessary (for possible action) Ruchi Pancholy, Epidemiologist, presented “Summary of 2017 Nevada County Health Rankings.” (Attachment 3)
4. Discuss and Approve Recommendations to the Southern Nevada District Board of Health on January 26, 2017; direct staff accordingly or take other action as deemed necessary (for possible action)
There was no action taken on this item.
VIII. HEALTH OFFICER & STAFF REPORTS
• CHO Comments
Andrew J. Glass, Director of Administration, presented an overview of the Southern Nevada Health District presented and overview of the Southern Nevada Health District Performance Management plan (Attachment 3)
Dr. Iser provided a brief update on legislative efforts as by Friday, April 14, all items must be out of its respective committee in order to go to the full house. Currently tracked is:
A laboratory bill that will legislatively set up a county public health lab with the District, designed to help expand and find additional sources of revenue. The Body Mass Index (BMI) bill, which is not likely to provide the required data to apply for chronic disease grants. A bill to put E-cigarettes (vapors) into the Clean Indoor Air Act.
• Allison Schnitzer, Health Educator, presented Nutrition Standards Policy presented “Nutrition
Standards Policy – Business Enterprises of Nevada”. (Attachment 4)
IX. PUBLIC COMMENT: A period devoted to comments by the general public, if any, and discussion of those comments, about matters relevant to the Board’s jurisdiction will be held. No action may be taken upon a matter raised under this item of this Agenda until the matter itself has been specifically included on an agenda as an item upon which action may be taken pursuant to NRS 241.020. Comments will be
Public Health Advisory Board Meeting Minutes Page 3 of 3 October 10, 2016
limited to five (5) minutes per speaker. Please step up to the speaker’s podium, clearly state your name and address, and spell your last name for the record. If any member of the Board wishes to extend the length of a presentation, this may be done by the Chairman or the Board by majority vote. Seeing no one, the Chair closed this portion of the meeting.
X. ADJOURNMENT
The Chair adjourned the meeting at 10:15 a.m.
Joseph P. Iser, MD, DrPH, MSc Chief Health Officer/Executive Secretary /jw
Community Health Improvement Plan
SEMI-ANNUAL PROGRESS REPORT
March 1, 2017
2 CHIP Semi-annual Progress Report
CONTENTSIntroduction .............................................................................................................................................................. 2Priority Areas ............................................................................................................................................................ 3
• Access to Care ................................................................................................................................................. 3• Healthcare Access and Navigation .................................................................................................... 3• Healthcare Workforce Resources and Transportation ................................................................ 4• Health Insurance ...................................................................................................................................... 4
• Chronic Diseases ........................................................................................................................................... 5• Policy and Funding ....................................................................................................................................... 6
Discussion .................................................................................................................................................................. 7Conclusion ................................................................................................................................................................. 7Table of Progress ..................................................................................................................................................... 8
INTRODUCTIONImproving population health requires collaboration by many community partners. The Community Health Improvement Plan (CHIP) is the community’s commitment to actively pursue opportunities to work together to improve the health of the Southern Nevada community. This is the semi-annual update to the CHIP. It represents the work accomplished by the multiple community partners.
This has been a remarkable journey for SNHD and our community partners. We are grateful to the array of community partners that have contributed to the success of the CHIP. Together we will make Southern Nevada a healthier place to live, learn, work, and play as we continue to cultivate a culture of health.
Community Health Improvement Plan SEMI-ANNUAL PROGRESS REPORT
3CHIP Semi-annual Progress Report
PRIORITY AREASAccess to Care, Chronic Diseases and Policy and Funding are the priority areas for the 2016-2020 CHIP action cycles. Community members organized into priority issue workgroups. The workgroups established broad long-reaching goals, measurable objectives, strategies, and action steps. Outcome and performance indicators were also selected. Each action step has been assigned to a specific individual or organization to ensure that the plan is action-oriented and accountable. Details of the progress made can be viewed on www.HealthySouthernNevada.org.
Access to CareVISION — To increase equitable access to healthcare services in a manner that ensures citizens receive appropriate, affordable, high-quality, and compassionate care.
GOAL AREA 1.1 — HEALTHCARE ACCESS AND NAVIGATION Develop a sustainable system to provide assistance with healthcare navigation to the citizens of Southern Nevada that identifies the right service, for the right person, at the right time.
The main objectives within this goal are threefold: to set up and fund an Emergency Communication Nurse System (ECNS) linked to the 911 system for alternative care disposition, to be able to refer to social services and to have a direct link to resources and connection with Nevada 211.
Progress —
1. The ECNS will partner with the 911 dispatch center for medical emergencies to identify and refer callers with low-priority, non-emergent complaints to a nurse who will complete additional triage and determine the most appropriate care disposition which may be an alternative to emergency response, such as: care in home, referral to primary care, self-transport to an urgent care center or health clinic, etc. The There are two components to this goal. The expected outcomes of the ECNS are improved healthcare service navigation at a reduced cost and improved health outcomes.
2. Southern Nevada CHIPs (SNV CHIPs) has partnered with Clark County Fire Department, North Las Vegas Fire Department, Henderson Fire Department, and Las Vegas Fire and Rescue to identify vulnerable members of the community accessing health and social services through the area’s first response agencies. Clients referred to SNV CHIPs are provided with a needs assessment, education, referrals, and advocacy. Expected outcomes of SNV CHIPs include an increase in a Quality of Life Index from time of referral to case closure as well as a reduction in the use of the 911 system access health and social services. They are working on sustainability, transitioning from a volunteer and student workforce to hired staff in order to provide services year around and with greater consistency.
3. Nevada 211 has been improving their presence, resource directory, website and more over the course of the last couple of years. Leveraging the existing resource through improved collaborations with other agencies as well as shared marketing strategies will benefit the community through improved awareness of and access to health and human services available in the community.
Potential revisions to objectives — As the 911 ECNS pilot study is implemented and data collected objectives will be reviewed for needed updates.
4 CHIP Semi-annual Progress Report
GOAL AREA 1.2 — HEALTHCARE WORKFORCE RESOURCES AND TRANSPORTATION Develop a sustainable system to provide healthcare resources to the citizens of Southern Nevada that overcomes barriers of quantity, type, specialty, and geography.
Progress — Although the main objective of this group was to identify gaps, early in the data review process the group realized the data itself had multiple gaps and the number of providers being added to the community was not adequate to meet the community need. Furthermore the length of time required and manpower commitment required to collect accurate data would not be able to keep pace with provider and insurance changes. It was noticed by the group that there were several communities that demographically rated high healthcare access when reviewing provider plotting, but extremely low provider access when reviewing non-acute 9-1-1 call volume and social needs indexes. It was decided by the group to address the key stakeholder perceived community needs such as the aforementioned and collect data to understand the communities’ perception of their own needs.
There is a schedule of community events.
Date Time Location Address Zip Code Status Comments3/30/2017 2-8 pm Hartke
Park1900 E. Tonopah Ave. North Las Vegas
89030 Approved Excellent community location
6/29/2017 City of Las Vegas Pending Heat concerns, reviewing with officials and community for indoor location; change hours to 4-9pm
9/29/2017 2-8pm Molasky Park
1065 E. Twain Las Vegas
89169 Pending Lack of parking concerns, may move to Cambridge Center
12/7/2017 2-8pm Heritage Park
300 S. Race Track Rd. Henderson
89015 Approved
The collaborative has grown from 5 members to over 50 partner agencies and local community stakeholders such as religious organizations, food banks, community and senior centers. This group task forces to address: logistics, follow-up care, services, data collection and publicity. They are creating their own logo and examining the potential to apply for grants as a community of intersectoral partnerships
Potential Revisions to Objectives — Group activities have out distanced the original goals. These activities will continue to be observed for the next six months. Data will be collected from the events in March and June. This data and the observations will direct the updates for this objective within the Access to Care priority.
GOAL AREA 1.3 — HEALTH INSURANCE Provide health insurance coverage opportunities to the people of Southern Nevada to meet the Healthy People national coverage goal of 100% by 2020.
Progress — Health Insurance enrollment data was received following the 2015-2015 enrollment period. The data was reviewed by SNHD and developed into the enrollment report. This report was given to Nevada Health Link and partners and is available on the HSN website. Strategies have been developed to address these gaps. With the current proposed changes to the ACA it is uncertain what the community needs will be. The landscape of public insurance will continue to be monitored and addressed.
Potential Revisions to Objectives — There is a strong potential for revisions to the health Insurance strategies that is dependent on the changes at the state and federal level. The goal of increasing the number of insured adults and children will continue the question is how that process will occur.
5CHIP Semi-annual Progress Report
Chronic DiseasesVISION — To achieve a healthier population in Southern Nevada by reducing risks and behaviors that contribute to chronic disease.
GOAL AREA 2.1 — OBESITY Promote and enhance interventions to reduce obesity in Southern Nevada by increasing physical activity and promoting healthy diets.
Progress — The Fit and Strong Program has been discontinued and the Walk With Ease Program has not yet been rolled out in Las Vegas. The majority of the other activities are progressing toward their expected goals with a few already exceeding their goals. Example of goals that have already been met or exceeded include:
• The Neon to Nature mobile app, an app to help locate walking and bicycle trails throughout Southern Nevada, was downloaded 7,647 times
• 100 people completed the Lifestyle Change Challenge• 500 girls enrolled in the Girls on the Run program • 100 school gardens have been built Staff is also working to be able to track this information/progress in a user-friendly format on the Healthy Southern Nevada website.
Potential revisions to objectives — There are no proposed changed at this time.
GOAL AREA 2.2 — TOBACCO USAGE Enhance interventions to reduce disease burden and lowered quality of life associated with tobacco use and secondhand smoke exposure in Southern Nevada.
Progress — The majority of the activities are on track to meet or exceed their goals. Example of goals that have already been met or exceeded include:
• over 160,000 youth participate in tobacco prevention programs• a question to ascertain e-cigarette and hookah use among youth will be added to Youth Risk Behavior Surveys in 2017• nearly 60 worksites in Clark County have expanded tobacco or e-cigarette policy• Over 12,000 smoke-free apartment units have been designated in southern Nevada. Potential revisions to objectives — There are no proposed changes at this time.
6 CHIP Semi-annual Progress Report
Policy and FundingVISION — To improve transparency in public health funding for key stakeholders and the public, thus ensuring a knowledgeable public and key stakeholders in the decision-making process.
GOAL AREA 3.1 — POLICY Educate the community and stakeholders about the influence of public health on the success of Southern Nevada and use health data and a Health in All Policies (HiAP) approach to formulate policy and drive decision-making.
Progress — SNHD with UNLV students and key legislatures are creating infomercials, fact sheets and info graphics to be available to legislature and the general public that address health equity and the social determinants of health. A subcommittee led by Jessica Johnson and Jamie Ross has created an opioid fact sheet and other resources on the opioid issues in Southern Nevada. These are available on the Healthy Southern Nevada website.
The system to increase access to reliable public health policy data is being put in place to increase transparency within PH funding. The system is not expected to be available until late 2017.
Potential revisions to objectives — This may change as this year’s legislature progress, community input increases and the changes to the ACA evolve. This goal area will be closely monitored.
GOAL AREA 3.2 — FUNDING Establish and promote awareness of Southern Nevada’s public health funding landscape using education and transparent data resources to increase data-driven health policy and funding decision-making.
Progress — UNLV students, under the direction of their dean, are working on this assessment; it is expected to be available before June 2017. This report is expected to be the cornerstone for campaigns to increase stakeholder understanding of current public health funding in Southern Nevada
Potential revisions to objectives — The strategies are expected to develop clarity as the report is completed and as any federal changes that support public health funding occur.
7CHIP Semi-annual Progress Report
DISCUSSIONIn the CHIP we stated that the purpose of monitoring the implementation was important for understanding three questions:
1. Are we doing the work we said we would do?2. Are we having an impact? 3. Are we addressing the social determinants of health, causes of higher health risks and poorer health outcomes of
specific populations and health inequities in our community? Some of the answers to these questions are contained in Appendix 1 Overview of the CHIP progress. Question 1 is answered in the progress column. Progress can be defined in how it relates to expectations as one of the following: below, met, exceed or evolving. The CHIP is a dynamic process and as such changes are to be expected, hence the category for evolving. These changes may be due to the ability of the group to move forward faster than the strategies or it may be due to changes in regulations and data findings that will affect various programs.
Some of the answers to question 2 can be found under comments. But six months is very early to be expecting measurable impact in the form of community assessments and outcomes. At this six month juncture, the CHIP impact can be measured in the increase in collaboration and the development of a shared vision between new and nontraditional partners.
The answer to question 3 is expected to be revealed closer to the completion of the report. Although data collection will continue and findings will be published, there may be undefined secondary outcomes. These may include other partners seeing gaps that the CHIP reveals and addressing them within their particular community or stakeholders mobilizing similar projects and strategies in other communities.
CONCLUSIONOverall the Chip has shown a tremendous increase in partnerships and non competitive collaborations. Our rural and frontier neighbors are observing our successes and looking for transferability in some strategies. The partners are becoming more flexible in adapting to changing data. Data is becoming more responsive to stakeholder need and identifying community perceptions. The CHIP process is an excellent method to increase collaboration and a shared community direction. The progress newly formed priorities have made is remarkable. Impact will be more readily accessed toward the end of the second year, 2018.
Update details can be accessed on www.HealthySouthernNevada.org.
8 CHIP Semi-annual Progress Report
TABLE OF PROGRESS Strategy Lead Target
DateProgress
below, met, exceed, evolving
Comments
Access to CareGOAL AREA 1.1 — HEALTHCARE ACCESS AND NAVIGATION911 with ECNS support
Sarah McCrea
LVFR
July 2017 Met On track for a July 17, 2017 go-live date of a one to two year scalable pilot, 1-2 nurses on staff 10-24 hours/day; funding dependent
Social service referral
SN CHIP
Lex Anderson
July 2016 Exceeds Linked to LVFR, CCFD and NLVFD, working with HFD and additional agencies; has received grant funds for positions and data collection
Robust resources connected to Nevada 211
Sarah McCrea
LVFR and Michele Johnson, Financial Guidance Center
July 2017 Evolving Increase community awareness and utilization of Nevada 211 through increased and targeted marketing strategies; Increase provider partnerships with Nevada 211 to improve directory potentials; refer clients of SNV CHIPs and the Community Nurse Call Line to Nevada 211 as appropriate
GOAL AREA 1.2 — PROVIDER AND TRANSPORTATIONIncrease healthcare workforce to increase access
Collaborate with insurance companies
SNHD
A. Solomon
Dec 2016 Exceeds It was determined we will bring services to the population, assist them in increasing their capacity to navigate the multiple systems. See strategic partnerships.
Assess providers by zip code
SNHD
Lei Zhang
Mar 2017 Evolving Data review showed provider scarcity in multiple areas. Because of the seriousness and magnitude the group has moved to action. Data refinement and collection will continue and be collected in the community. See strategic partnerships
Strategic partnerships to address gaps
HealthInsight June 2017 Exceeds Due to above, the group started action. Lead- Laura Culley, MD UNLV, Co-lead-Adele Solomon. Data is being refined and collected in communities. 50+ agencies partner to address high risk community needs. The “Mobile Health Collaborative” (MHC) mobilizes services in communities. MHC is a development of this group.
Improve transportation resources to increase access
Affordable and accessible transportation resources
Nevada 211 Dec 2016 Met-Evolving Nevada 211 call system has been upgraded. Other trans-portation options are being developed.
Directory of transportation resources to stakeholders
Nevada 211 June 2017 Met-Evolving Nevada 211 call system has been upgraded. The inclusion of telehealth and community health workers and the ACA changes are expected to have further impact. This will continue to be tracked and addressed
GOAL AREA 1.3 — HEALTH INSURANCEIncrease insured adults and children
Nevada Health Link July 2017 Evolving Insurance enrollment data was received following the 2015-2015 enrollment period. The insurance report was given to Nevada Health Link and partners and is available on the HSN website.
Develop partnerships to Identify gaps, target outreach and increase publicity.
Nevada Health Link July 2017 Evolving For the 2016-2017 enrollment strategies have been developed to address these gaps. With the current proposed changes to the ACA it is uncertain what the future community needs will be. The landscape of public insurance will continue to be monitored and addressed.
9CHIP Semi-annual Progress Report
Strategy Lead Target Date
Progress below, met,
exceed, evolving
Comments
Chronic DiseasesGOAL AREA 2.1 — OBESITYIncrease activities and access to activities for adults and children
SNHD Sept 2017 Met 48 schools participating in a “functional Fitness Program”
Overall about ¾ of the way through the planning process for updating and revising the Regional Bike and Pedestrian Plan for Southern Nevada and hope to wrap up the final plan by March 2017.
Increase access to fruits and vegetables and healthy food
SNHD Sept 2017 Met SNHD secured a grant to offer a nutrition incentive program at local farmers markets for SNAP recipients that provided $2 in free produce for every $5 spent on SNAP eligible foods. At one point in 2016, 6 local markets and 1 community garden (and it’s mobile market) were participating in the program. The program helped to increase SNAP purchases at participating locations by almost 20%. The grant ended in December; however two of the markets are pursuing other grant funding to continue to offer nutrition incentives.
Decrease consumption sugar-sweetened beverages
SNHD Sept 2017 Met The SNHD Soda Free Summer Initiative launched in June, 2016 and ran throughout August 2016. This year the Hispanic population was a priority focus. Online and in-person community classes were incorporated into the 2016 initiative which reached 400 people at community events or educational workshops.
GOAL AREA 2.2 — TOBACCO USAGEDecrease smoking rates for youth and adults
SNHD June 2017 Exceed 161,650 youths participant in existing youth tobacco prevention program (events, activities, and trainings) (goal: 160,000)
Staff participated in YRBS steering committee call and advocated for addition of a hookah use question. As a result, the question will be on the 2017 YRBS survey instrument and we will obtain a prevalence rate at that time.
Promote quitting among adults and youth
SNHD June 2017 Below Since July 2016 there has been an average of 22 healthcare provider Nevada Tobacco Quitline referrals per month and the average monthly call volume totals 107/month
Expand clean air policies
SNHD Sept 2017 Met 57 worksites or organizations have expanded policies (PICH Yr 2 report)
12,002 smoke-free multi-unit housing units available in Clark County (PICH Yr 2 report)
155 smoke-free meeting venues available in Clark County (PICH Yr 2 report)
10 CHIP Semi-annual Progress Report
Strategy Lead Target Date
Progress below, met,
exceed, evolving
Comments
Policy and FundingGOAL AREA 3.1 — POLICYIncrease community awareness of relationship between SDoH, PH and success of Southern Nevada
SNHD April 2017 Evolving SNHD with UNLV students and key legislatures has created one infomercial and more are being reviewed, supporting fact sheets will be available to the general public that address health equity and the social determinants of health. A subcommittee led by Jessica Johnson has created an opioid fact sheet and other resources on the opioid issues in Southern Nevada.
Increase access to reliable data for public health decisions
SNHD Sept 2017 Below The system is being put in place to increase transparency within PH funding. The system is not expected to be available until September.
GOAL AREA 3.2 — FUNDINGAssess the landscape to PH funding in Southern Nevada
SNHD Dec 2016 Evolving UNLV students, under the direction of their dean, are working on this assessment; it is expected to be available before June 2017.
Increase stakeholder understanding of current PH funding in Southern Nevada
SNHD Feb 2017 Below This has not started and the above report is expected to show a current comparison.
CHIP details are available on www.HealthySouthernNevada.org.
For questions please contact Adele Solomon [email protected].
Clark County 2016 Antibiogram
SOUTHERN NEVADA DISTRICT BOARD OF HEALTH PUBLIC HEALTH ADVISORY BOARD MEETING
April 10, 2017
• Zuwen Qiu-Shultz, MPH, CPH, Epidemiologist • Prut Udomwattawee, BS, Public Health Informatics Scientist
Objectives
Brief description of antibiogram
Demo of online antibiogram
What is Antibiogram?
An overall profile of organisms’ susceptibility to a panel of antibiotics
Why Do We Need Antibiogram?
Problem of Antibiotic Resistance
– In U.S. 2 million people become infected with bacteria that are resistant to antibiotics, and at least 23,000 people die each year as a direct result of these infections.
Empiric Antimicrobial Treatment
Antibiotic Resistance Pattern
Antimicrobial Stewardship Program
– The Joint Commission’s Antimicrobial Stewardship Standard became effective on January 1, 2017.
Demo
http://www.southernnevadahealthdistrict.org/stats-reports/antibiogram
SUMMARY OF 2017 NEVADA COUNTY HEALTH RANKINGS
Ruchi Pancholy, MPH Epidemiologist Southern Nevada Health District
BACKGROUND
County Health Rankings measures the health of all counties in the nation and ranks them within states.
Counties have been ranked in all 50 states since 2010. Goal is to improve overall health Main objective is to raise awareness about factors that influence health
and emphasize that health varies from place to place
4
COUNTY HEALTH RANKINGS: 2 RANKINGS
Today’s Health
Health Outcomes
Tomorrow’s Health
Health Factors
TODAY
THE FUTURE
6
HOW DO COUNTIES RANK FOR HEALTH OUTCOMES
‣ Nevada overall
– 1st: Lincoln County
– 17th: Mineral County
‣ Southern Nevada
– Lincoln (1st)
– Douglas County (3rd)
– Clark County (6th)
– Esmeralda County (15th)
– Nye County (16th)
7
HOW DO COUNTIES RANK FOR HEALTH FACTORS
‣ Nevada overall
– 1st: Douglas County
– 17th: Mineral County
‣ Southern Nevada
– Douglas County (1st)
– Clark County (12th)
– Lincoln County (9th)
– Esmeralda County (13th)
– Nye County (16th)
8
NEVADA COUNTY SNAPSHOTS – HEALTH OUTCOMES
Health Outcomes Clark
County
Lincoln
County
Esmeralda
County
Nye
County
Top US
Performers
Nevada
Length of Life Rank (out of 17)
4 3 9 16 ------ ------
Premature death* 6,800 6,800 Unknown 11,000 5,200 7,000
Quality of Life Rank (out of 17)
12 1 16 15 ------ ------
Poor or fair health 17% 14% 22% 17% 12% 17%
Poor physical health days
3.9 3.7 5.0 4.4 3.0 3.9
Poor mental health days
3.8 4.0 4.7 4.6 3.0 3.9
Low birth weight 8% 5% Unknown 10% 6% 8%
*Premature death includes: Years of potential l i fe lost before age 75 per 100,000 populat ion (age -adjusted )
Needs Improvement
Community Strength
9
Health Behaviors Clark
County
Lincoln
County
Esmeralda
County
Nye
County
Top US
Performers
Nevada
Rank (out of 17) 12 9 13 16 ----- -----
Adult Smoking 17% 16% 20% 19% 14% 18%
Adult Obesity 28% 26% 26% 32% 26% 27%
Food Environment
Index
7.7 4.1 4.9 5.7 8.4 7.6
Physical Inactivity* 22% 25% 22% 30% 19% 21%
Access to Exercise Opportunities
91% 52% 45% 18% 91% 88%
Excessive Drinking 16% 18% 15% 15% 12% 18%
Alcohol-impaired Driving Deaths
33% 41% 18% 32% 13% 33%
Sexually Transmitted Infections Rate**
464.0 Unknown Unknown 148.9 134.1 427.0
Teen Births*** 37 10 Unknown 39 17 37
*Physical Inactivity includes : Percentage of adults aged 20 and over report ing no leisure t ime physical act ivity.
** Sexually Transmitted Infections: Number of newly diagnosed Chlamydia cases per 100,000 populat ion
*** Teen Births : Number of births per 1,000 female populat ion, ages 15 -19
NEVADA COUNTY SNAPSHOTS – HEALTH FACTORS
10
NEVADA COUNTY SNAPSHOTS – HEALTH FACTORS
Social & Economic Factors
Clark
County
Lincoln
County
Esmeralda
County
Nye
County
Top US
Performers
Nevada
Rank (out of 17) 12 4 10 16 ------ ------
High School Graduation
72% 73% Unknown 69% 95% 73%
Some College 56% 60%
29% 48% 72% 57%
Unemployment 6.8% 6.2% 4.6% 8.7% 3.3% 6.7%
Children in Poverty 23% 18% 21% 29% 12% 22%
Income Inequality 4.2 3.7 3.9 4.0 3.7 4.3
Children in single-parent households
38% 19% 33% 38% 21% 36%
Social Associations* 3.3 3.9 0.0 6.6 22.1 4.2
Violent Crime 706 44
207 366 62 616
Injury Deaths** 64 103 Unknown 116 53 69
*Social Associations: Number of associat ions per 10,000 populat ion. Associat ions includes: membership
organizations such as bowling centers, golf clubs, f itness centers, sports organizations, etc.
** Injury Deaths : Number of deaths f rom unintentional and intentional injuries per 100,000 populat ion.
12
QUESTIONS?
Public Health Advisory Board Meeting April 10, 2017
Andrew J. Glass, M.S., FACHE Director of Administration
Strategic Goals Goal #1
Strengthen Financial Sustainability for Public Health in Southern Nevada and within SNHD
Goal #2 Increase Staff Capacity and Workforce Development Utilizing Quality Improvement Methods.
Goal #3 Develop and Implement an SNHD Branding and Marketing Plan
Goal #4 Increase Capacity to Adopt, Implement, and Enhance Information Management and New Technology
Goal #5 Continually Assess Progress on Priorities and Improve Public Health Policies, Communication, and Collaboration
Quality Assurance The competencies and standards of individual employees Daily Customer service Job function
PM - Performance Measures How are we doing? What are our goals?
Increase billing by 25% by November 2017 Implement and track the Workforce Development Plan
by June 2017 Improve transparency Define direction
Performance Measures Report
Performance Management System Report Date: March 23, 2017 Performance Indicators Number Percent
Total number of performance targets
90 100%
Number of performance indicators that exceeded targets
5 6%
CHIP Community Engagement; Access to Care – Nurse Call Line.
Number of performance indicators that met target 75 83%
Number of performance indicators that did not meet target
10 11%
Utilization of portal for capturing data. Pool regulations surpassed progress of completion of Food Code preparation and proper staffing to industry stakeholders. Informatics indicator was based on an external agency providing data in a timely manner which was not accomplished. Indicator will commence once the data have been submitted.
Quality Improvement Process for Organizational Improvement Develop improved systems Correct undesired results Evaluate processes
Questions?
