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 Community Health
Phone: 518.828.8013
Fax: 518.828.8119
Community Service Plan 2010-2012
I.
A. Mission Statement: The mission of Columbia Memorial Hospital is to provide our communities with high-quality, comprehensive health care services in a dignified and compassionate environment.
B. Vision statement: The partnership of hospital and communities will be the cornerstone of Columbia Memorial Hospital becoming the hospital of choice for patients, physicians, and staff.
Our approach to excellence in health care will be a continuum of services composed of a family of providers, including primary care, long term care, outpatient satellites, and access to a network of specialized care.
Our financial foundation will be strengthened; the facilities at Columbia Memorial will be in renewal; and the work environment will promote job satisfaction, wellness, productivity, and pride in meeting the many challenges of an ever-changing climate.
II. Service Area:
A. Hospital Service Area:
Columbia Memorial Hospital, established over 100 years ago is a full service, acute care not-for-profit general hospital, licensed under Public Health Law Section 2801 (10), located in Hudson, New York, about 120 miles north of New York City and 30 miles south of Albany. Certified for 192 beds, the hospital serves the people of Columbia and Greene Counties and part of Northern Dutchess County, with a combined population of approximately 115,000 people, which, is distributed between one small city and 32 towns. The two counties combined cover an area of nearly 1,300 square miles, most of which is agricultural or rural.
The hospital staff consists of approximately 1,400 employees and over 200 physicians and 50 allied health professionals. In addition, the hospital owns and operates 15 Family Care Practices and 13 Specialty Care Practices located throughout Columbia, Greene and northern of Dutchess County.
Columbia County is located in the Northeastern region of the Hudson Valley of New York State. It is bordered on the north by Rensselaer County, on the south by Dutchess, on the east by Berkshire and on the west by the Hudson River and Greene County. Columbia County is rural in nature and includes the city of Hudson and 18 towns.
Columbia County is located in the northeastern region of the Mid-Hudson Valley of New York State. It is bordered on the north by Rensselaer County, on the south by Dutchess County, on the east by the Berkshire County of the Commonwealth of Massachusetts and on the west by the Hudson River, opposite Greene County. Columbia County is roughly rectangular, measuring approximately 20 miles from east to west and 36 miles from north to south. It has a total area of approximately 643 square miles or 411,520 acres. Based on the U.S. Census, Columbia County’s population density is 97 persons per square mile. In 2007, the total population was estimated at 62,363. (NYS DOH, Estimated population Table 2)
Columbia County is basically rural and agricultural in nature and includes the City of Hudson (pop. 6,864) and the following 18 towns: Ancram, Austerlitz, Canaan, Chatham, Claverack, Clermont, Copake, Gallatin, Germantown, Ghent, Greenport, Hillsdale, Kinderhook, Livingston, New Lebanon, Stockport, Stuyvesant, and Taghkanic, and 4 villages, Chatham; Valatie, Kinderhook and Philmont.
In rural Columbia County, the local economy is one of diverse small businesses. Residents are also State of New York employees and commuters to businesses in the greater Albany area. Columbia County is also home to a significant community of New Yorkers for whom the County is home on weekends and during the summer months.
Greene County is situated between the Hudson River on the east and the Catskill Mountains at the Southern and Western ends. It is bordered by Albany County to the north, Rensselaer County to the northeast, Columbia County to the east, Ulster County to the south, Delaware County to the west and Schoharie County to the northwest. Greene County is located two hours north of the major metropolitan areas of New York City, and a half-hour south of Albany, New York State’s Capital District. It is easily accessible by New York State’s Thruway, and by public transportation, by air, rail and bus.
In the process of meeting the needs of our diverse community, Columbia Memorial Hospital has instituted an aggressive community health agenda in keeping with it’s strategic plan and operates and provides screening and health education programs that address several conditions such as asthma, diabetes, Lyme disease, breast cancer, prostate cancer, cardiovascular illnesses, and sexual assault, among others.
Columbia Memorial Hospital works with several organizations and coalitions to improve the health of the community. The Hospital participates in coalitions, business wellness programs, screening programs, and has an extensive health education program. In addition, the Hospital is an active member of several coalitions that strive to improve the health of the community.
Many in our region experience a lack of access to preventive and primary care given they do not have financial or geographic access to care. Others may have the resources, but through a lack of understanding or motivation, they do not access services appropriately. Thus, our health care indicators show that our population suffers from the typical range of health care problems affecting every county – high rates of heart disease, certain cancers, obesity, diabetes, asthma, depression and anxiety, low-birth weight, and poor oral health, among others. This document will provide a summary of the community health services planned for both Columbia and Greene Counties in collaboration with the local departments of health and community agencies.
B. Description of Service Area:
The target population will be the entire counties of Columbia and Greene with particular attention to areas in Greene County with especially limited access to healthcare services. Our target population is economically disadvantaged with many existing at or below poverty level.
The 2010-2013 Community Health Assessment considers the entire population
in Columbia County based on the updated 2000 census, local data from the
City of Hudson, New York State Community Health Status Indicators (CHSI), NYS
Vital statistics, NYS Department of Labor (Migrants), Nutrition Consortium
of NYS, CMH Emergency Department data, Divison of Criminal Justice, NYS
Department of Transportation, Columbia County Department of Social Services
NYS Bureau of Biometrics, NYS education department and local Human Services
Data.
According to the US Census Bureau, Greene County had an estimated population of 48,992 in 2008: this was an increase of about 800 residents since the 2000 census, or a percent change of approximately 1.5%. About two thirds of Greene County’s population is between ages 5-54. The two age groups that have seen the largest increase in population since 2000 are 15-24 and 55-64, with the latter age group representing the “baby boomer” population. The aging of the baby boomer population will be an important factor to consider for future health assessments, as this group may tax the
healthcare system in both nationwide and in Greene County. Just over 48% of Greene County residents are female, according to the 2008 Census estimate.
The median estimated income for Greene County in 2008 was $44,966, with 20% of households earning between $50,000-74,999. Greene County’s median household income is less than the median income for both New York State ($53,448) and United States ($50,740). ). Close to 40% of Greene County residents are low and moderate income, earning 80% or less of the area median income (Greene County Planning and Economic Development – July 2007).
Female- headed households are the family structure with the highest poverty level, with 48% of these households receiving some type of federal assistance.
While many outsiders know only of the resort areas of the mountaintop, the more rural areas including Halcott, Hunter and Ashland experience the highest poverty levels within Greene County. (Greene County Community Health Assessment 2010-2013).
III. Public Participation:
A. Participants:
The process for identifying community needs includes examining data and information that pinpoints where services are needed, and by listening to the individuals we serve. In fact, assessing the health care needs for our community is an ongoing process at Columbia Memorial Hospital. It involves every individual in our system including, Board of Trustees, Staff, Volunteers, and Physicians as well as reaching out and asking community members themselves. Participation with the local departments of health in both Columbia and Greene counties has also contributed to the process.
The following methods are used to gather information from the community:
• Focus groups (through collaboration)
• Community advisory groups
• Patient satisfaction questionnaires
• Community forums
• Support groups
• Participation with other service organizations throughout the two-county region
• Surveys
• Volunteers
• Active participation with local Human Service agencies
• Active participation with mental health and chemical dependency health providers in the two counties
• Active participation with area businesses
• Columbia-Greene Task Force on Access to Preventive and Primary Care.
• Columbia County Healthcare Consortium
• Greene County Rural Health
• Columbia County Department of Health
• Greene County Department of Health
A key source of information about community health needs are members of the Columbia Memorial Hospital family which consists of employees, physicians, volunteers, and Board members who listen to our patients and their families and work closely with members of the community and local healthcare agencies.
B. Outcomes:
1. The public input process occurred in 2009 during the monthly task force meetings, health advisory groups and Rural Health Networks meetings held throughout the year. The hospital’s administration has supported the needs of the community through the Community Health Services department dedicated to the development of programs and services to meet the needs of the community. Examples include, educational presentations at the local community college and community centers, health fairs, health screenings, community events and schools. In addition, the hospital staff participates on a variety of committees that contribute to the collection of information from the public.
2. The local health departments in both Columbia and Greene Counties have been very aggressive in the solicitation of the public in regard to healthcare issues that have an impact on the community we serve. Multiple meetings were held throughout the year with active participation by executive staff and local government officials. This process has reaffirmed our commitment to meet the needs of the community.
3. Public notification of this process was accomplished through media, on websites, direct mail and e-mail. Several hundred individuals that represent specific constituents were involved in the process through the local partnerships.
IV. Assessment of Public Health Priorities:
A. Criteria of Public Health Priorities: The selection of prevention agenda priorities has been accomplished in collaboration with local health department officials and multiple community forums, held monthly with several hundred participants.
B. Selected prevention Agenda Priorities: The new priority areas identified in Columbia County include: Chronic Care, Mental Health and Substance Abuse, and Healthy Mothers, Healthy Babies. In Greene County the priority areas include Access to care and Physical Activity and Nutrition.
C. Status of Priorities: The hospital and health departments in both Columbia and Greene Counties have a coordinated plan for addressing the selected health priorities. Included in the plan are programs, educational presentations and cost sharing.
D. Non-Prevention Priorities Considered in Assessment Process: The hospital’s public health programs not included in the prevention agenda include an aggressive education plan, a worksite wellness program, a coordinated child advocacy program, and health screenings. These services could not be accomplished without the collaboration and cooperation of multi-disciplinary teams working together in both counties.
V. Three Year Plan of Action
A. Strategies for Selected Priorities: In working with the local health departments in Columbia and Greene Counties as well as the local community agencies, the hospital plans to take each prevention agenda priority agenda topic and develop a comprehensive plan to address the issues. For example, in regard to access to care in Greene County, residents are faced with challenges related to their rural setting, including an insufficient supply of primary and specialty care providers, limited points of access and formidable distances to overcome in pursuit of care. Consequently, Greene County residents suffer from a higher than average incidence of chronic conditions such as asthma, cancer and heart disease. Furthermore, Greene County is plagued by poor access to care for Medicaid and uninsured patients. The plan for new medical staff by Columbia Memorial Hospital will facilitate the development of much needed primary care capacity for the underserved residents of Greene County, and will enhance the quality of existing primary care services through improved coordination and continuity of care.
In Columbia County, the hospital plans to partner with the local health department on the topic of healthy mothers, healthy babies, with multiple programs and educational presentations that are intended to ensure children are insured, immunized, safe and have access to health services. Currently, the hospital operates a dental van and provides services in both counties. Our child services program will strive to develop tools and protocols for a culturally competent model of care. In addition, through grant funds the Child Advocacy Program will expand services for victims of child abuse and their families.
In regard to mental health and substance abuse, the hospital plans to increase the bed capacity on the psychiatric unit and expand services offered to mental health clients by improving referrals to local resources.
VI. Financial Aid Program:
Successes and Challenges: Columbia Memorial Hospital has worked on multiple programs and processes to assist the uninsured over the past year. In an effort to better meet the needs of the community, a review of the financial aid program and uncompensated care was undertaken and Columbia Memorial increased the threshold for uncompensated care eligibility to 300% of the current year Federal Poverty Guidelines.
The plan allows for the improved access to facilitated enrollment programs through increased collaboration with service agencies. In addition, the hospital employs a Financial Counselor to assist insured individuals with program options that may provide better healthcare coverage. The Hospital has also expanded the prompt pay discount program to offer higher discounted percentages for those individuals uninsured or ineligible for other financial assistance programs.
VII. Changes Impacting Community Health/ Provision of Charity Care/ Access to Services
A. Potential Impacts: In realizing the need for primary care services to meet the needs of our community, the Hospital acquired multiple physician practices, recruited new physicians and expanded current practices. As a result, the community has the opportunity to access care without the discrimination of insurance, specifically, Medicaid and the uninsured. The expansion of physician practices includes gastroenterology, orthopedics, hospitalists and a dentist.
The dental van program is one of only a select few dental providers in Columbia and Greene Counties that accepts those individuals uninsured or on Medicaid. The program offers free care to eligible children with little or no dental insurance. The program operates in collaboration with local participating schools in both Columbia and Greene Counties.
VIII. Dissemination of the Report to the Public
Public Information: Columbia Memorial Hospital and the Family Care Centers distribute information regarding financial assistance to the public in the following ways:
● Continuing staff education
● CMH website
● Direct mail (enclosed in each client bill)
● Brochure
IX. Financial Information Notes: Institutional Cost Report submitted 5/29/09
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