Public Health andTransportation Webinar SeriesPart 2: On the Ground in Washington
County, Minnesota

Ø Launched in 2013
Ø Funded through the U.S. DOT, Federal Transit Administration
Ø Goal of the Center: Promoting customer-centeredmobility strategies to advance good health, economic
vitality, self-sufficiency, and community integration.
Ø Led by CTAA and operated through a partnership of :A Roadmap for collaboration: Integratingtransportation and mobility into a community
health assessment process
Stephanie Souter, Program Supervisor
Washington County Public Health and Environment
Marna Canterbury, Director of Community Health,HealthPartners Lakeview HospitalAgenda•Washington county context•Accountability requirements•2018-2019 Community Health Assessment process•Shared priorities•Shifting to implementation and tracking• Minneapolis – StPaul Metro area
• 256,000 residents• Suburban-rural mix• Growing andchanging (335,000by 2040)• Community hospital in Stillwater, MN• Part of the Health Partners healthsystem• 75% of hospital admissions
Minnesota counties:
Washington (50)
RamseySt. Croix (WI)

Health Assessments and Opportunity for Collaboration

Hospitals & Health SystemHealthPartners

Local Health Department-WashingtonCounty• Community Health Needs Assessment(CHNA)•• Tool for hospitals to meet their mission• Identify the needs of the community anddirect community benefit activities
toward those needs• Required every three years by IRS as partof the Affordable Care Act
Coordinated with:• All HealthPartners Hospitals• Valley Hospitals aligned effort• Boards of directors

Community Health Assessment (CHA)• Foundational activity to set priorities, develop
programs, seek funding, and maintain policies• Understand the health of the population, identify
contributing factors and community assets• Required every five years by state law since 2003
(Local Public Health Act, MN Statutes 145 A.10,Subd. 5a)• Requires development of Community HealthImprovement Plan (CHIP)• Required for Accredited status under Public HealthAccreditation Board (PHAB) standards
Coordinated with:• Washington County Board of Commissions
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Why Collaborate?
• Shared geographic area
• Long collaboration history• Trust and mutual respect• Similarities between CHA and CHNA
• CCH/East metro CCH (indicators,collaborations)• Greater range of expertise andperspectives

Potential roadblocks• State and geographic differences• Timeline• Requirements• Approval processes (6 BOD andCounty Commissioners)• Other leader input• Less complex to do within anorganization, than with two• Data sharing limits• Staff changes• Other collaboration commitmentsCollaboration around health assessments ismessy!
Polk County
PublicHealthCenter forCommunity
Health (CCH)

AllinaFairview Now M}
HealthEast Health
Fairview

CCH East Metro
CHA/CHNA Pilot

Ramsey County
Public HealthAmery

Lakeview

Regions

Methodist
Washington
County Public
Health &Environment

Westfields
HudsonHealthier
Together

St Croix andPierce County
Public Health11

Sharing the roadDecision: Do this together• Build on long partnerships• We have innovation potential• Shared goals, shared work, shared credit• Assume good intent

Our driver’s manual
Required process:1. Data Collection & Analysis• Health data profiles (public health and EHRdata)• Community Input

2. Set Priorities• Review and score health data
• Rank issues and select priorities

3. Plan/Implementation• Define goals and strategies• Review with internal and externalstakeholders• Continuously updated• Share dataCollaboration Opportunities:üData collectionüData analysis
üConveningüCommunicatingüPromotionüProcessüPriorities and language

Shared Leadership matters

Shared Priorities: A Driving Force• Access to Care
• Access to Health• Mental Health and Wellbeing• Nutrition and Physical Activity• Substance Abuse• Environmental Conditions (Washington County)Implementation Goal Setting
Access to Care

Access toHealthMental Health
Nutrition andand Well-being Physical Activity

Substance
Abuse

EQUITY
How are certain populations disproportionally impacted
and how can we partner with these communities toaddress needs and eliminate disparities?

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Health EquityPoverty can create multiple barriers forresidents including:• Access to healthy foods• Access to care
• Educational opportunities• Neighborhood safety• Health rates for low income populations toprovide a better picture of health for all
residents in Washington County.

Priority: Access to care

Access to care refers to having
appropriate, convenient andaffordable health care. Includes:
proximity to care, cost, insurance
coverage, cultural sensitivity andresponsiveness.

Priority: Access to HealthAccess to health refers to the social andenvironmental conditions that directlyand indirectly affect people’s health suchas housing, income, employment,education, and more.

Transportation is a bridge to access!

Transportation scorecard
All residents have opportunity to attain their full health potential.

Residents have improved mobility and transportation options that link them witha variety of health services and opportunities to be healthy.
Develop a one stop for transportation information and referral.
Increase awareness of the One-Stop and of existing transportation options throughhigh quality training and outreach events
Provide twenty high-quality travel orientation events that supports greater
mobility for persons with disabilities and older adults
Sustain the involvement of both external and internal partners in increasing awareness andimproving opportunities for mobility for those who cannot, do not, or opt not to drive
Advocate and promote long-term investments in transit to provide reliable and efficient transit services.

Roles of the road
Access to Care

Access toHealth

Mental Healthand Wellbeing

Substance
Abuse

Nutrition andPhysical Activity

Lakeview:

Washington County:• PowerUp-Lead• School health policy-Partner• PowerUp-Partner/Support• School health policy-Partner• School mental healthPartner/Support• Transportation-Lead• Opioid Collection-Lead• School mental health-Lead ,Make It Ok; Partner/Support• Transportation Partner/Support• Opioid Rx Reduction-Lead21

Where do we go from here?
• Public Health and Lakeview are both active partners
in transportation consortium work
• Continued collaboration on data sharing andreporting• Share and review with partners• Update with new population level data as it
becomes available• Annual update (county CHIP)

Questions?

Access to Care:

Fairview Lakes Medical Center, Transit Link, and Washington CountyRachelle Henkel
Sheila Holbrook-WhiteHow It All Began• Email to Washington CountyCommissioner Miron• CoffeeFairview Lakes Medical Center
Boundary between Chisago andWashington Counties

Framing the Challenge27

Visual Tour of Residents That
Call Washington County Home28

Washington County:
Older Adults

29

Washington County:
Persons with Disabilities

30

Washington County:
Individuals Living With Low
Incomes31

Washington County:
Zero-Vehicle Households

32Current Washington County:
Fixed-Route Services

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Transit Link•

Operated by Metropolitan Council via 3 contractors•Eligibility: Any one in Washington County.

•

Hours of service: Monday- Friday, 6 a.m. - 7 p.m.

•Requires advance reservations•

Curb-to-curb•

Fares vary by time & distance•

Trips are constrained by supply and are notguaranteed.

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Moving Forward• Engaging Transit Link
• Internal discussions with FairviewLakes• Outreach to Forest Lake partners

Fairview Lakes Medical CenterTransit LinkWashington County Pilot

The Plan:
Fairview Lakes Medical Center:• Flex and aggregate appointments for Forest
Lake patients, Wednesdays- Thursdays,
10:30 – 1:30 pm
Metro Council- Transit Link
• Cross into Chisago County• Through aggregation, increases likelihoodof trips for Forest Lake patients
Washington County• Increase awareness of the pilot throughone-on-one and small group engagement ofForest Lake residents

Anticipated Outcomes• Reduction in missed appointments• Increase in chronic disease(s) management• Reduction in preventable admissions/re-admissions• Increase in wellness• Increase in social connectedness

Questions?

Image Credit: https://goo.gl/images/whXcqM

NCMM ResourcesØ 30 + ”By Topic”Pages to provide resources on specific areas of interest
including Health and Transportation: nc4mm.org/by-topic
Ø Relevant Research including a recent publication on Opportunities toImprove Community Mobility through Community Health Needs
Assessments.
Ø Learn and connect with others. Email us to be connected with local
peers or other communities doing similar work
Ø Receive direct detailed technical assistanceContact us directly: info@nc4mm.org

Health and Transportation Resources
Partner Resources:
Ø CDC Transportation Recommendations
Ø CDC HI-5 Interventions
Ø ASTHO Transportation Policy Guidelines
Other Resources:
Ø CTAA’s Health Care and Transportation ResourceCenterØ Guidebook for Communications between
Transportation and Public Health Communities

Twitter: @NC4MM
www.nc4mm.org

Contact information:
Alex King
Senior Program Associate, Health Care and Transportation
Community Transportation Association of America
king@ctaa.org
202.340.5284