2017-2022 Illinois Project For Local Assessment Of Need .
2017-2022Illinois Project for LocalAssessment of Need (IPLAN)September 2018
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022)ContentsCommunity Health Needs Assessment. 4Board of Health Review . 4Statement of Purpose . 4Community Health Committee . 5Description of Committee Process. 6Model . 6Methodology. 7Organizational Capacity Self-Assessment . 8Local Public Health System Assessment and Internal Capacity Self-Assessment . 12Methodology. 13Participation . 14Assessment Administration . 15Assessment Results. 16Strengths/Weaknesses/Opportunities . 25Analysis /Key Findings. 26Description of Health Status and Health Problems . 28Primary Data Sources. 29Secondary Data Sources. 32Demographic and Socioeconomic Characteristics . 32General Health and Access to Care . 53Mortality . 54Maternal Child Health . 67Chronic Disease . 73Infectious Disease. 81Environmental, Occupational and Injury Control . 83Sentinel Events . 85Prioritization . 87Process Used in Selecting Priorities . 87Method . 87Analysis . 87Three Health Priorities . 88Community Health Improvement Plan . 89Page 1 of 106
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022)Statement of Purpose . 89Health Priority One – Adolescent Health. 89Analysis of Adolescent Health . 89Overview . 89Risk Factors . 90Physical Determinants of Health . 90Protective Factors . 91Adolescent Health (AH) Vision . 92AH1: Outcome Objective . 92AH1: Impact Objectives . 93AH1: Proven Intervention Strategies . 93AH2: Outcome Objective . 93AH2: Impact Objectives . 93AH2: Proven Intervention Strategies . 93AH Collaborative Partners . 94Health Priority Two – Behavioral Health . 94Analysis of Behavioral Health. 94Overview . 94Risk and Protective Factors . 96Behavioral Health (BH) Vision . 97BH1 - Measurable Outcome . 97BH1 – Measurable Impact . 97BH1 – Proven Intervention Strategies . 97BH2 - Measurable Outcome . 98BH2 – Measurable Impact . 98BH2 – Proven Intervention Strategies . 98BH3 - Measurable Outcome . 98BH3 – Measurable Impact . 98BH3 – Proven Intervention Strategies . 98BH Collaborative Partners . 99Health Priority Three – Maternal Child Health . 99Analysis of Maternal Child Health. 99Overview . 99Page 2 of 106
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022)Risk Factors . 99Protective Factors . 102Maternal Child Health (MCH) Vision . 102MCH1 - Measurable Outcome. 102MCH1 – Measurable Impact. 102MCH1 – Proven Intervention Strategies . 102MCH2 - Measurable Outcome. 103MCH2 – Measurable Impact. 103MCH2 – Proven Intervention Strategies . 103MCH Collaborative Partners . 104Sources . 105Page 3 of 106
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022)Community Health Needs AssessmentThe Illinois Department of Public Health (IDPH) requires that all health departments complete an IllinoisProject for Local Assessment of Needs (IPLAN) every five years. This is an assessment of the needs in acommunity and a community health improvement plan for meeting those needs. The IPLAN mustcomply with Section 600.410 (Illinois Department of Public Health [IDPH], 2008).Board of Health ReviewThe DeKalb County Board of Health reviewed and approved the IPLAN on September 25, 2018.Statement of PurposeDeKalb County has a unique history of collaboration between local public health and care providers. Formany years, these organizations have worked together to leverage and combine resources to addresshealth concerns of the community. In 2017, the organizations came together to develop a joint healthneeds assessment under the name, Together for a Healthier DeKalb County. Since this development,the collaborative has committed to pursue approaches aimed at improving the health of DeKalb County.The DeKalb County Health Department 2017-2022 IPLAN builds on the Community Needs Assessmentcompleted by the Together for a Healthier DeKalb County collaborative. It combines population healthdata in addition to feedback gathered from the community in the form of a community survey, healthsystem assessment and a force of change perspective. This presents a panoramic view of factorsimpacting the health of DeKalb County. Although DeKalb County indicators of health are positive overall,there are specific disparities related to race, gender, and social economic opportunities that impacthealth outcomes.The Together for a Healthier DeKalb County collaborative recognizes the health needs of the communityand availability of resources are constantly evolving. The results of their efforts can serve as a valuableguide to establishing shared priorities and as a benchmarking tool as organizations continue to work tocreate a healthy DeKalb County. Table 1 is a list of the steering committee for the Together for aHealthier DeKalb County collaborative.Page 4 of 106
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022)Community Health CommitteeTogether for a Healthier DeKalb County Steering CommitteeNameOrganizationTitleDr. Todd Barrowclift, DODeanna Cada, MSRebecca Frieders, MPH,CPH, CHESLisa Gonzalez, MPHJennifer Kleckner, RN,BSN, IBCLC, LCCEVincent Leonforte, LEHPNorthwestern Medicine Kishwaukeeand Valley West HospitalsDeKalb County Mental Health Board &DeKalb County Community ActionNorthwestern Medicine Kishwaukee andValley West Hospitals, Community HealthServicesDeKalb County Health DepartmentNorthwestern Medicine KishwaukeeHospital and Northwestern MedicineBreastfeeding CenterDeKalb County Health DepartmentDawn Lomax, RN, BSNorthwestern Medicine Valley WestHospitalRocio MarungoDeKalb County Health DepartmentMarci Millburg, RN, BSNStacia Runge, MSWNorthwestern Medicine KishwaukeeHospitalDeKalb County Health DepartmentDeKalb County Health DepartmentNorthwestern Medicine Kishwaukee andValley West Hospitals, Community HealthServicesDeKalb County Health DepartmentAnnie Tripicchio, MBADeKalb County Health DepartmentGabriela Ortiz, BSNDebra PeiferDawn Roznowski, MBATable 1Page 5 of 106Director of PhysicianOperationsDirectorProgram ManagerPublic HealthAdministratorCommunity WellnessCharge NurseLicensed EnvironmentalHealth Practitioner-LeadManager of InpatientServices and EmergencyDepartmentHealth PromotionAssociateWellness NursePublic Health NurseAccounting AssistantDirectorHIV/STD ClinicalTeam LeaderAdministrative Support &Marketing Manager
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022)Description of Committee ProcessThe DeKalb County Health Department served as the lead agency guiding the Together for a HealthierDeKalb County collaborative through the Community Health Needs Assessment process. The steeringcommittee, listed in Table 1, met each month from August 2017 to May 2018. The committee’s sharedagenda and vision allowed for consistent, diligent work through the phases of the selected model. Thecommittee severed as experts in the field and made decisions collectively regarding the timing, contentand delivery of each phase to the community.The Together of a Healthier DeKalb County collaborative participated in a visioning session to establish abrand and to develop one shared vision. This offered a useful mechanism for convening the communityand building enthusiasm for the process. In addition, it set the stage for planning, and provided acommon framework throughout subsequent phases.On September 22, 2017 the committee met to brainstorm and creatively design a logo that would brandthis initiative moving forward. The committee voted on a logo to use on materials and documentsdeveloped by Together for a Healthier DeKalb County. Below is the final logo.On November 17, 2017 the committee met to further their visioning process. A PowerPoint waspresented, and a visioning worksheet was completed by the entire committee. The following visioningstatement was decided upon by the committee members.“Working together to prevent disease, promote wellness and improve health outcomes for all DeKalbCounty residents.”ModelThe Together for a Healthier DeKalb County collaborative selected Mobilizing Action for Planning andPartnership (MAPP) to be the evidenced based model used for the Community Health NeedsAssessment. MAPP is a community driven strategic planning process for improving community health.Facilitated by Together for a Healthier DeKalb County, this framework requires strategic thinking toidentify health issues and resources needed to address them. MAPP is not an agency focusedassessment process, it is an interactive process that can improve the efficiency, effectiveness andultimately the performance of the public health system. 1Page 6 of 106
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022)Figure 1MethodologyThere are 6 phases in the MAPP process, Figure 1. Phase 1 – Organize for Success Phase 2 – Visioning Phase 3 – The Four Assessments Phase 4 – Identify Strategic Issues Phase 5 - Formulate Goals and Strategies Phase 6 – Action CycleThe MAPP model was developed by the National Association of County and City Health Officials(NACCHO) in cooperation with the Public Health Practice Program Office and Centers for Disease Controland Prevention (CDC).The following 9 principles are integral to the successful implementation of MAPP:1. Strategic planning2. Systems thinking3. Community ownership and stakeholder investment4. Shared responsibility and working toward a shared vision5. Comprehensive data informs each step of the process (data includes information on healthstatus, quality of life, assets, external forces, and how the public health system functions)6. Builds on previous experience7. Partnerships8. Celebration of successes9. Involved the local public health systemPage 7 of 106
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022)Organizational Capacity Self-AssessmentThe DeKalb County Health Department (DCHD) serves a population of 104,528. DCHD has three mainservice areas. These include Health Promotion and Emergency Preparedness, Community Health andPrevention, and Health Protection. The Administration branch provides support and administrativeservices. Together this chart provides a schematic of how DCHD delivers the 10 Essential Services ofpublic health to DeKalb County. Figure 2 is the overall organization and Figure 3 focuses on the largestservice area, Community Health and Prevention.Figure 2Page 8 of 106
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022)Figure 3Page 9 of 106
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022)DCHD employs 42 people. The largest job category according to Table 2 is Clerical Support making up 33percent of the workforce, followed by Leadership/Administration at 26 percent, Nurse/Case Manager at19 percent, Environmental Health Specialists at 10 percent, Nutritionists and Animal Control Warden 5percent and Health Educator at 2 percent.DCHD Workforce by Job CategoryCategoryCountPercentLeadership/ Administration1126%Nurse/Case Manager819%Environmental Health Specialist410%Health Educator12%Nutritionist25%Clerical Support (Secretaries, Accounting)1433%Animal Control Warden25%Other00%42100%Grand TotalTable 2Table 3 depicts the ethnic diversity of DCHD, 21 percent of staff report being of Hispanic ethnicity. Thiscompliments the demographic breakdown of the county where DeKalb County is 11 percent Hispanic.DCHD Workforce Breakdown by anic3379%42100%Grand TotalTable 3In 2018, DCHD participated in the Public Health Foundation Core Competency assessment. The purposeof this competency assessment is to help discover DCHD’s level of competence regarding the keydimensions of public health practice. A competency is any knowledge or skill of an individual ororganization that has been shown to cause or predict outstanding performance. A collection ofcompetencies delivers a behavioral roadmap that is directly related to both individual and organizationalperformance. By assessing this level of knowledge or skill for each competency indicator described,Page 10 of 106
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022)organizations can prioritize learning opportunities and focus on those areas that are most important andto concentrate where the need for training and learning may be greatest. 2The Public Health Foundation’s Core Competency Assessment uses a four-point scale. The participantswere asked to score themselves based on skill knowledge: 1 – No awareness or Knowledge, 2- LimitedKnowledge or Ability to Apply; 3 – Comfortable with Knowledge and Apply Skill, 4 – Comfortable, Expert,or Teach Others.The assessment is divided into Tiers, where Tier 1 includes all direct service staff, Tier 2 includescoordinators and managers, and Tier 3 includes directors and administration. Table 4 depicts the resultsof this assessment. The three highest categories for DCHD include Communication at 2.4, CulturalCompetency at 2.4, and Leadership and System Thinking at 2.3. The two lowest categories include PolicyDevelopment and Program Planning at 2.1 and Public Health Sciences at 2.1. The results of thisassessment will be used to allocate resources for staff training. The goal of DCHD is to have everycategory averaging 2.5 to 3.0, suggesting DCHD staff is comfortable with knowledge and able to applyskills related to each category. This would demonstrate significant improvement in DCHD competency.DeKalb County Health DepartmentPublic Health Foundation Competency Assessment2017CategoryTier 1Tier 2Tier 3Average Scoreby CategoryAnalytical/Assessment Skills1.72.22.92.2Policy Development/ Program Planning1.52.12.82.1Communication Skills1.82.52.92.4Cultural Competency Skills2.02.62.72.4Community Dimensions of Practice Skills1.82.42.72.3Public Health Sciences Skills1.52.12.72.1Financial Planning and Management Skills1.52.13.02.2Leadership and Systems Thinking Skills1.92.33.02.4Average Score by Tier1.72.32.82.3SkillsTable 4Page 11 of 106
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022)Local Public Health System Assessment and Internal Capacity Self-AssessmentThe Local Public Health System Assessment (LPHSA) is a standardized assessment utilizing the NationalPublic Health Performance Standards (NPHPS)developed collaboratively by Centers for Disease Controland Prevention (CDC); American Public HealthAssociation (APHA); Association of State and TerritorialHealth Officials (ASTHO); National Association of Countyand City Health Officials (NACCHO); National Associationof Local Boards of Health (NALBOH); National Networkof Public Health Institutes (NNPHI); and then PublicHealth Foundation (PHF). These optimal standards allowresponding sites to consider activities of all public healthsystem partners contributing to the public health withina community. 3The Together for a Healthier DeKalb Countycollaborative utilized the Local Public Health SystemPerformance Assessment Instrument to answer twomain questions of the health in their community.Figure 41) “What are the components, activities, competencies, and capacities of our public healthsystem?”2) “How well are the 10 Essential Services being provided in our system?”The dialog that occurred at each session contributes to specifically identifying strengths, weaknessesand opportunities for immediate improvements and long-term investments.The LPHSA Local Score Sheet suggested two optional assessments to be completed. These optionalassessments add dimension to the final report. The reports with the optional assessments depictperformance scores in relation to how they have prioritized Model Standards and the contributiondirectly to the standard. The Agency Contribution Assessment is designed to allow local healthdepartments to rate how much the agency contributes to each Essential Service Model Standard. ThePriority Rating Assessment allows for respondents to rank the Model Standards to their public healthsystem.The information obtained from these sessions will be used to improve and better coordinate publichealth activities in DeKalb County. The information will inform the community health improvement planand the community health needs assessment. The Together for a Healthier DeKalb County collaborativewill use the results of this assessment to enhance existing policy, advocate for new policy, and makeresource decisions with the aim of a healthier DeKalb County.Page 12 of 106
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022)MethodologyDeKalb County Health Department (DCHD) staff completed the Agency Contribution (OrganizationalCapacity) Assessment in November of 2017. The steering committee selected personnel that wouldhave knowledge and insight as to how much of each Model Standard DCHD contributes to the overallpublic health system. The format of this assessment followed the same process as the performancescore assessment described below.The community participants contributing to the LPHSA performance score were selected according tothe organization or type of entity they represent. This included public, private, and voluntaryorganizations. The Facilitators Guide suggested organization types that would have knowledge and/orinsight into the capacity and operations of the system entity. The project steering committee selectedspecific individuals to represent their organization or organization type within the DeKalb County localpublic health system. A formal invitation was sent requesting the organization send representation.The LPHSA was scheduled to be administered to the community participants every Thursday morningfrom 8:30 to 10:30; the sessions took place between January 25, 2018 and February 22, 2018. TwoEssential Services were covered in each two-hour block. The meetings took place at the DeKalb CountyFarm Bureau, 1350 West Prairie Drive, Sycamore, IL 60178.Session I: Essential Service 1 & 2Date: January 25, 2018, 8:30 to 10:30 a.m.Session II: Essential Service 3 & 4Date: February 1, 2018, 8:30 to 10:30 a.m.Session III: Essential Service 5 & 6Date: February 8, 2018, 8:30 – 10:30 a.m.Session IV: Essential Service 7 & 9Date: February 15, 2018, 8:30 – 10:30 a.m.Session V: Essential Service 8 & 10Date: February 22, 2018, 8:30 – 10:30 a.m.Page 13 of 106
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022)ParticipationThe LPHSA main performance assessment in DeKalb County attracted over 100 participants.Participation included 25 unique organizations representing the following groups; mental health, lawoffice, city and county officials, public health, elementary and secondary schools, the local university,fire, police, emergency response, health services, advocacy agencies, private clubs and a youth mentalhealth organization, Table 5.Local Public Health System Assessment ParticipationOrganizationAdventure Works DeKalb - Mental Health (Youth)Brown Law Group & BOH MemberCity of DeKalbCity of SycamoreDeKalb County Board of HealthDeKalb County Community DevelopmentDeKalb County Community FoundationDeKalb County GovernmentDeKalb County Health DepartmentDeKalb CUSD 428DeKalb Fire DepartmentDeKalb Police DepartmentDepartment of Human ServicesFirst Lutheran Church-DeKalbKishwaukee YMCANorthern Illinois University (NIU)NIU- Center for Governmental StudiesNIU- Emergency Management & PlanningNIU- Health ServicesNM Ben Gordon CenterNM KishHealth System/ DCHD Board of HealthNM KishHealth System/Steering CommitteeNM Valley WestRetired- Northern Illinois UniversityRotary Club of SandwichTable 5TypeMental HealthPolicy/LawCity OfficialCity OfficialBoard of HealthCommunity AdvocacyNonprofit/AdvocacyGovernmentPublic HealthSchoolFirePoliceSocial iversityHealthMental e community participants were asked to complete the optional Priority Rating Assessment after theperformance scores were collected. This assessment was in the form of a survey that was emailed outafter the sessions closed.Page 14 of 106
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022)Assessment AdministrationThe LPHSA participants were directed to a large conference room at the DeKalb County Farm Bureau.Each participant registered and was given an information packet including a response survey. All 5sessions followed the same format. Discussion questions were used to introduce the Essential ServiceModel Standard. These included asking respondents to consider their knowledge and involvement ineach standard. Next, they were asked to answer the assessment questions using the Summary ofAssessment Response Options, Table 6. The response then generates a score for each Model Standard,Essential Service, and one overall assessment score.Summary of Response OptionsTable 6The participants then identified strengths, weaknesses, immediate and long-term opportunities. Thisopen dialog was recorded and analyzed to gain insight to each standard and the unique position theDeKalb County public health system must address to improve each Essential Service.Page 15 of 106
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022)Assessment ResultsPerformance Scoring LPHSASummary of
DeKalb County Health Department - Illinois Project for Local Assessment of Need (2017-2022) Page . 4. of . 106. Community Health Needs Assessment. The Illinois Department of Public Health (IDPH) requires that all health departments complete an Illinois Project for Local Assessment of Needs (
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