LiveWell Kershaw recently released the official Community Health Improvement Plan, or CHIP, for Kershaw County. The plan is a result of a kick-off held March 27 and subsequent small group meetings focusing on the plan’s three priorities: access to care, obesity and emotional health. Participants re-gathered Wednesday morning at the Kershaw County School District’s offices in Camden to review the plan and launch the first steps in reaching the goals associated with each priority.
(Editor’s Note: Due to meeting Memorial Day weekend deadlines, the C-I was unable to attend Wednesday’s meeting.)
The CHIP’s overall goal is to provide “Healthier Tomorrows for Everyone” in Kershaw County. It is a three-year plan to “achieve our destination postcard of optimal health in Kershaw County.” In essence, it is a guide with concrete steps for all residents “to be able to access healthcare, achieve optimal emotional health, and to be physically active and eat healthy foods.”
The plan will effectively run from June 1 of this year to May 31, 2002, based on data provided by a 2017 Community Health Needs Assessment, which those who participated in the March 27 kickoff and subsequent meetings used along with other information to determine the priorities and how to meet their associated goals.
“It is the goal of the LiveWell Kershaw Coalition that organizations will review this three-year plan and determine what specific role they can play in supporting the improvement of health outcomes in our county,” part of the introduction to the plan reads. “This guidance document can be used as policies are being developed and revised and also to determine what key actions and resources are needed to advance the three goals crafted in this plan. This three-year plan can be modified as conditions change.”
During the month of April, workgroups -- ranging in size from five to 12 people -- met to focus on one of the three priorities. They developed goal statements, objectives, tactics and outcome metrics. The Mental Health workgroup changed its name to the Emotional Health workgroup to reduce any stigma attached to “mental health.”
On May 3, a draft outline of the CHIP was presented with workgroup members sharing their initial thoughts. Twenty-seven participants provided feedback on the draft and offered ways to strengthen particular elements. The final draft was produced May 15.
With the understanding that the three priorities -- obesity, access to care and emotional health -- have overlaps in terms of issues, the CHIP’s authors realized that they will have to be tackled step-by-step, completing one step before moving on to the next.
“We acknowledge that change is difficult. Through strategic action and implementation, we will see indicators of progress as we tackle a strategy at a time,” they said.
The next steps include disseminating the CHIP to community organizations and residents; having implementation teams prioritize action items for each of the three priorities; and having the teams finalize their respective metrics and develop a work plan including baselines metrics, strategy leads, and target completion dates.
Each priority in the CHIP includes a goal statement, the outcome metrics the coalition would like to see, several objectives with a number of parts, a list of key partners to assist with the priority, key indicators to watch, and a “Bright Spot” of something already being done to deal with the priority.
Goal Statement: Increase healthy lifestyles among families (includes all adults, children and elderly [everyone]) countywide in order to decrease the obesity epidemic.
Outcome Metrics: Decrease obesity rates among adults and children, and have students rank in the top 25 percent of FitnessGram data for the nation.
Objective One: Strengthen existing collaborations -- by supporting other groups’ current obesity efforts.
Objective Two: Implement evidence-based interventions -- use HEAL (Healthy Eating, Active Living) Champions in schools, faith-based organizations, worksites and local communities; launch school campaigns (“5-2-1-0” and “Say Yes! to Water”); create FAN (faith, activity and nutrition) Program for churches; implement worksite wellness programs; enact policy changes to decrease obesity; and build public infrastructure that supports physical activity (outdoor fitness parks, walking trails, community parks).
Objective Three: Conduct an awareness campaign -- through mass and small media, and social media; and through local resolutions.
Key Indicators to Watch: Personal stories of transformation, number of local residents participating in local health events and using trails, decrease in screen time, decrease in sugar-sweetened beverages, number of policy changes/types, percentage of participating churches, number of students leading health initiatives, number of participating schools, number of functional trails, number of media presentations/articles.
The “Bright Spot” for the obesity priority is the county’s efforts, including the city of Camden, to support active living with trails and “complete streets.” The CHIP notes that, starting with a Healthy South Carolina Initiative Grant in 2012, county agencies began working on the Kershaw County Bicycle, Pedestrian and Greenways plan to develop an on- and off-street bikeway, walkway and trails network. It includes “complete streets” designs to promote safer travel for pedestrians, cyclists and drivers and encourages the use of the bike/walk/trail network. Both city and county councils incorporated the greenways plan into their comprehensive plans, and have already created the one-half mile, 10-foot wide Sweet Gum Connector Trail between Woodward and Scott parks in Camden; includes marked and signed pedestrian crosswalks on Broad Street in downtown Camden; and the installation of 50 “share the road” signs throughout the county to alert drivers and bicyclists to safely share the county’s roads.
Access to Care
Goal Statement: Increase and improve ways to access affordable healthcare and transportation services among rural and underserved residents with dignity and empowerment embedded throughout the framework.
Outcome Metrics: Decreased uninsured rate, decrease in avoidable emergency room visits and readmissions rates, and reduction in missed follow-up appointments due to transportation.
Objective One: Connect every community member to timely and quality care -- improve workplace wellness by monitoring a Workplace Health Index, encourage the creation of more workplace clinics and “Doc In a Box” locations, and through policy changes; expand existing and add new telehealth opportunities; strengthen the county’s transportation backbone with Rides to Wellness, LYFT, work by a transportation consortium, and health-related billboards at bus stops and churches; and expanding mobile clinic opportunities using the Sullivan Center Model and community paramedicine.
Objective Two: Advociate for meaningful and trusting relationships with community residents -- conduct training sessions to promote dignity and empowerment, including certification and the use of a hotline; support organizational policy revisions addressing “gatekeepers” and partner engagement; and the identification of Community Champions who are influencers in each community and can help identify and address barriers.
Key Indicators to Watch: Increased access to healthcare for those who live west of the Wateree River, increase in the number of providers accepting Medicare and Medicaid, decreased number of missed follow-up appointments due to transportation, increased healthcare visits (whether to nurse practitioners, physician assistants, clinics, school wellness centers or via telehealth), having human resource directors share the reasons why employees miss work, changes in attitudes and perceptions related to healthcare (especially in terms of availability), and the number of local policy changes or procedures/type (including time off to see doctors, etc.).
The Access to Care “Bright Spot” focused on the Community Medical Clinic of Kershaw County’s decision to provide patients with medical attention prior to undergoing an eligibility process to receive services. “Staff members recognized that the in-depth eligibility process can be a barrier to creating trust between (the) medical provider and patient,” LiveWell noted.
Goal Statement: Improve the emotional well-being of Kershaw County residents by increasing the quality, availability, and effectiveness of community health programs.
Outcome Metrics: A decrease in the rates of suicides and drug overdose deaths, and an increase overall well-being.
Objective One: Identify and assess the impact of our local mental health programs and initiatives -- this objective calls for an assessment and evaluation of these programs, followed by continuous quality improvement.
Objective Two: Provide training and resources to prevent mental health crises -- by providing “Mental Health First Aid,” a Family Foundations program, using the GROW model, engaging in mindfulness practices, and reduce screen time.
Objective Three: Provide safety-net crisis intervention resources and provide children and youth access to adequate and timely school-based behavioral health services -- this would be accomplished thorugh the community crisis response and intervention efforts, implementation of “Roads of Independence,” providing mental health counselors at high schools, creating lasting family connection programs, and forming health clubs at high schools.
Key Indicators to Watch: Utilization of the hospital for mental health, when programs reach capacity, the number of training opportunities offered, the use of support groups and the number of manuals distributed, and the impact of interventions through referrals and testimonials.
The “Bright Spot” for emotional health LiveWell noted is the introduction of life coaches -- doctoral students -- at North Central high and middle schools, Camden High School and Lugoff-Elgin High School through a partnership with the University of South Carolina’s Community Psychology Program. The program, which started at North Central High School, was able to be expanded to Camden and Lugoff-Elgin high schools thanks to additional funding and support from the Community Medical Clinic of Kershaw County, the Kershaw County School District and the Health Services District of Kershaw County.
“A total of 81 students were served with most receiving more than five visits and reporting reaching at least half of their goals set by the student and life coach. Students frequently report feeling appreciative that they ‘have someone to talk to,’” the report said.