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2022Community Health NeedsAssessment

2 I Community Health Needs AssessmentTABLE OF CONTENTSINTRODUCTION.......................................................................................................................................5-6Executive Summary..............................................................................................................................................7-10Background.......................................................................................................................................................................11Hopedale Medical Complex Services...................................................................................................12-14Local Impact of COVID......................................................................................................................................14-15ESTABLISHING THE CHNA INFRASTRUCTURE AND PARTNERSHIPS.........................17 DATA COLLECTION...........................................................................................................................17-21Secondary Data.....................................................................................................................................................17-19Primary Data............................................................................................................................................................19-21DATA ANALYSIS...................................................................................................................................23-66Demographics.......................................................................................................................................................23-26Social Determinants of Health...................................................................................................................27-42Health and Wellness Indicators...............................................................................................................43-66- Chronic Illness...................................................................................................................................................48-58- Behavioral Health...................................................................................................................................................59- Mental Health...................................................................................................................................................60-62- Healthcare Workforce................................................................................................................................63-65Emergency Preparedness..................................................................................................................................66Copyright ©2022 by the Illinois Critical Access Network (ICAHN). All rights reserved. The contents of this publication may not be copied, reproduced, replaced, distributed, published, displayed, modied, or transferred in any form or by any means except with the prior permission of ICAHN. Copyright infringement is a violation of federal law subject to criminal and civil penalties.

Hopedale Medical Complex I 3IDENTIFICATION AND PRIORITIZATION OF NEEDS.........................................................69-70Process...............................................................................................................................................................................69Description of the Community Health Needs Identied...............................................................70 RESOURCES AVAILABLE TO MEET PRIORITY HEALTH NEEDS.........................................73Hospital Resources....................................................................................................................................................73 Healthcare Services and Partners.................................................................................................................73Community Resources...........................................................................................................................................73DOCUMENTING AND COMMUNICATING RESULTS................................................................75 IMPLEMENTATION STRATEGY.....................................................................................................77-81Planning Process.........................................................................................................................................................77Implementation Strategy..............................................................................................................................78-81REFERENCES AND APPENDIX..........................................................................................................83

Hopedale Medical Complex I 5INTRODUCTIONOpened in May, 1955, the 20-bed Hopedale Hospital was the culmination of eorts led by Dr. Lawrence Rossi, Sr., and many volunteer citizens and donors. Dr. Rossi, along with citizens of Hopedale and the surrounding communities, felt it was very important to keep a doctor in Hopedale. They concluded that the only way to ensure this was to build a hospital. Not long after the 20-bed hospital opened, Dr. Rossi realized that providing a home for elderly patients who needed ongoing medical care made more sense than extending their hospital stay. In 1957, Dr. Rossi opened the 76-bed Hopedale Nursing Home as the rst of its kind in the state of Illinois. But Dr. Rossi was not nished. In 1962, he started an innovative continuum-of-care approach to treating patients when he opened the rst assisted living facility (Hopedale House) in central Illinois. The hospital then grew and not long after, the 76-bed nursing home and hospital were transferred to the non-prot charitable Hopedale Medical Foundation. Before his death in 2001, Dr. Rossi saw a need for preventative and proactive health activities for the members of the community. The Foundation pursued his vision in Hopedale Medical Complex (HMC), as it is known today, and opened the beautiful $2.5 million HMC Wellness Center on July 4, 2002, dedicating it in Dr. Rossi’s memory.AdolescentsAdultsSeniorsEarly Childhood AdolescentsAdultsSeniors

6 I Community Health Needs AssessmentThe center includes a walking track, junior Olympic lap pool, cardio equipment, basketball court, and a host of tness classes and other options which provide its 1,200 members a signicant local option for tness and physical therapy services. It is also the home of a substantial physical therapy and sports medicine rehab unit oering cardiac, pulmonary, and orthopedic rehabilitation. Recently, Hopedale Medical Complex conducted an acute care upgrade consisting of six new ambulatory surgery suites, six new large hospital rooms, a new surgery waiting area, as well as a new three-suite Emergency Room and Intensive Care Unit. A spacious lobby and atrium were also added, along with a helipad and an upgrade to the Angiography Suite, which was completed in the Operating Room in 2014. HMC has also added several specialty medical services to its suite of oerings.The foundation’s Board is still operating the hospital and is made up of nine local volunteer citizens who have watched HMC grow into a state-of-the-art healthcare destination. The complex now includes a 25-bed critical access hospital, a 51-bed skilled nursing home, 34,000 square foot wellness center, satellite oces in the towns of Delavan, Atlanta, Mackinaw, Manito, and Tremont, and a 70-bed assisted living and independent living facility.

Hopedale Medical Complex I 7Provisions in the Aordable Care Act (ACA) require charitable hospitals to conduct a Community Health Needs Assessment (CHNA). The CHNA is a systematic process involving the community to identify and analyze community health needs as well as community assets and resources in order to plan and act upon priority community health needs. This assessment process results in a CHNA report which assists the hospital in planning, implementing, and evaluating hospital strategies and community benet activities. This Community Health Needs Assessment was developed and conducted, in partnership with representatives from the community, by a consultant provided through the Illinois Critical Access Hospital Network (ICAHN). ICAHN is a not-for-prot 501(c)(3) corporation established in 2003 for the purposes of sharing resources, education, promoting operational eciencies, and improving healthcare services for member critical access and rural hospitals and their communities. ICAHN, with 58 member hospitals, is an independent network governed by a nine-member board of directors, with standing and project development committees facilitating the overall activities of the network. ICAHN continually strives to strengthen the capacity and viability of its members and rural health providers.This Community Health Needs Assessment will serve as a guide for planning and implementation of healthcare initiatives that will allow the hospital and its partners to best serve the emerging health needs of Hopedale and the surrounding area. The CHNA process was coordinated by the Manager of the Wellness Center at HMC.EXECUTIVE SUMMARY

8 I Community Health Needs AssessmentTwo focus groups met to discuss the state of overall health and wellness in the Hopedale Medical Complex service area and to identify health concerns and needs in the delivery of healthcare and health services in order to improve wellness and reduce chronic illness for all residents. The focus groups included representation of healthcare providers, community leaders, community services providers, schools, faith-based organizations, local elected ocials, public health and others. Several members of the focus groups provided services to underserved and unserved persons as all or part of their roles. The ndings of the focus groups were presented along with secondary data analyzed by the consultant to a third group for identication and prioritization of the signicant health needs facing the community. The group consisted of representatives of public health, community leaders, healthcare providers, and community services providers.

Hopedale Medical Complex I 9IDENTIFICATION AND PRIORITIZATION ADDRESSING THE NEED At the conclusion of their review and discussion, the identication and prioritization group advanced the following needs:1. Improve access to healthy foods and nutrition information across the service area2. Improve access to targeted education and information about local resources for achieving and maintaining wellness3. Re-establish communication among community partners post-pandemic4. Address transportation issues, including transportation to and from primary care and EMS response time5. Expand chronic care management to reduce hospital visits The results of the assessment process were then presented to senior sta at Hopedale Medical Complex through a facilitated discussion for development of a plan to address the identied and prioritized needs.Access to Healthy Food and NutritionInformationAccess to Targeted Wellness EducationRe-establishCommunicationAmongCommunityPartnersAddressTransportationIssuesExpand Chronic CareManagement

10 I Community Health Needs AssessmentADDRESSING THE NEED CREATING THE PLANThe group addressed the needs with the following strategies:• Hopedale Medical Complex will collaborate with local food pantries to oer assistance for coordination of services through the Wellness Center.• Hopedale Medical Complex will create and maintain a robust library of nutrition information and resources that will be available at a nutrition information station at the Wellness Center.• Hopedale Medical Complex will utilize its social and print media resources to make more information available about access to healthy foods and nutrition information.• Hopedale Medical Complex will collaborate with local schools to provide information about local wellness resources for health and wellness for youth.• Hopedale Medical Complex will continue social and print media eorts to provide information about local wellness resources for health and wellness for youth and adults.• Hopedale Medical Complex will continue broad social media outreach within the service area.• Hopedale Medical Complex will continue utilizing a newsletter to inform the community and partner organizations of developments and opportunities at HMC.• Hopedale Medical Complex will update and re-establish lines of communication with partner organizations.• Hopedale Medical Complex will explore potential transportation solutions with local partners and through the Illinois Critical Access Hospital Network (ICAHN).• Hopedale Medical Complex will continue and expand critical care management based on review of progress and impact and needs analysis.

Hopedale Medical Complex I 11The Community Health Needs process is conducted every three years. In response to issues identied and prioritized and the implementation strategy developed to address them, Hopedale Medical Complex has taken the following steps since the last CHNA.Hopedale Medical Complex had begun the process of implementation for its ve-priority groups for the 2019 CHNA prior to the pandemic. Those priorities included:1. Mental Health – Hopedale Medical Complex was working with outside resources for referrals of patients in the emergency department that need care.2. Emergency Care – Hopedale Medical Complex was in talks with the Delavan City Council on the EMS needs of the community, facilitation of response, recruitment of volunteers, nances, and usage of the ambulance rigs that Delavan owns.3. Access to Healthy Food – The Wellness Center was working with the Partnership for Healthy Communities and the Healthy Eating Active Living Program to establish local food pantries and accessibility for residents.4. Recreation Opportunities – The Hopedale Wellness Center was beginning to implement more recreational and tness activities targeting families and health.5. Access to Medical Care – Hopedale Medical Complex has educational materials regarding medical care and HMC’s response to scal situations. Additionally, there is a specialist that takes calls to answer questions from patients or potential patients.The implementation strategies for each of our priority groups was signicantly impacted by the COVID-19 pandemic. The mitigation regulations as directed by local, state, and federal authorities required Hopedale Medical Complex to cease programs, implement health and safety strategies, and redirect all resources to managing COVID during this cycle. BACKGROUND

12 I Community Health Needs AssessmentHopedale Medical Complex Service Area - NorthFebruary 21, 2022©2022 Esri Page 1 of 1HopedaleMinierTremontStanfordDelavanDanversMackinawAtlantaFor the purpose of this CHNA, Hopedale Medical Complex has dened its primary service area and populations as the general population within the geographic area in and surrounding Hopedale, dened in detail below. The hospital’s patient population includes all who receive care without regard to insurance coverage or eligibility for assistance. A total of 21,220 people live in the 460.17 square mile report area dened for this assessment according to the U.S. Census Bureau American Community Survey 2015-‐19 5-‐year estimates. The population density for this area, estimated at 46 persons per square mile, is less than the national average population density of 92 persons per square mile.AREA SERVED BY Hopedale Medical ComplexHopedale Medical Complex Service Area - SouthFebruary 21, 2022©2022 Esri Page 1 of 1

Hopedale Medical Complex I 13Hopedale Infographic - Key Facts9 ZIP Codes Prepared by Esri61568 (Tremont) et al. Geography: ZIP Code KEY FACTS22,097Population41.3Median Age2.6AverageHousehold Size$73,333Median HouseholdIncomeEDUCATION5%No High SchoolDiploma34%High SchoolGraduate32%Some College28%Bachelor's/Grad/Prof DegreeBUSINESS506Total Businesses5,320Total EmployeesEMPLOYMENT65%White Collar27%Blue Collar8%Services3.3%UnemploymentRateINCOME$73,333Median HouseholdIncome$33,654Per Capita Income$226,382Median Net WorthHouseholds By IncomeThe largest group: $50,000 - $74,999 (20.8%)The smallest group: $200,000+ (4.5%)Indicator▲Value Diff<$15,000 5.2% -4.8%$15,000 - $24,999 6.3% -1.7%$25,000 - $34,999 7.1% -3.1%$35,000 - $49,999 11.6% -2.3%$50,000 - $74,999 20.8% +0.7%$75,000 - $99,999 17.3% +1.9%$100,000 - $149,999 20.6% +6.4%$150,000 - $199,999 6.7% +2.0%$200,000+ 4.5% +1.0%Bars show deviation from Logan CountyThis infographic contains data provided by Esri, Esri and Data Axle. The vintage of the data is 2021, 2026. © 2022 EsriThe data on the following pages will take a deep dive into the demographics of Hopedale Medical Complex’s service area and will oer insight to both the commonality and complexity of the Hopedale Medical Complex audience. The infographic above highlights some of the key facts of that data and provides a snapshot of the population served by Hopedale Medical Complex.The average household size of the area, at 2.6, is lower than Illinois (3.00) and higher than the U.S. (2.50). Median age is 41.3 years, which is higher than Illinois (38.6) and the U.S. (38.0). The largest education segment is high school graduate, followed by some college.Hopedale Medical Complex Service Area – Key Facts

14 I Community Health Needs AssessmentNote: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention and the National Center for Health Statistics, CDC - GRASP, 2022. Source geography: CountyLOCAL IMPACT OF COVID as of 6/1/2022Adults Fully Vaccinated for COVID-19This indicator reports the percent of adults fully vaccinated for COVID-19. Data is updated daily from the CDC API. Vaccine hesitancy is the percent of the population estimated to be hesitant towards receiving a COVID-19 vaccine. The Vaccine Coverage Index is a score of how challenging vaccine roll-out may be in some communities compared to others, with values ranging from 0 (least challenging) to 1 (most challenging). Data are current as of 6/1/2022.The unemployment rate of 3.3% is lower than both Illinois (4.6%) and the U.S. (3.6%)Also, median family household income in the service area is higher than both Illinois’ median family household income ($65,886) and the U.S. ($61,937).

Hopedale Medical Complex I 15COVID-19 MortalitiesNote: This indicator is compared to the state average. Data Source: Johns Hopkins University. Accessed via ESRI. Additional data analysis by CARES. 2021. Source geography: CountyIn the service area, there have been 87 total deaths among patients with conrmed cases of the coronavirus disease COVID-19. Data are current as of 6/1/2022.

Hopedale Medical Complex I 17Data Collection QuantitativeQualitativeData AnalysisESTABLISHING THE CHNA INFRASTRUCTURE AND PARTNERSHIPSData CollectionDescription of Data Sources – QuantitativeQuantitative (secondary) data is collected from many resources including, but not restricted to, the following:Source DescriptionBehavioral Risk Factor Surveillance SystemThe BRFSS is the largest, continuously conducted telephone health survey in the world. It enables the Center for Disease Control and Prevention (CDC), state health departments, and other health agencies to monitor modiable risk factors for chronic diseases and other leading causes of death.SparkMap SparkMapis an online mapping and reporting platform powered by the Center for Applied Research and Engagement Systems (CARES) at the University of Missouri. US Census National census data is collected by the US Census Bureau every 10 years.Centers for Disease ControlThrough the CDC’s National Vital Statistics System, states col-lect and disseminate vital statistics as part of the US’s oldest and most successful intergovernmental public health data sharing system.SECONDARY DATA

18 I Community Health Needs AssessmentSource DescriptionCounty Health RankingsEach year, the overall health of each county in all 50 states is assessed and ranked using the latest publicly available data through a collaboration of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.American Communities SurveyTheAmerican Community Survey(ACS), a product of the U.S. Census Bureau, helps local ocials, community leaders, and businesses understand the changes taking place in their communities. It is the premier source for detailed population and housing information about our nation.Illinois Department of Employment SafetyThe Illinois Department of Employment Security is the state’s employment agency. It collects and analyzes employment information.National CancerInstituteThe National Cancer Institute coordinates the National Cancer Program, which conducts and supports research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer, rehabilitation from cancer, and the continuing care of cancer patients, and the families of cancer patients. Illinois Department of Public HealthThe Illinois Department of Public Health is the state agencyresponsible for preventing and controlling disease and injury, regulating medical practitioners, and promoting sanitation.HRSA The Health Resources and Services Administration of the US Department of Health and Human Services develops health professional shortage criteria for the nation and uses that data to determine the location of Health Professional Shortage Areas and Medically Underserved Areas and Populations.Local IPLANS The Illinois Project for Local Assessment of Needs (IPLAN) is a communityhealth assessment and planning process that is conducted every ve years by local health jurisdictions in Illinois.ESRI ESRI (Environmental Systems Research Institute) is an international supplier ofGeographic Information System (GIS) software, web GIS and geodatabasemanagement applications. ESRI allows for specialized inquiries at the zip code, or other dened, level.Illinois State Board of EducationThe Illinois State Board of Education administers public education in the state of Illinois. Each year, it releases school “report cards” which analyze the makeup, needs, and performance of local schools.USDA USDA, among its many functions, collects and analyzes information related to nutrition and local production and food availability.

Hopedale Medical Complex I 19Secondary data is initially collected through the SparkMap and/or ESRI systems and then reviewed. Questions raised by the data reported from those sources are compared with other federal, state and local data sources in order to resolve or reconcile potential issues with reported data. Two focus groups were convened at Hopedale Medical Complex on March 1, 2022. The groups included representation of healthcare providers, community leaders, community services providers, schools, faith-based organizations, local elected ocials, public health, and others. Multiple members of the groups provided services to underserved and unserved persons as all or part of their roles. In response to a request to identify positive developments in health and healthcare in the service area of Hopedale Medical Complex, the groups put forward the following: Focus Groups• Growth of the pain management clinic at Hopedale Medical Complex• Collaboration among Hopedale Medical Complex and its partner agencies has improved• Tazewell County Health Department is working to achieve better birth outcomes• Food access across the area has improved due to collaboration and innovation• Service lines at Hopedale Medical Complex have increased, allowing better local access to more services• Improved access to child care through the new after-school program at Mackinaw• Stigma surrounding rural healthcare has diminished as rural healthcare facilities practice more innovation• The 4-H program has started local mini-food pantries• There is better collaboration to address poverty and mental health issues among youthPRIMARY DATA

20 I Community Health Needs Assessment• COVID funds have allowed schools to better address signicant mental health needs among youth• Hopedale Medical Complex is continuing to increase local access to specialists• Hopedale Medical Complex has improved communications about available local health services• Hopedale Medical Complex, local agencies, not-for-prots, faith-based organizations, local governments, and others have cooperated to address local needs• Collaboration among Hopedale Medical Complex and area schools for sports medicine and wellness is strong and still improving• Hopedale Medical Complex is providing prompt outpatient services• Hopedale Medical Complex opened the Tremont Medical Arts Building, increasing access in the Tremont area• Opening of the Share Closet in Tremont• COVID funding has allowed collaborating agencies and groups to provide and improve local community services• Access to services and programs for seniors at the Hopedale Medical Complex Wellness Center has improved• Communication through technology is improving and growing• Assisted living is providing opportunities for local careThe groups were also each asked to discuss local needs in wellness, health, delivery of healthcare and health services. The group responded with the following:• Improve easy local access to aordable physical and mental healthcare for families• Increase local access to aordable broadband• Identify and develop existing local wellness resources• Local obstetrics services and delivery units• Recruiting and retaining medical sta at local hospitals, especially small hospitals

Hopedale Medical Complex I 21• Stang and support for local EMS• Public transportation across the area that is exible enough to get people to medical appointments and services• Community education and resources around mental health issues to promote awareness• Addressing substance use and substance use disorders at all levels, especially self-medicating• Parenting skills education and support• Nutrition education targeted at youth• Improve local access to aordable care by improving community understanding about insurance and government programs• Local services for long-term memory care• Expand local services for veterans• Improve local access to care for the underinsured and uninsured• Improve local access to mental health services• Education about vaping for local youth• Improve community education about available local services• Improve ambulance stang and services for local emergency response and transport out-of-the-area• Aordable housing• Housing security• Local health services in the Stanford area• Improve local broadband access• Improve ambulance emergency response time• Improve community respect for rural healthcare• Improve Hopedale Medical Complex’s information and outreach to communities beyond Hopedale• Expand use of social media by Hopedale Medical Complex

Hopedale Medical Complex I 23Age Group EthnicityRaceDisabilityDATA ANALYSISTotal Population by Age GroupData Source: US Census Bureau, American Community Survey. 2016‐-20. Source Geography: TractDEMOGRAPHICS

24 I Community Health Needs AssessmentTotal Population by EthnicityData Source: US Census Bureau, American Community Survey. 2016-‐20. Source geography: TractTotal Population by Age Groups, Hopedale Medical Complex Service Area

Hopedale Medical Complex I 25Total Population by Race AloneData Source: US Census Bureau, American Community Survey. 2016‐-20. Source geography: TractTotal Population by Race Alone, Hopedale Medical Complex Service Area

26 I Community Health Needs AssessmentPopulation with any DisabilityThis indicator reports the percentage of the total civilian non-institutionalized population with a disability. The service area has a total population of 21,144 for whom disability status has been determined, of which 2,412 or 11.41% have any disability. This indicator is relevant because disabled individuals comprise a vulnerable population that requires targeted services and outreach by providers.Total PopulationA total of 21,271 people live in the 460.17 square mile service area dened for this assessment, according to the U.S. Census Bureau American Community Survey 2016-20 5-year estimates. The population density for this area, estimated at 46 persons per square mile, is less than the national average population density of 92 persons per square mile.Note: This indicator is compared to the state average.Data Source: US Census Bureau, American Community Survey. 2016-20. Source geography: Tract

Hopedale Medical Complex I 27SOCIAL DETERMINANTS OF HEALTHThe data and discussion on the following pages will take a look into the socialdeterminants in the Hopedale Medical Complex service area and will oer insightinto the complexity of circumstances that impact physical and mental wellness forthe Hopedale Medical Complex audience. The infographic on Page 29 provides asnapshot of the at-risk population served by Hopedale Medical Complex.The CDC describes social determinants of health as conditions in the places wherepeople live, learn, work, and play that aect a wide range of health and quality oflife risks and outcomes. Healthy People 2030 uses a place-based framework thatoutlines ve key areas of SDoH:• Healthcare access and quality, including: - Access to healthcare- Access to primary care- Health insurance coverage- Health literacy• Education access and quality, including: - High school graduation- Enrollment in higher education- Educational attainment in general- Language and literacy- Early childhood education and development• Social and community context – within which people live, learn work and play, including:- Civic participation- Civic cohesiveness- Discrimination- Conditions within the workplace• Economic stability, including: - Income- Cost of living- Socioeconomic status- Poverty

28 I Community Health Needs Assessment• - Employment - Food security - Housing stability• Neighborhood and built environment, including: - Quality of housing - Access to transportation - Availability of healthy food - Air and water quality - Crime and violenceSome of the social determinant indicators reected in the data include:• 1,782 households with disability• 528 households below the poverty level (7%)• Median household income is $73,333 which is higher than both Illinois and the U.S.Veteran PopulationThis indicator reports the percentage of the population age 18 and older that served (even for a short time), but is not currently serving, on active duty in the U.S. Army, Navy, Air Force, Marine Corps, or the Coast Guard, or that served in the U.S. Merchant Marine during World War II. Of the 15,912 population of the service area, 1,460 or 9.18% are veterans.Note: This indicator is compared to the state average.Data Source: US Census Bureau, American Community Survey. 2016-20. Source geography: Tract

Hopedale Medical Complex I 29AT RISK POPULATION PROFILEGeography: CountyHopedale Infographic - At Risk Population9 ZIP Codes Prepared by Esri61568 (Tremont) et al. Geography: ZIP Code Version 1.8© 2022 EsriSource: Esri forecasts for 2021, U.S. Census Bureau2015-2019 American Community Survey (ACS) Data,AT RISK POPULATION PROFILE9 ZIP CodesGeography: ZIP Code22,097Population8,556Households2.57Avg SizeHousehold41.3MedianAge$73,333MedianHousehold Income$179,069MedianHome Value90WealthIndex229HousingAffordability10DiversityIndexAT RISK POPULATION1,782Households WithDisability4,201Population 65+232HouseholdsWithout VehiclePOVERTY AND LANGUAGE7%Households Belowthe Poverty Level528Households Belowthe Poverty Level0Pop 65+ SpeakSpanish & No EnglishPOPULATION AND BUSINESSES18,625DaytimePopulation506TotalBusinesses5,320TotalEmployeesPOPULATION BY AGE12,0008,0004,0000Aged65+18to65Under183,8954,97713,225Language Spoken (ACS) Age 5-17 18-64 Age 65+ TotalEnglish Only 3,856 11,853 3,505 19,214Spanish 48 149 24 221Spanish & English Well 48 123 24 195Spanish & English Not Well 0 5 0 5Spanish & No English 0 20 0 20Indo-European 24 120 3 147Indo-European & English Well 24 115 3 142Indo-European & English Not Well 0 6 0 6Indo-European & No English 0 0 0 0Asian-Pacic Island 7 55 1 63Asian-Pacic Isl & English Well 7 55 0 62Asian-Pacic Isl & English Not Well 0 0 1 1Asian-Pacic Isl & No English 0 0 0 0Other Language 10 8 2 20Other Language & English Well 10 8 2 20Other Language & English Not Well 0 0 0 0Other Language & No English 0 0 0 0Hopedale Infographic - At Risk Population9 ZIP Codes Prepared by Esri61568 (Tremont) et al. Geography: ZIP Code Version 1.8© 2022 EsriSource: Esri forecasts for 2021, U.S. Census Bureau2015-2019 American Community Survey (ACS) Data,AT RISK POPULATION PROFILE9 ZIP CodesGeography: ZIP Code22,097Population8,556Households2.57Avg SizeHousehold41.3MedianAge$73,333MedianHousehold Income$179,069MedianHome Value90WealthIndex229HousingAffordability10DiversityIndexAT RISK POPULATION1,782Households WithDisability4,201Population 65+232HouseholdsWithout VehiclePOVERTY AND LANGUAGE7%Households Belowthe Poverty Level528Households Belowthe Poverty Level0Pop 65+ SpeakSpanish & No EnglishPOPULATION AND BUSINESSES18,625DaytimePopulation506TotalBusinesses5,320TotalEmployeesPOPULATION BY AGE12,0008,0004,0000Aged65+18to65Under183,8954,97713,225Language Spoken (ACS) Age 5-17 18-64 Age 65+ TotalEnglish Only 3,856 11,853 3,505 19,214Spanish 48 149 24 221Spanish & English Well 48 123 24 195Spanish & English Not Well 0 5 0 5Spanish & No English 0 20 0 20Indo-European 24 120 3 147Indo-European & English Well 24 115 3 142Indo-European & English Not Well 0 6 0 6Indo-European & No English 0 0 0 0Asian-Pacic Island 7 55 1 63Asian-Pacic Isl & English Well 7 55 0 62Asian-Pacic Isl & English Not Well 0 0 1 1Asian-Pacic Isl & No English 0 0 0 0Other Language 10 8 2 20Other Language & English Well 10 8 2 20Other Language & English Not Well 0 0 0 0Other Language & No English 0 0 0 0Hopedale Infographic - At Risk Population9 ZIP Codes Prepared by Esri61568 (Tremont) et al. Geography: ZIP Code Version 1.8© 2022 EsriSource: Esri forecasts for 2021, U.S. Census Bureau2015-2019 American Community Survey (ACS) Data,AT RISK POPULATION PROFILE9 ZIP CodesGeography: ZIP Code22,097Population8,556Households2.57Avg SizeHousehold41.3MedianAge$73,333MedianHousehold Income$179,069MedianHome Value90WealthIndex229HousingAffordability10DiversityIndexAT RISK POPULATION1,782Households WithDisability4,201Population 65+232HouseholdsWithout VehiclePOVERTY AND LANGUAGE7%Households Belowthe Poverty Level528Households Belowthe Poverty Level0Pop 65+ SpeakSpanish & No EnglishPOPULATION AND BUSINESSES18,625DaytimePopulation506TotalBusinesses5,320TotalEmployeesPOPULATION BY AGE12,0008,0004,0000Aged65+18to65Under183,8954,97713,225Language Spoken (ACS) Age 5-17 18-64 Age 65+ TotalEnglish Only 3,856 11,853 3,505 19,214Spanish 48 149 24 221Spanish & English Well 48 123 24 195Spanish & English Not Well 0 5 0 5Spanish & No English 0 20 0 20Indo-European 24 120 3 147Indo-European & English Well 24 115 3 142Indo-European & English Not Well 0 6 0 6Indo-European & No English 0 0 0 0Asian-Pacic Island 7 55 1 63Asian-Pacic Isl & English Well 7 55 0 62Asian-Pacic Isl & English Not Well 0 0 1 1Asian-Pacic Isl & No English 0 0 0 0Other Language 10 8 2 20Other Language & English Well 10 8 2 20Other Language & English Not Well 0 0 0 0Other Language & No English 0 0 0 0Hopedale Medical Complex Service Area

30 I Community Health Needs AssessmentNote: This indicator is compared to the state average.Data Source: US Census Bureau, American Community Survey, 2016-20. Source geography: TractEconomic Stability – Income and Economics Economic and social insecurity often are associated with poor health. Poverty, unemployment, and lack of educational achievement aect access to care and a community’s ability to engage in healthy behaviors. Without a network of support and a safe community, families cannot thrive. Ensuring access to social and economic resources provides a foundation for a healthy community. Income – Median Household IncomeThis indicator reports median household income based on the latest 5-year American Community Survey estimates. This includes the income of the householder and all other individuals 15 years old and over in the household, whether they are related to the householder or not. Because many households consist of only one person, average household income is usually less than average family income.

Hopedale Medical Complex I 31Poverty – Population Below 100% FPLPoverty is considered a key driver of health status. Within the service area, 7.10% or 1,498 individuals for whom poverty status is determined are living in household with income below the Federal Poverty Level (FPL). This indicator is relevant because poverty creates barriers to access including health services, healthy food, and other necessities that contribute to poor health status. Note: The total population measurements for poverty are lower, as poverty data collection does not include people in group Note: This indicator is compared to the state average.Data Source: US Census Bureau, American Community Survey. 2016‐20. Source geography: Tract

32 I Community Health Needs AssessmentPoverty – Children Below 100% FPLIn the service area, 9.24% or 484 children aged 0-17 are living in households with income below the Federal Poverty Level (FPL). This indicator is relevant because poverty creates barriers to access including health services, healthy food, and other necessities that contribute to poor health status.Note: This indicator is compared to the state average.Data Source: US Census Bureau, American Community Survey. 2016‐20. Source geography: Tract

Hopedale Medical Complex I 33Education Attainment This category contains indicators that describe the education system and the educational outcomes of the service area populations. Education metrics can be used to describe variation in population access, prociency, and attainment throughout the education system, from access to pre-kindergarten through advanced degree attainment. These indicators are important because education is closely tied to health outcomes and economic opportunity. Educational attainment is calculated for persons over 25 and is an estimated average for the period from 2016 to 2020. For the service area, 19.9% have at least a college bachelor’s degree, while 33.5% stopped their formal educational attainment after high school.Note: This indicator is compared to the state average.Data Source: U.S. Census Bureau, American Community Survey, 2016-20. Source geography: County

34 I Community Health Needs AssessmentProciency – Student Reading Prociency (4th Grade)Information about student performance in the 4th grade English Language Arts portion of the state-specic standardized tests are displayed in the table below. Of 914 students tested, 41.2% of 4th graders performed at or above the “procient” level, and 58.8% tested below the “procient” level, according to the latest data. Students in the service area tested better than the statewide rate of 32.5%.Note: This indicator is compared to the state average. Data Source: U.S. Department of Education, EDFacts. Additional data analysis by CARES, 2018-19. Source geography: School District

Hopedale Medical Complex I 35Prociency – Student Math Prociency (4th Grade)Information about student performance in the 4th grade Math portion of the state-specic standardized tests are displayed in the table below. Of 226 students tested, 49.1% of 4th graders performed at or above the “procient” level, and 50.7% tested below the “procient” level, according to the latest data. Students in the service area tested better than the statewide rate of 29.8%.Note: This indicator is compared to the state average. Data Source: U.S. Department of Education, EDFacts, Additional data analysis by CARES, 2018-19. Source geography: School District

36 I Community Health Needs AssessmentHousing and FamiliesThis category contains indicators that describe the structure of housing and families, and the condition and quality of housing units and residential neighborhoods. These indicators are important becasue housing issues like overcrowding and aordability have been linked to multiple health outcomes, including infectious disease, injuries, and mental disorders. Furthermore, housing metrics like home-ownership rates and housing prices are key for economic analysis. Aordable HousingThis indicator reports the number and percentage of housing units aordable at various income levels. Aordability is dened by assuming that housing costs should not exceed 30% of the total household income. Income levels are expressed as a percentage of each county’s area median household income (AMI).Note: This indicator is compared to the state average. Data Source: U.S. Census Bureau, American Community Survey, 2016-20. Source geography: Tract

Hopedale Medical Complex I 37Other Social & Economic FactorsEconomic and social insecurity often are associated with poor health. Poverty, unemployment, and a lack of educational achievement aect access to care and a community’s ability to engage in healthy behaviors. Without a network of support and a safe community, families cannot thrive. Ensuring access to social and economic resources provides a foundation for a healthy community. Food Insecurity RateThis indicator reports the estimated percentage of the population that experienced food insecurity at some point during the report year. Food insecurity is the household-level economic and social condition of limited or uncertain access to adequate food.Note: This indicator is compared to the state average.Data Source: Feeding America, 2017. Source geography: County

38 I Community Health Needs AssessmentHomeless Children and YouthAccording to the data source denitions, homelessness is dened as lacking a xed, regular, and adequate nighttime residence. Those who are homeless may be sharing the housing of other persons, living in motels, hotels, or camping grounds, in emergency transitional shelters, or may be unsheltered. Data are aggregated to the service area level based on school district summaries where three or more homeless children are counted. In the service area, of all the 3,554 students enrolled in the service area’s public school system during the school year 2019-202, there were 47 or 1.76% homeless students, which is lower than the statewide rate of 2.61%. Note: Data are available for 100% of school districts in the service area, representing 76.10% of the public school student population.Note: This indicator is compared to the state average.Data Source: U.S. Department of Education, EDFacts, Additional data analysis by CARES, 2019-20. Source geography: School District

Hopedale Medical Complex I 39Note: This indicator is compared to the state average. Data Source: U.S. Census Bureau, American Community Survey, 2016-20. Source geography: CountyInsurance – Insured Population and Provider TypeEconomic and social insecurity often are associated with poor health. Poverty, unemployment, and lack of educational achievement aect access to care and a community’s ability to engage in healthy behaviors. Without a network of support and a safe community, families cannot thrive. Ensuring access to social and economic resources provides a foundation for a healthy community.

40 I Community Health Needs AssessmentBuilt Environment – Broadband AccessThis indicator reports the percentage of the population with access to high-speed internet. Data are based on the reported service area of providers oering download speeds of 25 MBPS or more and upload speeds of 3 MBPS or more. This data represents both wireline and xed/terrestrial wireless internet providers. Cellular internet providers are not included.Note: This indicator is compared to the state average. Data Source: National Broadband Map, Dec. 2020. Source geography: Tract

Hopedale Medical Complex I 41Food Environment – Grocery StoresHealthy dietary behaviors are supported by access to healthy foods, and grocery stores are a major provider of these foods. There are 3 grocery establishments in the service area, a rate of 14.32 per 100,000 population. Grocery stores are dened as supermarkets and smaller grocery stores primarily engaged in retailing a general line of food, such as canned and frozen foods; fresh fruits and vegetables; and fresh and prepared meats, sh, and poultry. Delicatessen-type establishments are also included. Convenience stores and large general merchandise stores that also retail food, such as supercenters and warehouse club stores, are excluded. Note: This indicator is compared to the state average. Data Source: U.S. Census Bureau, County Business Patterns. Additional data analysis by CARES, 2019. Source geography: County

42 I Community Health Needs AssessmentFood Environment – Food Desert Census TractsThis indicator reports the number of neighborhoods in the service area that are within food deserts. The USDA Food Access Research Atlas denes a food desert as any neighborhood that lacks healthy food sources due to income level, distance to supermarkets, or vehicle access. The service area has a population of 11,879 living in food deserts, and a total of four census tracts classied as food deserts by the USDA.Data Source: U.S. Department of Agriculture, Economic Research Service, USDA - Food Access Research Atlas, 2019. Source geography: Tract

Hopedale Medical Complex I 43Clinical Care and PreventionA lack of access to care presents barriers to good health. Supply of facilities and physicians, the rate of uninsurance, nancial hardship, transportation barriers, cultural competency, and coverage limitations aect access. Rates of morbidity, mortality, and emergency hospitalizations can be reduced if community residents access services such as health screenings, routine tests, and vaccinations. Prevention indicators can call attention to a lack of access or knowledge regarding one or more health issues and can inform program interventions. Prevention – Core Preventative Services for MenThis indicator reports the percentage of males age 65 and older who report that they are up-to-date on a core set of clinical preventative services. Services include: an inuenza vaccination in the past year, a pneumococcal vaccination (PPV) ever, and either a fecal occult blood test (FOBT) within the past year, a sigmoidoscopy within the past 5 years and an FOBT within the past 3 years, or a colonoscopy within the previous 10 years. Within the service area, there are 37.50% men 65 and older who had core preventative services in the last one to 10 years of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System. Accessed via the PLACES Data Portal, 2018. Source geography: TractHEALTH AND WELLNESS INDICATORS

44 I Community Health Needs AssessmentPrevention – Core Preventative Services for WomenThis indicator reports the percentage of females age 65 and older who report that they are up-to-date on a core set of clinical preventative services. Services include: an inuenza vaccination in the past year, a pneumococcal vaccination (PPV) ever, either a fecal occult blood test (FOBT) within the past year, a signmoidoscopy within the past 5 years and an FOBT within the past 3 years, or a colonoscopy within the previous 10 years, and a mammogram in the past 2 years. Within the service area, there are 27.40% women 65 and older who had core preventative services in the last one to 10 years of the total population.Note: This indicator is compared to the state average. Data Source: U.S. Department of Health & Human Services,Health Resources and Services Administration, HRSA - Area Health Resource File, 2015. Source geography: County

Hopedale Medical Complex I 45Prevention – Annual Wellness Exam (Medicare)This indicator reports the percentage of Medicare beneciaries who had one or more annual wellness visits in the most recent reporting year. Annual wellness visists are visits to develop or update a personalized prevention plan and perform a health risk assessment. These services are fully covered once every 12 months. In the latest reporting period, there were 4,144 Medicare beneciaries in the service area, and 19% had an annual wellness visit. The rate in the service area was lower than the state rate of 22% during the same time period.Note: This indicator is compared to the state average. Data Source: Centers for Medicare and Medicaid Services, Mapping Medicare Disparities Tool, 2019. Source geography: County

46 I Community Health Needs AssessmentHealth BehaviorsIn the service area, 6,196 or 21.42% of the adults self-report excessive drinking in the last 30 days, which is less than the state rate of 21.54%. Data for this indicator were based on survey responses to the 2018 Behavioral Risk Factor Surveillance System (BRFSS) annual survey and are used for the 2021 County Health Rankings. Excessive drinking is dened as the percentage of the population who report at least one binge drinking episode involving ve or more drinks for men and four or more for women over the past 30 days, or heavy drinking involving more than two drinks per day for men and more than one per day for women, over the same period. Alcohol use is a behavioral health issue that is also a risk factor for a number of netative health outcomes, including: physical injuries related to motor vehicle accidents, stroke, chronic diseases such as heart disease and cancer, and mental health conditions such as depression and suicide. Alcohol – Binge Drinking This indicator reports the percentage of adults age 18 and older who report having ve or more drinks (men) or four or more drinks (women) on an occasion in the past 30 days. Within the service area, there are 20.90% of adults who reported having four or more drinks in the last month of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, Accessed via the PLACES Data Portal, 2019. Source geography: Tract

Hopedale Medical Complex I 47Tobacco – Current SmokersThis indicator reports the percentage of adults age 18 and older who report having smoked at least 100 cigarettes in their lifetime and currently smoke every day or some days. Within the service area, there are 17.30% adults who have smoked or currently smoke of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System. Accessed via the PLACES Data Portal, 2019. Source geography: Tract

48 I Community Health Needs AssessmentCHRONIC ILLNESS Health OutcomesMeasuring morbidity and mortality rates allows assessing linkages between social determinants of health and outcomes. By comparing, for example, the prevalence of certain chronic diseases to indicators in other categories (e.g., poor diet and exercise) with outcomes (e.g., high rates of obesity and diabetes), various causal relationships may emerge, allowing a better understanding of how certain community health needs may be addressed.Cancer Incidence – All SitesThis indicator reports the age adjusted incidence rate (cases per 100,000 population per year) of cancer (all sites) adjusted to 2000 U.S. standard population age groups (under age 1, 1-4, 5-9, ..., 80-84, 85 and older). Within the service area, there were 178 new cases of cancer reported. This means there is a rate of 480.9 for every 100,000 total population.

Hopedale Medical Complex I 49Top Five Most Commonly Diagnosed CancersThe table below shows counts and age-adjusted incidence rates of the ve most common newly diagnosed cancers by site for the ve-year period of 2014-2018.

50 I Community Health Needs AssessmentCancer Incidence – Breast This indicator reports the age adjusted incidence rate (cases per 100,000 population per year) of females with breast cancer adjusted to 2000 U.S. standard population age groups (under age 1, 1-4, 5-9, ..., 80-84, 85 and older). Within the service area, there were 28 new cases of breast cancer. This means there is a rate of 147.2 for every 100,000 total population.Note: This indicator is compared to the state average. Data Source: State Cancer Proles, 2014-18. Source geography: County

Hopedale Medical Complex I 51Cancer Incidence – Colon and Rectum This indicator reports the age adjusted incidence rate (cases per 100,000 population per year) of colon and rectum cancer adjusted to 2000 U.S. standard population age groups (under age 1, 1-4, 5-9, ..., 80-84, 85 and older). Within the service area, there were 16 new cases of colon and rectum cancer. This means there is a rate of 43.1 for every 100,000 total population.Note: This indicator is compared to the state average. Data Source: State Cancer Proles, 2014-18. Source geography: County

52 I Community Health Needs AssessmentCancer Incidence – LungThis indicator reports the age adjusted incidence rate (cases per 100,000 population per year) of lung cancer adjusted to 2000 U.S. standard population age groups (under age 1, 1-4, 5-9, ..., 80-84, 85 and older). Within the service area, there were 27 new cases of lung cancer. This means there is a rate of 70.7 for every 100,000 total population.Note: This indicator is compared to the state average. Data Source: State Cancer Proles, 2014-18. Source geography: County

Hopedale Medical Complex I 53Chronic Conditions – AdultChronic Obstructive Pulmonary DiseaseThis indicator reports the percentage of adults age 18 and older who report ever having been told by a doctor, nurse, or other health professional that they had chronic obstructive pulmonary disease (COPD), emphysema, or chronic bronchitis. Within the service area, there were 6.80% of adults 18 and older who reported having chronic obstructive pulmonary disease of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System. Accessed via the PLACES Data Portal, 2019. Source geography: Tract

54 I Community Health Needs AssessmentAsthma PrevalenceThis indicator reports the percentage of adults age 18 and older who answer “yes” to both of the following questions: “Have you ever been told by a doctor, nurse, or other health professional that you have asthma?” and the question “Do you still have asthma?” Within the service area, there were 8.90% of adults 18 and older who reported having asthma of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System. Accessed via the PLACES Data Portal, 2019. Source geography: Tract

Hopedale Medical Complex I 55DiabetesThis indicator reports the number and percentage of adults age 20 and older who report ever having been told by a doctor that they have diabetes. This indicator is relevant because diabetes is a prevalent problem in the U.S. It may indicate an unhealthy lifestyle and puts individuals at risk for further health issues. Within the service area, there were 1,479 of adults 20 and older have diabetes. This represents 8.2% of the total survey population. Note: In 2021, the CDC updated the methodology used to produce estimates for this indicator. Estimated values for prior years (2004-2017) have been updated in this platform to allow comparison across years. Use caution when comparing with saved assessments generated prior to November 10, 2021.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 2019. Source geography: County

56 I Community Health Needs AssessmentCoronary Heart Disease This indicator reports the percentage of adults age 18 and older who report ever having been told by a doctor, nurse, or other health professional that they had angina or coronary heart disease. Within the report area, there were 5.90% of adults 18 and older who reported having coronary heart disease of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System. Accessed via the PLACES Data Portal, 2019. Source geography: Tract

Hopedale Medical Complex I 57ObesityThis indicator reports the number and percentage of adults age 20 and older who self-report having a Body Mass Index (BMI) greater than 30.0 (obese). Respondents were considered obese if their Body Mass Index (SMI) was 30 or greater. Body mass index (weight [kg]/height [m]2) was derived from self-report of height and weight. Excess weight may indicate an unhealthy lifestyle and puts individuals at risk for further health issues. Within the report area, there are a total of 4,166 adults age 20 and older who self-reported having a BMI greater than 30.0. This represents 26.9% of the survey population. Note: In 2021, the CDC updated the methodology used to produce estimates for this indicator. Estimated values for prior years (2004-2017) have been updated in this platform to allow comparison across years. Use caution when comparing with saved assessments generated prior to November 10, 2021.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 2019. Source geography: County

58 I Community Health Needs AssessmentTeeth Loss This indicator reports the number and percentage of adults age 18 and older who report having lost all of their natural teeth because of tooth decay or gum disease. Within the service area, there were 11.0% of adults 18 and older who reported losing all their natural teeth of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System. Accessed via the PLACES Data Portal, 2019. Source geography: Tract

Hopedale Medical Complex I 59BEHAVIORAL HEALTH Deaths of Despair – Suicide + Drug/Alcohol PoisoningThis indicator reports average rate of death due to intentional self-harm (suicide), alcohol-related disease, and drug overdose, also known as “deaths of despair,” per 100,000 population. Figures are reported as crude rates, and as rates age-adjusted to year 2000 standard. Rates are resummarized for service areas from county level data, only where data is available. This indicator is relevant because death of despair is an indicator of poor mental health. Within the service area, there were 66 deaths of despair. This represents an age-adjusted death rate of 41.6 per every 100,000 total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention, National Vital Statistics System. Accessed via CDC WONDER, 2016-2020. Source geography: County

60 I Community Health Needs AssessmentPoor Mental HealthThis indicator reports the percentage of adults age 18 and older who report 14 or more days during the past 30 days during which their mental health was not good. Data were from the 2019 Behavioral Risk Factor Surveillance System (BRFSS) annual survey. Within the service area, there 13.70% of adults 18 and older who reported poor mental health in the past month of the total population.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention: Behavioral Risk Factor Surveillance System. Accessed via the PLACES Data Portal, 2019. Source geography: TractMENTAL HEALTH

Hopedale Medical Complex I 61Mortality – SuicideThis indicator reports the 2016-2020 ve-year average rate of death due to intentional self-harm (suicide) per 100,000 population. Figures are reported as crude rates, and as rates age-adjusted to year 2000 standard. Rates are resummarized fore service areas from county level data, only where data is available. This indicator is relevant because suicide is an indicator of poor mental health. Within the service area, there are a total of 21 deaths due to suicide. This represents an age-adjusted death rate of 13.2 per every 100,000 total population. Note: Data are suppressed for counties with fewer than 20 deaths in the timeframe.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention: National Vital Statistics System. Accessed via CDC WONDER: 2016-2020. Source geography: County

62 I Community Health Needs AssessmentDepression (Medicare Population)This indicator reports the number and percentage of the Medicare fee-for-service population with depression. Data are based upon Medicare administrative enrollment and claims data for Medicare beneciaries enrolled in the fee-for-service program. Within the service area, there were 494.87 beneciaries with depression based on administrative claims data in the latest report year. This represents 17.2% of the total Medicare fee-for-service beneciaries.Note: This indicator is compared to the state average. Data Source: Centers for Medicare & Medicaid Services, CMS - Chronic Conditions Warehouse, 2018. Source geography: County

Hopedale Medical Complex I 63Healthcare WorkforceA lack of access to care presents barriers to good health. The supply and accessibility of facilities and physicians, the rate of uninsurance, nancial hardship, transportatin barriers, cultural competency, and coverage limitations aect access. Rates of morbidity, mortality, and emergency hospitalizations can be reduced if community residents access services such as health screening, routine tests, and vaccinations. Prevention indicators can call attention to a lack of access or knowledge regarding one or more health issues and can inform program interventions. Access to Care – Dental Health This indicator reports the number of dentists per 100,000 population. This indicator includes all dentists - qualied as having a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), who are licensed by the state to practice dentistry and who are practicing within the scope of that license. Within the service area, there are 18 dentists. This represents 56.20 dentists per 100,000 total population.

64 I Community Health Needs AssessmentAccess to Care – Mental Health This indicator reports the number of mental health providers in the service area as a rate per 100,000 total area population. Mental health providers are dened psychiatrists, psychologiest, licensed clinical social workers, counselors, marriage and family therapists, and mental health providers that treat alcohol and other drug abuse, as well as advanced practice nurses specializing in mental healthcare. Data from the 2020 Centers for Medicare and Medicaid Services (CMS) National Provider Identier (NPI) downloadable le are used in the 2021 County Health Rankings. Within the service area, there are 23 mental health providers with a CMS National Provider Identier (NPI). This represents 80.4 providers per 100,000 total population. Note: Data are suppressed for counties with population greater than 1,000 and 0 mental health providers.Note: This indicator is compared to the state average. Data Source: Centers for Medicare and Medicaid Services, CMS - National Plan and Provider Enumeration System (NPPES), Accessed via County Health Rankings, 2020.Source geography: County

Hopedale Medical Complex I 65Access to Care – Primary CareThis indicator reports the number of primary care physicians per 100,000 population. Doctors classied as “primary care physicians” by the AMA include: General Family Medicine MDs and DOs, General Practice MDs and DOs, General Internal Medicine MDs and General Pediatrics MDs. Physicians age 75 and over and physicians practicing sub-specialties within the listed specialties are excluded. This indicator is relevant because a shortage of health professionals contributes to access and health status issues. Within the service area, there are 9 primary care physicians. This represents 46.85 providers per 100,000 total population.Note: This indicator is compared to the state average. Data Source: U.S. Department of Health & Human Services, Health Resources and Services Administration, HRSA - Area Health Resource File, Accessed via County Health Rankings, 2017. Source geography: County

66 I Community Health Needs AssessmentHopedale Medical Complex works with the US-HHS ASPR, the Illinois Department of Public Health, county health departments, the Illinois Emergency Management Agency, and other state, regional, and local partners to plan, exercise, and equip for emergency preparedness and to ensure the ability to address a wide range of potential emergencies, ranging from disasters of all causes to pandemics and terrorism. EMERGENCY PREPAREDNESS

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Hopedale Medical Complex I 69SECONDARY DATAThe ndings of the focus groups were presented, along with secondary data, analyzed by the consultant, to a third group for identication and prioritization of the signicant health needs facing the community. The group consisted of representatives of public health, community leaders, healthcare providers, and community services providers. The group reviewed notes from the focus groups and summaries of data reviewed by the consultant which included SparkMap, ESRI, Illinois Department of Public Health, CDC, USDA, Illinois Department of Labor, HRSA, County Health Rankings and Roadmaps, National Cancer Institute, and other resources.PROCESSIDENTIFICATION AND PRIORITIZATION OF NEEDSAccess to Healthy Food and NutritionInformationAccess to Targeted Wellness EducationRe-establishCommunicationAmongCommunityPartnersAddressTransportationIssuesExpand Chronic CareManagement

70 I Community Health Needs AssessmentAt the conclusion of their review and discussion, the identication and prioritization group advanced the following needs:1. Improve access to healthy foods and nutrition information across the service area2. Improve access to targeted education and information about local resources for achieving and maintaining wellness3. Re-establish communication among community partners post-pandemic4. Address transportation issues, including transportation to and from primary care and EMS response time5. Expand chronic care management to reduce hospital visits DESCRIPTION OF THE COMMUNITY HEALTH NEEDS IDENTIFIED

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Hopedale Medical Complex I 73Resources PartnersVolunteersGovernment
Services at Hopedale Medical Complex•  Administration• Manager of the Wellness Center• Dietitian• Clinic Manager• HOSPITAL RESOURCESRESOURCES AVAILABLE TO MEET PRIORITY HEALTH NEEDSCOMMUNITY RESOURCES• Tazewell County Health Department• Local ambulance services• Illinois Critical Access Hospital NetworkHEALTHCARE SERVICES AND PARTNERS• Local food pantries• Area churches• School districts• Community groups• Other interested groups

Hopedale Medical Complex I 75Documentation Online PresenceCommentsImplementationSECONDARY DATAThis CHNA Report will be available to the community on the hospital’s public website, www.hopedalemc.org. A hard copy may be reviewed at the hospital by inquiring at the information desk at the main entrance. No written comments were received concerning the hospital facility’s most recently conducted CHNA nor on the most recently adopted Implementation Strategy. A method for retaining written public comments and responses exists,but none were received.DOCUMENTING AND COMMUNICATING RESULTS

Hopedale Medical Complex I The results of the assessment process were presented to the COO and theManager of the Wellness Center through a facilitated discussion for developmentof a plan to address the identied and prioritized needs.They reviewed the needs assessment process completed to that point andconsidered the prioritized signicant needs and supporting documents. Theyrecounted some of the steps taken to address previous Community Health NeedsAssessments. They also considered internal and external resources potentiallyavailable to address the current prioritized needs.They then considered each of the prioritized needs. For each of the ve prioritizedneeds, actions the hospital intends to take were identied along with theanticipated impact of the actions, the resources the hospital intends to committo the actions, and the external collaborators the hospital plans to cooperate withto address the need. The plan will be evaluated by periodic review of measurableoutcome indicators in conjunction with annual review and reporting.PLANNING PROCESSIMPLEMENTATION STRATEGYAccess toHealthy Food  and NutritionInformationAccess toTargetedWellnessEducationRe-establishCommunicationAmongCommunityPartnersAddressTransportationIssuesExpandChronic CareManagement

78 I Community Health Needs AssessmentThe group addressed the needs with the following strategies:1. Improve access to healthy foods and nutrition information across the service areaActions the hospital intends to take to address the health need:• Hopedale Medical Complex will collaborate with local food pantries to oer assistance for coordination of services through the Wellness Center.• Hopedale Medical Complex will create and maintain a robust library of nutrition information and resources that will be available at a nutrition information station at the Wellness Center.• Hopedale Medical Complex will utilize its social and print media resources to make more information available about access to health foods and nutrition information.Anticipated impacts of these actions:Hopedale Medical Complex anticipates that the steps set out above will improve access to both healthy foods and nutrition information across the service area.Programs and resources the hospital plans to commit to address health need:• Manager of the Wellness Center• Dietitian• MarketingPlanned collaboration between the hospital and other facilities:• Local food pantries• Tazewell County Health Department• Area churchesIMPLEMENTATION STRATEGY

Hopedale Medical Complex I 792. Improve access to targeted education and information about local resources for achieving and maintaining wellnessActions the hospital intends to take to address the health need:• Hopedale Medical Complex will collaborate with local schools to provide information about local wellness resources for health and wellness for youth.• Hopedale Medical Complex will continue social and print media eorts to provide information about local wellness resources for health and wellness for youth and adults.Anticipated impacts of these actions:Hopedale Medical Complex anticipates that collaboration with the schools to expand education and resources, combined with social and print media eorts in the community to spread information, will improve access to education and information about local resources for health and wellness for all ages.Programs and resources the hospital plans to commit to address health need:• Manager of the Wellness Center• MarketingPlanned collaboration between the hospital and other facilities:• School districts3. Re-establish communication among community partners post-pandemicActions the hospital intends to take to address the health need:• Hopedale Medical Complex will continue broad social media outreach within the service area.• Hopedale Medical Complex will continue utilizing a newsletter to inform the community and partner organizations of developments and opportunities at HMC.• Hopedale Medical Complex will update and re-establish lines of communication with partner organizations.

80 I Community Health Needs AssessmentPrograms and resources the hospital plans to commit to address health need:• MarketingPlanned collaboration between the hospital and other facilities:• Tazewell County Health Department• Community groups • Faith-based organizations• Schools4. Address transportation issues, including transportation to and from primary care and EMS response timeActions the hospital intends to take to address the health need:• Hopedale Medical Complex will explore potential transportation solutions with local partners and through the Illinois Critical Access Hospital Network.Anticipated impacts of these actions: Hopedale Medical Complex anticipates that undertaking studies and collaborations will result in more options for addressing transportation needs.Programs and resources the hospital plans to commit to address health need:• AdministrationPlanned collaboration between the hospital and other facilities:• Local transportation providers• Local EMS• Illinois Critical Access Hospital Network• Other interested groups5. Expand chronic care management to reduce hospital visits Actions the hospital intends to take to address the health need:• Hopedale Medical Complex will continue and expand critical care management based on review of progress and impact and needs analysis.

Hopedale Medical Complex I 81Anticipated impacts of these actions: Hopedale Medical Complex anticipates that planned expansion of the program will improve reduction in hospital visits.Programs and resources the hospital plans to commit to address health need:• Administration• Clinic managerPlanned collaboration between the hospital and other facilities:Hopedale Medical Complex views this as an internal project and is not anticipating outside partners.

Hopedale Medical Complex I 83Focus Groups AdministrationOrganizationsBusinessHopedale CHNA Small Group ParticipantsBruce Homan, Ag Teacher/FFA Advisor, Olympia High SchoolStacie Ealey, Director of Community Health, Tazewell County Health DepartmentBeth Beachy, Director, Birth to Five Division, Tazewell County Health DepartmentChelsea Lowe, Assistant Director of Nursing, Hopedale Medical ComplexAldo Rossi, Director, Patient Care Services, Hopedale Medical ComplexMary Lanier, Principal, Dee-Mack High SchoolEmily Whitson, Chief Operating Ocer, Hopedale Medical ComplexKathy Weinzierl, Director, Helping Hands Community CenterDeb Wheeler, Director, StanfordCarl Miller, Consult, TremontRick Otey, Volunteer, TremontDavid Zimmerman, County Board Chair, TazewellSean Berry, Superintendent, Tremont Community Unit School District 702Matt Shipton, Board Member, Delavan Community Unit School District 703Jenn Hubert, Registered Dietitian Nutritionist, Hopedale Medical ComplexGreg Eberle, Manager, Hopedale Wellness CenterREFERENCES AND APPENDIX

107 Tremont Street, Hopedale, IL 61747 • (309) 449-3321 • www.hopedalemc.com