Haywood County's 2021 Community Health Assessment priority areas are:
Clear Impact Scorecard™ is a strategy and performance management software that is accessible through a web browser and designed to support collaboration both inside and outside organizations. WNC Healthy Impact is using Clear Impact Scorecard™ to support the development of electronic community health improvement plans (eCHIP), State of the County Health Reports and Hospital Implementation Strategy scorecards in communities across the region. The 2022 Haywood County Community Health Improvement Plan (eCHIP) was submitted by Friday, September 30, 2022.
Scorecard helps communities organize their community health improvement efforts by:
A key to navigating this scorecard:
The following link displays the resources used/reviewed to complete this scorecard:
Community Health Improvement Plan Resources
An additional resource related to the CHIP is the CHA tools located at: https://publichealth.nc.gov/lhd/.
A list of Community Health Improvement Process partners is located at this link.
Haywood County 2021 Community Health Assessment Executive Summary
The ultimate goal for Haywood County is to build a healthy and resilient community.
Leadership for the Community Health Assessment Process
A data team of community partners and the public health education team from Haywood County Health and Human Services led the CHA process. Following internal review of both primary and secondary data, the data team received a condensed list. This team provided input to public health staff on which data to review during the prioritization process.
Name |
Agency |
Title |
Agency Website |
Megan Hauser |
Haywood County Health and Human Services |
Public Health Education Supervisor |
|
Jeanine Harris |
Haywood County Health and Human Services |
Public Health Education Specialist/Preparedness Coordinator |
|
Darion Vallerga |
Haywood County Health and Human Services |
Public Health Educator |
|
Vicky Gribble |
Mountain Projects, Inc. |
Certified Application Counselor |
|
Tobin Lee |
MountainWise |
Region 1 Tobacco Prevention Manager/Interim Project Manager |
|
Libby Ray |
Mountain Projects, Inc. |
Preventionist |
|
Lindsey Solomon |
Haywood Regional Medical Center |
Marketing and Communications Coordinator |
|
Jennifer Stuart |
Haywood County Public Library |
Branch Librarian |
Partnerships
Name |
Agency |
Title |
Agency Website |
Greg Caples |
Haywood Regional Medical Center |
CEO |
|
Greg Christopher |
Haywood County Sheriff’s Office |
Sheriff |
|
Travis Donaldson |
Haywood County Emergency Services |
Emergency Services Director |
|
Shelly Foreman |
Vaya Health |
Community Relations Regional Director |
|
Vicky Gribble |
Mountain Projects, Inc. |
Certified Application Counselor |
|
Mandy Haithcox |
Haywood Pathways Center |
Executive Director |
|
Norm Hoffman |
Evince Clinical Assessments |
President/CHA Prioritization |
|
Tobin Lee |
MountainWise |
Region 1 Tobacco Prevention Manager/Interim Project Manager/CHA Data Team |
|
Courtney Mayse |
Meridian Behavioral Health Services |
Haywood County Director of Services/CHA Prioritization |
|
Jody Miller |
Region A Partnership for Children |
Community Engagement Coordinator/CHA Prioritization |
|
Debbie Ray |
Great by Eight |
Faith-Based Guiding Team Member/CHA Prioritization |
Not applicable |
Libby Ray |
Mountain Projects, Inc. |
Preventionist/CHA Data Team and Prioritization |
|
Jessica Rodriguez |
Vecinos, Inc. |
Farmworker Health Program Manager/ CHA Prioritization |
|
Julie Sawyer |
Haywood County Cooperative Extension |
Extension Agent/ CHA Prioritization |
|
Lindsey Solomon |
Haywood Regional Medical Center |
Marketing and Communications Coordinator/CHA Data Team and Prioritization |
|
Jennifer Stuart |
Haywood County Public Library |
Branch Librarian/CHA Data Team and Prioritization |
|
Florence Willis |
Blue Ridge Community Health Services |
Patient Navigator/CHA Prioritization |
|
Mary Ann Widenhouse |
National Alliance on Mental Illness/ Vaya Health |
President/Member/CHA Prioritization |
|
Christy Yazan |
NC Department of Health and Human Services |
Infant Toddler Program Supervisor/CHA Prioritization |
Regional/Contracted Services
Our county received support from WNC Healthy Impact, a partnership and coordinated process between hospitals, public health agencies, and key regional partners in western North Carolina working towards a vision of improved community health. We work together locally and regionally to assess health needs, develop collaborative plans, take action, and evaluate progress and impact. This innovative regional effort is coordinated and supported by WNC Health Network. WNC Health Network is the alliance of stakeholders working together to improve health and healthcare in western North Carolina. Learn more at www.WNCHN.org.
Theoretical Framework/Model
WNC Health Network provides local hospitals and public health agencies with tools and support to collect, visualize, and respond to complex community health data through Results-Based Accountability™ (RBA). RBA is a disciplined, common-sense approach to thinking and acting with a focus on how people, agencies, and communities are better off for our efforts.
Collaborative Process Summary
Haywood County’s collaborative process is supported on a regional level by WNC Healthy Impact.
Locally, our process began with an internal public health education team reviewing a large list of primary (newly collected) and secondary data (existing). The team narrowed the list before sharing with a data team of community partners. The data team further reviewed the information and arrived at a ‘short list.’ Before and during prioritization meetings, participants received opportunities to review this data. Following a data presentation, participants used a ‘Local Rating and Prioritization’ worksheet to rate the relevance, impact, and feasibility of addressing the key issues presented. After arriving at their top three scores, each participant selected their top three key issues using an online poll. The three top-scoring areas overall are the county’s new health priorities.
Phase 1 of the collaborative process began in January, 2021 with the collection of community health data. For more details on this process see Chapter 1 – Community Health Assessment Process.
Key Findings
Findings that were particularly telling included:
Chronic Disease
Over 72% of individuals are experiencing overweight or obesity (WNC Health Network, 2021), root causes for many chronic diseases. This was an increase from 2018.
Substance Use and Mental Health
Over 88% reported feeling hopeful, but 23% of individuals experienced more than seven days of poor mental health in the past month, an increase from 2018. In addition, over 18% were unable to get necessary mental health care in the past year, also an increase from 2018 (WNC Health Network, 2021).
A decrease in all opioid use (prescription and non-prescription) was reported: 15.3% vs. 12.4% (WNC Health Network, 2021).
Alcohol continues to be a widely misused substance, with over 12% of adults reporting past-month binge drinking, an increase from 2018 This was defined as five or more drinks for a man or four or more for a woman during any occasion (WNC Health Network, 2021). In addition, Haywood County residents made over 500 emergency department visits in 2021 for ‘alcohol abuse and dependence,’ a decrease from over 600 visits in 2018 (North Carolina Disease Event Tracking and Epidemiologic Detection Tool*, 2022). **NC DETECT is a statewide public health syndromic surveillance system, funded by the NC Division of Public Health (NC DPH) Federal Public Health Emergency Preparedness Grant and managed through collaboration between NC DPH and UNC-CH Department of Emergency Medicine’s Carolina Center for Health Informatics. The NC DETECT Data Oversight Committee does not take responsibility for the scientific validity or accuracy of methodology, results, statistical analyses, or conclusions presented.
Violent Crime
A larger number of survivors were served by domestic violence shelters: 413 vs 320 (NC Department of Administration, 2021).
The community has experienced an increase in violent crime: 342.7 vs 326.8 per 100,000 (NC Department of Justice, 2021).
Social Determinants of Health
Over 12% reported a loss of health Insurance during the pandemic, with 24% losing work hours or wages (WNCHN, 2021), affecting access to care. This is a point-in-time figure.
In spite of a pandemic, fewer people reported experiencing food insecurity: 3.4% vs. 18.9% (WNC Health Network, 2021).
While over 13% of residents live below the poverty level, this figure sharply increases to 33% for those under age 5. This data point is unchanged, as we reviewed a 2015-2019 estimate (U.S. Census, 2021).
The top three health priorities identified through the Online Key Informant Survey were the same as those emerging from health prioritization meetings.
Health Priorities
Mental Health
Obesity
Substance Use
*Obesity and substance use received an equal number of votes during prioritization meetings.
Next Steps
Monthly action team meetings based on each health priority;
Engage existing and new partners in health priority action teams;
Select priority strategies and performances measures to help us evaluate community health improvement progress;
The evidence-based strategy, Results-based Accountability (RBA), will be utilized to guide decision-making to create swift and effective health improvements;
The county’s health action teams will hold ‘Getting to Strategies’ meetings during spring 2022. These meetings will include discussing the quality of life conditions desired for the county, the county’s progress on related data points, partners with a role to play, and possible evidence-based strategies.
Following completion of strategy development for each priority area, the Community Health Improvement Plan (CHIP) will be published using electronic scorecard software. The scorecard allows anyone to monitor progress of the CHIP, the current plan shown here. A CHIP, built from evidence-based strategies, is submitted to the North Carolina Division of Public Health.
To access the full data set(s) (primary and secondary data), community members are encouraged to contact megan.hauser@haywoodcountync.gov.
*Obesity and substance use received an equal number of votes during prioritization meetings.
How would we experience improved physical activity, healthy eating, and quality healthcare in our community?
Physical activity
Emphasis on physical activity; community is more physically active
Increasing mobility
Active lifestyles
Less screen time
Regular physical exercise
Decreased barriers
Access to care/access to nutritional services
Access to information
Socioeconomics
Affordable housing
Built environment
More resources for more people to walk, outdoor recreation options
People using recreational options
Happier community
What information led to the selection of this health issue and related result?
The Healthy Haywood Coalition and Wellness Action Group received Community Health Assessment data. Both groups discussed the relevance, impact, and feasibility around obesity, specifically considering weight, physical activity, chronic disease, nutrition, economic (poverty), insurance/access to care and stress data. The community members in attendance then unanimously voted to move forward with the obesity priority as a result of evaluating the primary and secondary community health data. This is a continuation from previous years’ health priorities.
Weight
Adult overweight/obesity- 72% (WNC Health Network, 2021)
Adult healthy weight- 26.3% (WNC Health Network, 2021)
Child overweight/obesity (ages 2-18)- 29.9% (Eat Smart, Move More, 2017)
Challenges to accessing affordable food: ‘Foods found at convenience stores and ‘dollar’ stores in less populated geographic areas tend to be highly processed, high in sodium & sugar, etc.’ -Community Leader (Online Key Informant Survey-WNCHN, 2021)
Physical activity
No past-month leisure-time physical activity- 21.7% (WNC Health Network, 2021)
Meeting physical activity recommendations- 22.2% (WNC Health Network, 2021)
Strengthening activity- 31.7% (WNC Health Network, 2021)
Qualities of a healthy community: ‘Access to free or low-cost healthy activities, such as walking trails, community parks, etc.’ -Community Leader (OKIS-WNCHN, 2021)
Chronic disease
Diabetes- 18.6% (WNC Health Network, 2021)
Pre-diabetes- 2.9% (WNC Health Network, 2021)
Heart Disease- 10.9% (WNC Health Network, 2021)
High Blood Pressure- 40.2% (WNC Health Network, 2021)
High Cholesterol- 31.8% (WNC Health Network, 2021)
Nutrition
Fruit and Vegetable intake- 5.1% (WNC Health Network, 2021)
Food and Nutrition Services (SNAP) participation- 8,930 individuals (UNC-CH Jordan Institute for Families, 2021)
Free/reduced lunch participation- 7,131 (average daily membership) (NC Department of Public Instruction, 2021)
Food Insecurity- 18.9% (WNC Health Network, 2021)
Access to nutritional/healthy food- 23% have difficulty buying fresh produce (WNC Health Network, 2015)
Strengths- ‘The amazing network of people who ensure that food is consistently available. During COVID the flexibility and creativity that included food being delivered to homes without transportation, strong partnerships to move food to reduce waste.’ -Community Leader (OKIS-WNCHN, 2021)
Economics: Poverty (2015-2019 estimate) (US Census Bureau, 2021)
Total Population (~60,256)
8,087 residents below poverty [13.4%]
Children under 18 (~10,743)
2,423 residents below poverty [22.6%] (down)
Children under 5 (~2,962)
2,962 residents below poverty [33.4%] (up)
Populations impacted- ‘Low income, working-class and historically marginalized communities’ and ‘Older adults on fixed incomes and families with low income jobs or multiple jobs.’ -Community Leader (OKIS-WNCHN, 2021)
Insurance/access to care
No health insurance coverage- 20.2% (WNC Health Network, 2021)
Lost health insurance during pandemic- 12.1% (WNC Health Network, 2021) (point-in-time)
Qualities of a healthy community: Ability to see a provider when needed—insurance and free/reduced cost clinics, pop-up free clinics including dental/vision clinics.’ -Community Leader (OKIS-WNCHN, 2021)
Stress
Typical day is extremely/very stressful- 12.0% (down)
Confident in ability to manage stress- 87.3%
Limited access to healthy foods
Percentage of population who are low-income and do not live close to a grocery store.
The 2020 County Health Rankings used data from 2015 for this measure.
Haywood 4 Good is a free wellness initiative that addresses physical, spiritual, emotional, and community wellness. The program operates in six-month sessions and offers continuous enrollment. Participants have the opportunity to participate in at least three wellness challenges each month. Unlike the typical heart health or weight loss challenge, Haywood 4 Good is more broad and inclusive. Challenges such as screen time, water consumption, and volunteerism are accessible by a wider range of people and ability levels.
Haywood 4 Good was identified by the Healthy Haywood Wellness Action Group as an action, that when combined with other actions in our community, that has a reasonable chance of making a difference in adult overweight and obesity prevalence in our community. This is an ongoing program in our community.
The current intervention shows promise. Of participants registered for the first 2022 program, zero participants reported getting at least 30 minutes of flexibility or balance training per week. During the closing survey, over nine percent of participants reported meeting this goal. Vegetable consumption was also a challenge, as zero participants in the first program reported not regularly eating two to three cups of daily vegetables. The closing survey showed that nearly 13% reported meeting this goal. The primary limitation for the program's evaluation is that fewer participants completed the closing survey, demonstrating a gap in behavior change data.
The priority population/customers for this community wellness program are Haywood County residents, and the Haywood 4 Good aims to make a difference at the individual level. Implementation will take place in a virtual format, as all activities may be done individually.
This strategy addresses health disparities by providing a free program that does not require transportation or internet access to complete.
2022 update:
The partners for this community wellness program include:
Agency |
Person |
Role |
Haywood County Health and Human Services Agency | Megan Hauser, Darion Vallerga | Lead |
Haywood Regional Medical Center | Lindsey Solomon | Support, Collaborate |
Wellness Action Group | Team Members |
Support, Collaborate |
Activity |
Resources Needed |
Agency/Person Responsible |
Target Completion Date |
Challenge Runner (account updates and payment) |
Staff time, funding |
Haywood County Health and Human Services/Megan Hauser |
Ongoing |
Marketing |
Staff time |
Haywood County Health and Human Services (Darion Vallerga)/Wellness Action Group members |
Ongoing |
Participant E-mail Listserv |
Staff time |
Haywood County Health and Human Services/Megan Hauser |
Ongoing |
Participant assessments (beginning, midpoint, and closing) | Staff time | Haywood County Health and Human Services/Megan Hauser/Darion Vallerga | Ongoing |
Evaluation Plan:
We plan to evaluate the impact of the community wellness challenge through the use of Results-Based Accountability™ to monitor specific performance measures. We will be monitoring How Much, How Well, and/or Better Off Performance Measures. Our evaluation activities will be tracked in the Work Plan table, above.
Data limitations: Due to the confidentiality and anonymity of survey participation, there is a chance of participant duplication due to surveyor error (participants may have forgotten they had previously signed up and signed up a second time).
Sustainability Plan:
The following is our sustainability plan for the community wellness challenge:
Faithful Families Thriving Communities (FFTC) was identified by members of the Wellness Action Group as an action, that when combined with other actions in our community, that has a reasonable chance of making a difference in fruit and vegetable consumption and overweight/obesity prevalence in our community. This is a new program in our community.
FFTC is led by program facilitators and lay leaders. The curriculum features nine sessions addressing topics such as nutrition, meal preparation, and becoming more physically active. The program encourages changes at the organization and community levels, such as having a policy to serve water during events.
The priority population/customers for this educational program are members of faith communities, and the educational program aims to make a difference at the individual and organizational levels. Implementation will take place in churches and other faith-based organizations.
This strategy addresses health disparities by connecting individuals with free, evidence-based education in a convenient setting.
Cook Smart, Eat Smart (CSES) was identified by members of the Wellness Action Group as an action, that when combined with other actions in our community, that has a reasonable chance of making a difference in fruit and vegetable consumption and overweight/obesity prevalence in our community. This is an ongoing program in our community.
CSES is led by a trained instructor through North Carolina Cooperative Extension. This four-session program provides recipes demonsrations and instruction about simple cooking techniques.
The priority population/customers for this educational program are adults and older teenagers, and the educational program aims to make a difference at the individual level. Implementation will take place in a community organization.
This strategy addresses health disparities by demonstrating that a healthy diet is accessible even when funds are limited.
Both programs were identified by Haywood County Cooperative Extension as priorities and programs with potential. CSES was offered successfully in the past.
Med Instead of Meds
2022 update:
Cooperative Extension staff offered Cook Smart, Eat Smart in October. Six participants completed the four-class series. The program was enhanced by offering an Instant Pot® to one randomly-selected participant.
The partners for evidence-based nutrition programs include:
Agency |
Person |
Role |
Haywood County Cooperative Extension | Julie Sawyer/Sally Dixon |
Lead |
Haywood County Health and Human Services | Health Education/WIC/Food and Nutrition Services Staff |
Collaborate |
Activity |
Resources Needed |
Agency/Person Responsible |
Target Completion Date |
Cook Smart Eat Smart (CSES) marketing and recruitment |
Staff time, social media, printed materials |
Cooperative Extension/Julie Sawyer Haywood County Health and Human Services/Health Education, WIC, and Food and Nutrition Services' staff |
Spring 2023 |
CSES program instruction |
Funding, class materials, staff time |
Cooperative Extension/Julie Sawyer |
Spring 2023 |
CSES program evaluation and reporting |
Staff time |
Cooperative Extension/Julie Sawyer |
Summer 2023 |
How would we experience improved health and resiliency in our community?
Haywood County would be healthier and happier as a result of reduction of substance misuse. According to previous community partner meetings, community members would experience the following:
What information led to the selection of this health issue and related result?
The Healthy Haywood Coalition and Substance Use Prevention Alliance were presented with relevant community health assessment data (above). Both groups received information about the relevance, impact, and feasibility around substance misuse, specifically looking at opioid, tobacco/vaping, and alcohol data. Social determinants of health data such as poverty, community resiliency estimates, and other community-based data were also provided. The community members in attendance then unanimously voted to move forward with the substance abuse priority as a result of evaluating the primary and secondary community health data. This is a continuation from previous years’ health priorities.
Known risk factors for this issue are as follows:
WNC Anti-Stigma Messaging Campaign was identified by community members and the Substance Use Prevention Alliance as an action. When the WNC Anti-Stigma Campaign is combined with other actions in our community, it has a reasonable chance of making a difference in 'Life has been negatively affected by substance use (self or someone else)', 'Past-year opioid use (with or without prescription), 'Emergency department visits for unintentional medication or drug overdoses' in our community. This is a new program in our community.
The priority population for this anti-stigma messaging campaign is individuals living in Haywood County misusing substances, living with substance use disorder (SUD), and those who are indirectly affected by SUD. The anti-stigma messaging campaign aims to make a difference at the interpersonal, community, and organizational levels. Implementation will take place at the community and organizational levels.
Public health staff and partners helped plan a regional anti-stigma campaign, which is actively seeking funding. During this process, participants focused on the overall direction, listening and learning, planning their approach, and designing the messages. Many participants were previously involved in a nationally-recognized COVID campaign.
The partners for this campaign include:
Agency |
Person |
Role |
Western North Carolina Health Network | Adrienne Ammerman, Emily Kujawa | Lead |
Haywood County Health and Human Services | Megan Hauser, Darion Vallerga, Jeanine Harris | Collaborate |
SHARE Project | Michele Rogers, Lisa Falbo | Collaborate |
Vaya Health | Shelly Foreman | Collaborate |
Mountain Projects, Inc. | Libby Ray | Collaborate |
Tobin Lee | Collaborate | |
Meridian Behavioral Health Services | Penelope Rollins | Collaborate |
Appalachian Community Services | Tabatha Brafford | Collaborate |
Haywood County Public Library | Jennifer Stuart | Collaborate |
Blue Ridge Community Health Services | Florence Willis | Collaborate |
National Alliance on Mental Illness/Vaya Health | Mary Ann Widenhouse |
Collaborate |
Haywood Regional Medical Center | Lindsey Solomon | Support |
Haywood County Sheriff’s Office | Christina Esmay | Support |
Haywood County Emergency Services | Travis Donaldson | Support |
Activity |
Resources Needed |
Agency/Person Responsible |
Target Completion Date |
Planning [advisory meetings and listening sessions] |
All individuals/organizations in advisory group & Haywood County residents (for listening sessions) |
WNC Health Network [Adrienne Ammerman/Emily Kujawa], Megan Hauser, Darion Vallerga |
10/31/2022 |
Planning [Create campaign toolkit that includes tailored strategies for focused target audiences, resources, template materials, key data, printable materials, a video library, etc.] | Individuals with subject matter expertise, individuals with lived experience, third-party media partner | WNCHN | 10/31/2022 |
Identify or create a website to hold resources, content, and information needed to support the campaign goals. | Website host, domain name, dashboard sfotware | WNCHN | 10/31/2022 |
Implementation (TBD) |
Media for messaging/platforms willing to display messaging (e.g. radio, billboard, news outlets, etc.)/funding |
Adrienne Ammerman, Megan Hauser, Darion Vallerga |
TBD |
Ongoing Evaluation |
TBD |
TBD |
Ongoing |
Evaluation Plan:
We plan to evaluate the impact of the anti-stigma messaging campaign through the use of Results-Based AccountabilityTM to monitor specific performance measures. We will monitor How Much, How Well and Better Off Performance Measures. Currently, we plan to evaluate the 'number of advertisements placed,' 'Number of advertisement engagements,' 'Number of clicks from online advertisements,' and 'Number of Haywood County residents reached.' We will track evaluation activities using the draft Work Plan table.
Results | Measures | Methods |
Campaign materials are reaching [target audiences]. How much |
» Extent to which campaign materials are disseminated through channels that reach a significant proportion of the population » Extent to which efforts are made to touch historically |
» Reporting data - Reach - Demographics |
Campaign materials are engaging. How well |
» Appeal of materials » Perceived likelihood of materials to shift behavior |
» Reporting data - Engagement rate » Survey of participant leads |
Western NC residents have increased awareness, attitudes, and practices around the identified health practice [name here]. How well and Better off |
» Frequency of sharing of positive attitudes and practices associated with campaign among social media participants |
» Reporting data - Impressions - Engagement rate - Link clicks - Video views » Public Survey - % who report seeing the ads had an affect on their [topic]-related behaviors - % who report the ads led them to seek more information about [topic] and related preventive behaviors |
Local health communicators have increased capacity to create and disseminate health communication materials. Better off |
Extent to which participants experienced changes in: » Knowledge and skills to create [topic-related] materials » Ability to disseminate materials » Knowledge of how and where to obtain support |
» Survey of participant leads: % who agree with the statements: - “My participation in this campaign helps me to build my capacity to support my agency/facility or community to address [health topic]” - “Participation in this campaign increases my capacity to create and/or disseminate communications materials related to [health topic]” |
Campaign participants believe that the collaboration was a positive experience. How well |
Ways that the campaign was experienced by the participants » Communication with WNCHN and others in the campaign » Respect » Valuable use of time |
» Survey of participant leads - % of participants who agree with the statement: “I feel respected” and “participation in this campaign is a valuable use of my time” |
Sustainability Plan:
The following is our sustainability plan for Haywood County's anti-stigma messaging campaign:
How would we experience improved mental health in our community?
Decreased stigma and barriers to care, injury/self-harm prevention, those with mental health challenges obtain the care they need from reliable mental health practitioners, increased mental health care support for families, and improvements in the broader mental health care system that ensure seamless and continuity of care.
What information led to the selection of this health issue and related result?
Since 2018, self-reported data from Haywood County adults shows increases in the following areas: past-30 day poor mental health, an inability to access needed mental health care or counseling in the last year, not receiving needed social and/or emotional support, and being dissatisfied or very dissatisfied with life. Prioritization team members attributed increases to: nearly 21% of individuals reporting no health care insurance, an increase in the number of individuals reporting homelessness, and stigma for seeking mental health care (WNC Health Network, 2021).
Establishing a Trauma-Informed System of Care was identified by various community members and the Substance Use Prevention Alliance as an action, when combined with other actions in our community, that has a reasonable chance of making a difference in 'Life has been negatively affected by substance use (self or someone else)', 'Past-month binge drinking', and 'Emergency department visits for unintentional medication or drug overdoses in our community. This is a new program in our community.
The priority population for establishing a trauma-informed system of care are all Haywood County residents using health, human, or public services (any organization serving Haywood County residents) and the establishment of a trauma-informed system of care aims to make a difference in the community, organizational, and policy levels. Implementation will take place at the organizational level.
Although anyone can experience trauma and especially adverse childhood experiences, this strategy addresses health disparities due to the higher prevalence of trauma in populations experiencing poor social determinants of health such as unstable housing, low income, and racism. Addressing trauma at the socio-ecological level mentioned above will create a more equitable environment to access quality healthcare, access to education, and increase social and community support among all Haywood County residents.
2022 update:
The partners for establishing a trauma-informed system of care include:
Agency | Person | Role |
Haywood County Health and Human Services | Megan Hauser, Darion Vallerga, Jeanine Harris | Lead |
Haywood Connect | Lynn Carlson | Collaborate |
Haywood Regional Medical Center | Lindsey Solomon | Support |
Haywood County Sheriff’s Office | TBD | Support |
Haywood County Emergency Services | Travis Donaldson | Support |
Vaya Health | Shelly Foreman | Collaborate |
Mountain Projects, Inc. | Libby Ray | Collaborate |
Tobin Lee | Support | |
Meridian Behavioral Health Services | Courtney Mayse | Collaborate |
Region A Partnership for Children | Jody Miller | Collaborate |
Vecinos, Inc. | Yolanda Pinzon Uribe | Support |
Great by Eight | Debbie Ray | Support |
Haywood County Public Library | Jennifer Stuart | Collaborate |
Blue Ridge Community Health Services | Florence Willis | Collaborate |
National Alliance on Mental Illness/Vaya Health | Mary Ann Widenhouse | Collaborate |
Activity |
Resources Needed |
Agency/Person Responsible |
Target Completion Date |
Develop Road Map To Success for Organizational and Commmunity Awareness for Trauma Informed Care/ACES |
HHSA developed Trauma Informed Care/ACES materials |
Darion Vallerga, Public Health Education Specialist |
12/31/2022 |
Train all Haywood County Health and Human Services Staff (HCHHSA) (Internal HCHHSA trauma-informed systemm of care initative) | Presentation Slideshow, Trainers (Health Education Staff), Mobile Technology [e.g. portable projector] | HCHHSA Health Education Team | 10/15/2022 |
Administer Process Evaluation to HCHHSA staff | Process evaluation (survey), contact information | Darion Vallerga | 10/15/2022 |
Outcome Evaluation | Outcome evaluation (survey), contact information | Darion Vallerga | 10/15/2022 |
Six-month Impact Evaluation | Impact evaluation (survey), contact information, attrition mitigation strategy | HCHHSA Health Education Team | TBD |
Implement Road Map To Success for Organizational and Commmunity Awareness for Trauma Informed Care/ACES |
Haywood Connect Particpants and Staff |
Haywood Connect, Darion Vallerga |
8/31/2025 |
Evaluation Plan:
We plan to evaluate the impact of the trauma-informed system of care initative through the use of Results-Based AccountabilityTM to monitor specific performance measures. We will be monitoring How Much, How Well and Better Off Performance Measures. Currently, we plan to evaluate 'Number of HHSA staff who complete training sessions about trauma-informed care and ACEs', 'Number of members who participate in the ACES Collaborative group (Haywood Connect)', and 'Number of organizations who complete training session about trauma-informed care and ACEs'. Our evaluation activities will be tracked in the Work Plan table, above (ongoing).
Sustainability Plan:
Trauma-Informed Care (Adverse Childhood Experiences) and Question, Persuade, Refer suicide prevention training (QPR) programs are existing programs being utilized and promoted by our Substance Use Prevention Alliance (SUPA) coalition. Coalition partners recommend continuing these programs and think that when combined with other actions in our community, they have a reasonable chance of making a difference to improve mental health and mental health care in our community.
The priority population/customers for Trauma-Informed Care and QPR-Suicide Prevention Training are health care and social work professionals. The goal is to make a difference at the individual/interpersonal behavior level for staff and the clients they serve. The intent of this goal is to develop a community-wide workforce skilled at recognizing suicidal ideations and individuals affected by adverse outcomes, resulting in quick, appropriate services and care for at-risk populations they serve.
2022 update:
The SUPA scheduled local National Alliance on Mental Illness members for an early 2023 training. The program, 'In Our Own Voice,' shared lived experiences of presenters. Vaya Health (MCO) staff presented at a SUPA meeting about training options available to the community. Sessions include Mental Health First Aid and Question, Persuade, Refer.
The partners for Trauma-Informed Care and QPR include:
Agency | ||
Vaya Health- QPR | Shelly Foreman |
Lead, Collaborate, Support, and Represent Target Population
|
Haywood County HHSA- Trauma-Informed Care | Darion Vallerga |
Lead, Collaborate, Support, and Represent Target Population
|
Mountain Projects- QPR and Trauma Informed Care | Vicky Gribble |
Collaborate, Support, and Represent Target Population
|
Activity |
Resources Needed |
Agency/Person Responsible |
Target Completion Date |
QPR Classes |
QPR program materials |
Vaya Health/Shelly Forman |
On-going |
Trama Informed Care/ACES |
HHSA-developed materials |
Haywood County HHSA/Darion Vallerga |
On-going |
Evaluation Plan:
We plan to evaluate the impact of QPR and Trauma-Informed Care/ACES through the use of Results-Based AccountabilityTM to monitor specific performance measures. We will be monitoring How Much, How Well and/or Better Off Performance Measures. Our evaluation activities will be tracked in the Work Plan table, above.
Sustainability Plan:
The following is our sustainability plan for QPR and Trauma Informed Care/ACES trainings:
The following represent significant morbidity and mortality changes in our community.
Leading Causes of Death Table - Age-Adjusted Death Rates per 100,000 Population
Heart Disease (Rate: 172.1)
Cancer (Rate: 154.9)
All Other Unintentional Injuries (Rate: 58.1)
Chronic Lower Respiratory Diseases (Rate: 51.1)
Cerebrovascular Diseases (Rate: 35.4)
Death rate - 24.1 (2020) vs. 43.3 (2021) per 100,000 residents
Emergency Department visits - 141.2 (2020) vs 105.9 (2021) per 100,000 residents
Unemployment among working - age residents- 6.6% (2020) vs. 2.7 (2021)
Alcohol-impaired driving deaths (health behaviors) - 0 (2019) vs. 13 (2020)
Dentists (clinical care) - 2150 (2019) vs. 2250 (2020)
Poverty (social and economic factors - 17% (2019) vs. 21% (2020)
These are the new or emerging issues in our community in 2022 that were not identified as priorities in our Community Health Assessment.
Food insecurity remains a community health issue in Haywood County. In 2018, Feeding America reported over 8200 or 13.6% of Haywood County experienced food insecurity. Over 19% of children in the county are impacted (NC Child). The pandemic greatly increased the number of those seeking assistance. Food distributions increased, with creative solutions such as holiday food bags for students and drive-through events. Unfortunately, decreasing food donations and increasing fuel costs hit the community hard.
Gun violence- Fourteen individuals visited an emergency department due to firearm injuries of all intents (*NC DETECT, 2022).
Suicide- The county saw 12 suicides, nine due to gunshot wounds (Haywood County Health and Human Services, 2022). Over 330 individuals visited an emergency department with suicidal ideations (NC DETECT, 2022).
Health equity- Over 13% of the total population lives below the poverty level, with over 22% of those under 18 affected (U.S. Census Bureau. (2021). Poverty Status in the Past 12 Months: ACS 5-Year Estimates. [Data tables]. Available from http://census.data.gov). This impacts access to healthy food, transportation, and other non-medical influences on health.
Social media misinformation is defined as "any claims or depictions that are inaccurate" and disinformation is defined as "a subset of misinformation intended to mislead" (American Psychological Association). The dissemination of misinformation and disinformation has been a trending topic due to the uncertainties caused by the COVID-19 pandemic. Misinformation surrounding COVID-19 was so rampant that the World Health Organization declared a parallel "infodemic" in 2020. Haywood County is no different and has certainly been affected by the spread of misinformation and disinformation potentially impacting the community's trust in local government agencies.
*NC DETECT is a statewide public health syndromic surveillance system, funded by the NC Division of Public Health (NC DPH) Federal Public Health Emergency Preparedness Grant and managed through collaboration between NC DPH and UNC-CH Department of Emergency Medicine’s Carolina Center for Health Informatics. The NC DETECT Data Oversight Committee does not take responsibility for the scientific validity or accuracy of the methodology, results, statistical analyses, or conclusions presented.
The following are new initiatives or changes in our community in 2022:
The county received a $1.5 million Substance Abuse Prevention and Treatment Block Grant. This program will navigate participants to substance use and mental health treatment, as well as other services needed to promote health.
A portion of American Rescue Plan Act funding was dedicated to a regional health communications campaign. The campaign is in the planning phase. It is led by the WNC Health Network and will include input from county stakeholders.
The county began developing its first Comprehensive Recreation Master Plan, including public surveys and input sessions. The plan was approved in early 2023.
The county received $7 million in funds to support affordable housing.