St Clair Hospital 2013 Community Health Needs Assessment by NFM + Dymun

Ourvision: A healthy community COMMUNITY HEALTH NEEDS ASSESSMENT FY 2013

C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

How do you define a community? Is it a neighborhood? Is it a specific geographic area, outlined by clear boundaries? Is it a group of people with something in common â&#x20AC;&#x201D; a shared history or mission, or a relationship grounded in living or working together? At St. Clair Hospital, community is all of the above, and much more. Commitment to the community has always been our focus. In fact, from its earliest inception, St. Clair has strived to meet the healthcare needs of our community. Sixty years later, the Hospital stands strong, and that community continues to grow. St. Clair Hospital is a beloved and trusted institution that has always responded to emerging healthcare needs with innovation, growth and improvement. As the largest non-profit organization in the South Hills, the Hospital is a leader, serving as a hub for the many partner organizations that share our vision and commitment. Through decades of advances, one thing has remained constant: our commitment to the health and well-being of the people within the community we serve. We are all united by more than a common geographic area; we share a sense of mission, of wanting to continually improve the place that we call home. We believe in this community and we remain strongly committed to serving the people who live and work here.

St. Clair Hospital

Table of contents COMMUNITY BENEFITS PROGRAMS Our History

Continued Growth

Ways We Give Back to the Community

St. Clair Hospitalâ&#x20AC;&#x2122;s Economic Development Impact

COMMUNITY HEALTH NEEDS ASSESSMENT Evolution of Our Assessment

Part of the Solution

The Community We Serve

Gathering Information

To Better Understand and Serve

Critical Region-Wide Health Issues

Top Three Priority Health Issues

The Power of Partnerships: Existing Facilities and Resources

Thank You to Our Community Partners

If you have additional questions or would like to receive a paper copy of our Community Health Needs Assessment, please e-mail us at Community@stclair.org. Community Benefits Programs

COMMUNITY BENEFITS PROGRAMS

Our history St. Clair Hospital‘s Beginnings t all started with an unmet need — a need for a healthcare facility close to home, for the residents of Pittsburgh’s south and west suburbs. During the years after World War II, returning soldiers moved to these areas to buy homes and start their families. The regions grew dramatically, but residents had to travel to hospitals in the city for medical emergencies and healthcare. For many, this was not easy, as not all families owned cars in those days. To Arthur S. Haines, M.D., this situation was unacceptable. Dr. Haines and a group of fellow visionaries were committed to having a hospital in their community, and they worked for 10 years to raise funds to build one, engaging the entire community in the effort. In October 1951, ground was broken at the Silhol Farm on Bower Hill Road for a new hospital that would care for the people of the South Hills in their own community. In 1954, that new hospital, named to honor Revolutionary War patriot Major General Arthur St. Clair, opened its doors and has never stopped moving forward.

St. Clair Hospital has four outpatient centers in addition to the hospital, and is the largest employer in Pittsburgh’s South Hills, with 2,200 employees.

St. Clair Hospital

Continued growth St. Clair Hospital in 2013 Today, St. Clair Hospital is a dynamic, growing, independent acute care hospital providing healthcare to more than 480,000 residents of Southwestern Pennsylvania. With 2,220 employees and 550 physicians, St. Clair is the largest employer in Pittsburgh’s South Hills. St. Clair is best known for outstanding services in cardiovascular care, cancer care, maternal-infant care, psychiatry and mental health, and emergency care. Signs of success are evident as the Hospital continues to attract many of the region’s leading physicians. In the last few years, dozens of medical professionals, including primary care providers and board-certified specialists, have chosen to relocate their practices to St. Clair. Patient satisfaction drives our mission of providing the highest quality healthcare. A notable example is our Emergency Department, one of the region’s busiest, treating over 60,000 patients every year and consistently ranked the best in the nation for patient satisfaction, with average wait times regularly under five minutes .

Today, St. Clair Hospital is a 328-bed, independent,

The Hospital continues to invest in the most advanced technology, from our medication administration to state-of-the-art imaging and the da Vinci robotic surgery equipment. This investment provides our medical teams with the innovative tools that enhance diagnosis and delivery of care.

acute care hospital that offers advanced, high-quality healthcare to more than 480,000

Today, the Hospital has modernized, inviting lobbies, the new Sipe Infusion Center, renovated

residents of Southwestern

patient rooms and brand-new, state-of-the-art operating rooms. Strategic expansion has

Pennsylvania.

extended our reach and enhanced our services into the community. We recently expanded our Outpatient Center at Village Square and opened a new Outpatient Center in Peters Township. Recognizing our accomplishments, Thomson Reuters named St. Clair to its list of the

100 Top Hospitals in the nation, based upon St. Clair’s record of patient safety, high quality outcomes, high patient satisfaction and clinical efficiency.

“ To provide highly valued, service-oriented healthcare to the community.” ST. CLAIR HOSPITAL MISSION STATEMENT

Community Benefits Programs

COMMUNITY BENEFITS PROGRAMS

Ways we give back to the community St. Clair is a community-based hospital, and has always had the goals of promoting health, improving access to healthcare and providing benefits to the community as a whole. St. Clair envisions our community as a place where healthful lifestyles are the norm, where residents of any neighborhood have access to health education, disease prevention, screenings and primary care. By engaging in partnerships with established non-profit agencies and charitable organizations who share our values and goals,

In the St. Clair service area, approximately 20% of all households had incomes below $25,000.

St. Clair Hospital expands its reach into the community, building on existing strengths and enhancing services to improve health and quality of life. CHARITY, DISCOUNTED AND UNCOMPENSATED CARE

range of services, from emergency food and clothing to

As a non-profit organization, St. Clair cares for everyone who

summer camp and early childhood education. With the

enters our doors, regardless of their ability to pay. Last year,

Hospital, SHIM holds Wellness Days for clients, featuring

St. Clair provided $28.5 million worth of charity, discounted

free health screenings and education offered by the Hospital’s

and uncompensated care. Over 14% of net patient revenue

expert staff. In addition, St. Clair supported SHIM’s successful

is put back into Community Benefit programs.

Twitter campaign to raise money for holiday meals for area

DONATIONS

poverty. For every retweet of the original message, the

St. Clair regularly makes donations to partnering agencies

Hospital donated 50 cents to SHIM.

families while educating South Hills residents about suburban

in the form of monetary donations and in-kind contributions.

• The Hospital supports the Carnegie Boys and Girls Club,

• With South Hills Interfaith Ministries, a social service agency,

which promotes health, social education, and vocational

St. Clair provides emergency assistance, supports families

and character development for children and teens from

in need and promotes healthful lifestyles. SHIM offers a

6 to 18 years of age. Through monetary donations, St. Clair

St. Clair Hospital

supports after-school programs, such as the Homework Power Hour and Dapper Dan Charities. St. Clair also helps with the annual Holiday Party, donating services and refreshments, as well as with individual events to promote physical activity and fun learning.

• In the Sto-Rox community, Focus on Renewal has been a beacon of hope for over 40 years, serving as a resource for healthcare, parenting support, day care and services for seniors. When members of St. Clair’s staff recognized that the Sto-Rox Neighborhood Health Center, part of Focus on Renewal, had old, out-of-date exam tables, the Hospital donated new ones as well as other essential furnishings. St. Clair provides smoking cessation classes

COURTESY VAN SERVICE

for women through a grant from Tobacco Free Allegheny,

With a fleet of eight vehicles, the Hospital’s Courtesy Van

as well as childbirth education classes, held on site at

provides rides to and from the Hospital and our affiliate

the Center.

locations for anyone having difficulty arranging private or

• Every year, the Hospital joins forces with the Boy Scouts

public transportation on their own. Without St. Clair’s van

of America and the United Way for the Scouting for Food

transportation, literally hundreds of friends and neighbors

drive that replenishes local food pantries. Throughout the

would not be able to get to their medical appointments.

Hospital, departments compete to collect the most food

These are the men and women of the South Hills and

for the drive. In the last few years, the food pantries of

western suburbs who for myriad reasons do not have access

South Hills Interfaith Ministries, the Borough of McDonald

to private or public transportation. Our familiar blue-and-white

and Peters Township have been recipients of our Scouting

vans operate Monday through Friday, and have provided

for Food drive.

nearly 13,000 rides to patients at no charge.

Community Benefits Programs

Ways we give back to the community (continued)

St. Clair Hospital is a training site for advanced clinical degree programs, offering praxis for medical imaging, CRNA, and 5th and 6th year pharmacy students. In 2012, St. Clair staff provided more than 2,000 hours as preceptors of 181 nursing students

HEALTH EDUCATION

from neighboring nursing

Health education is an essential part of disease prevention, and St. Clair offers classes

schools. Its medical school

at numerous locations as well as at the Hospital. Classes in CPR, childbirth preparation,

preceptor program hosts 6â&#x20AC;&#x201C;8

smoking cessation, diabetes management are among the offerings. St. Clair offers more

students for 8-week rotations

than 22 community education programs annually.

throughout each year.

SUPPORT GROUPS For those who are dealing with bereavement, addiction, or illnesses such as cancer, St. Clair provides support groups for patients and families, in recognition of the human needs that accompany serious illness. St. Clair offers more than 10 support groups.

And more than 2,000 hours of clinical training were provided in 2012 to more than 130 Emergency Medical Technicians and Paramedics.

NEEDLE DISPOSAL PROGRAM In the interest of safety and disease prevention, St. Clair has a needle disposal program for those who utilize needles, syringes and other sharps in managing conditions such as diabetes. This free service, provided through our Environmental Services Department, enables people to exchange containers of contaminated needles for new empty ones.

MENTORSHIP FOR HEALTH PROFESSIONS STUDENTS St. Clair opens its doors to the regionâ&#x20AC;&#x2122;s many training programs and universities whose health professions students come to the Hospital to gain clinical experience. Medical students, residents, nursing students and others rotate through our clinical departments as they prepare for careers in healthcare, and often times, returning to communities in need.

St. Clair Hospital

YOUTH PROGRAMS In a variety of ways, St. Clair Hospital regularly sponsors Youth Programs in the community, including those offered by the 14 school districts within our service area. These programs provide opportunities for children and teens to socialize with their peers, engage in the arts, and participate in sports.

GREEN TEAM St. Clair Hospital believes that our commitment to the community means a commitment to a healthy environment. We have created a Green Team of employee volunteers who work in partnership with two programs, Adopt a Highway and Keep Pennsylvania Beautiful, to maintain the beauty and health of our environment. Our employee volunteers have â&#x20AC;&#x153;adoptedâ&#x20AC;? Bower Hill Road and Vanadium Road and pledged to keep them clean and green.

Last year, more than 635 St. Clair Hospital volunteers

SPEAKERS BUREAU

provided approximately 90,000 hours of service,

Recognizing that our employees possess a wealth

ranging from clerical duties to patient assistance.

of knowledge and experience, St. Clair Hospital has developed a Speakers Bureau that any community group can call upon. Our speakers are available to give presentations on health and wellness topics, from stress management to living with diabetes.

Community Benefits Programs

COMMUNITY BENEFITS PROGRAMS

St. Clair Hospital’s Economic Development Impact ST. CLAIR HOSPITAL PLAYS A PIVOTAL ROLE IN THE ECONOMIC HEALTH AND VITALITY OF THE COMMUNITY, WITH A DIRECT AND INDIRECT IMPACT ON THE AREA’S ECONOMY.

DIRECT IMPACT

INDIRECT IMPACT

Hospital employment Hospital spending Emergency department capacity Regional vitality Community health

Non-hospital employment Regional spending State and local tax revenues State economic development support

$6.3 MILLION TAXES PAID TO THE COMMUNITY

TOTAL SPENDING

COMMUNITY BENEFIT PROGRAMS

HOSPITAL

• Community Health Improvement Services & Community Benefit Operations

$222,772,394 ECONOMIC RIPPLE EFFECT

• Health Professions Education

HOSPITAL

$83,575,916 ECONOMIC RIPPLE EFFECT

• Community Health Improvement Advocacy

TOTAL VALUE

TOTAL BENEFIT

SALARIES

• Community Support

• Subsidized Health Services

$246,386,268 $469,158,662

• Cash and In-Kind Contributions

5,826,764

CHARITY, DISCOUNTED AND UNCOMPENSATED CARE • Charity Care • Discounts to Uninsured/ Underinsured

• Unpaid Patient Expenses • Unreimbursed Medicare • Unreimbursed Medical Assistance

TOTAL VALUE

$28,527,194

$64,545,680 TOTAL

$148,121,596 Source: The Hospital and Healthsystem Association of Pennsylvania

St. Clair Hospital

VALUE OF QUANTIFIABLE SERVICE TO THE COMMUNITY TOTAL VALUE

$34,353,958

COMMUNITY HEALTH NEEDS ASSESSMENT FISCAL YEAR 2013

Commitment to the community has always been our focus. In fact, the hospital was founded nearly 60 years ago through the efforts of visionary, South Hills community members who recognized the need for a healthcare facility close to home. In 2011 under the leadership of Joseph B. Smith, Chairperson of the St. Clair Hospital Community Benefit Committee and Senior Vice Presidentâ&#x20AC;&#x201C;Marketing, Dollar Bank, as well as the administrative direction of Andrea L. Kalina, Vice President of Human Resources and Organizational Advancement at St. Clair, the Hospital endeavored to better understand the unmet health needs of people living in neighborhoods served by St. Clair. A three-year study overseen by the Community Benefit Committee and conducted in collaboration with St. Clair Hospital clinical experts, regional healthcare leaders, community members, and partnering health and human services agencies was completed. The findings of our 2013 assessment are detailed in the following pages. The report also identifies the action plan approved by the Hospitalâ&#x20AC;&#x2122;s Board of Directors to address these unmet needs and ensure that we are providing the healthcare services that are most important to those we serve. Community Health Needs Assessment

C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

Chronology of our assessment In an effort to maximize the opportunity presented by the Patient Protection and Affordable Care Act, we invited experts from within and outside of the region to share their expertise regarding the healthcare needs of the community. The three-year process to complete the Community Health Needs Assessment (CHNA) began in December 2010 and is presented in the timeline below.

2010

DECEMBER

> The Community Benefit Committee reviewed proposals from several consulting agencies specializing

in Community Health Needs Assessments. Verité Consulting was selected for the engagement based on their extensive expertise and knowledge.

2011

JANUARY–MAY

> St. Clair and Verité designed a comprehensive methodology for conducting a Community Heath

Needs Assessment. The action plan was presented to the Committee and approved at the May meeting.

JUNE–JULY

> Interviews with more than 40 key community stakeholders, partners, leaders and community members,

as well as data analysis (review of other community CHNAs, available public data, Highmark regional health indicators, and St. Clair discharge information).

SEPTEMBER

> Initial draft report of the findings (including identification of key pervasive health needs in the

community) completed.

SEPTEMBER–NOVEMBER DECEMBER–MAY 2012

> Public input surveys were conducted online.

> Comprehensive review of the information and statistics surrounding the pervasive health

needs in St. Clair Hospital’s service region were presented to the committee. Those initiatives include: Inadequate Prenatal Care; Behavioral/Mental Health Issues; Access to Care and Chronic Diseases; Cancer; Community Health Education; and Addiction.

2012

AUGUST

> The committee identified the programmatic prioritization criteria that would be used to rank which

community- wide health needs the Hospital would address first.

SEPTEMBER–NOVEMBER

> St. Clair Hospital senior management and staff developed plans to address the pervasive

health needs. The Community Benefit Committee prioritized the initiatives that best aligned with the Hospital’s core competencies.

DECEMBER–JANUARY 2013

> An implementation strategy was developed and presented to the St. Clair Hospital

Board of Directors. It was approved on January 31, 2013.

2013

MARCH

> Specific action plans were developed (including the identification of key community partners) to execute

the implementation strategy initiatives.

APRIL–JUNE

> A final Community Health Needs Assessment report was created and made widely available to the public,

via the St. Clair Hospital website. A paper copy was also made for community members, which they can receive upon request.

St. Clair Hospital

Part of the solution A hospital exists in order to meet the healthcare needs of the people who live and work in the neighborhoods that surround it. It offers preventive care to keep people healthy, as well as therapeutic care to treat diseases, conditions and injuries. Hospitals collaborate with the people and organizations in the communities they serve, to identify emerging problems and needs, and to develop effective solutions and strategies. In other words, hospitals are always responsible for being “part of the solution” — but first, the problems must be recognized, described and understood. One of the ways hospitals do this is through a Community Health Needs Assessment — a comprehensive, systematic examination of a community’s entire healthcare environment. In the fall of 2011, St. Clair Hospital began conducting a Community Health Needs Assessment of the regions served by the Hospital. A CHNA identifies and prioritizes health and healthcare access needs for specific geographic areas and groups of people, so that new ways can be found to meet those needs. This is accomplished by asking the following questions:

WHO in the community is most vulnerable in terms of health or access to care? WHAT are the unique health and/or access needs of these people? WHERE in the community do these people live? WHAT is causing these problems? To answer these questions, our CHNA turned to numerous sources of information. We conducted a survey and interviews with persons who represent the broad interests of the community, including those with expertise in public health. We also gathered data such as demographic information, health status indicators and measures of healthcare access, as well as assessments prepared by other organizations.

Community Health Needs Assessment

C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

St. Clair Hospital was founded in 1954 and is located on Bower Hill Road in Mt. Lebanon, Region 1.

Coraopolis

Airport

The boundaries of the regions are

McKees Rocks

Moon

determined by the growth patterns

Region 6 Robinson Imperial

of patient care at St. Clair Hospital.

Pittsburgh

Crafton Rosslyn Farms

Region 2

Noblestown

Heidelberg

McDonald

Region 4

Bridgeville

Midway

South Fayette Southview

Green Tree Dormont Brookline

Castle Shannon Mt. Lebanon

Baldwin

Bethel Park

Region 3 Houston

Canonsburg

Strabane

white population and an increasing non-white population, speciﬁcally

Upper St. Clair Peters

2010 and 2015, it is anticipated that this population will change; there is expected to be a decreasing

St. Clair Hospital

Region 1

In 2010, the total population of this community was 497,000. Between

Library

Region 5

Asian and Hispanic. There will also be an approximately 9% increase in the 65+ population.

Gastonville Venetia Ginger Hill

The community we serve St. Clair Hospital is located in the South Hills region of Pittsburgh, Pennsylvania. The St. Clair Hospital community is defined by the geographic origins of the Hospital’s patients. The area includes parts of both Allegheny and Washington counties, covering a total of 32 ZIP codes, and is broken down into six regions. (Please refer to map above.)

The community is comprised of a Primary Service Area (PSA), which is the geographic area from which the majority of the Hospital’s patients originate. The PSA is composed of Regions 1 and 2 and is home to 57% of the community’s population. A Secondary Service Area (SSA) consists of Regions 3, 4, 5 and 6, and is home to 43% of the population.

St. Clair Hospital

Gathering information The Process and Methods To assess, identify, understand and prioritize the unmet health needs of the community, St. Clair Hospital engaged the services of Verité Healthcare Consulting, LLC, based in Alexandria, Virginia. With Verité, the Hospital took into consideration the perspectives and experience of our numerous community partners, utilizing multiple primary sources of information, including interviews with community leaders, public health experts, medical staff and Hospital staff and representatives from numerous agencies and organizations. These individuals and organizations provided valuable, expert information. Data from secondary sources, including demographic, economic, health status and health status indicators from local, state and federal sources, were also considered. The primary and secondary data were analyzed by St. Clair Hospital staff and by Verité’s president and senior-level staff, with support from associates and research analysts. The methodologies included quantitative analysis, benchmarking, and trend analysis. Verité applied a ranking methodology to help prioritize the health needs identified by the assessment. Identifying priority community health needs involves benchmarking and trend analysis. Statistics for several health status and health access indicators thus were analyzed and compared to state-wide and national benchmarks or goals. While conducting the CHNA, St. Clair and Verité did not discover any information gaps that would have affected their ability to reach reasonable conclusions regarding the community health needs.

About Verité Because of their national expertise with Community Health Needs Assessment projects, St. Clair selected Verité Healthcare Consulting, founded in 2006, as

Review of other recent community health needs assessments As part of St. Clair Hospital’s CHNA, the Hospital reviewed other community health needs assessment documents for the purpose of comparison as it defined and prioritized unmet health needs.

the ﬁrm to assist with the Hospital’s process. Verité’s

Since 2004, there have been eight of these assessments conducted

president, Keith Hearle, MBA, has worked in health-

and published by organizations within the St. Clair region:

care consulting for over 30 years, and has extensive expertise with community beneﬁt regulations. Hearle continues to work closely with these initiatives, even today, bringing expert guidance to organizations working to improve health needs. Verité Healthcare Consulting is dedicated to optimizing the planning, organization, ﬁnancing and delivery of health services for vulnerable people and communities.

• Allegheny County Health Department - Infant Mortality Study (2010) - Maternal and Child Health Needs (2010) - Mortality Study (2008) • Central Assembly of God Church (2010) • Healthy Start (2000–2002) • Highmark Regional Assessment (2009–2010) • United Way of Allegheny County (2006) • Washington County Health Partners (2007)

Community Health Needs Assessment

C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

To better understand and serve Our 2013 Community Health Needs Assessment was conducted for St. Clair Hospital to better understand the health needs of the community we serve, and to identify the resources and strengths within that community, so that we can develop ways to address unmet health needs with our many community partners. The goal of the CHNA is to improve community health in order to enhance the quality of life and well-being of all those who live and work within the community we serve. This report is a summary of our findings and our plans to meet the high-priority needs identified by our CHNA.

THE CHNA REPORT SPOTLIGHTED THE FOLLOWING PROBLEMS THAT IMPACT THE OVERALL HEALTH OF OUR COMMUNITY:

General Issues While the St. Clair community compares favorably to state and national averages on a variety of factors, this report spotlights the problems that impact the overall health of our community. These include poverty, lack of preventive care, the presence of medically underserved

areas and populations, and shortages of healthcare professionals. Poverty and unemployment in the area contribute to poor health by creating barriers to

• POVERTY • LACK OF PREVENTIVE CARE • MEDICALLY UNDERSERVED AREAS AND POPULATIONS • SHORTAGES OF HEALTHCARE PROFESSIONALS

obtaining healthful food, preventive care and other health services. In the St. Clair community, the greatest proportion of low-income households are located in relatively urban neighborhoods. Racial and ethnic minorities are more likely to lack essential social and economic resources, putting them at increased risk for poor health. An additional factor is the impact of state budget reductions on health and human services providers, including the adultBasic insurance program, Medical Assistance, and child care assistance for women in welfare-to-work programs. The CHNA also determined that 15% of St. Clair Hospital discharges were “Ambulatory Care Sensitive (ACS)” — meaning that, if these patients had better access to primary care resources, their admission to the Hospital might have been prevented. The most common conditions for which these patients were treated include bacterial pneumonia, congestive heart failure, urinary tract infections and chronic obstructive pulmonary disease; 75% were for patients 65 years of age or older. ACS discharges are also common among Medicare and uninsured patients. The St. Clair community includes medically underserved areas and populations, as well as one area and two facilities that are considered health professional shortage areas. Both Allegheny and Washington counties include areas designated by the U.S. Health Resources and Services Administration (HRSA) as Medically Underserved. This includes groups within a geographic area with economic, cultural or linguistic barriers to accessing primary care.

St. Clair Hospital

Critical health issues identified in Allegheny and Washington counties Poor health is a consequence of multiple, complex factors with medical, social, economic, and behavioral dimensions, in addition to lack of access to care. Addressing the roots of poor health is essential to improving a communityâ&#x20AC;&#x2122;s quality of life and reducing death and disease. ALLEGHENY COUNTY Allegheny County includes areas designated by St. Clair Hospital as Regions 1 and 2, as well as portions of Regions 4 and 5. In comparison to Washington County, Allegheny County has higher proportions of low-income and uninsured residents living in an urban environment; these factors contribute to the areaâ&#x20AC;&#x2122;s health issues. Among the issues that are affecting the health of residents in these regions are a prevalence of unsafe sex practices; high rates of communicable disease and HIV; high rates of low birth weight infants and infant mortality; high rates of breast, colon and lung cancer; and high rates of suicide and community safety issues.

WASHINGTON COUNTY Washington County includes areas served by St. Clair Hospital and designated as Region 3, plus portions of Region 4 and 5. Washington County is more rural than Allegheny County and has different health issues. These include poor dental

health; high rates of high blood pressure; high rates of lung and bronchial cancer, and breast cancer; and high rates of births to women ages 40-54.

Health issues identified by the 2013 CHNA as critical for Allegheny and Washington counties, in alphabetical order: ACCESS TO CARE Lack of Affordable and Accessible Care Lack of Affordable and Accessible Mental & Behavioral Health Facilities/Services Lack of Resources for Providers Lack of Services and Care of Seniors COMMUNITY SAFETY Poor Community Safety DENTAL HEALTH Poor Dental Health HEALTH BEHAVIORS Prevalent Drug Use Prevalent Unsafe Sex

HEALTH CONDITIONS High Rates of Cancer High Rates of Communicable Diseases High rates of High Blood Pressure Prevalent Diet and Exercise-Related Conditions INFANT & MATERNAL HEALTH High Rates of Births to Women Age 40-54 High Rates of Infant Mortality High Incidences of Low Birth Weight Infants

MORTALITY RATES High Rates of Cirrhosis Mortality High Rates of Colon Cancer Mortality High Rates of Injury and Violence Mortality High Rates of Mortality for Young Adults Ages 20-24 High Rates of Suicide PHYSICAL ENVIRONMENT Poor Air Quality SOCIAL & ECONOMIC FACTORS Low and Moderate Income Populations Unable to Meet Basic Needs.

Community Health Needs Assessment

C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

St. Clair Hospital has prioritized the following three health issues in the community:

Access to Care; Inadequate Prenatal Care; and Chronic & Lifestyle-Related Conditions Since its inception, St. Clair has been dedicated to meeting the health needs of the communities it serves. Through a number of initiatives, St. Clair will continue this commitment, focusing primarily on priority health needs, as well as other selected needs identified in the 2013 Community Health Needs Assessment.

To meet these healthcare needs, St. Clair Hospital is taking action

ISSUE 1: ACCESS TO CARE ACTION: TO IMPROVE ACCESS TO CARE FOR SENIORS AND THE UNDERSERVED

Itâ&#x20AC;&#x2122;s well documented that there is growing concern in the region and across the state that access to healthcare is contracting. While this concern is impacted by many factors, including transportation, education, insurance, language barriers, primary care physician shortages and geographic availability, it is undisputed that access to high quality health services is essential to our quality of life. In 2011, the Hospitalâ&#x20AC;&#x2122;s Courtesy Van Program provided nearly 13,000 rides to community residents in need.

St. Clair Hospital

Vulnerable populations such as the elderly and those living in poverty are at higher risk where access to care is limited. The Community Health Needs Assessment (CHNA) identified a number of areas throughout the St. Clair service region where senior citizens and low-income individuals and families struggle to receive basic medical care. The need to better serve this population is a key finding of the study and a priority for St. Clair’s CHNA Implementation Plan. n St. Clair Hospital provides free and reduced-cost care through its Uncompensated Care Program and in the delivery of services to beneficiaries of government sponsored programs such as Medicare and Medical Assistance. In 2012, this direct assistance amounted to more than $28 million in the provision of services to community residents in need. Greater access to all patient populations will be enhanced through the expansion of St. Clair’s Outpatient Center at Village Square–Bethel Park and the June 2013 opening of the St. Clair Hospital Outpatient Center–Peters Township. n With transportation cited as a critical factor in accessing and receiving care, St. Clair will expand

in these and other areas, improvements in accessing care will be achieved. n With the understanding that quality care is highly coordinated across the continuum, collaborative programming and relationships lead to better patient outcomes. Taking that commitment to care even further, efforts are already underway to enhance access to care through the expansion of our primary care network and the creation of our Accountable Care Organization (ACO). These efforts will help to ensure that patients, especially the chronically ill, will get the right care at the right time. St. Clair serves more than 69 LongTerm Care and Assisted Living facilities in the

its Courtesy Van transportation program and

six-region area. Working with these partners and

prioritize service to areas such as Bridgeville, Brookline,

others to reduce readmissions, eliminate unnecessary

Glendale, Carnegie and Green Tree with emphasis on

hospital stays associated with chronic conditions, and

increasing the ridership of the senior, low-income,

positively impact the health status of our community

and underserved populations. By increasing service

was seen as a priority in the CHNA.

Community Health Needs Assessment

C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

ISSUE 2: INADEQUATE PRENATAL CARE ACTION: TO IMPROVE INFANT HEALTH THROUGH EXPANDED PRENATAL CARE SERVICES

Identified as both a regional and community problem of growing proportion is the inadequacy of prenatal care and its impact on the overall health status of a baby at birth. The St. Clair Hospital CHNA considered findings from studies conducted at the national (Community Health Status Indicators Project 2009 and Healthy People 2010) and regional level (PA Department of Health, Health Profile 2010 and Allegheny County Mortality Report 2008). The findings underscore the interdependence of the two factors and further reveal that county-wide, Allegheny compared unfavorably to Washington in six of 12 indicators related to low birth weight and infant mortality. Additionally, Allegheny County’s low birth weight indicator was found to be 7.2% greater than the Pennsylvania state average. Contributing to the concern is the fact that nearly 17% of Allegheny County’s mothers smoked during pregnancy and only 31.8% initiated breast feeding. These same concerns were represented in data gathered from patients in St. Clair’s direct service area. Smoking, low birth weight and gestational diabetes were conditions seen in five of the six regions served by St. Clair. While there are Hospital programs in place to address these conditions, more needs to be done.

St. Clair Hospital

Focus on Renewal in the delivery of programs and

need, St. Clair will provide subsidized prenatal education for low-income families and families who

services aimed at improving the overall health status

lack insurance coverage. The four-part series covers

of moms and babies in neighborhoods like Stowe,

childbirth preparation, labor and delivery, baby basic

Ingram and McKees Rocks. To confront prenatal health

care and breast-feeding instruction.

n St. Clair partners with Tobacco Free Allegheny and

concerns head-on, expanded programs will be

offered to reduce the incidence of smoking while pregnant and to address the critical need for prenatal care and counseling. Already providing this important care at the Sto-Rox Neighborhood Family

n A number of communities in St. Clairâ&#x20AC;&#x2122;s region are federally designated as â&#x20AC;&#x153;Medically Underserved,â&#x20AC;? meaning there is insufficient access to medical providers and services. In these areas, inadequate

efforts to expectant mothers in the McKees Rocks and

prenatal care is of particular concern. A new program, focused on maintaining a healthy pregnancy through proper nutrition, exercise and lifestyle choices will be delivered directly in

Carnegie areas.

communities where the unmet

Health Center, St. Clair clinicians will expand upon these needed services. Additionally, St. Clair is partnering with Women, Infants & Children (WIC) to aid prenatal

need exists. This pilot effort will begin in the neighborhood of McDonald and be evaluated for use in other areas.

n Nearly 10% of expectant moms in the region do not receive prenatal care in their first trimester. The CHNA indicates that lack of insurance coverage, household income and available transportation are all barriers to receiving this very important care. While a comprehensive, prenatal education and care program is currently available through St. Clair, participants in the program are wellinsured and have the means to cover the associated costs. With the goal of reaching those with the greatest

Community Health Needs Assessment

C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

ISSUE 3: CHRONIC AND LIFESTYLE-RELATED CONDITIONS ACTION: TO REDUCE THE INCIDENCE OF CHRONIC DISEASES AND LIFESTYLE-RELATED CONDITIONS

Chronic health conditions like diabetes, cancer, hypertension and lung disease make daily living activities unmanageable for more than one in every 10 people. With chronic conditions to blame for seven of every 10 deaths in the nation and more than $262 billion in healthcare expense annually, the treatment of chronic diseases must be a priority. Unfortunately, residents living in St. Clair’s service area are not immune from chronic conditions. St. Clair’s own data suggest that between 12%–15% of hospital admissions related to cancer, lung disease, stroke and coronary heart disease were potentially preventable with better management of chronic conditions. In addition to being among the most frequent and most expensive health concerns, chronic conditions are also among the most preventable health problems.

Prevention and education are key

worse. Learning to

first steps in the struggle to reduce the incidence

cope with these

In St. Clair’s service

of chronic diseases. In identifying chronic disease

feelings is a critical

region the incidence

management as a priority in the CHNA, St. Clair will

step in the recovery

of breast, colorectal,

offer community-based programs and resources

process. Through our

prostate and bladder

to help area residents reduce their risk

CHNA work, we heard

cancer is equal to

of developing chronic disease, and better

feedback from our

or greater than both

manage diseases before they worsen.

patients and local

state and national

public health experts

averages.

n Chronic disease is often associated with vulnerable populations such as the elderly, uninsured and underinsured.

Health symposiums will be offered in areas throughout the region where known gaps in education and service exist. Symposiums provide participants with education aimed at developing a healthful lifestyle through proper nutrition, exercise and preventative healthcare. Health screenings are offered and

was needed. St. Clair will partner with other local nonprofit organizations like Gilda’s Club, South Hills Interfaith Ministry, Adagio, Susan B. Komen and Livestrong to expand this care and reach more patients in need in neighborhoods such as Bridgeville and Whitehall. n High rates of obesity and diabetes were also cited as priority issues in the CHNA. Often linked to poor diet and physical inactivity, St. Clair offers a

with St. Clair clinicians to better under-

seven-week community weight reduction program

stand and manage their health concerns.

to area residents struggling with these conditions.

a significant impact on the emotional well-being of a person struggling with persistent disease. Illness and stress can often lead to depression, and depression can make a chronic illness St. Clair Hospital

support and education delivered in the community

participants are encouraged to dialogue

n Chronic conditions, especially cancer, can have

that greater cancer

The Weigh of Life program provides nutritional counseling, weigh-ins, individual meal plan development and group support.

Mental and behavioral health concerns were found to be critical issues impacting the entire St. Clair community, ranging across all age groups and income levels. The CHNA identified a lack of support services and outreach programs, particularly for young adults, teens and their families. Alcohol and substance abuse were noted to be on the rise at a time when budget constraints were limiting or reducing available treatment options. n Consistent with the desire to provide services directly in the community and through existing collaborative relationships, St. Clair is responding to these needs with an expansion of services in a number of communities it serves. An existing mental health support program is in place at the Christ United Methodist Church in Bethel Park. A second group has been added and mental health clinicians are now reaching more patients in need. This same program will be offered in the Bridgeville/Scott Township area.

Although St. Clair does not offer drug and alcohol addiction treatment, close partnerships with organizations that include Outreach Teen and Family Services and Greenbriar Treatment Center provide the necessary conduit for those in need to access treatment. Additionally, St. Clair is joining forces with the Mt. Lebanon Drug Task Force and sponsoring the development of a public education campaign surrounding prescription drug abuse. The task force has worked with local law enforcement and other area partners to identify a root cause behind the increase in overdose deaths in our community.

Between 2009â&#x20AC;&#x201C;2011, Opioid dependence increased 27% and alcohol addiction has decreased 11%.

Community Health Needs Assessment

C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

EXISTING FACILITIES AND RESOURCES:

The power of partnerships

The St. Clair Hospital community is fortunate to have a variety of resources that can assist in meeting the healthcare needs identified in the CHNA. These resources include other hospitals, county public health and human services agencies, organizations and ambulatory care centers or clinics that may be Federally Qualified Health Centers (FQHC). These were created by Congress to improve access to care in “medically underserved” areas, where economic, cultural or linguistic barriers inhibit groups of people from receiving primary care. The St. Clair service area includes medically underserved areas and populations.

Within the St. Clair Community, there are four FQHCs • Hilltop Community Healthcare Center, located in

• Sto-Rox Neighborhood Family Health Center is a full service

Beltzhoover, a satellite of the Sto-Rox Neighborhood

medical center that treats patients of all ages. It is open six

Family Health Center, providing pediatrics, women’s

days per week with some extended hours. It is part of Focus

health and family medicine.

on Renewal, an organization focused on health and social

• McDonald Family Medicine provides family medicine services. It is part of a large physicians’ group of 19 medical practices that provide family medical care.

services needs in the McKees Rocks community. • West End Health Center provides primary mental health, women’s health, and dental care.

Other hospitals within the St. Clair community

• Southwood Psychiatric Hospital, Upper St. Clair

• Kindred Long-Term Care Hospital, Oakdale

• Canonsburg General Hospital, Canonsburg

• Ohio Valley General Hospital, Kennedy Township

St. Clair Hospital

Other agencies and organizations in the St. Clair communities, by county: County COUNTY

ALLEGHENY

Organization/Agency

ORGANIZATION/AGENCY Adagio Health Centers Allegheny County Department of Health Allegheny County Department of Human Services Allegheny County Economic Development Allegheny County Housing Authority Angel's Place Bloomfield/Garfield Family Health Center Cancer Caring Center Catholic Charities Free Health Care Center Centers for Healthy Hearts and Souls Chartier's Community Mental Health and Retardation Center Christian Ministry of Whole Person Healthcare Community Human Services Corp. â&#x20AC;&#x201C; The Health Station Compassion Connection Gilda's Club Western Pennsylvania Greater Pittsburgh Community Food Bank Hill House Dental Services Latino Family Center McKeesport 9th Street Clinic Metro Family Practice Inc. Mon Yough Community Services, Inc. North Hills Community Outreach North Side Christian Health Center Outreach Teen and Family Services Pittsburgh Coalition for Dynamic Psychotherapy/Clinic without Walls Primary Care Health Services Inc. Sheep Inc. Health Care Center South Hills Interfaith Ministries Squirrel Hill Health Center The Kingsley Association The Midwife Center The Spirit of Health Mobile Wellness Van The Welcome Center for Immigrants and Internationals Tobacco Free Allegheny United Way of Allegheny County UPMC Centers and Clinics

WASHINGTON Ami Inc. of Washington-Greene counties Arc of Washington Community Action Southwest Community Circle Food Pantry Greater Washington County Food Bank Home and Community Services Mental Health Association of Washington County Pathways of Southwestern Pennsylvania Southwest Pennsylvania Human Services, Inc. United Way of Washington County Washington County Department of Human Services

Community Health Needs Assessment

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _

C O M M U N I T Y H E A LT H N E E D S A S S E S S M E N T

Thank you to our community partners… St. Clair Hospital gathered information through

interviews and surveys of dozens of persons who are

invested in the health of the community. Also, St. Clair

Hospital interviews were conducted in June and July

of 2011. The web-based survey was conducted from

September–November of 2011. These included

external stakeholders — those not affiliated with

St. Clair — as well as members of our medical and

Hospital staff. These persons shared their perspectives

and expertise on community health needs and their

Andrea L. Kalina Executive Liaison, Community Benefit Committee Vice President of Human Resources and Organizational Development, St. Clair Hospital

Joan R. Massella Administrative Vice President and Chief Nursing Officer, St. Clair Hospital Board of Directors, St. Clair Hospital Harriett M. Rea Board of Directors, St. Clair Hospital

Melvin D. Rex Chairman, St. Clair Hospital Board of Directors T.A. Ward President, T.A. Ward Constructors, Inc. Board of Directors, St. Clair Hospital

G. Alan Yeasted, M.D. Sr. Vice President & Chief Medical Officer St. Clair Hospital Board of Directors, St. Clair Hospital

ideas for interventions and innovative programs to

meet those needs.

St. Clair Hospital acknowledges the following leaders for their valuable feedback and ideas.

ST. CLAIR HOSPITAL COMMUNITY BENEFIT COMMITTEE MEMBERS Joseph B. Smith Senior Vice President, Marketing, Dollar Bank Chairman, Community Benefit Committee Board of Directors, St. Clair Hospital

Andrew Aloe Chair CE 411, Vistage International Board of Directors, St. Clair Hospital

Frank Arcuri, Esq. Law Office of Frank Arcuri Board of Directors, St. Clair Hospital Karl E. Bushman, M.D. Mt. Lebanon Internal Medicine Board of Directors, St. Clair Hospital

James M. Collins President & Chief Executive Officer, St. Clair Hospital Board of Directors, St. Clair Hospital

Andrew R. Hays Managing Director, Strategic Advisors Board of Directors, St. Clair Hospital

St. Clair Hospital

COMMUNITY LEADERS AND EXPERTS

Frank Aggazio Director, Allegheny County Housing Authority

Barbara Baulding Resident Services Assistant Director Allegheny County Housing Authority

Sister Ruth Bearer Associate Director Sto-Rox Neighborhood Health Center (Focus on Renewal) James Brophy Former Director of Operations Outreach Teen and Family Services

Venard Campbell EMS and Emergency Communications Coordinator St. Clair Hospital

Richard C. Chesnos Senior Vice President and Chief Financial Officer St. Clair Hospital

Mary Jo Dickson Administrator, Adult Mental Health Services Allegheny County Department of Human Services

Bruce Dixon, M.D. (Now deceased) Former Director, Allegheny County Health Department Michael J. Flanagan Sr. Vice President and Chief Operating Officer St. Clair Hospital

Harry Fruecht Police Chief, Peters Township Tom Salerno Director of Operations, Scott Township

James Guffey Executive Director South Hills Interfaith Ministries Andrea Schachner Program Director Angelâ&#x20AC;&#x2122;s Place

Nora Helfrich EMS Director, Tri-Community South EMS James Secrete Chief of Police, Scott Township

Keith Kanel Chief Medical and Learning Officer Pittsburgh Regional Health Initiative

Mary Sedore Administrative Services Coordinator Chartiers Community Mental Health

Tim Kimmel Director, Washington County Department of Human Services Scott Seltzer Assistant Superintendent, Mt. Lebanon School District

Chad King Chief of Police, Bridgeville

Richard M. Sieber Director of Marketing and Development St. Clair Hospital

Sue Martone Assistant Deputy Director, Office of Behavioral Health Allegheny County Department of Human Services

Coleman McDonough Police Chief, Mt. Lebanon

Jenny Michaux Director of Community Impact United Way of Allegheny County

Mildred Morrison Director, Area Agency on Aging Allegheny County Department of Human Services

Todd Pritchard Director, Medical Rescue Team South

Mary Lynn Spilak Director of Aging Services Washington County Department of Human Services

Timothy Steinhauer Superintendent, Mt. Lebanon School District Kay Stepp Executive Director, Compassion Connection Michelle Tipton Executive Director Angelâ&#x20AC;&#x2122;s Place

Denis Valentine Director, Southbridge EMS

Barbara Murphy President, United Way of Washington County

Joe Wissel Director, Kirwan Heights EMS

Marianne K. Olschesky Community Outreach and Marketing Coordinator St. Clair Hospital

Reginald Young Deputy Director, Office of Community Services Allegheny County Department of Human Services

Kathe Niznik Director, St. Clair Hospital Behavioral Health

Janet Yuhasz Health Services Coordinator, Pittsburgh Public Schools

Michael Panka Former Superintendent, Sto-Rox School District

Patricia Zurawski Medical Services Director Sto-Rox Neighborhood Health Center

Nan Rees Former Director, St. Clair Hospital Care Management

Father Regis Ryan Former Executive Director Sto-Rox Neighborhood Health Center (Focus on Renewal)

Community Health Needs Assessment

St.Clair Hospital 1000 Bower Hill Road Pittsburgh, PA 15243 412.942.4000 www.stclair.org

Our vision of a healthy community endures We believe that a healthy community is a nexus of relationships and supports, anchored by a strong, solid core. In our community, St. Clair Hospital is that core. Through focused and collaborative efforts with the persons and organizations who are community strengths and our partners, the Hospital continually strives to satisfy the unmet healthcare needs of the people we serve. Conducting a Community Health Needs Assessment (CHNA) is one of the many ways that the Hospital expresses our caring and our commitment. St. Clair Hospital is always moving forward, advancing our care and generating initiatives to improve health, strengthen existing resources and enhance quality of life for all the people of the community, especially the most vulnerable. The 2013 Community Health Needs Assessment enables this by serving as a catalyst for progress. Three years from now, the Hospital will assess that progress when we conduct another CHNA. We will determine how well we met the objectives that were set in this assessment, and we will once again gather information to assess the health of the community and identify unmet needs. The challenge is constant, but the vision endures, and inspires our work.

This community, after all, is our home, too.

One of St. Clairâ&#x20AC;&#x2122;s community partners is South Hills Interfaith Ministries (SHIM). As part of our relationship, the Hospital brings healthcare into the community to aid SHIMâ&#x20AC;&#x2122;s support of a burgeoning refugee population.