Pali Momi Medical Center
Community Health Improvement Plan— September 2016 —Table of Contents
1Introduction.................................................................................................... 42Community Served by Pali Momi Medical Center .............................................5

3Community Benefit Planning Process .............................................................. 73.1
Development of the Community Health Needs Assessment ....................... 73.2
Areas of Need ............................................................................................ 73.3
Priorities ................................................................................................... 73.4
CHNA Areas of Need not Addressed ......................................................... 84Community Health Improvement Strategy ...................................................... 9Priority Area 1: Access to Health Services .......................................................... 9Strategy 1.1: Support development of West O‘ahu’s health care workforce ...... 9Strategy 1.2: Increase access to health services for medically-underserved
communities and vulnerable populations ....................................................... 9Strategy 1.3: Provide and subsidize health services that would not otherwise beavailable to the community ............................................................................ 10
Priority Area 2: Diabetes ................................................................................... 10
Strategy 2.1: Improve diabetes self-management ........................................... 10
Strategy 2.2: Prevent diabetes by reducing obesity and developing healthy
lifestyles ......................................................................................................... 101 Introduction
Pali Momi Medical Center is pleased to share its Community Health Improvement Plan,
which follows the development of the March 2016 Community Health Needs
Assessment. In accordance with requirements in the Affordable Care Act and IRS 990
Schedule H requirements, this Plan was approved by the Board of Directors for Pali
Momi Medical Center on September 21, 2016.2 Community Served by Pali Momi MedicalCenterPali Momi Medical Center serves thehealth needs of residents in West Oahu,Hawai‘i, including the Census County
Divisions of Ewa, Wahiawa, Waialua, andWaianae. In 2009-2013, West Oahu had apopulation of 476,408.1

Figure 2.1: Pali Momi Service Area Map

West Oahu’s population is younger than
the rest of the Honolulu County and stateof Hawai‘i. Children under 18 made up
25.5% of the region’s population(compared to 21.9% in Honolulu Countyand 22.2% in Hawai‘i) and adults over 65
made up 11.8% of the population(compared to 14.9% in the county and14.8% in the state). The largest single race group in West Oahu is Asian at 40.4%, withthe majority of the Asian population identifying as Filipino or Japanese. The
Black/African American, Native Hawaiian and Other Pacific Islander, multiracial, andHispanic populations are relatively larger in West Oahu than both Honolulu County andHawai‘i overall, and a closer examination of the multiracial population shows that themajority (59.8%) of West Oahu residents identified as any part Asian.1
The 2008-2012 median household income in West Oahu ($77,045) was relatively highcompared to the county ($72,292) and the state ($67,492).2 However, per capita income
was just $27,652 in West Oahu in 2009-2013, lower than Honolulu County ($30,361),
Hawai‘i ($29,305), and the U.S. ($28,155).1 Larger household sizes account for thisjuxtaposition. While the average household has 3.0 members in Hawai‘i and Honolulu
County, the average West Oahu household has over 3.3 members.
9.0% of West Oahu’s population lived below poverty level in 2009-2013, comparable toHawai‘i overall (11.2%) and lower than the U.S. average (15.4%). It is important to note,however, that federal definitions of poverty are not geographically adjusted, so the data
may not adequately reflect the proportion of residents who struggle to provide forthemselves due to the high cost of living across the state of Hawai‘i. Certain race/ethnic
groups in West Oahu are also more affected by poverty: overall, the “Other” and Native
Hawaiian or Other Pacific Islander populations had the highest poverty rates in 20092013.1
A comparable percentage of West Oahu and Honolulu Count residents have at least ahigh school degree or a bachelor’s degree. However, rates of completing higher

1 U.S. Census Bureau, American Community Survey, 2009-2013 Estimates
2 U.S. Census Bureau, American Community Survey, 2008-2012 Estimates

education were lower: only 25.9% of West Oahu residents ages 25 and older had atleast a bachelor’s degree, compared to 32.1% in the county and 30.1% in the state.1

3 Community Benefit Planning Process
3.1 Development of the Community Health Needs
AssessmentFifteen Hawai‘i hospitals across the state, including Pali Momi, jointly conducted aCommunity Health Needs Assessment (CHNA) to fulfill requirements mandated by theAffordable Care Act, and in accordance with final IRS rules issued on December 31,
2014. The Healthcare Association of Hawai‘i led this collaboration to conduct state- andcounty-wide assessments. Following the development of a Honolulu County CHNA, Pali
Momi contracted with Healthy Communities Institute to develop a CHNA report focusedon the hospital’s West Oahu service area.

3.2 Areas of Need
The CHNA looked at health broadly and considered a wide array of health and quality oflife data. These five topic areas were identified as being the highest areas of need forWest O‘ahu:
Access to Health Services

Diabetes

Respiratory Diseases

Teen & Adolescent HealthMaternal, Fetal & Infant
Health

3.3 Priorities
In January 2016, Pali Momi’s Community Benefit team prioritized the significant
community health needs of West Oahu considering several criteria:





Alignment with CHNA
Opportunity for partnership
Availability of existing resources or programs
Opportunities to address disparities or race/ethnic sub-groups
Community input from stakeholder interviews

A Prioritization Matrix methodology was used to select the priority topic areas for thehospital’s Community Health Improvement Strategy. For each of the prioritization criteria
listed above, the top five topic areas were scored using a scale of 1-3, and scores weretotaled to establish ranks for each of the topic areas. These ranking results weretabulated across the Community Benefit Team participants to establish the top two Pali
Momi priorities.
After reviewing the scoring and ranking, the top two topic areas selected as priorities
were:


Access to Health ServicesDiabetes

3.4 CHNA Areas of Need not Addressed
The following areas of need identified from the CHNA will not be addressed in thisCommunity Health Improvement Plan.
Children’s HealthDisabilities
Immunizations & Infectious Diseases
Environmental & Occupational HealthHeart Disease & Stroke
Maternal, Fetal & Infant Health
Mental Health & Mental Disorders
Men’s HealthOlder Adults & Aging
Oral HealthPrevention & Safety
Respiratory Diseases
Teen & Adolescent Health
Substance Abuse
Women’s Health

These needs were not selected because they are beyond Pali Momi’s current community
benefit resources and/or areas of expertise.
It is expected that the priority areas that were selected will include activities that have impact
on multiple topic areas where there is a need for services.

4 Community Health Improvement Strategy
Priority Area 1: Access to Health Services
Strategy 1.1: Support development of West O‘ahu’s health care
workforce
Activities

Hospital
Resources

Partners

Train physicians in a family practice
medical residency program at Pali Momi.

Provide teaching
staff and training
site

University of Hawai‘i, John
A. Burns School ofMedicine

Contribute program
funding

University Clinical
Education & Research
Associates (UCERA)

Present continuing medical education(CME) programming for community
physicians.

Fund andadminister program

Recruit physicians to West O‘ahu forspecialties where the area has adocumented shortage.

Provide recruiting
staff

Provide expertise

Fund recruitment
activities

Strategy 1.2: Increase access to health services for medicallyunderserved communities and vulnerable populations
Activities

Hospital
Resources

Partners

Contract for Medical Respite services upondischarge for homeless patients who
require stepped-down care and a safe
place to recover.

Provide funding forservices

Mental Health Kokua

Conduct health and wellness programmingon-site at community health centers,
YMCAs, and other locations incommunities with high socio-economic
need, such as Wahiawa and Waipahu.

Fund and conduct
programs

Wahiawa Center forCommunity HealthStraub Medical Center

Waipahu YMCA

9Strategy 1.3: Provide and subsidize health services that would nototherwise be available to the community
Activities

Hospital
Resources

Partners

Provide a Level 3 Trauma Center serving
Central and West O‘ahu. This service is
not otherwise available in the service area.

Subsidize service
line costs

Department of HealthPriority Area 2: Diabetes
Strategy 2.1: Improve diabetes self-management
Activities

Hospital
Resources

Partners

Diabetes Self-Management Education:
In partnership with Straub Medical Center,
offer an American Diabetes Associationapproved, evidence-based diabetes
management education program todiabetics living in West O‘ahu – with afocus on recruiting and enrolling high need
and low-income populations.

Contribute program
funding

Straub Medical Center

Organize andprovide
administrative
support for
programming inWest O‘ahu

Strategy 2.2: Prevent diabetes by reducing obesity and developing
healthy lifestyles
Activities

Hospital
Resources

Partners

NEW Keiki: Provide this validated, familybased intensive lifestyle intervention forhigh BMI youth ages 7-18 at locations inWest O‘ahu, in partnership with the YMCAand HPH affiliated hospitals. Focus onenrollment from high need geographies andpopulations with health disparities.

Contributeprogram funding

YMCA of Honolulu

Organize
programming inWest Oahu

Kapiolani Medical Centerfor Women & ChildrenWilcox Medical Center
Straub Medical Center1011