Return to flip book view
2022Community Health NeedsAssessment
2 I Community Health Needs AssessmentTABLE OF CONTENTSINTRODUCTION........................................................................................................................................5-7Executive Summary.................................................................................................................................................7-9Background...............................................................................................................................................................12-17Marshall Browning Hospital Services...................................................................................................18-19Local Impact of COVID...........................................................................................................................................20ESTABLISHING THE CHNA INFRASTRUCTURE AND PARTNERSHIPS.........................23 DATA COLLECTION............................................................................................................................23-28Secondary Data.....................................................................................................................................................23-25Primary Data............................................................................................................................................................25-28DATA ANALYSIS...................................................................................................................................31-85Demographics........................................................................................................................................................31-34Social Determinants of Health....................................................................................................................35-57Health and Wellness Indicators...............................................................................................................58-85- Chronic Illness...................................................................................................................................................66-75- Substance Use...................................................................................................................................................76-79- Mental and Behavioral Health...............................................................................................................80-84Emergency Preparedness....................................................................................................................................85Copyright ©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, modied, 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.
Marshall Browning Hospital I 3IDENTIFICATION AND PRIORITIZATION OF NEEDS.........................................................87-88Process................................................................................................................................................................................87Description of the Community Health Needs Identied...............................................................88 RESOURCES AVAILABLE TO MEET PRIORITY HEALTH NEEDS..................................91-92Hospital Resources....................................................................................................................................................91Healthcare Partners or other Resources including Telemedicine.........................................91Community Resources...........................................................................................................................................92DOCUMENTING AND COMMUNICATING RESULTS...............................................................93 IMPLEMENTATION STRATEGY....................................................................................................95-99Planning Process.........................................................................................................................................................95Implementation Strategy..............................................................................................................................96-99REFERENCES AND APPENDIX................................................................................................101-103
Marshall Browning Hospital I 5INTRODUCTIONMarshall Browning Hospital was conceived on January 14, 1919, when Lillie F. Browning drew up her last will and testament, leaving the bulk of her estate to a trust which would have the responsibility of erecting and supporting a public hospital in or near Du Quoin. She requested the hospital be named in memory of her husband, Marshall. Today, Marshall Browning Hospital is licensed as a 25-bed critical access hospital established to provide quality medical, surgical, and emergency health services to the residents of Du Quoin and the surrounding areas.AdolescentsAdultsSeniorsEarly Childhood AdolescentsAdultsSeniors
6 I Community Health Needs AssessmentThe mission, vision, pillars, and strategic initiatives of Marshall Browning Hospital are:MISSION STATEMENT To improve the health and quality of life for the people and communities we serve.VISION STATEMENT To be the hospital of choice for our community by providing exceptional patient care and outstanding service.PILLARS (VALUES) • Quality• Service• Community• GrowthSTRATEGIC INITIATIVES• Patient-Centered Healthcare• Commit to a Culture of Quality and Service• Improve Financial Viability
Marshall Browning Hospital I 7Provisions in the Aordable 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 benet 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-prot 501(c)(3) corporation established in 2003 for the purposes of sharing resources, education, promoting operational eciencies, 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 Du Quoin and the surrounding area. The CHNA process was coordinated by the Director of Marketing/Patient Relations.EXECUTIVE SUMMARY
8 I Community Health Needs AssessmentTwo focus groups met to discuss the state of overall health and wellness in the Marshall Browning Hospital 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 ocials, public health, and others. Several members of these groups provide 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 identication and prioritization of the signicant health needs facing the community. The group consisted of representatives of public health, community leaders, healthcare providers, and community services providers.
Marshall Browning Hospital I 9IDENTIFICATION AND PRIORITIZATION ADDRESSING THE NEED At the conclusion of their review and discussion, the identication and prioritization group advanced the following needs:1. Issues surrounding mental health, including:– Increase access and improve transportation for long-term mentalhealthcare outside the community, including care for substance use disorders– Improve community education about risky behavior among youth– Increase education and training opportunities on youth mental healthfor school faculty and sta2. Begin to address the issues surrounding youth living in poverty.3. Sta public transportation needs to be at a sucient level to fully meet needs for broader general services and exibility to address access to health-related appointments and services.4. Telehealth access for youth in schools for physical and mental health.5. Address the teen birth rate.6. Better access to services from the Department of Human Services.Mental Health ServicesYouth Livingin PovertyPublicTransportationTelehealthServicesTeen BirthRateBetter Access toDHS Services
10 I Community Health Needs AssessmentThe results of the assessment process were then presented to senior sta at Marshall Browning Hospital through a facilitated discussion for development of a plan to address the identied and prioritized needs.ADDRESSING THE NEED CREATING THE PLANThe group addressed the needs with the following strategies:1. Issues surrounding mental health, including:– Increase access and improve transportation for long-term mentalhealthcare outside the community, including care for substance use disorders– Improve community education about risky behavior among youth– Increase education and training opportunities on youth mental healthfor school faculty and sta• Marshall Browning Hospital will cooperate with emerging eorts of Christopher Rural Health Clinic and the Perry County Health Department on new behavioral health problems.• Marshall Browning Hospital will explore cooperative transport programs with South Central Transit.• Marshall Browning Hospital will collaborate with area hospitals to develop funding for distant transfer for inpatient mental health and substance use disorder treatment.• Marshall Browning Hospital will explore expanding community education programs to locations away from the hospital in order to increase access and attendance. • Marshall Browning Hospital will explore developing local Mental Health First Aid trainers and other resources for school sta, parents, and community members.2. Begin to address the issues surrounding youth living in poverty.• Marshall Browning Hospital will support the school system’s eorts to create local career opportunities for youth and young adults.• Marshall Browning Hospital will re-engage and broaden its work shadowing program.
Marshall Browning Hospital I 113. Sta public transportation needs to be at a sucient level to fully meet needs for broader general services and exibility to address access to health-related appointments and services.• Marshall Browning Hospital will support South Central Transit in its post-pandemic rebuilding as is reasonable and appropriate.4. Telehealth access for youth in schools for physical and mental health.• Marshall Browning Hospital will explore expanding telehealth services to provide reasonable and appropriate access to sta and youth in schools in collaboration with the Perry County Health Department.5. Address the teen birth rate.• Marshall Browning Hospital will collaborate with the Perry County Health Department to increase education on topics relevant to this issue to the community and into schools.6. Better access to services from the Department of Human Services.• Marshall Browning Hospital will explore a collaboration to provide a liaison for services that present at the hospital.• Marshall Browning Hospital will explore support of any reasonable and appropriate community-based eort to convince the Department of Human Services to restore local access to the Department in this area if such an eort is initiated.
12 I Community Health Needs AssessmentThe Community Health Needs process is conducted every three years. In response to issues identied and prioritized and the implementation strategy developed to address them, Marshall Browning Hospital has taken the following steps since the last CHNA. Marshall Browning Hospital’s Community Health Needs Assessment for 2019:Five needs were identied as signicant health needs and prioritized:1. Availability of ambulances for emergency, local, and out-of-area transport.2. Area-wide nursing shortage that impacts access to transfer beds.3. Education for youth including wellness, substance abuse, and sexual health.4. Access to mental health education and services for youth and young adults in general, including coping skills and opportunities for peer support.5. Plan for continued access to prevention education for chronic illness, especially diabetes and cardiovascular issues. Process by which needs were addressed:1. Availability of ambulances for emergency, local, and out-of-area transport.Actions the hospital took to address the health need:• Marshall Browning Hospital representatives met with Du Quoin city ocials, Du Quoin Fire Department, Pinckneyville Ambulance Service, and Pinckneyville Community Hospital sta to discuss working together to possibly secure, equip, and sta at least one additional ambulance for local service. Unfortunately, this was an issue that could not be adequately addressed.2. Area-wide nursing shortage that impacts access to transfer beds.Actions the hospital took to address the health need:• In 2019, Marshall Browning Hospital was able to adequately address nurse stang needs. While it was not equipped to provide nursing education, it didBACKGROUND
Marshall Browning Hospital I 13cooperate as appropriate with other resources to help address the concern in this region. The hospital was supportive of the collaboration between Southern Illinois University-Carbondale (SIU-C) and Southern Illinois Healthcare (SIH) to implement a BSN program at SIU-C to help alleviate the nursing shortage.Marshall Browning Hospital successfully implemented succession planning for its own stang needs related to nursing leadership. Due to the retirements of the Chief Clinical Ocer and Quality/Safety Ocer, replacements were hired well in advance of their retirements to ensure a smooth transition and continuity of care.At the onset of the COVID-19 pandemic in early 2020, the nursing shortage became more challenging at Marshall Browning Hospital and across southern Illinois. Nurses were fatigued and stressed. Even though Marshall Browning Hospital increased nursing wages, nurses were accepting travel positions at higher wages. In addition, the COVID-19 vaccine mandate presented additional stang challenges throughout the area. Marshall Browning was fortunate to supplement stang with nurses provided through IEMA at various times during the height of the pandemic.The nursing shortage faced by hospitals throughout the region had a signicant impact on the ability to access transfer beds. Transferring patients to a higher level of care was extremely challenging and many times resulted in keeping critical patients for a longer period of time until a staed bed could be located.At this writing, the transfer situation has improved somewhat due to the lower COVID-19 positivity rate. However, the hospital continues to experience a nursing shortage. Hospital representatives continue to reach out to nursing education programs, attend job fairs, and spend signicant dollars in advertising for nursing positions.
14 I Community Health Needs Assessment3. Education for youth including wellness, substance abuse, and sexual health.Actions the hospital took to address the health need:• Education was provided to parents of junior high and high school students through a program entitled “Hidden in Plain Sight.” This drug education program displayed a room at the hospital that was turned into an interactive display of a teenager’s bedroom. The room contained items that hid substances and educated parents in spotting signs of at-risk behaviors that may lead to opioid misuse, addiction, and substance abuse disorders.• Marshall Browning Hospital provided a speaker for the annual 8th Grade Teen Conference. This included all eighth grade students in Perry County. The hospital provided a speaker who focused on educating students on sexual health and STDs. However, this program was canceled the last two years due to COVID-19.• Marshall Browning Hospital provided education to the public on the dangers of vaping through education in a community newsletter, reaching 13,000 homes. Education was also provided to area high school students.• Marshall Browning Hospital works in collaboration with the Perry County Health Department oering a medical provider for sexual health services through the local high school. This includes education on STDs and birth control.• Marshall Browning Hospital employees collect food and clothing each year for the local food pantries and Du Quoin Community Clothes’ Closet.• Marshall Browning Hospital employed a “Community Champion,” provided through a Delta Region Community Health System Development (DRCHSD) three-year grant. The “Community Champion” worked with community partners to assess community health needs and monitor changes in community health outcomes. The hospital hosted two virtual community events with partners to build an awareness of services available in the community and develop and implement a community care coordination plan. This involved healthcare professionals, mental health, community service organizations, schools, transportation, factories, etc., to improve transitions of care. Three committees were established from these events including “Healthy Behaviors and Lifestyles”, “Mental Health”, and “Good Jobs and
Marshall Browning Hospital I 15Healthy Economy.” Some of the accomplishments include the develop-ment of a Community Resource Guide, job fair, sexual health education classes for high school students, falls and re safety, and annual wellness visits for seniors. The hospital provided a free swim event at the local swimming pool for children and parents. The day included lunch and education on sun safety. The “Community Champion” is also involved with T2Hope, which is working to bring a warming center and transition center to Perry County.• Marshall Browning Hospital provided free school physicals, sports physicals, and immunizations by appointment to students during the COVID-19 pandemic. This was provided by appointment in place of the two annual sports physical clinics which could not be oered due to social distancing requirements.• Marshall Browning Hospital provided a free mask to every student in District #300 high school’s system at the onset of COVID-19.• Marshall Browning Hospital provides an athletic trainer to Du Quoin students at no charge.• Marshall Browning Hospital extended its Wi-Fi range to provide additional opportunities to students during e-learning throughout the pandemic.• Marshall Browning Hospital provided ongoing education on COVID-19 and the importance of regular screenings and vaccinations through various mediums including social media videos, newsletters, website, and print as well as education at the city park for children.• Marshall Browning Hospital donated each year to the Du Quoin Youth Club, NubAbility, Special Olympics, Du Quoin Food Pantry, Du Quoin Community Clothes Closet, and various other needs in the community.
16 I Community Health Needs Assessment4. Access to mental health education and services for youth and young adults in general, including coping skills and opportunities for peer support.Actions the hospital took to address the health need:• Marshall Browning Hospital provides mental health services through a contractual agreement with Tate Psychiatric. Services are oered at the hospital’s rural health clinic. Sandra Tate, APNC, specializes in pediatric psychiatry and sees patients by appointment one Monday each month. Alicia Yaeger, APRN, sees patients twice a month by scheduled appointments.• The “Community Champion” made available an online community health questionnaire to assess the most pressing concerns in the community that impact health. A separate survey was conducted of patients during registration at the hospital and two rural health clinics. This survey assessed their knowledge of COVID, their mental health, and the importance of seeking care during a pandemic. 5. Plan for continued access to prevention education for chronic illness, especially diabetes and cardiovascular issues.Actions the hospital took to address the health need:• Marshall Browning Hospital signed a collaborative agreement with McKendree University verifying commitment to a population health project with Barbara Stevenson, facilitated through the Perry County Healthy Communities Coalition, and the Tamaroa Community Center. The goal of the project was to provide education and information on planning and implementing outdoor exercise accessibility at the Tamaroa Community Center, educational material on physical activity, and knowing your numbers.• Prior to the COVID-19 pandemic, Marshall Browning Hospital oered a monthly educational luncheon program for individuals aged 50 and older with a physician or other healthcare provider presenting programs on various healthcare topics including chronic disease management. The hospital recently received a population health grant and will be providing monthly in-person education programs due to the lower COVID-19 positivity rate.
Marshall Browning Hospital I 17• Marshall Browning Hospital oered deeply discounted lab testing for the public on a quarterly basis and now oers the service every Tuesday. The lab testing consists of a blood prole, lipid prole, thyroid function, diabetic screen, Vitamin D level, and prostate cancer screen.• Marshall Browning Hospital initiated a care coordination program that organizes patient care activities driven by a patient-centered focus.To support care coordination, Marshall Browning Hospital added three key team members. The new positions include a Transitional Care Navigator, Annual Wellness Nurse, and Care Coordinator.MBH’s new sta members coordinate safe patient transitions between hospital stays to discharge home, additional follow-up after ED visits, and chronic disease care management.Annual wellness visits include a comprehensive yearly health review that helps patients create a personalized prevention plan with their primary care provider. • Marshall Browning Hospital will soon publish a Community Health Resource Guide that will be made available in print and online for community members.• The hospital oers a Coumadin clinic, which is an anticoagulation clinic held each Wednesday. The clinic provides one-on-one care to assist patients with the control of their anticoagulation therapy, specically Coumadin (generic Warfarin). Patients are given education and dietary instruction and know their results and dosage for the week following each appointment. This is a collaborative practice with no billing codes for the consultation of the pharmacist or lab personnel who provide the instruction for the patients. This service is donated back to the community. The clinic is highly successful and results in the avoidance of emergency room visits and admissions to the hospital by decreasing serious complications from blood-thinning medications. Patient benets include one-on-one contact with a healthcare provider, increased access to education and support, and anticoagulant management. • Community members are given free colorectal cancer screening kits during the month of March. The hospital provides the testing at no charge during Colon Cancer Awareness Month. • Marshall Browning Hospital sta assisted the Perry County Health Department with ongoing COVID-19 testing and vaccinations of community members.
18 I Community Health Needs AssessmentDu QuoinMulkeytownElkvilleSesserDowellTamaroaFor the purpose of this CHNA, Marshall Browning Hospital has dened its primary service area and populations as the general population within the geographic area in and surrounding Du Quoin, dened in detail below. The hospital’s patient population includes all who receive care without regard to insurance coverage or eligibility for assistance. Marshall Browning Hospital’s area of service is comprised of around 441 square miles, with a population of approximately 27,900 people and a population density of 63 people per square mile. The service area consists of rural communities, including:AREA SERVED BY MARSHALL BROWNING HOSPITALChristopherPinckneyvilleMarshall Browning Hospital Service AreaApril 05, 2022©2022 Esri Page 1 of 1
Marshall Browning Hospital I 19Marshall Browning Hospital Service Area Key Facts8 ZIP Codes Prepared by Esri62274 (Pinckneyville) et al. Geography: ZIP Code KEY FACTS28,455Population42.1Median Age2.3AverageHousehold Size$50,645Median HouseholdIncomeEDUCATION14%No High SchoolDiploma35%High SchoolGraduate36%Some College15%Bachelor's/Grad/Prof DegreeBUSINESS755Total Businesses7,730Total EmployeesEMPLOYMENT51%White Collar32%Blue Collar16%Services5.1%UnemploymentRateINCOME$50,645Median HouseholdIncome$25,086Per Capita Income$118,214Median Net WorthHouseholds By IncomeThe largest group: $50,000 - $74,999 (19.9%)The smallest group: $200,000+ (2.4%)Indicator▲Value Diff<$15,000 13.5% -2.5%$15,000 - $24,999 12.1% -0.5%$25,000 - $34,999 10.4% -1.5%$35,000 - $49,999 13.2% -1.3%$50,000 - $74,999 19.9% +1.8%$75,000 - $99,999 12.5% +1.3%$100,000 - $149,999 13.2% +2.0%$150,000 - $199,999 2.8% 0$200,000+ 2.4% +0.6%Bars show deviation from Franklin CountyThis infographic contains data provided by Esri, Esri and Data Axle. The vintage of the data is 2021, 2026. © 2022 EsriThe infographic above highlights some of the key facts of that data and provides a snapshot of the population served by Marshall Browning Hospital. The data on the following pages will take a deep dive into the demographics of Marshall Browning Hospital’s service area and will oer insight to both the commonality and complexity of the Marshall Browning Hospital audience. The average household size in the area, at 2.3, is lower than both Illinois (3.0) and the U.S. (2.5) overall average. Median age is 42 years, which is higher than Illinois (38.6) and the U.S. (38) benchmark. The largest level of education is some college, followed by high school graduate.Marshall Browning Hospital Service Area – Key Facts
20 I Community Health Needs AssessmentNote: This indicator is compared to the state average. Data Source: Johns Hopkins University. Accessed via ESRI. Additional data analysis by CARES. 2021. Source geography: CountyConrmed COVID-19 CasesLOCAL IMPACT OF COVIDCOVID-19 Conrmed Cases and MortalitiesThe COVID-19 epidemic has overshadowed many local health functions since March 2020. It has dramatically impacted overall health of the communities and the delivery of healthcare and health-related services. The broad impact has been seen throughout the communities, changing the way people work, shop, learn, and communicate. This indicator reports incidence rate of conrmed COVID-19 cases per 100,000 population. Data for this indicator are updated daily and derived from the Johns Hopkins University data feed. In the service area, there have been 12,272 total conrmed cases of COVID-19. The rate of conrmed cases is 31,710 per 100,000 population, which is greater than the state average of 24,129. The mortality rate related to COVID-19 in the service area of Marshall Browning Hospital has generally exceeded the rate of the state of Illinois. Data are current as of 4/5/2022.The area’s unemployment rate of 5.1% is higher than statewide and national average. Also, as is the case in much of rural Illinois, median family household income in the service area is lower than the statewide average.
Marshall Browning Hospital I 21
Marshall Browning Hospital I 23Data 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 modiable risk factors for chronic diseases and other leading causes of death.SparkMap SparkMapis 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
24 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 SurveyTheAmerican Community Survey(ACS), a product of the U.S. Census Bureau, helps local ocials, 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 agencyresponsible 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 communityhealth 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 ofGeographic Information System (GIS) software, web GIS and geodatabasemanagement applications. ESRI allows for specialized inquiries at the zip code, or other dened, 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.
Marshall Browning Hospital I 25Secondary 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. The rst focus group of community representatives met on October 14, 2021, and the second focus group of healthcare representatives met on October 15, 2021. A combined group met on March 7, 2022, to identify and prioritize current signicant health needs. The executive team met on March 8, 2022, for the Implementation Strategy.In response to a request to identify positive developments in health and healthcare in the service area of Marshall Browning Hospital, the groups put forward the following: Focus Group One - Community Representatives• New urgent care at Marshall Browning Hospital• Perry County Counseling has expanded available counseling services• More clinics seem to be available• Better access to mental health counselors and social workers• There are attempts in the community to address mental health stigma• Marshall Browning Hospital has joined an Accountable Care Organization that has aided the total care approach• Marshall Browning Hospital has established and maintained COVID-19 clinics• COVID-19 response in the community and at Marshall Browning Hospital has been good• The community has expanded social service programs for seniors• Marshall Browning Hospital has created new partnerships to facilitate an increase in available specialistsPRIMARY DATA
26 I Community Health Needs Assessment• Marshall Browning Hospital conducts community health check programs where low-cost testing is available• Improved community awareness of the impacts of social determinants of local health issues• COVID-19 has resulted in enhanced cooperation among Marshall Browning Hospital, local agencies, and schools• Marshall Browning Hospital has achieved high levels of respect in the community and has shed an image of being a “band-aid hospital.”• Marshall Browning Hospital has added Advanced Practice Psychiatric services for youth and adultsWhen asked to identify health needs in the community and the delivery of healthcare and healthcare services, whether related to Marshall Browning Hospital or not:• Transportation to appointments and services out of the service area• Better ow of information about availability of local health services• Motivate the community to pay attention to available health services and personal responsibility for wellness• More attention for homebound persons without support• Services to veterans• Address delay for transfers out of the hospital for behavioral health and substance abuse• Improve resources and services for youth for basic needs• Improve resources for prevention and services for persons facing substance use disorders, especially for methamphetamines, heroin, and marijuana• Find a community approach to COVID-19 conspiracy theories and social media attacks on health sciences and services• Expand partnerships to address health needs and related education needs of youth• Diverse resources for transportation needs• People and equipment for ambulance services• Address local suicide attempts by youth and adults
Marshall Browning Hospital I 27• Paid transportation to appointments for youth• Financial assistance with laundry needs• Dental care for underserved and unserved families• Health department services in Du Quoin one day a week• Access to food and hygiene items for youth• Expanded mental health resourcesFocus Group Two – Healthcare Representatives The second group included medical professionals and partners including representatives of public health, a community wellness organization, a senior services organization, a care coordinator, and others. The group reported the following recent positive developments:• New specialists, especially new GI (gastrointestinal) specialist, at Marshall Browning Hospital• New Accountable Care Organization at Marshall Browning Hospital has enhanced accessibility• Improved local availability of specialists• Remodeling at Marshall Browning Hospital has improved patient privacy• Transitional care program at Marshall Browning Hospital has improved services• Internal team at Marshall Browning Hospital is working well together• Case management follow-through has improved• Telehealth has improved access for many patients• Marshall Browning Hospital has addressed COVID-19 well• The Marshall Browning Hospital Community HealthCheck lab testing is very helpful for underserved and unserved persons• Marshall Browning Hospital services have increased as people begin to emerge from COVID-19 and come back to the hospital• Communication among agencies, providers, and Marshall Browning Hospital have improved
28 I Community Health Needs AssessmentThe group then oered the following needs:• Community awareness of the impact of social determinants on physical and mental health among youth and adults• Address issues concerning non-emergency transportation from the hospital• Address gaps in assessment and services for youth• Increase training for adults working with youth• Continue to recruit local specialists, including ENT (Ear/Nose/Throat)• Local assistance for Medicaid and Medicare information and assistance• Assisted living• Aordable access to exible transportation for appointments, especially out-of-the-area• Encourage the community to get back to pursuing wellness• Aordable local opportunities for exercise and recreation• Local services for the homeless• Address senior substance abuse and its impacts• Education for community and providers about MMAI (Medicare-Medicaid Alignment Initiative)• Get people back to work• Local access to women’s healthcare• Parenting education
Marshall Browning Hospital I 29
Marshall Browning Hospital I 31Age Group EthnicityRaceDisabilityDATA ANALYSISTotal Population by Age GroupData Source: US Census Bureau, American Community Survey. 2016‐-20. Source Geography: TractDEMOGRAPHICS
32 I Community Health Needs AssessmentTotal Population by EthnicityData Source: US Census Bureau, American Community Survey. 2016-‐20. Source geography: TractTotal Population by Age Groups, Marshall Browning Hospital Service Area
Marshall Browning Hospital I 33Total Population by Race AloneData Source: US Census Bureau, American Community Survey. 2016‐-20. Source geography: TractTotal Population by Race Alone, Marshall Browning Hospital Service Area
34 I Community Health Needs AssessmentPopulation with any DisabilityThis indicator reports the percentage of the total civilian non-institutionalized population with a disability. The report area has a total population of 25,265 for whom disability status has been determined, of which 5,044 or 19.96% have any disability. This indicator is relevant because disabled individuals comprise a vulnerable population that requires targeted services and outreach by providers.Data Source: US Census Bureau, American Community Survey. 2016-‐20. Source geography: Tract
Marshall Browning Hospital I 35
SOCIAL DETERMINANTS OF HEALTHThe data and discussion on the following pages will take a look into the socialdeterminants in the Marshall Browning Hospital service area and will oer insightinto the complexity of circumstances that impact physical and mental wellness forthe Marshall Browning Hospital audience. The infographic on Page 33 provides asnapshot of the at-risk population served by Marshall Browning Hospital.The CDC describes social determinants of health as conditions in the places wherepeople live, learn, work, and play that aect 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
36 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 reected in the data include:• 3,935 households with disability• 1,903 households below the poverty level• Median household income is $50,645, which is lower than both Illinois and the U.S.Economic and social insecurity often are associated with poor health. Poverty, unemployment, and lack of educational achievement aect 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.
Marshall Browning Hospital I 37AT RISK POPULATION PROFILEGeography: CountyMarshall Browning Hospital Service Area - At Risk Population8 ZIP Codes Prepared by Esri62274 (Pinckneyville) et al. Geography: ZIP Code Version 1.9© 2022 EsriSource:Esri forecasts for 2021, U.S. Census Bureau2015-2019 American Community Survey(ACS) Data,AT RISK POPULATION PROFILE8 ZIP CodesGeography: ZIP Code28,455Population11,122Households2.34Avg SizeHousehold42.1MedianAge$50,645MedianHousehold Income$96,563MedianHome Value61WealthIndex279HousingAffordability26DiversityIndexAT RISK POPULATION3,935Households WithDisability5,866Population 65+753HouseholdsWithout VehiclePOVERTY AND LANGUAGE17%Households Belowthe Poverty Level1,903Households Belowthe Poverty Level0Pop 65+ SpeakSpanish & No EnglishPOPULATION AND BUSINESSES23,687DaytimePopulation755TotalBusinesses7,730TotalEmployeesPOPULATION BY AGEUnder18 18to65 Aged65+04,0008,00012,00016,00020,0005,2045,49717,754Language Spoken (ACS) Age 5-17 18-64 Age 65+ TotalEnglish Only 4,061 16,622 5,096 25,779Spanish 20 408 30 458Spanish & English Well 20 389 30 439Spanish & English Not Well 0 18 0 18Spanish & No English 0 0 0 0Indo-European 30 132 161 323Indo-European & English Well 30 132 161 323Indo-European & English Not Well 0 0 0 0Indo-European & No English 0 0 0 0Asian-Pacic Island 0 44 17 61Asian-Pacic Isl & English Well 0 34 14 48Asian-Pacic Isl & English Not Well 0 10 3 13Asian-Pacic Isl & No English 0 0 0 0Other Language 0 4 0 4Other Language & English Well 0 4 0 4Other Language & English Not Well 0 0 0 0Other Language & No English 0 0 0 0Marshall Browning Hospital Service Area - At Risk Population8 ZIP Codes Prepared by Esri62274 (Pinckneyville) et al. Geography: ZIP Code Version 1.9© 2022 EsriSource:Esri forecasts for 2021, U.S. Census Bureau2015-2019 American Community Survey(ACS) Data,AT RISK POPULATION PROFILE8 ZIP CodesGeography: ZIP Code28,455Population11,122Households2.34Avg SizeHousehold42.1MedianAge$50,645MedianHousehold Income$96,563MedianHome Value61WealthIndex279HousingAffordability26DiversityIndexAT RISK POPULATION3,935Households WithDisability5,866Population 65+753HouseholdsWithout VehiclePOVERTY AND LANGUAGE17%Households Belowthe Poverty Level1,903Households Belowthe Poverty Level0Pop 65+ SpeakSpanish & No EnglishPOPULATION AND BUSINESSES23,687DaytimePopulation755TotalBusinesses7,730TotalEmployeesPOPULATION BY AGEUnder18 18to65 Aged65+04,0008,00012,00016,00020,0005,2045,49717,754Language Spoken (ACS) Age 5-17 18-64 Age 65+ TotalEnglish Only 4,061 16,622 5,096 25,779Spanish 20 408 30 458Spanish & English Well 20 389 30 439Spanish & English Not Well 0 18 0 18Spanish & No English 0 0 0 0Indo-European 30 132 161 323Indo-European & English Well 30 132 161 323Indo-European & English Not Well 0 0 0 0Indo-European & No English 0 0 0 0Asian-Pacic Island 0 44 17 61Asian-Pacic Isl & English Well 0 34 14 48Asian-Pacic Isl & English Not Well 0 10 3 13Asian-Pacic Isl & No English 0 0 0 0Other Language 0 4 0 4Other Language & English Well 0 4 0 4Other Language & English Not Well 0 0 0 0Other Language & No English 0 0 0 0Marshall Browning Hospital Service Area - At Risk Population8 ZIP Codes Prepared by Esri62274 (Pinckneyville) et al. Geography: ZIP Code Version 1.9© 2022 EsriSource:Esri forecasts for 2021, U.S. Census Bureau2015-2019 American Community Survey(ACS) Data,AT RISK POPULATION PROFILE8 ZIP CodesGeography: ZIP Code28,455Population11,122Households2.34Avg SizeHousehold42.1MedianAge$50,645MedianHousehold Income$96,563MedianHome Value61WealthIndex279HousingAffordability26DiversityIndexAT RISK POPULATION3,935Households WithDisability5,866Population 65+753HouseholdsWithout VehiclePOVERTY AND LANGUAGE17%Households Belowthe Poverty Level1,903Households Belowthe Poverty Level0Pop 65+ SpeakSpanish & No EnglishPOPULATION AND BUSINESSES23,687DaytimePopulation755TotalBusinesses7,730TotalEmployeesPOPULATION BY AGEUnder18 18to65 Aged65+04,0008,00012,00016,00020,0005,2045,49717,754Language Spoken (ACS) Age 5-17 18-64 Age 65+ TotalEnglish Only 4,061 16,622 5,096 25,779Spanish 20 408 30 458Spanish & English Well 20 389 30 439Spanish & English Not Well 0 18 0 18Spanish & No English 0 0 0 0Indo-European 30 132 161 323Indo-European & English Well 30 132 161 323Indo-European & English Not Well 0 0 0 0Indo-European & No English 0 0 0 0Asian-Pacic Island 0 44 17 61Asian-Pacic Isl & English Well 0 34 14 48Asian-Pacic Isl & English Not Well 0 10 3 13Asian-Pacic Isl & No English 0 0 0 0Other Language 0 4 0 4Other Language & English Well 0 4 0 4Other Language & English Not Well 0 0 0 0Other Language & No English 0 0 0 0Marshall Browning Hospital Service Area
38 I Community Health Needs AssessmentEconomic Stability – Income and Economics Economic and social insecurity often are associated with poor health. Poverty, unemployment, and lack of educational achievement aect 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.Note: This indicator is compared to the state average.Data Source: US Census Bureau, American Community Survey. 2015‐19. Source geography: Tract
Marshall Browning Hospital I 39Poverty – Population Below 100% FPLPoverty is considered a key driver of health status. Within the service area, 17.06% or 4,287 individuals 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, health 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. 2015‐19. Source geography: Tract
40 I Community Health Needs AssessmentPoverty – Children Below 100% FPLIn the service area, 25.53% or 1,372 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. 2015‐19. Source geography: Tract
Marshall Browning Hospital I 41Poverty – Children Eligible for Free/Reduced Price LunchFree or reduced price lunches are served to qualifying students in families with income between under 185% (reduced price) or under 130% (free lunch) of the U.S. federal poverty threshold as part of the federal National School Lunch Program (NSLP). Out of 11,764 total public school students in the service area, 6,206 were eligible for the free or reduced price lunch program in the latest report year. This represents 52.75% of public school students, which is higher than the state average of 48.67%.Note: This indicator is compared to the state average. Data Source: National Center for Education Statistics, NCES - Common Core of Data, 2019-20. Source geography: Address
42 I Community Health Needs AssessmentHouseholds Receiving SNAP BenetsIn the service area, an estimated 2,079 or 18.42% of the households receive Supplemental Nutrition Assistance Program (SNAP) benets. The value for the service area is greater than the national average of 11.74%. This indicator is relevant because it assesses vulnerable populations which are more likely to have multiple health access, health status, and social support needs. When combined with poverty data, providers can use this measure to identify gaps in eligibility and enrollment.Note: This indicator is compared to the state average.Data Source: US Census Bureau, American Community Survey. 2015‐19. Source geography: Tract
Marshall Browning Hospital I 43Education Attainment – Associate’s Level Degree or HigherThis 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, prociency, 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. For the selected area, 10.2% have at least a college bachelor’s degree, while 34.5% stopped their formal education attainment after high school.
44 I Community Health Needs AssessmentProciency – Student Math Prociency (4th Grade)Information about student performance in the 4th grade math portion of the state-specic standardized tests are displayed in the table below. Of 203 students tested, 23.6% of 4th graders performed at or above the “procient” level, and 76.4% tested below the “procient” level, according to the latest data. Students in the report area tested worse 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
Marshall Browning Hospital I 45Prociency – Student Reading Prociency (4th Grade)Information about student performance in the 4th grade English language arts portion of the state-specic standardized tests are displayed in the table below. Of 203 students tested, 28.8% of 4th graders performed at or above the “procient” level, and 71.2% tested below the “procient” level, according to the latest data. Students in the report area tested worse than the statewide rate of 32.4%.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
46 I Community Health Needs AssessmentFood Insecurity RateEconomic and social insecurity often are associated with poor health. Poverty, unemployment, and a lack of educational achievement aect 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. This 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
Marshall Browning Hospital I 47Food Insecurity – Food Insecure ChildrenThis indicator reports the estimated percentage of the population under age 18 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.Food Environment – Food Desert Census TractThis indicator reports the number of neighborhoods in the service area that are within food deserts. The USDA Food Access Research Atlas denes 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 8,082 living in food deserts and a total of two census tracts classied as food deserts by the USDA.Note: This indicator is compared to the state average. Data Source: U.S. Department of Agriculture, Economic Research Service, USDA - Food Access Research Atlas, 2019. Source geography: Tract.Note: This indicator is compared to the state average.Data Source: Feeding America, 2017. Source geography: County
48 I Community Health Needs AssessmentTeen BirthsThis indicator reports the seven-year average number of births per 1,000 female population age 15-19. Data were from the National Center for Health Statistics - Natality Files (2013-2019) and are used for the 2021 County Health Rankings. In the service area, of the 7,927 total female population age 15-19, the teen birth rate is 43.9 per 1,000, which is greater than the state’s teen birth rate of 19.4. Note: Data are suppressed for counties with fewer than 10 teen births 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 County Health Rankings, 2013-2019. Source geography: County
Marshall Browning Hospital I 49Note: This indicator is compared to the state average. Data Source: U.S. Department of Education, EDFacts. Additional data analysis by CARES, 2019-2020. Source geography: School DistrictHomeless Children & YouthThis indicator reports the number of homeless children and youth enrolled in the public school system during the school year 2019-2020. According to the data source denitions, homelessness is dened 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 report area level based on school district summaries where three or more homeless children are counted. In the service area, of all the 3,558 students enrolled during the school year 2019-2020, there were 125 or 1.5% homeless students, which is lower than the statewide rate of 2.6%. Note: Data are available for 100.0% of school districts in the service area, representing 100.0% of the public school student population.
50 I Community Health Needs AssessmentFood Environment – Low Food AccessThis indicator reports the percentage of the population with low food access. Low food access is dened as living more than one-half mile from the nearest supermarket, supercenter, or large grocery store. Data are from the April 2021 Food Access Research Atlas dataset. This indicator is relevant because it highlights populations and geographies facing food insecurity. Within the service area, 22.97% of the total population have low food access. The total population in the service area with low food access is 6,716.Note: This indicator is compared to the state average. Data Source: U.S. Department of Agriculture, Economic Research Service, USDA - Food Access Research Atlas, 2019. Source geography: Tract.
Marshall Browning Hospital I 51Food Environment – Low Income and Low Food AccessThis indicator reports the percentage of the low income population with low food access. Low food access is dened as living more than one-half mile from the nearest supermarket, supercenter, or large grocery store. Data are from the April 2021 Food Access Research Atlas dataset. This indicator is relevant because it highlights populations and geographies facing food insecurity. Within the service area, 24.94% of the total low income population have low food access. The total low income population in the service area with low food access is 2,689.Note: This indicator is compared to the state average. Data Source: U.S. Department of Agriculture, Economic Research Service, USDA - Food Access Research Atlas, 2019. Source geography: Tract.
52 I Community Health Needs AssessmentFood Environment – Grocery StoresHealthy dietary behaviors are supported by access to healthy foods, and grocery stores are a major provider of these foods. There are ve grocery establishments in the service area, a rate of 16.34 per 100,000 population. Grocery stores are dened 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
Marshall Browning Hospital I 53Area Deprivation IndexThis indicator reports the average (population weighted) Area Deprivation Index (ADI) for the selected area. The Area Deprivation Index ranks neighborhoods and communities relative to all neighborhoods across the nation (national percentile) or relative to other neighborhoods within just one state (state percentile). The ADI is calculated based on 17 measures related to four primary domain (education, income and employment, housing, and household characteristics). The overall scores are measured on a scale of 1 to 100, where 1 indicates the lowest level of deprivation (least disadvantaged) and 100 is the highest level of deprivation (most disadvantaged).Note: This indicator is compared to the state average. Data Source: University of Wisconsin-Madison School of Medicine and Public Health, Neighborhood Atlas, 2021. Source geography: Block Group.
54 I Community Health Needs AssessmentAordable HousingThis indicator reports the number and percentage of housing units aordable at various income levels. Aordability is dened by assuming that housing costs should not exceed 30% of 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, 2015-2019. Source geography: Tract
Marshall Browning Hospital I 55Households With No ComputerThis indicator reports the percentage of households who don’t own or use any types of computers, including desktop or laptop, smartphone, tablet, or other portable wireless computer, and some other type of computer, based on the 2014-2019 American Community Survey estimates. Of the 11,287 total households in the service area, 1,825 or 16.17% are without a computer.Note: This indicator is compared to the state average. Data Source: U.S. Census Bureau, American Community Survey, 2015-2019. Source geography: Tract
56 I Community Health Needs AssessmentHouseholds With No or Slow InternetThis indicator reports the percentage of households who either use dial-up as their only way of internet connection, or have internet access but don’t pay for their service, or have no internet access in their home, based on the 2015-2019 American Community Survey estimates. Of the 11,287 total households in the service area, 2,926 or 25.92% have no or slow internet.Note: This indicator is compared to the state average. Data Source: U.S. Census Bureau, American Community Survey, 2015-2019. Source geography: Tract
Marshall Browning Hospital I 57Broadband Access – Percent by Time PeriodThe table below displays temporal trends in high-speed internet availability as the percent of the population with access to broadband in the service area.
58 I Community Health Needs AssessmentAccess to Care – Dental HealthThis indicator reports the number of dentists per 100,000 population. This indicator includes all dentists qualied 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 13 dentists. This represents 47.97 dentists 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: CountyHEALTH AND WELLNESS INDICATORS
Marshall Browning Hospital I 59Access to Care – Mental HealthThis indicator reports the number of mental health providers in the service area as a rate per 100,000 total area population. Mental health providers include psychiatrists, psychologists, 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 Identier (NPI) downloadable le are used in the 2021 County Health Rankings. Within the report area, there are 257 mental health providers with a CMS National Provider Identier (NPI). This represents 668.1 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: U.S. Department of Health & Human Services,Health Resources and Services Administration, HRSA - Area Health Resource File, 2015. Source geography: CountyNote: 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
60 I Community Health Needs AssessmentAccess to Care – Primary CareThis indicator reports the number of primary care physicians per 100,000 population. Doctors classied 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 subspecialties 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 14 primary care physicians. This represents 52.68 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
Marshall Browning Hospital I 61Poor or Fair HealthThis indicator reports the percentage of adults age 18 and older who self-report poor or fair health (age-adjusted to the 2000 standard). Data were from the 2020 Behavioral Risk Factor Surveillance System (BRFSS) annual survey and are used for the 2021 County Health Rankings. This indicator is relevant because it is a measure of general poor health status. Within the service area, the estimated prevalence of fair or poor health among adults aged 18 years and older was 21.4%. This value is based on the crude number of adults who self-report their general health status as “fair” or “poor.”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 500 Cities Data Portal, 2019. Source geography: Tract
62 I Community Health Needs AssessmentThis 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 inuenza 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 ve years and an FOBT within the past three years, or a colonoscopy within the past 10 years. Within the service area, there are 24.6% women age 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 500 Cities Data Portal, 2018. Source geography: TractPrevention – Core Preventative Services for Women
Marshall Browning Hospital I 63This 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 inuenza 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 ve years and an FOBT within the past three years, or a colonoscopy within the past 10 years. Within the service area, there are 34.5% men age 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 500 Cities Data Portal, 2018. Source geography: TractPrevention – Core Preventative Services for Men
64 I Community Health Needs AssessmentAccess to recreation and tness facilities encourages physical activity and other healthy behaviors. The service area includes two establishments primarily engaged in operating tness and recreational sports facilities featuring exercise and other active physical tness conditioning or recreational sports activities, such as swimming, skating, or racquet sports.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: CountyBuilt Environment – Recreation and Fitness Facility Access
Marshall Browning Hospital I 65
66 I Community Health Needs AssessmentHealth 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.Teeth LossThis 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 16.5% of adults age 18 and older who reported losing all 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 500 Cities Data Portal, 2018. Source geography: CountyCHRONIC ILLNESS
Marshall Browning Hospital I 67Top 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.
68 I Community Health Needs AssessmentChronic Conditions – Asthma Prevalence (Adult)This 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 9.7% 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 500 Cities Data Portal, 2019. Source geography: Tract
Marshall Browning Hospital I 69Chronic Conditions – Chronic Obstructive Pulmonary Disease (Adult)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 chronic obstructive pulmonary disease (COPD), emphysema, or chronic bronchitis. Within the service area, there were 9.0% 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 500 Cities Data Portal, 2019. Source geography: Tract
70 I Community Health Needs AssessmentChronic Conditions – Diabetes (Adult)This indicator reports the number and percentage of adults age 20 and older who have ever 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, 1,981 of adults age 20 and older have diabetes. This represents 7.9% 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, Behavioral Risk Factor Surveillance System, Accessed via the 500 Cities Data Portal, 2019. Source geography: Tract
Marshall Browning Hospital I 71Chronic Conditions – Kidney Disease (Adult)This indicator reports the number and percentage of adults age 18 and older who report ever having been told by a doctor, nurse, or other health professional that they have kidney disease.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 500 Cities Data Portal, 2019. Source geography: Tract
72 I Community Health Needs AssessmentChronic Conditions – Coronary Heart Disease (Adult)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 service area, there were 7.4% 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 500 Cities Data Portal, 2019. Source geography: Tract
Marshall Browning Hospital I 73Chronic Conditions – High Blood Pressure (Adult)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 have high blood pressure. Women who were told high blood pressure only during pregnancy and those who were told they had borderline hypertension were not included. Within the service area, there were 35.8% 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 500 Cities Data Portal, 2019. Source geography: Tract
74 I Community Health Needs AssessmentChronic Conditions – High Cholesterol (Adult)This indicator reports the percentage of adults age 18 and older who report having been told by a doctor, nurse, or other health professional that they had high cholesterol. Within the service area, there were 34.4% of adults age 18 and older who reported having high cholesterol 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 500 Cities Data Portal, 2019. Source geography: Tract
Marshall Browning Hospital I 75Stroke (Adult)This indicator reports the number and percentage of adults age 18 and older who report ever having been told by a doctor, nurse, or other health professional that they have had a stroke. Within the service area, there were 3.9% of adults age 18 and older who reported having a stroke 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 500 Cities Data Portal, 2019. Source geography: Tract
76 I Community Health Needs AssessmentAlcohol – Heavy Alcohol ConsumptionIn the service area, 7,841 or 20.26% of 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 dened 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 heaving drinking involving more than two drinks per day for man and more than one per day for women, over the same time period. Alcohol use is a behavioral health issue that is also a risk factor for a number of negative 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. Note: There are a number of evidence-based interventions that may reduce excessive/binge drinking. Examples include raising taxes on alcoholic beverages, restricting access to alcohol by limiting days and hours of retail sales, and screening and counseling for alcohol abuse (Centers for Disease Control and Prevention, Preventing Excessive Alcohol Use, 2020).Note: This indicator is compared to the state average. Data Source: University of Wisconsin Population Health Institute, County Health Rankings, 2018. Source geography: CountySUBSTANCE USE
Marshall Browning Hospital I 77Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention: Behavioral Risk Factor Surveillance System, Accessed via the 500 Cities Data Portal, 2019. Source geography: TractAlcohol – Binge DrinkingThis 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 report area, there are 20.0% adults who reported having four or more drinks in the last month of the total population.
78 I Community Health Needs AssessmentTobacco Usage – 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 21.8% 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 500 Cities Data Portal, 2019. Source geography: Tract
Marshall Browning Hospital I 79Note: This indicator is compared to the state average. Data Source: Centers for Medicare and Medicaid Services, CMS - Geographic Variation Public Use File, 2018. Source geography: CountySubstance Use Disorder (Medicare Population)This indicator reports the percentage of the Medicare fee-for-service population with substance use disorder. Data are based upon Medicare administrative enrollment and claims data for Medicare beneciaries enrolled in the fee-for-service program. Within the service area, there are 162 beneciaries with substance use disorder. This represents 3.5% of the Medicare fee-for-service beneciaries.
80 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 report area, there were 15.4% 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 500 Cities Data Portal, 2019. Source geography: TractMENTAL AND BEHAVIORAL HEALTH
Marshall Browning Hospital I 81Poor Mental Health DaysThis indicator reports the average number of self-reported mentally unhealthy days in the past 30 days among adults (age adjusted to the 2000 standard). Data were from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) annual survey and are used for the 2021 County Health Rankings. Of the 9,150 total adults in the report area, the average poor mental health days is 4.9 per months, which is greater than the state’s monthly average of 4.1.Note: This indicator is compared to the state average. Data Source: Centers for Disease Control and Prevention: Behavioral Risk Factor Surveillance System, Accessed via County Health Rankings, 2018. Source geography: County
82 I Community Health Needs AssessmentPoor Mental Health – Mental Health and Substance Use ConditionsThis indicator reports the rate of diagnoses for mental health and substance use conditions among the Medicare population. Figures are reported as age-adjusted to year 2000 standard. Rates are resummarized for report areas from county level data, only where data is available. This indicator is relevant because mental health and substance use is an indicator of poor health.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
Marshall Browning Hospital I 83Mortality – 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 summarized for 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 23 deaths due to suicide. This represents an age-adjusted death rate of 17.5 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
84 I Community Health Needs AssessmentDeaths of Despair (Suicide + Drug/Alcohol Poisoning)This 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 deaths of despair is an indicator of poor mental health. Within the service area, there were 73 deaths of despair. This represents an age-adjusted death rate of 52.4 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
Marshall Browning Hospital I 85
Marshall Browning Hospital works with the US-HHS ASPR, the Illinois Departmentof Public Health, county health departments, the Illinois Emergency Management Agency, and other state, regional, and local partners to plan, exercise, and equipfor emergency preparedness and to ensure the ability to address a wide rangeof potential emergencies, ranging from disasters of all causes to pandemicsand terrorism. Marshall Browning Hospital utilizes ambulance services fromPinckneyville Ambulance Service and United Medical Response.EMERGENCY PREPAREDNESS
Marshall Browning Hospital I 87The ndings of the focus groups were presented, along with secondary data, analyzed by the consultant, to a third group for identication and prioritization of the signicant health needs facing the community. The group consisted of representatives of public health, community leaders, healthcare providers, law enforcement, faith-based organizations and community services providers. The group reviewed notes from the focus groups and summaries of data reviewed by the consultant which included SparkMaps, 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 NEEDSMental Health ServicesYouth Livingin PovertyPublicTransportationTelehealthServicesTeen BirthRateBetter Access toDHS Services
88 I Community Health Needs AssessmentAt the conclusion of their review and discussion, the identication and prioritization group advanced the following needs as being the signicant community health needs facing the Marshall Browning Hospital service area:1. Issues surrounding mental health, including:– Increase access and improve transportation for long-term mentalhealthcare outside the community, including care for substance use disorders– Improve community education about risky behavior among youth– Increase education and training opportunities on youth mental healthfor school faculty and sta2. Begin to address the issues surrounding youth living in poverty.3. Sta public transportation needs to be at a sucient level to fully meet needs for broader general services and exibility to address access to health-related appointments and services.4. Telehealth access for youth in schools for physical and mental health.5. Address the teen birth rate.6. Better access to services from the Department of Human Services.DESCRIPTION OF THE COMMUNITY HEALTH NEEDS IDENTIFIED
Marshall Browning Hospital I 89
Marshall Browning Hospital I 91Resources PartnersVolunteersGovernmentA• AdministrationHOSPITAL RESOURCES RESOURCES AVAILABLE TO MEET PRIORITY HEALTH NEEDS• Health Departments• Christopher Rural Health ClinicHEALTHCARE PARTNERS OR OTHER RESOURCES, INCLUDING TELEMEDICINECOMMUNITY RESOURCES• Social services providers• Community organizations• Schools• South Central Transit• Community and economic development partners• Good Jobs and Healthy Community Committee• Du Quoin Park District• Du Quoin Youth Club
Marshall Browning Hospital I 93Documentation Online PresenceCommentsImplementationSECONDARY DATAThis CHNA Report will be available to the community on the hospital’s public website, www.marshallbrowninghospital.com. 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
Marshall Browning Hospital I 95
The results of the assessment process were presented to senior sta througha facilitated discussion for development of a plan to address the identied andprioritized needs on March 8, 2022.The group reviewed the needs assessment process completed to that point andconsidered the prioritized signicant 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.The group then considered each of the prioritized needs. For each of the threeprioritized needs, actions the hospital intends to take were identied, along withthe anticipated 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 STRATEGYMental HealthServicesYouth Livingin PovertyPublicTransportationTelehealthServicesTeen BirthRateBetter Access toDHS Services
96 I Community Health Needs AssessmentThe group addressed the needs with the following strategies:1. Issues surrounding mental health, including:– Increase access and improve transportation for long-term mentalhealthcare outside the community, including care for substance use disorders– Improve community education about risky behavior among youth– Increase education and training opportunities on youth mental healthfor school faculty and staActions the hospital intends to take to address the health need:• Marshall Browning Hospital will cooperate with emerging eorts of Christopher Rural Health Clinic and the Health Department on new behavioral health problems.• Marshall Browning Hospital will explore cooperative transport programs with South Central Transit.• Marshall Browning Hospital will collaborate with area hospitals to develop funding for distant transfer for inpatient mental health and substance use disorder treatment.• Marshall Browning Hospital will explore expanding community education programs to locations away from the hospital in order to increase access and attendance.• Marshall Browning Hospital will explore developing local Mental Health First Aid trainers and other resources for school sta, parents, and community members.Anticipated impacts of these actions:Marshall Browning Hospital anticipates that these steps will improve local access to mental health services and community education.IMPLEMENTATION STRATEGY
Marshall Browning Hospital I 97Programs and resources the hospital plans to commit to address health need:• AdministrationPlanned collaboration between the hospital and other facilities:• Health departments• School districts• Christopher Rural Health Clinic• South Central Transportation• Keyes Park and Du Quoin Municipal Pool• Du Quoin Youth Club 2. Begin to address the issues surrounding youth living in poverty.Actions the hospital intends to take to address the health need:• Marshall Browning Hospital will support the school system’s eorts to create local career opportunities for youth and young adults.• Marshall Browning Hospital will re-engage and broaden its work shadowing program.Anticipated impacts of these actions:Marshall Browning Hospital anticipates that the above steps will result in opportunities for older youth and young adults (future parents) to improve their socio-economic position.Programs and resources the hospital plans to commit to address health need:• AdministrationPlanned collaboration between the hospital and other facilities:• Health departments• School districts• Good Jobs and Healthy Community Committee
98 I Community Health Needs Assessment3. Sta public transportation needs to be at a sucient level to fully meet needs for broader general services and exibility to address access to health-related appointments and services.Actions the hospital intends to take to address the health need:Marshall Browning Hospital will support South Central Transit in its post-pandemic rebuilding as is reasonable and appropriate.Anticipated impacts of these actions: Marshall Browning Hospital believes that the solutions to mass transit issues must be led by transit experts and leaders. Marshall Browning Hospital anticipates that recently announced steps to restore and expand the local transit program will address the issues raised here.Programs and resources the hospital plans to commit to address health need: • AdministrationPlanned collaboration between the hospital and other facilities:• South Central Transit• Other community and economic development partners 4. Telehealth access for youth in schools for physical and mental health.Actions the hospital intends to take to address the health need:Marshall Browning Hospital will explore expanding telehealth services to provide reasonable and appropriate access to sta and youth in schools in collaboration wit the health department.Anticipated impacts of these actions: Marshall Browning Hospital anticipates that this cooperative eort between the hospital, public health, and the schools could provide increased access to mental and physical care for youth.Programs and resources the hospital plans to commit to address health need: • AdministrationPlanned collaboration between the hospital and other facilities:• Health department• Schools
Marshall Browning Hospital I 995. Address the teen birth rate.Actions the hospital intends to take to address the health need:Marshall Browning Hospital will collaborate with the health department to increase education on topics relevant to this issue to the community and into schools.Anticipated impacts of these actions: Marshall Browning Hospital anticipates that increasing communication on topics related to teen births will have a positive impact on the birth rate.Programs and resources the hospital plans to commit to address health need: • AdministrationPlanned collaboration between the hospital and other facilities:• Health departments• Schools 6. Better access to services from the Department of Human Services.Actions the hospital intends to take to address the health need:• Marshall Browning Hospital will explore a collaboration to provide a liaison for services that present at the hospital.• Marshall Browning Hospital will explore support of any reasonable and appropriate community-based eort to convince the Department of Human Services to restore local access to the Department in this area, if such an eort is initiated.Anticipated impacts of these actions: Marshall Browning Hospital anticipates that its collaborative eorts will increase local access to resources and services.Programs and resources the hospital plans to commit to address health need: • AdministrationPlanned collaboration between the hospital and other facilities:• Social services providers• Health departments• Community organizations
Marshall Browning Hospital I 101Focus Groups AdministrationOrganizationsBusinessFocus Group One – Healthcare Providers and Community LeadersSherry Bassen, Director of Marketing, South Central TransitHoward Baxter, Assistant Chief of Police, Du Quoin Police DepartmentAshley Greer, Manager, Western Egyptian Food PantryAbigail Hammonds, Executive Director, Du Quoin Chamber of CommerceGuy Alongi, Mayor, City of Du QuoinLindell Slaughter, Retiree/VolunteerCelena Slowick, Community Champion, Marshall Browning HospitalDan Eaves, CEO, Marshall Browning HospitalLarry Spour, COO, Marshall Browning HospitalPam Logan, Director, Marketing and Patient Relations, Marshall Browning HospitalREFERENCES AND APPENDIX
102 I Community Health Needs AssessmentFocus Group Two – Medical Professionals and PartnersBarbara Stevenson, Administrator, Perry County Health Department Danielle Klump, Nurse Practitioner, MBH Medical ClinicPatsy Lipe, Manager, Pinckneyville Ambulance ServiceJanet Wolfe, Business Director, Du Quoin Nursing and RehabBrock McGee, Administrator, Du Quoin Nursing and RehabBrenda Cullen, Administrator, Fairview Rehabilitation and Healthcare Center Brooke Feltmeyer, Clinic Manager, MBH Medical Clinic/Family Health CenterShirley Kellerman, M/S Case Manager, Marshall Browning HospitalJordyn Kellerman, Transitional Care Navigator, Marshall Browning HospitalCelena Slowick, Community Champion, Marshall Browning HospitalDan Eaves, CEO, Marshall Browning HospitalLarry Spour, COO, Marshall Browning HospitalPam Logan, Director, Marketing and Patient Relations, Marshall Browning HospitalIdentication and Prioritization GroupSherry Bassen, Director of Marketing, South Central TransitJamie Downes, Recruiting/Marketing, South Central TransitHoward Baxter, Assistant Chief of Police, Du Quoin Police DepartmentAbigail Hammonds, Executive Director, Du Quoin Chamber of CommerceGuy Alongi, Mayor, City of Du QuoinBarbara Stevenson, Administrator, Perry County Health DepartmentPatsy Lipe, Manager, Pinckneyville Ambulance ServiceJanet Wolfe, Business Director, Du Quoin Nursing and RehabBrooke Feltmeyer, Clinic Manager, MBH Medical Clinic/Family Health CenterJordyn Kellerman, Transitional Care Navigator, Marshall Browning HospitalStephanie Hall, Chief Nursing Ocer, Marshall Browning HospitalCelena Slowick, Community Champion, Marshall Browning HospitalPam Logan, Director, Marketing and Patient Relations, Marshall Browning HospitalLarry Spour, CEO, Marshall Browning Hospital
Marshall Browning Hospital I 103Implementation Planning and Strategy GroupLarry Spour, Chief Executive Ocer, Marshall Browning Hospital Stephanie Hall, Chief Nursing Ocer, Marshall Browning Hospital Harold Calderon, Chief Financial Ocer, Marshall Browning Hospital Joanna Elliott, Performance Improvement Ocer, Marshall Browning Hospital Brooke Feltmeyer, Clinic Manager, MBH Medical Clinic/Family Health Center Nathan Bartnicki, Information Technology Manager, Marshall Browning Hospital Ryan Juhl, Director of Plant Operations, Marshall Browning Hospital Pam Logan, Director, Marketing and Patient Relations, Marshall Browning Hospital Heather Kattenbraker, Executive Assistant, Marshall Browning Hospital Celena Slowick, Community Champion, Marshall Browning Hospital