Assessment pinpoints areas to improve local health care

Hospitals in the Flathead Valley are creating plans to address areas were medical service may be lacking after conducting a countywide heathcare assessment.

North Valley Hospital, along with Kalispell Regional Healthcare and the Flathead City-County Health Department, conducted the needs assessment. The Affordable Care Act mandates that an assessment be compiled every three years and that nonprofit hospitals adopt a strategy to meet the community needs.

The county, NVH and KRMC held a public forum earlier this month in Whitefish to present their findings and gather public input.

The three organizations collected data about rates and causes of death in the county. They also held focus groups and conducted surveys to determine the areas of need.

“We needed to really understand the needs of the community if we’re supposed to be helping the community,” said Leslie Diede with the county health department.

The health assessment found a few key areas of need.

Low income, uninsured or underinsured had difficulty getting dental care and access to primary care. There were also gaps in mental health care, and patient advocacy or coordination of care between multiple agencies was an issue. Another concern is a lack of education and programs targeting preventable disease.

Transportation is listed as a concern for not being able to access care. Of those surveyed, 43.6 percent said a lack of transportation was what prevents them from going to a doctor or dentist.

“Transportation comes up in almost every single need,” said Catherine Todd with NVH. “One thing that we don’t understand is what is meant by lack of transportation — is it not having a car, don’t have money for the bus or knowing where the bus is. We know transportation is a problem, but what that specifically means we don’t know.”

Of those surveyed, 93.8 percent said cost was what prevented them from seeking care.

Diede noted that while there are several programs for low-income or uninsured, that still may not be enough.

“You can have all the programs in world, but if somebody still can’t afford to pay for it, they won’t access those programs,” she said.

Obtaining access to health care can go beyond immediate health care concerns — it can impact longterm health.

According to the assessment, Flathead County’s mortality rate of 8.6 per 1,000 people is less than Montana’s 9 per, but higher than the national rate of 8.13.

Heart disease and cancer are the leading killers in the Flathead, Montana and the United States, according to the assessment.

Diede noted the top causes of death can be prevented through proper health care.

“If you consider the contributing factors that cause those — it’s smoking, obesity, poor diet, lack of exercise, not getting cancer screenings early enough,” Diede said. “The lack of health care effects all of the top causes of death.”

In the county, suicide is the sixth-leading cause of death. Montana has been at or near the top of the nation for rate of suicide for more than 30 years and Flathead County is near the top in the state.

Hillary Hanson, with the county health department, said the county’s suicide rate is more than double the national average.

“Suicide and mental health services is a really big deal across Montana,” Hanson said. “There is a lot of existing services, but when we talk to the community were seeing a lot of barriers and gaps in those services.”

One of those gaps is the lack of mental health providers available to low-income patients and a lack of information about services.

“Awareness comes into play — does everyone know about the services and where to refer people,” Hanson said. “Sometimes people don’t know about all the resources in the community.”

To address the key areas of need, NVH and KRMC have both created implementation plans to tackle the identified health needs.

NVH plans to incorporate screening services, education, wellness programs and support groups, among other programs, to target the most prevalent and preventable diseases affecting the community. Future plans include bringing wellness education and programs to local communities and organizations.

The hospital has worked to address access to affordable primary health care in a number of ways including by establishing two rural health clinics in Columbia Falls and Eureka. To continue this effort, the hospital plans to continue to recruit additional primary care providers, including physicians, according to its implementation plan.

To address mental health care needs, over the next three years NVH plans to strengthen its senior mental health program and support coordination with community mental health providers.

Because dental care falls outside NVH’s mission and scope, the hospital plans to increase education on the benefits of preventative dental care and continue to support community efforts to provide affordable dental care.

The hospital also intends to improve its services to help guide patients through the healthcare system. Plans include expansion of the care manager role to provide resources for patients and partnership with joint efforts to enhance communication between agencies, the public and patients to create awareness about care.