2014 CT State Health Care Facilities and Services Plan Advisory Group Meeting Thursday, July 31,...

2014 CT State Health Care Facilities and Services Plan

Advisory Group MeetingThursday, July 31, 2014

9:00am – 11:00am

Today’s Agenda

9:00 Welcome and Introductions CT DPH

9:10 Health Care Facilities and Services Survey HRiA and large discussion

9:40 Bed Need Projections CT DPH and large discussion

10:05 Unmet Need and Gaps in Services HRiA, CT DPH, and large discussion

10:40 Planning Process for Developing the 2014 Recommendations HRiA

10:40 Next Steps and Adjourn CT DPH

July 2014 | CT State Health Care Facilities and Services Plan

CT DPH 2014 Facilities and Services Supplemental Plan

Builds off of the 2012 Plan, to include: An inventory of the availability and accessibility of services and facilities An assessment of the unmet health care related needs of persons at-risk and

vulnerable populations; Projections of future demand, capacity and need for acute care hospital

inpatient services Recommendations for the expansion, modification, or reduction of certain

health care facilities or services

The 2014 report serves as supplement to the more comprehensive 2012 report For overarching issues: What has changed since 2012? Focus on vulnerable populations and projected demand and unmet need Can align with CT State Health Improvement Plan


Project Timeline

Dec 2013 Kick Off Meeting

Jan – July 2014 Data Collection and Analysis:• Facility Survey• Identify Vulnerable Populations• Projections of Future Demand and Unmet Need

July – Sept 2014 Recommendations/Planning Process•Meetings of Work Groups to identify and flesh out recommendations

Oct 2014 Final 2014 CT State Health Care Facilities and Services Plan Completed


Health Care Facilities and Services Survey

Develop an inventory of the availability and accessibility of outpatient surgical services, imaging services, and hospital-based services including primary care services: name and location of facility, type of facility, hours of operation, description of services provided, and total number of clients, treatments, patient visits,

procedures, and/or scans performed in a calendar year.



Similar questions to the 2012 instruments with some minor revisions

Final instrument consisted of four surveys geared towards facilities that provide:

Acute-care hospital-based service linesHospital-based primary care services Imaging servicesOutpatient surgery services

Four surveys then streamlined into single, web-based instrument Survey pilot tested by OHCA staff and sample of facilities with

assistance from associations




Survey Administration Survey web-link/hard copies disseminated by association

leaders and HRiAAdministered between April and June 2014 with extensive

follow-up regarding missing, incomplete, or unclear responses executed through July 2014

All complete surveys combined into large database by survey type (i.e., imaging services, outpatient surgery services, etc.)

Currently in process of cleaning data and reformatting for publication

Data on non-surveyed facilities being compiled via e-licensure files

Challenges to the Health Care Facilities and Services Survey

Unresponsiveness of some facilities Duplications – some facilities submitted multiple

surveys by different staff with different information Misinterpretation that survey is not a requirement Concerns about information being public –

specifically about number of scans and patient visits

New information for current calendar year needed, so facilities could not just confirm previous data for all fields


Acute Care Hospital Bed NeedBrian A. Carney, MBA, Connecticut Department of Public Health


Acute Care Hospital Utilization:

CT Acute Care FY 2009 FY 2010 FY 2011 FY 2012 FY 2013

% chg (09-13)

Discharges 430,159 428,428 426,235 417,009 412,071 -4%

Patient Days 2,076,937 2,053,724 2,074,265 2,025,886 2,026,012 -2%


Connecticut Hospital Volumes by Service (FY 2011-2013)

Service Discharges P-Days Discharges P-Days Discharges P-Days Discharges P-Days

Maternity 41,827 127,228 40,352 121,830 39,566 117,838 -5.4% -7.4%

Medical/Surgical 302,069 1,490,461 295,882 1,454,256 292,309 1,459,606 -3.2% -2.1%

Newborn 39,666 154,707 38,443 151,200 37,864 147,126 -4.5% -4.9%

Pediatric 15,104 53,753 14,722 54,536 14,694 50,467 -2.7% -6.1%

Psychiatric 25,131 215,785 25,381 215,586 25,701 225,857 2.3% 4.7%

Rehabilitation 2,438 32,331 2,229 28,478 1,937 25,118 -20.5% -22.3%

Total 426,235 2,074,265 417,009 2,025,886 412,071 2,026,012 -3.3% -2.3%

FY 2012 FY 2013FY 2011-2013

% chg

Statewide

FY 2011

Utilization (continued):


Bed Need Methodology:

Hospital Services1

2011 patient

days

2012 patient

days

2013 patient

days 2011 ADC 2012 ADC 2013 ADCWeighted

ADC

DEMHS Region Pop chg 2015 to

20202Projected

ADCTarget

OccupancyBeds

Needed

Licensed

Beds3

Excess (-) or Deficit

(+)Medical/Surgical

0-14 0.0 0.0 0.0 - 0.92976 0.0 0.80 015 - 44 0.0 0.0 0.0 - 1.01558 0.0 0.80 045 - 64 0.0 0.0 0.0 - 1.01076 0.0 0.80 0

65+ 0.0 0.0 0.0 - 1.10290 0.0 0.80 0Sub Total 0 0 0 0.0 0.0 0.0 - 0.0 0

Maternity0-14 0.0 0.0 0.0 - 0.92886 0.0 0.50 0

15 - 44 0.0 0.0 0.0 - 1.01274 0.0 0.50 045 - 64 0.0 0.0 0.0 - 1.01209 0.0 0.50 0

65+ 0.0 0.0 0.0 - 1.08045 0.0 0.50 0Sub Total 0 0 0 0.0 0.0 0.0 - 0.0 0

Psychiatric0-14 0.0 0.0 0.0 - 0.92976 0.0 0.80 0

15 - 44 0.0 0.0 0.0 - 1.01558 0.0 0.80 045 - 64 0.0 0.0 0.0 - 1.01076 0.0 0.80 0

65+ 0.0 0.0 0.0 - 1.10290 0.0 0.80 0Sub Total 0 0 0 0.0 0.0 0.0 - 0.0 0

Rehabilitation0-14 0.0 0.0 0.0 - 0.92976 0.0 0.80 0

15 - 44 0.0 0.0 0.0 - 1.01558 0.0 0.80 045 - 64 0.0 0.0 0.0 - 1.01076 0.0 0.80 0

65+ 0.0 0.0 0.0 - 1.10290 0.0 0.80 0Sub Total 0 0 0 0.0 0.0 0.0 - 0.0 0

Pediatric0-19 0.0 0.0 0.0 - 0.94167 0.0 0.80 020+ 0.0 0.0 0.0 - 1.03539 0.0 0.80 0

Sub Total 0 0 0 0.0 0.0 0.0 - 0.0 00 0 0 0 0 0 - 0.0 0 0

A

Facility Total

Bed Need Results:

FY 2009 Patient

Daysa

FY 2010 Patient

Daysa

FY 2011 Patient

DaysaWeighted

ADCProjected ADC 2015

Beds Needed

Licensed

Bedsb


(+)387,655 394,049 392,123 1,074 1,073 1,408 1,653 -245470,952 467,202 480,843 1,300 1,352 1,746 1,817 -71663,114 648,363 651,204 1,787 1,783 2,315 3,041 -726149,602 150,786 152,093 414 466 601 727 -126245,697 238,115 243,295 663 700 907 1,321 -414

1,917,020 1,898,515 1,919,558 5,239 5,375 6,978 8,559 -1,581

FY 2011 Patient

Daysa

FY 2012 Patient

Daysa

FY 2013 Patient

DaysaWeighted

ADCProjected ADC 2020

Beds Needed

Licensed

Bedsb


(+)392,123 377,652 374,322 1,037 1,095 1,433 1,653 -220480,843 465,846 471,058 1,290 1,360 1,753 1,817 -64651,204 654,888 665,555 1,807 1,918 2,482 3,041 -559152,093 147,457 139,995 396 433 560 727 -167243,295 228,843 227,956 632 690 893 1,321 -428

1,919,558 1,874,686 1,878,886 5,162 5,496 7,120 8,559 -1,439Source: CT DPH Offi ce of Health Care Access Acute Care Hospita l Discharge Databasea Excludes Newborn service categoryb Excludes bass inets (861)

Statewide Health Care Facilities and Services Plan - October 2012

Statewide Health Care Facilities and Services Plan - July 2014

Acute Care Hospital 2015 Bed Need:

Acute Care Hospital 2020 Bed Need:

Statewide

DEMHS Region

12345

5Statewide

DEMHS Region

1234


Availability of Care/Unmet Need (Sec. 19a-634):

Psychiatric FY 2009 FY 2010 FY 2011 FY 2012 FY 2013

% chg (09-13)

Patient Days 216,865 216,855 215,785 215,586 225,857 4%

Discharges 25,101 25,474 25,131 25,381 25,701 2%


Available Bed Allocation:

Services1

FY 2013 patient

daysFY 2013

ADC

FY 2013 ADC/target

occupancy

Available BedsFY 13

(HRS RPT 400)


(+) Available

BedsMedical/Surgical 1,459,606 3,998.9 4999 6145 -1146Maternity 117,838 322.8 646 599 47Psychiatric 225,857 618.8 773 788 -15Rehabilitation 25,118 68.8 86 111 -25Pediatric 50,467 138.3 173 259 -86

Total 1,878,886 5,148

Services1

FY 2013 patient

daysFY 2013

ADC

FY 2013 ADC/target

occupancy

Available BedsFY 13

(HRS RPT 400)


(+) Available

BedsMedical/Surgical 279,024 764.4 956 1142 -186Maternity 30,508 83.6 167 129 38Psychiatric 47,474 130.1 163 150 13Rehabilitation 14,308 39.2 49 63 -14Pediatric 3,008 8.2 10 23 -13

Total 374,322 1,026

Services1

FY 2013 patient

daysFY 2013

ADC

FY 2013 ADC/target

occupancy

Available BedsFY 13

(HRS RPT 400)


(+) Available

BedsMedical/Surgical 368,408 1,009.3 1262 1530 -268Maternity 25,332 69.4 139 105 34Psychiatric 53,386 146.3 183 152 31Rehabilitation 2,636 7.2 9 18 -9Pediatric 21,296 58.3 73 109 -36

Total 471,058 1,291

Statewide

CT

DEMHS Region

1

DEMHS Region

2


Comments/Questions?


Unmet Need and Gaps in Services

Review of data on at-risk and vulnerable populations Elderly, disabled, less educated, uninsured, immigrants,

etc.

Examination of wide geographic variations of health status across the state

Review of all community health needs assessments and strategic implementation plans of Connecticut hospitals


Top Health Issues across 21 CHNAs

Health Needs # of CHNAs Identifying Health Need

Chronic Disease 18Overweight, Obesity, Nutrition, & Physical Activity

16

Gaps in Primary Care 13Substance Abuse 12Mental Health 12Gaps in Mental Health Care 7Respiratory Health 5Maternal & Child Health 5Healthy Aging 4Housing 4


Examination of Unmet Need

When looking at unmet need, it is important to look at issues of access

Further work aims to examine the range of issues that affect unmet need across the state. Goal is to develop an index to compare scores across the state. Including: SES factors such as poverty, unemployment, less than HS

education, transportation Health status indicators such as hospitalizations for

ambulatory care sensitive conditions, mortality rates


Planning Process for 2014 Recommendations

Work groups to meet in the next few weeks to develop 2014 recommendations

Meetings to revisit and build off of 2012 recommendations

Meeting process to be determined by work group – may be virtual or in-person


Next Steps and Adjourn


2014 CT State Health Care Facilities and Services Plan Advisory Group Meeting Thursday, July 31,...

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