St Clair Hospital 2013 Community Health Needs Assessment

COMMUNITY HEALTH NEEDS ASSESSMENT FY 2013

Ourvision: A healthy community

At St. Clair Hospital, community is all of the above,

and much more. Commitment to the community has

always been our focus. In fact, from its earliest

inception, St. Clair has strived to meet the healthcare

needs of our community.

Sixty years later, the Hospital stands strong, and

that community continues to grow. St. Clair Hospital is a beloved and trusted

institution that has always responded to emerging healthcare needs with

innovation, growth and improvement. As the largest non-profit organization

in the South Hills, the Hospital is a leader, serving as a hub for the many

partner organizations that share our vision and commitment.

Through decades of advances, one thing has remained constant: our commitment

to the health and well-being of the people within the community we serve. We are

all united by more than a common geographic area; we share a sense of mission,

of wanting to continually improve the place that we call home. We believe in this

community and we remain strongly committed to serving the people who live

and work here.

How do you define a community? Is it a neighborhood? Is it a specific geographic area, outlined by clear boundaries? Is it

a group of people with something in common — a shared history

or mission, or a relationship grounded in living or working together?

2 S t . C l a i r H o s p i t a l

C O M M U N I T Y H E A L T H N E E D S A S S E S S M E N T

Table of contentsCOMMUNITY BENEFITS PROGRAMS

Our History 4

Continued Growth 5

Ways We Give Back to the Community 6

St. Clair Hospital’s Economic Development Impact 10

COMMUNITY HEALTH NEEDS ASSESSMENT

Evolution of Our Assessment 12

Part of the Solution 13

The Community We Serve 14

Gathering Information 15

To Better Understand and Serve 16

Critical Region-Wide Health Issues 17

Top Three Priority Health Issues 18

The Power of Partnerships:Existing Facilities and Resources 24

Thank You to Our Community Partners 26

C o m m u n i t y B e n e f i t s P r o g r a m s 3

If you have additional questions or would like to receive apaper copy of our Community Health Needs Assessment,please e-mail us at [email protected].

C O M M U N I T Y B E N E F I T S P R O G R A M S


St. Clair Hospital‘s Beginnings

t all started with an unmet need — a need for a healthcare facility close to home, for the residents of

Pittsburgh’s south and west suburbs. During the years after World War II, returning soldiers moved

to these areas to buy homes and start their families. The regions grew dramatically, but residents

had to travel to hospitals in the city for medical emergencies and healthcare. For many, this was not easy,

as not all families owned cars in those days. To Arthur S. Haines, M.D., this situation was unacceptable.

Dr. Haines and a group of fellow visionaries were committed to having a hospital in their community,

and they worked for 10 years to raise funds to build one, engaging the entire community in the effort.

In October 1951, ground was broken at the Silhol Farm on Bower Hill Road for a new hospital that

would care for the people of the South Hills in their own community. In 1954, that new hospital,

named to honor Revolutionary War patriot Major General Arthur St. Clair, opened its doors and

has never stopped moving forward.

Our history

St. Clair Hospital has four

outpatient centers in

addition to the hospital,

and is the largest employer

in Pittsburgh’s South Hills,

with 2,200 employees.

Today, St. Clair Hospital is a dynamic, growing, independent

acute care hospital providing healthcare to more than 480,000residents of Southwestern Pennsylvania. With 2,220 employees

and 550 physicians, St. Clair is the largest employer in Pittsburgh’s

South Hills. St. Clair is best known for outstanding services in

cardiovascular care, cancer care, maternal-infant care, psychiatry

and mental health, and emergency care.

Signs of success are evident as the Hospital continues to attract

many of the region’s leading physicians. In the last few years,

dozens of medical professionals, including primary care providers

and board-certified specialists, have chosen to relocate their

practices to St. Clair.

Patient satisfaction drives our mission of providing the highest

quality healthcare. A notable example is our Emergency

Department, one of the region’s busiest, treating over 60,000patients every year and consistently ranked the best in the nation for

patient satisfaction, with average wait times regularly under five minutes.

The Hospital continues to invest in the most advanced technology, from our medication

administration to state-of-the-art imaging and the da Vinci robotic surgery equipment.

This investment provides our medical teams with the innovative tools that enhance

diagnosis and delivery of care.

Today, the Hospital has modernized, inviting lobbies, the new Sipe Infusion Center, renovated

patient rooms and brand-new, state-of-the-art operating rooms. Strategic expansion has

extended our reach and enhanced our services into the community. We recently expanded

our Outpatient Center at Village Square and opened a new Outpatient Center in Peters Township.

Recognizing our accomplishments, Thomson Reuters named St. Clair to its list of the

100 Top Hospitals in the nation, based upon St. Clair’s record of patient safety, highquality outcomes, high patient satisfaction and clinical efficiency.

Continued growth St. Clair Hospital in 2013

Today, St. Clair Hospital

is a 328-bed, independent,

acute care hospital

that offers advanced,

high-quality healthcare

to more than 480,000

residents of Southwestern

Pennsylvania.

“To provide highly valued, service-oriented healthcare to the community.”

ST. CLAIR HOSPITAL MISSION STATEMENT


CHARITY, DISCOUNTED AND UNCOMPENSATED CAREAs a non-profit organization, St. Clair cares for everyone who

enters our doors, regardless of their ability to pay. Last year,

St. Clair provided $28.5 million worth of charity, discounted

and uncompensated care. Over 14% of net patient revenue

is put back into Community Benefit programs.

DONATIONSSt. Clair regularly makes donations to partnering agenciesin the form of monetary donations and in-kind contributions.

• With South Hills Interfaith Ministries, a social service agency,

St. Clair provides emergency assistance, supports families

in need and promotes healthful lifestyles. SHIM offers a

range of services, from emergency food and clothing to

summer camp and early childhood education. With the

Hospital, SHIM holds Wellness Days for clients, featuring

free health screenings and education offered by the Hospital’s

expert staff. In addition, St. Clair supported SHIM’s successful

Twitter campaign to raise money for holiday meals for area

families while educating South Hills residents about suburban

poverty. For every retweet of the original message, the

Hospital donated 50 cents to SHIM.

• The Hospital supports the Carnegie Boys and Girls Club,

which promotes health, social education, and vocational

and character development for children and teens from

6 to 18 years of age. Through monetary donations, St. Clair

Ways we give back to the communitySt. Clair is a community-based hospital, and has always had the goals of promoting

health, improving access to healthcare and providing benefits to the community as a

whole. St. Clair envisions our community as a place where healthful lifestyles are the

norm, where residents of any neighborhood have access to health education, disease

prevention, screenings and primary care. By engaging in partnerships with established

non-profit agencies and charitable organizations who share our values and goals,

St. Clair Hospital expands its reach into the community, building on existing strengths

and enhancing services to improve health and quality of life.

In the St. Clair service

area, approximately

20% of all households

had incomes below

$25,000.



supports after-school programs, such as the Homework

Power Hour and Dapper Dan Charities. St. Clair also

helps with the annual Holiday Party, donating services

and refreshments, as well as with individual events to

promote physical activity and fun learning.

• In the Sto-Rox community, Focus on Renewal has been a

beacon of hope for over 40 years, serving as a resource

for healthcare, parenting support, day care and services

for seniors. When members of St. Clair’s staff recognized

that the Sto-Rox Neighborhood Health Center, part of

Focus on Renewal, had old, out-of-date exam tables, the

Hospital donated new ones as well as other essential

furnishings. St. Clair provides smoking cessation classes

for women through a grant from Tobacco Free Allegheny,

as well as childbirth education classes, held on site at

the Center.

• Every year, the Hospital joins forces with the Boy Scouts

of America and the United Way for the Scouting for Food

drive that replenishes local food pantries. Throughout the

Hospital, departments compete to collect the most food

for the drive. In the last few years, the food pantries of

South Hills Interfaith Ministries, the Borough of McDonald

and Peters Township have been recipients of our Scouting

for Food drive.

COURTESY VAN SERVICEWith a fleet of eight vehicles, the Hospital’s Courtesy Van

provides rides to and from the Hospital and our affiliate

locations for anyone having difficulty arranging private or

public transportation on their own. Without St. Clair’s van

transportation, literally hundreds of friends and neighbors

would not be able to get to their medical appointments.

These are the men and women of the South Hills and

western suburbs who for myriad reasons do not have access

to private or public transportation. Our familiar blue-and-white

vans operate Monday through Friday, and have provided

nearly 13,000 rides to patients at no charge.



Ways we give back to the community (continued)

HEALTH EDUCATIONHealth education is an essential part of disease prevention, and St. Clair offers classes

at numerous locations as well as at the Hospital. Classes in CPR, childbirth preparation,

smoking cessation, diabetes management are among the offerings. St. Clair offers more

than 22 community education programs annually.

SUPPORT GROUPSFor those who are dealing with bereavement, addiction, or illnesses such as cancer, St. Clair

provides support groups for patients and families, in recognition of the human needs that

accompany serious illness. St. Clair offers more than 10 support groups.

NEEDLE DISPOSAL PROGRAMIn the interest of safety and disease prevention, St. Clair has a needle disposal program

for those who utilize needles, syringes and other sharps in managing conditions such as

diabetes. This free service, provided through our Environmental Services Department,

enables people to exchange containers of contaminated needles for new empty ones.

MENTORSHIP FOR HEALTH PROFESSIONS STUDENTSSt. Clair opens its doors to the region’s many training programs and universities whose

health professions students come to the Hospital to gain clinical experience. Medical

students, residents, nursing students and others rotate through our clinical departments

as they prepare for careers in healthcare, and often times, returning to communities in need.

St. Clair Hospital is a training

site for advanced clinical

degree programs, offering

praxis for medical imaging,

CRNA, and 5th and 6th year

pharmacy students. In 2012,

St. Clair staff provided more

than 2,000 hours as precep-

tors of 181 nursing students

from neighboring nursing

schools. Its medical school

preceptor program hosts 6–8

students for 8-week rotations

throughout each year.

And more than 2,000 hours

of clinical training were

provided in 2012 to more

than 130 Emergency Medical

Technicians and Paramedics.

Last year, more than 635 St. Clair Hospital volunteers

provided approximately 90,000 hours of service,

ranging from clerical duties to patient assistance.

C o m m u n i t y B e n e f i t s P r o g r a m s 9C o m m u n i t y B e n e f i t s P r o g r a m s 9

YOUTH PROGRAMSIn a variety of ways, St. Clair Hospital regularly sponsors

Youth Programs in the community, including those offered

by the 14 school districts within our service area. These

programs provide opportunities for children and teens

to socialize with their peers, engage in the arts, and

participate in sports.

GREEN TEAMSt. Clair Hospital believes that our commitment to the

community means a commitment to a healthy environment.

We have created a Green Team of employee volunteers

who work in partnership with two programs, Adopt a

Highway and Keep Pennsylvania Beautiful, to maintain

the beauty and health of our environment. Our employee

volunteers have “adopted” Bower Hill Road and Vanadium

Road and pledged to keep them clean and green.

SPEAKERS BUREAURecognizing that our employees possess a wealth

of knowledge and experience, St. Clair Hospital has

developed a Speakers Bureau that any community

group can call upon. Our speakers are available to

give presentations on health and wellness topics,

from stress management to living with diabetes.



St. Clair Hospital’s Economic Development Impact ST. CLAIR HOSPITAL PLAYS A PIVOTAL ROLE IN THE ECONOMIC HEALTH AND VITALITY OF THE COMMUNITY,WITH A DIRECT AND INDIRECT IMPACT ON THE AREA’S ECONOMY.

$6.3 MILLION

TAXES PAID TOTHE COMMUNITY

TOTAL SPENDINGHOSPITAL

$222,772,394

ECONOMIC RIPPLE EFFECT

$246,386,268

TOTAL BENEFIT

$469,158,662

SALARIESHOSPITAL

$83,575,916

ECONOMIC RIPPLE EFFECT

$64,545,680

TOTAL

$148,121,596

Source: The Hospital and Healthsystem Association of Pennsylvania

CHARITY, DISCOUNTED AND UNCOMPENSATED CARE• Charity Care • Unpaid Patient Expenses• Discounts to Uninsured/ • Unreimbursed Medicare

Underinsured • Unreimbursed Medical Assistance

TOTAL VALUE

$28,527,194

COMMUNITY BENEFIT PROGRAMS• Community Health Improvement

Services & Community BenefitOperations

• Health Professions Education

• Subsidized Health Services

TOTAL VALUE

$ 5,826,764

VALUE OF QUANTIFIABLE SERVICE TO THE COMMUNITY

TOTAL VALUE

$34,353,958

DIRECT IMPACTHospital employmentHospital spendingEmergency department capacityRegional vitalityCommunity health

INDIRECT IMPACTNon-hospital employmentRegional spendingState and local tax revenuesState economic development

support

• Cash and In-Kind Contributions

• Community Support

• Community Health Improvement Advocacy

COMMUNITYHEALTH NEEDSASSESSMENT FISCAL YEAR 2013

C o m m u n i t y H e a l t h N e e d s A s s e s s m e n t 11

Commitment to the community has always been our focus. In fact, the hospital was founded nearly 60 years ago

through the efforts of visionary, South Hills community members who recognized the need for a healthcare facility

close to home.

In 2011 under the leadership of Joseph B. Smith, Chairperson of the St. Clair Hospital Community Benefit Committeeand Senior Vice President–Marketing, Dollar Bank, as well as the administrative direction of Andrea L. Kalina, Vice Presidentof Human Resources and Organizational Advancement at St. Clair, the Hospital endeavored to better understand theunmet health needs of people living in neighborhoods served by St. Clair.

A three-year study overseen by the Community Benefit Committee and conducted in collaboration with St. Clair Hospital clinical experts, regional healthcare leaders, community members, and partnering health and human services agencies was completed. The findings of our 2013 assessment are detailed in the following pages. The report also identifies the action plan approved by the Hospital’s Board of Directors to address these unmet needs and ensure that we are providingthe healthcare services that are most important to those we serve.

Chronology of our assessment

DECEMBER> The Community Benefit Committee reviewed proposals from several consulting agencies specializing

in Community Health Needs Assessments. Verité Consulting was selected for the engagement based on their extensive

expertise and knowledge.

JANUARY–MAY> St. Clair and Verité designed a comprehensive methodology for conducting a Community Heath

Needs Assessment. The action plan was presented to the Committee and approved at the May meeting.

JUNE–JULY> Interviews with more than 40 key community stakeholders, partners, leaders and community members,

as well as data analysis (review of other community CHNAs, available public data, Highmark regional health indicators,

and St. Clair discharge information).

SEPTEMBER> Initial draft report of the findings (including identification of key pervasive health needs in the

community) completed.

SEPTEMBER–NOVEMBER> Public input surveys were conducted online.

DECEMBER–MAY 2012> Comprehensive review of the information and statistics surrounding the pervasive health

needs in St. Clair Hospital’s service region were presented to the committee. Those initiatives include: Inadequate

Prenatal Care; Behavioral/Mental Health Issues; Access to Care and Chronic Diseases; Cancer; Community Health

Education; and Addiction.

AUGUST > The committee identified the programmatic prioritization criteria that would be used to rank which

community- wide health needs the Hospital would address first.

SEPTEMBER–NOVEMBER > St. Clair Hospital senior management and staff developed plans to address the pervasive

health needs. The Community Benefit Committee prioritized the initiatives that best aligned with the Hospital’s

core competencies.

DECEMBER–JANUARY 2013> An implementation strategy was developed and presented to the St. Clair Hospital

Board of Directors. It was approved on January 31, 2013.

MARCH> Specific action plans were developed (including the identification of key community partners) to execute

the implementation strategy initiatives.

APRIL–JUNE > A final Community Health Needs Assessment report was created and made widely available to the public,

via the St. Clair Hospital website. A paper copy was also made for community members, which they can receive upon request.

2010

2011

2012

2013



In an effort to maximize the opportunity presented by the Patient Protection and Affordable Care Act,

we invited experts from within and outside of the region to share their expertise regarding the healthcare

needs of the community. The three-year process to complete the Community Health Needs Assessment

(CHNA) began in December 2010 and is presented in the timeline below.

Part of the solutionA hospital exists in order to meet the healthcare needs of the people who live and work in the neighborhoods

that surround it. It offers preventive care to keep people healthy, as well as therapeutic care to treat diseases,

conditions and injuries. Hospitals collaborate with the people and organizations in the communities they serve,

to identify emerging problems and needs, and to develop effective solutions and strategies. In other words,

hospitals are always responsible for being “part of the solution” — but first, the problems must be recognized,

described and understood.

One of the ways hospitals do this is through a Community Health Needs Assessment — a comprehensive, systematic examination

of a community’s entire healthcare environment. In the fall of 2011, St. Clair Hospital began conducting a Community Health

Needs Assessment of the regions served by the Hospital. A CHNA identifies and prioritizes health and healthcare access needs

for specific geographic areas and groups of people, so that new ways can be found to meet those needs. This is accomplished by

asking the following questions:

WHO in the community is most vulnerable in terms of health or access to care?WHAT are the unique health and/or access needs of these people?WHERE in the community do these people live?WHAT is causing these problems?

To answer these questions, our CHNA turned to numerous sources of information. We conducted a survey and interviews with

persons who represent the broad interests of the community, including those with expertise in public health. We also gathered

data such as demographic information, health status indicators and measures of healthcare access, as well as assessments

prepared by other organizations.


Region 6

Region 4

Region 2

Pittsburgh

Mt. Lebanon

St. Clair Hospital

Bethel Park

Peters

Strabane

Houston Canonsburg

McDonaldBridgeville

Noblestown

Southview

Midway

Imperial

Moon

Castle Shannon

Green TreeHeidelberg

Rosslyn FarmsCrafton

Coraopolis

Robinson

McKees Rocks

Dormont

Venetia

GingerHill

Library

Gastonville

Airport

Region 1

Region 5Region 3

Upper St. Clair

Baldwin

South Fayette

Brookline

St. Clair Hospital is located in the South Hills region of Pittsburgh, Pennsylvania. The St. Clair Hospital

community is defined by the geographic origins of the Hospital’s patients. The area includes parts of both

Allegheny and Washington counties, covering a total of 32 ZIP codes, and is broken down into six regions.

(Please refer to map above.)

The community we serve

In 2010, the total population of this

community was 497,000. Between

2010 and 2015, it is anticipated

that this population will change;

there is expected to be a decreasing

white population and an increasing

non-white population, specifically

Asian and Hispanic. There will also

be an approximately 9% increase

in the 65+ population.

St. Clair Hospital was founded in

1954 and is located on Bower Hill

Road in Mt. Lebanon, Region 1.

The boundaries of the regions are

determined by the growth patterns

of patient care at St. Clair Hospital.

The community is comprised of a Primary Service Area (PSA), which is the geographic area from which

the majority of the Hospital’s patients originate. The PSA is composed of Regions 1 and 2 and is home

to 57% of the community’s population. A Secondary Service Area (SSA) consists of Regions 3, 4, 5 and 6,

and is home to 43% of the population.


4



The Process and Methods

To assess, identify, understand and prioritize the unmet health needs of the community, St. Clair Hospital

engaged the services of Verité Healthcare Consulting, LLC, based in Alexandria, Virginia. With Verité, the

Hospital took into consideration the perspectives and experience of our numerous community partners,

utilizing multiple primary sources of information, including interviews with community leaders, public health

experts, medical staff and Hospital staff and representatives from numerous agencies and organizations.

These individuals and organizations provided valuable, expert information.

Gathering information

Data from secondary sources, including demographic, economic,

health status and health status indicators from local, state and

federal sources, were also considered.

The primary and secondary data were analyzed by St. Clair Hospital

staff and by Verité’s president and senior-level staff, with support

from associates and research analysts. The methodologies included

quantitative analysis, benchmarking, and trend analysis. Verité

applied a ranking methodology to help prioritize the health needs

identified by the assessment.

Identifying priority community health needs involves benchmarking

and trend analysis. Statistics for several health status and health

access indicators thus were analyzed and compared to state-wide

and national benchmarks or goals.

While conducting the CHNA, St. Clair and Verité did not discover

any information gaps that would have affected their ability to reach

reasonable conclusions regarding the community health needs.

Review of other recent community health needs assessments

As part of St. Clair Hospital’s CHNA, the Hospital reviewed other

community health needs assessment documents for the purpose

of comparison as it defined and prioritized unmet health needs.

Since 2004, there have been eight of these assessments conducted

and published by organizations within the St. Clair region:

• Allegheny County Health Department- Infant Mortality Study (2010)- Maternal and Child Health Needs (2010)- Mortality Study (2008)

• Central Assembly of God Church (2010)• Healthy Start (2000–2002)• Highmark Regional Assessment (2009–2010)• United Way of Allegheny County (2006)• Washington County Health Partners (2007)

About VeritéBecause of their national expertise with Community

Health Needs Assessment projects, St. Clair selected

Verité Healthcare Consulting, founded in 2006, as

the firm to assist with the Hospital’s process. Verité’s

president, Keith Hearle, MBA, has worked in health-

care consulting for over 30 years, and has extensive

expertise with community benefit regulations. Hearle

continues to work closely with these initiatives, even

today, bringing expert guidance to organizations

working to improve health needs. Verité Healthcare

Consulting is dedicated to optimizing the planning,

organization, financing and delivery of health services

for vulnerable people and communities.


To better understand and serveOur 2013 Community Health Needs Assessment was conducted for St. Clair Hospital to better understand the

health needs of the community we serve, and to identify the resources and strengths within that community,

so that we can develop ways to address unmet health needs with our many community partners. The goal of

the CHNA is to improve community health in order to enhance the quality of life and well-being of all those

who live and work within the community we serve. This report is a summary of our findings and our plans

to meet the high-priority needs identified by our CHNA.

General IssuesWhile the St. Clair community compares favorably to state and national averages on a variety

of factors, this report spotlights the problems that impact the overall health of our community.

These include poverty, lack of preventive care, the presence of medically underservedareas and populations, and shortages of healthcare professionals.

Poverty and unemployment in the area contribute to poor health by creating barriers to

obtaining healthful food, preventive care and other health services. In the St. Clair community,

the greatest proportion of low-income households are located in relatively urban neighborhoods.

Racial and ethnic minorities are more likely to lack essential social and economic resources,

putting them at increased risk for poor health. An additional factor is the impact of state budget

reductions on health and human services providers, including the adultBasic insurance program,

Medical Assistance, and child care assistance for women in welfare-to-work programs.

The CHNA also determined that 15% of St. Clair Hospital discharges were “Ambulatory Care

Sensitive (ACS)” — meaning that, if these patients had better access to primary care resources,

their admission to the Hospital might have been prevented. The most common conditions for

which these patients were treated include bacterial pneumonia, congestive heart failure, urinary

tract infections and chronic obstructive

pulmonary disease; 75% were for patients

65 years of age or older. ACS discharges

are also common among Medicare and

uninsured patients.

The St. Clair community includes

medically underserved areas and

populations, as well as one area and

two facilities that are considered health

professional shortage areas. Both

Allegheny and Washington counties

include areas designated by the U.S.

Health Resources and Services

Administration (HRSA) as Medically

Underserved. This includes groups

within a geographic area with economic,

cultural or linguistic barriers to

accessing primary care.

THE CHNA REPORT SPOTLIGHTED THE

FOLLOWING PROBLEMS THAT IMPACT THE

OVERALL HEALTH OF OUR COMMUNITY:

• POVERTY

• LACK OF PREVENTIVE CARE

• MEDICALLY UNDERSERVEDAREAS AND POPULATIONS

• SHORTAGES OF HEALTHCARE

PROFESSIONALS



Poor health is a consequence of multiple, complex factors with medical, social, economic, and

behavioral dimensions, in addition to lack of access to care. Addressing the roots of poor health

is essential to improving a community’s quality of life and reducing death and disease.

Critical health issues identified in Allegheny and Washington counties

MORTALITY RATESHigh Rates of Cirrhosis MortalityHigh Rates of Colon Cancer MortalityHigh Rates of Injury and Violence MortalityHigh Rates of Mortality for Young Adults

Ages 20-24High Rates of Suicide

PHYSICAL ENVIRONMENTPoor Air Quality

SOCIAL & ECONOMIC FACTORSLow and Moderate Income Populations Unable to Meet Basic Needs.

ALLEGHENY COUNTYAllegheny County includes areas designated by St. Clair

Hospital as Regions 1 and 2, as well as portions of Regions 4

and 5. In comparison to Washington County, Allegheny County

has higher proportions of low-income and uninsured residents

living in an urban environment; these factors contribute to

the area’s health issues. Among the issues that are affecting

the health of residents in these regions are a prevalence ofunsafe sex practices; high rates of communicable diseaseand HIV; high rates of low birth weight infants and infantmortality; high rates of breast, colon and lung cancer;and high rates of suicide and community safety issues.

WASHINGTON COUNTYWashington County includes areas served by St. Clair Hospital

and designated as Region 3, plus portions of Region 4 and 5.

Washington County is more rural than Allegheny County and

has different health issues. These include poor dentalhealth; high rates of high blood pressure; high rates oflung and bronchial cancer, and breast cancer; and highrates of births to women ages 40-54.

Health issues identified by the 2013 CHNA as critical for Allegheny and Washington counties, in alphabetical order:

ACCESS TO CARELack of Affordable and Accessible Care

Lack of Affordable and Accessible Mental & Behavioral Health Facilities/Services

Lack of Resources for Providers

Lack of Services and Care of Seniors

COMMUNITY SAFETYPoor Community Safety

DENTAL HEALTHPoor Dental Health

HEALTH BEHAVIORS

Prevalent Drug UsePrevalent Unsafe Sex

HEALTH CONDITIONSHigh Rates of CancerHigh Rates of Communicable DiseasesHigh rates of High Blood PressurePrevalent Diet and Exercise-Related

Conditions

INFANT & MATERNAL HEALTHHigh Rates of Births to Women

Age 40-54High Rates of Infant MortalityHigh Incidences of Low Birth

Weight Infants

St. Clair Hospital has prioritized the following three health issues in the community:

Access to Care; Inadequate Prenatal Care; and Chronic & Lifestyle-Related ConditionsSince its inception, St. Clair has been dedicated to meeting the health needs of the communities it serves.

Through a number of initiatives, St. Clair will continue this commitment, focusing primarily on priority

health needs, as well as other selected needs identified in the 2013 Community Health Needs Assessment.

To meet these healthcare needs, St. Clair Hospital is taking action.

It’s well documented that there is growing

concern in the region and across the state that

access to healthcare is contracting. While this

concern is impacted by many factors, including

transportation, education, insurance, language

barriers, primary care physician shortages and

geographic availability, it is undisputed that

access to high quality health services is essential

to our quality of life.

In 2011, the Hospital’s Courtesy Van Program

provided nearly 13,000 rides to community

residents in need.



ISSUE 1: ACCESS TO CARE

ACTION: TO IMPROVE ACCESS TO CARE FOR SENIORSAND THE UNDERSERVED

n St. Clair Hospital provides free and reduced-cost care

through its Uncompensated Care Program and in the

delivery of services to beneficiaries of government

sponsored programs such as Medicare and Medical

Assistance. In 2012, this direct assistance amounted

to more than $28 million in the provision of services

to community residents in need. Greater access to all

patient populations will be enhanced through the

expansion of St. Clair’s Outpatient Center at Village

Square–Bethel Park and the June 2013 opening of the

St. Clair Hospital Outpatient Center–Peters Township.

n With transportation cited as a critical factor in

accessing and receiving care, St. Clair will expandits Courtesy Van transportation program and

prioritize service to areas such as Bridgeville, Brookline,

Glendale, Carnegie and Green Tree with emphasis on

increasing the ridership of the senior, low-income,

and underserved populations. By increasing service

in these and other areas, improvements in accessing

care will be achieved.

n With the understanding that quality care is highly

coordinated across the continuum, collaborative

programming and relationships lead to better patient

outcomes. Taking that commitment to care even further,

efforts are already underway to enhance access to care

through the expansion of our primary care network

and the creation of our Accountable Care Organization

(ACO). These efforts will help to ensure that patients,

especially the chronically ill, will get the right care at

the right time. St. Clair serves more than 69 Long-Term Care and Assisted Living facilities in the

six-region area. Working with these partners and

others to reduce readmissions, eliminate unnecessary

hospital stays associated with chronic conditions, and

positively impact the health status of our community

was seen as a priority in the CHNA.

Vulnerable populations such as the elderly and those living in poverty are at higher risk where access tocare is limited. The Community Health Needs Assessment (CHNA) identified a number of areas throughoutthe St. Clair service region where senior citizens and low-income individuals and families struggle to receive basic medical care. The need to better serve this population is a key finding of the study and a priority for St. Clair’s CHNA Implementation Plan.




ISSUE 2: INADEQUATE PRENATAL CARE

ACTION: TO IMPROVE INFANT HEALTH THROUGH EXPANDED PRENATAL CARE SERVICES

Identified as both a regional and community problem of growing proportion is the inadequacy of

prenatal care and its impact on the overall health status of a baby at birth. The St. Clair Hospital

CHNA considered findings from studies conducted at the national (Community Health Status Indicators

Project 2009 and Healthy People 2010) and regional level (PA Department of Health, Health Profile

2010 and Allegheny County Mortality Report 2008). The findings underscore the interdependence of

the two factors and further reveal that county-wide, Allegheny compared unfavorably to Washington

in six of 12 indicators related to low birth weight and infant mortality. Additionally, Allegheny County’s

low birth weight indicator was found to be 7.2% greater than the Pennsylvania state average.

Contributing to the concern is the fact that nearly 17% of Allegheny County’s mothers smoked during

pregnancy and only 31.8% initiated breast feeding.

These same concerns were represented in data gathered from patients in St. Clair’s direct service

area. Smoking, low birth weight and gestational diabetes were conditions seen in five of the six

regions served by St. Clair. While there are Hospital programs in place to address these conditions,

more needs to be done.

n St. Clair partners with Tobacco Free Allegheny and

Focus on Renewal in the delivery of programs and

services aimed at improving the overall health status

of moms and babies in neighborhoods like Stowe,

Ingram and McKees Rocks. To confront prenatal health

concerns head-on, expanded programs will be offered to reduce the incidence of smoking whilepregnant and to address the critical need for prenatal care and counseling. Already providing

this important care at the Sto-Rox Neighborhood Family

Health Center, St. Clair clinicians will expand upon these

needed services. Additionally, St. Clair is partnering

with Women, Infants & Children (WIC) to aid prenatal

efforts to expectant mothers in the McKees Rocks and

Carnegie areas.

n Nearly 10% of expectant moms in the region do not

receive prenatal care in their first trimester. The CHNA

indicates that lack of insurance coverage, household

income and available transportation are all barriers to

receiving this very important care. While a comprehensive,

prenatal education and care program is currently available

through St. Clair, participants in the program are well-

insured and have the means to cover the associated

costs. With the goal of reaching those with the greatest

need, St. Clair will provide subsidized prenatal education for low-income families and families who

lack insurance coverage. The four-part series covers

childbirth preparation, labor and delivery, baby basic

care and breast-feeding instruction.

n A number of communities in St. Clair’s region are

federally designated as “Medically Underserved,”

meaning there is insufficient access to medical

providers and services. In these areas, inadequate

prenatal care is of particular concern. A new program,focused on maintaining a healthy pregnancythrough proper nutrition, exercise and lifestylechoices will be delivered directly in

communities where the unmet

need exists. This pilot effort

will begin in the neighbor-

hood of McDonald and

be evaluated for use in

other areas.


Prevention and education are key

first steps in the struggle to reduce the incidence

of chronic diseases. In identifying chronic disease

management as a priority in the CHNA, St. Clair will

offer community-based programs and resources

to help area residents reduce their risk

of developing chronic disease, and better

manage diseases before they worsen.

n Chronic disease is often associated with

vulnerable populations such as the

elderly, uninsured and underinsured.

Health symposiums will be offered in

areas throughout the region where

known gaps in education and service

exist. Symposiums provide participants

with education aimed at developing a

healthful lifestyle through proper nutrition,

exercise and preventative healthcare.

Health screenings are offered and

participants are encouraged to dialogue

with St. Clair clinicians to better under-

stand and manage their health concerns.

n Chronic conditions, especially cancer, can have

a significant impact on the emotional well-being

of a person struggling with persistent disease.

Illness and stress can often lead to depression,

and depression can make a chronic illness

worse. Learning to

cope with these

feelings is a critical

step in the recovery

process. Through our

CHNA work, we heard

feedback from our

patients and local

public health experts

that greater cancersupport and education delivered in the community

was needed. St. Clair will partner with other local

nonprofit organizations like Gilda’s Club, SouthHills Interfaith Ministry, Adagio, Susan B.Komen and Livestrong to expand this care and

reach more patients in need in neighborhoods

such as Bridgeville and Whitehall.

n High rates of obesity and diabetes were also cited

as priority issues in the CHNA. Often linked to

poor diet and physical inactivity, St. Clair offers a

seven-week community weight reduction program

to area residents struggling with these conditions.

The Weigh of Life program provides nutritional

counseling, weigh-ins, individual meal plan

development and group support.

Chronic health conditions like diabetes, cancer, hypertension and lung disease make daily living activities unmanageable for more than one in every 10 people. With chronic conditions to blame for seven of every 10 deathsin the nation and more than $262 billion in healthcare expense annually, the treatment of chronic diseases mustbe a priority.

Unfortunately, residents living in St. Clair’s service area are not immune from chronic conditions. St. Clair’s owndata suggest that between 12%–15% of hospital admissions related to cancer, lung disease, stroke and coronaryheart disease were potentially preventable with better management of chronic conditions. In addition to beingamong the most frequent and most expensive health concerns, chronic conditions are also among the most preventable health problems.

In St. Clair’s service

region the incidence

of breast, colorectal,

prostate and bladder

cancer is equal to

or greater than both

state and national

averages.

ISSUE 3: CHRONIC AND LIFESTYLE-RELATED CONDITIONS

ACTION: TO REDUCE THE INCIDENCE OF CHRONIC DISEASES AND LIFESTYLE-RELATED CONDITIONS



Between 2009–2011,

Opioid dependence

increased 27% and

alcohol addiction

has decreased 11%.

Although St. Clair does not offer drug and alcohol addiction treatment, close partnerships with organizations that

include Outreach Teen and Family Services and Greenbriar Treatment Center provide the necessary conduit for those

in need to access treatment. Additionally, St. Clair is joining forces with the Mt. Lebanon Drug Task Force and

sponsoring the development of a public education campaign surrounding prescription drug abuse. The task force has

worked with local law enforcement and other area partners to identify a root cause behind the increase in overdose

deaths in our community.

Mental and behavioral health concerns were found to be critical

issues impacting the entire St. Clair community, ranging

across all age groups and income levels. The CHNA

identified a lack of support services and outreach programs,

particularly for young adults, teens and their families.

Alcohol and substance abuse were noted to be on the

rise at a time when budget constraints were limiting

or reducing available treatment options.

n Consistent with the desire to provide services directly

in the community and through existing collaborative

relationships, St. Clair is responding to these needs with

an expansion of services in a number of communities it

serves. An existing mental health support programis in place at the Christ United Methodist Church in

Bethel Park. A second group has been added and

mental health clinicians are now reaching more patients

in need. This same program will be offered in the

Bridgeville/Scott Township area.


The St. Clair Hospital community is fortunate to have a variety of resources that can assist in meeting the healthcare needs identified in the CHNA. These resources include other hospitals, county public health and human services agencies, organizations and ambulatory care centers or clinics that may be FederallyQualified Health Centers (FQHC). These were created by Congress to improve access to care in “medicallyunderserved” areas, where economic, cultural or linguistic barriers inhibit groups of people from receivingprimary care. The St. Clair service area includes medically underserved areas and populations.

Within the St. Clair Community, there are four FQHCs

Other hospitals within the St. Clair community• Southwood Psychiatric Hospital, Upper St. Clair • Kindred Long-Term Care Hospital, Oakdale

• Canonsburg General Hospital, Canonsburg • Ohio Valley General Hospital, Kennedy Township


E X I S T I N G F A C I L I T I E S A N D R E S O U R C E S :

The power of partnerships


• Hilltop Community Healthcare Center, located in

Beltzhoover, a satellite of the Sto-Rox Neighborhood

Family Health Center, providing pediatrics, women’s

health and family medicine.

• McDonald Family Medicine provides family medicine

services. It is part of a large physicians’ group of

19 medical practices that provide family medical care.

• Sto-Rox Neighborhood Family Health Center is a full service

medical center that treats patients of all ages. It is open six

days per week with some extended hours. It is part of Focus

on Renewal, an organization focused on health and social

services needs in the McKees Rocks community.

• West End Health Center provides primary mental health,

women’s health, and dental care.

County Organization/Agency

ALLEGHENY Adagio Health CentersAllegheny County Department of HealthAllegheny County Department of Human ServicesAllegheny County Economic DevelopmentAllegheny County Housing AuthorityAngel's PlaceBloomfield/Garfield Family Health CenterCancer Caring CenterCatholic Charities Free Health Care CenterCenters for Healthy Hearts and SoulsChartier's Community Mental Health and Retardation CenterChristian Ministry of Whole Person HealthcareCommunity Human Services Corp. – The Health StationCompassion ConnectionGilda's Club Western PennsylvaniaGreater Pittsburgh Community Food BankHill House Dental ServicesLatino Family CenterMcKeesport 9th Street ClinicMetro Family Practice Inc.Mon Yough Community Services, Inc.North Hills Community OutreachNorth Side Christian Health CenterOutreach Teen and Family ServicesPittsburgh Coalition for Dynamic

Psychotherapy/Clinic without WallsPrimary Care Health Services Inc.Sheep Inc. Health Care CenterSouth Hills Interfaith MinistriesSquirrel Hill Health CenterThe Kingsley AssociationThe Midwife CenterThe Spirit of Health Mobile Wellness VanThe Welcome Center for Immigrants and InternationalsTobacco Free AlleghenyUnited Way of Allegheny CountyUPMC Centers and Clinics

WASHINGTON Ami Inc. of Washington-Greene countiesArc of WashingtonCommunity Action SouthwestCommunity Circle Food PantryGreater Washington County Food BankHome and Community ServicesMental Health Association of Washington CountyPathways of Southwestern PennsylvaniaSouthwest Pennsylvania Human Services, Inc.United Way of Washington CountyWashington County Department of Human Services

COUNTY ORGANIZATION/AGENCY

Other agencies and organizations in the St. Clair communities, by county:


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Andrea L. KalinaExecutive Liaison, Community Benefit CommitteeVice President of Human Resources and Organizational Development, St. Clair Hospital

Joan R. MassellaAdministrative Vice Presidentand Chief Nursing Officer, St. Clair HospitalBoard of Directors, St. Clair Hospital

Harriett M. ReaBoard of Directors, St. Clair Hospital

Melvin D. RexChairman, St. Clair Hospital Board of Directors

T.A. WardPresident, T.A. Ward Constructors, Inc.Board of Directors, St. Clair Hospital

G. Alan Yeasted, M.D.Sr. Vice President & Chief Medical Officer St. Clair HospitalBoard of Directors, St. Clair Hospital

COMMUNITY LEADERS AND EXPERTS

Frank AggazioDirector, Allegheny County Housing Authority

Barbara BauldingResident Services Assistant DirectorAllegheny County Housing Authority

Sister Ruth BearerAssociate DirectorSto-Rox Neighborhood Health Center (Focus on Renewal)

James BrophyFormer Director of OperationsOutreach Teen and Family Services

Venard CampbellEMS and Emergency Communications Coordinator St. Clair Hospital

Richard C. ChesnosSenior Vice President and Chief Financial OfficerSt. Clair Hospital

Mary Jo DicksonAdministrator, Adult Mental Health ServicesAllegheny County Department of Human Services

Bruce Dixon, M.D. (Now deceased)Former Director, Allegheny County Health Department

Michael J. FlanaganSr. Vice President and Chief Operating Officer St. Clair Hospital

ST. CLAIR HOSPITAL COMMUNITY BENEFIT COMMITTEE MEMBERS

Joseph B. SmithSenior Vice President, Marketing, Dollar BankChairman, Community Benefit CommitteeBoard of Directors, St. Clair Hospital

Andrew AloeChair CE 411, Vistage InternationalBoard of Directors, St. Clair Hospital

Frank Arcuri, Esq.Law Office of Frank ArcuriBoard of Directors, St. Clair Hospital

Karl E. Bushman, M.D.Mt. Lebanon Internal MedicineBoard of Directors, St. Clair Hospital

James M. CollinsPresident & Chief Executive Officer, St. Clair HospitalBoard of Directors, St. Clair Hospital

Andrew R. HaysManaging Director, Strategic AdvisorsBoard of Directors, St. Clair Hospital

Thank you to our communitypartners…St. Clair Hospital gathered information through

interviews and surveys of dozens of persons who are

invested in the health of the community. Also, St. Clair

Hospital interviews were conducted in June and July

of 2011. The web-based survey was conducted from

September–November of 2011. These included

external stakeholders — those not affiliated with

St. Clair — as well as members of our medical and

Hospital staff. These persons shared their perspectives

and expertise on community health needs and their

ideas for interventions and innovative programs to

meet those needs.

St. Clair Hospital acknowledges the following leaders for their valuable feedback and ideas.

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_C o m m u n i t y H e a l t h N e e d s A s s e s s m e n t 27

Harry FruechtPolice Chief, Peters Township

James GuffeyExecutive DirectorSouth Hills Interfaith Ministries

Nora HelfrichEMS Director, Tri-Community South EMS

Keith KanelChief Medical and Learning OfficerPittsburgh Regional Health Initiative

Tim KimmelDirector, Washington County Department of Human Services

Chad KingChief of Police, Bridgeville

Dave KishExecutive Director, St. Clair Hospital Emergency Services

Sue MartoneAssistant Deputy Director, Office of Behavioral Health Allegheny County Department of Human Services

Coleman McDonoughPolice Chief, Mt. Lebanon

Jenny MichauxDirector of Community Impact United Way of Allegheny County

Mildred MorrisonDirector, Area Agency on AgingAllegheny County Department of Human Services

Barbara MurphyPresident, United Way of Washington County

Marianne K. OlscheskyCommunity Outreach and Marketing Coordinator St. Clair Hospital

Kathe NiznikDirector, St. Clair Hospital Behavioral Health

Michael PankaFormer Superintendent, Sto-Rox School District

Todd PritchardDirector, Medical Rescue Team South

Nan ReesFormer Director, St. Clair Hospital Care Management

Father Regis RyanFormer Executive DirectorSto-Rox Neighborhood Health Center (Focus on Renewal)

Tom SalernoDirector of Operations, Scott Township

Andrea SchachnerProgram DirectorAngel’s Place

James SecreteChief of Police, Scott Township

Mary SedoreAdministrative Services CoordinatorChartiers Community Mental Health

Scott SeltzerAssistant Superintendent, Mt. Lebanon School District

Richard M. SieberDirector of Marketing and Development St. Clair Hospital

Mary Lynn SpilakDirector of Aging Services Washington County Department of Human Services

Timothy SteinhauerSuperintendent, Mt. Lebanon School District

Kay SteppExecutive Director, Compassion Connection

Michelle TiptonExecutive DirectorAngel’s Place

Denis ValentineDirector, Southbridge EMS

Joe WisselDirector, Kirwan Heights EMS

Reginald YoungDeputy Director, Office of Community ServicesAllegheny County Department of Human Services

Janet YuhaszHealth Services Coordinator, Pittsburgh Public Schools

Patricia ZurawskiMedical Services DirectorSto-Rox Neighborhood Health Center

We believe that a healthy community is a nexus of relationships and supports, anchored by a strong, solid core. In our community,

St. Clair Hospital is that core. Through focused and collaborative efforts with the persons and organizations who are community

strengths and our partners, the Hospital continually strives to satisfy the unmet healthcare needs of the people we serve. Conducting

a Community Health Needs Assessment (CHNA) is one of the many ways that the Hospital expresses our caring and our commitment.

St. Clair Hospital is always moving forward, advancing our care and generating initiatives to improve health, strengthen existing

resources and enhance quality of life for all the people of the community, especially the most vulnerable. The 2013 Community Health

Needs Assessment enables this by serving as a catalyst for progress.

Three years from now, the Hospital will assess that progress when we conduct another CHNA. We will determine how well we

met the objectives that were set in this assessment, and we will once again gather information to assess the health of the community

and identify unmet needs. The challenge is constant, but the vision endures, and inspires our work.

This community, after all, is our home, too.

Our vision of a healthy community endures

St.Clair Hospital1000 Bower Hill RoadPittsburgh, PA 15243

412.942.4000www.stclair.org

One of St. Clair’s community partners is SouthHills Interfaith Ministries (SHIM). As part of our relationship, the Hospital brings healthcareinto the community to aid SHIM’s support of aburgeoning refugee population.

Documents

St Clair Hospital 2013 Community Health Needs Assessment