The Community Health Improvement Plan (CHIP) is a strategic community work plan that defines how Washington County Public Health (WCPH) and community partners come together to develop a culture of health and to address priority health issues identified by a comprehensive assessment of local Washington County data.
Many factors affect the health of individuals and communities. The complexity of these factors makes it essential to work collaboratively with many partners across sectors to address the unique needs of the community.
In addition, Washington County’s diversity increases the need for cross-sector strategic partnerships to improve health. The CHIP addresses the social and environmental determinants of health by engaging partners from across the community to tap in to expertise, knowledge and resources.
• Decrease percent of population with limited access to healthy food. • Increase percent of adults with adequate fruit and vegetable consumption. • Increase percent of adults who engage in regular physical activity.
The CHIP Leadership Team includes a representative from each of six community committees along with other partners and is focused on implementing equity and trauma-informed care objectives across the CHIP committees. The leadership team is responsible for tracking and coordinating strategies. The committees have aligned organizational goals and developed collaborative approaches to address these common priorities. The CHIP is developed using evidence-based best practices and a collective impact approach to identify mutually reinforcing collaborative activities.
The six committees and leadership team are described below:
1. Access to Care Committee
This committee includes partners from hospitals, health care systems, federally qualified health care centers, safety net clinics, behavioral health service providers, oral health organizations, public health and behavioral health leadership, emergency medical services and culturally-specific community-based organizations.
• Improve access to and utilization of primary care, mental and behavioral health services and oral health services.
• Current focus areas include access to oral health, reproductive health, urgent care, and access for the uninsured and resources for alternative pain care.
This collaborative includes both an internal committee and an external community committee. The internal committee is focused on implementing trauma-informed strategies across Washington County Health and Human Services. The community committee is made up of early childhood experts, education partners, healthcare partners, community-based organizations and mental health organizations. The group focuses on sharing lessons learned, increasing awareness of trauma-informed strategies, providing technical assistance to assist organizations in implementing trauma-informed practices, and identifying ways to implement a trauma-informed lens across the other CHIP committees.
• Coordinate information sharing and sharing lessons learned across organizations.
• Provide technical assistance for implementing trauma- informed care practices.
• Implementation of a trauma-informed lens across CHIP committees in partnership with Steering Committee.
This committee was formed to implement the evidence-based Pathways community coordination model in Washington County. The national Pathways approach involves referring eligible participants and their families to a community health worker (CHW). The CHW works directly with the family to provide navigation and closed loop referrals to needed resources. The navigation includes selecting a number of specific defined pathways that, when bundled together, achieve the selected outcome. This committee is focused on increasing CHW workforce in Washington County and coordinating services and resources. The current project goal is to increase high school graduation rates among Latinx and immigrant youth in Washington County.
• Support coordination between direct service providers and community-based organizations to improve access to care for specific priority populations (physical, behavioral, oral health).
• Increase capacity for the community health worker (CHW) workforce in Washington County.
• Increase high school graduation rates among Latinx and immigrant youth.
This committee is comprised of organizations focused on improving access to healthy food and opportunities for physical activity, reducing tobacco use, improving programs for people living with chronic disease, and addressing built environment and place-based issues that impact chronic disease. The committee’s goals are focused on supporting health in all policies and increasing access to and awareness of affordable, healthy food, physical activity and chronic disease self-management opportunities.
• Increase access to and awareness of affordable and healthy food, physical activity and chronic disease self-management opportunities through educational programs and resources.
• Identify opportunities to incorporate health into community design processes and policies to support (1) access to healthy and affordable food, (2) opportunities for physical activity and (3) access to tobacco-free environments.
• Develop and maintain infrastructure to support implementation of committee objectives.
This committee is focused on identifying and implementing innovative strategies to treat and prevent depression and anxiety in older adults in Washington County. Washington County Disability, Aging and Veteran Services, in partnership with Washington County Behavioral Health, is providing support and resources to community partners to implement strategies. The committee is focused on identifying, implementing and evaluating those efforts.
• Prevent and treat anxiety and depression in older adults by cultivating and strengthening a community that supports the aging process.
The Council’s objectives and strategies are based on the 2012 National Strategy for Suicide Prevention, with the goal of preventing suicide in Washington County. The Council is comprised of behavioral health service providers, community-based organizations, law enforcement, medical examiners, emergency medical services, private practice mental health providers, public health and faith leaders. The goals are focused on integrating and coordinating suicide prevention activities across multiple sectors, reducing access to lethal means, promoting suicide prevention as a core component of health care services, and evaluating the impact and effectiveness of suicide prevention interventions. With permission from the family, a Suicide Fatality Review subcommittee reviews these deaths to inform local prevention efforts.
The vision of the council is “Zero Is Possible” in alignment with the national Zero Suicide Initiative. Zero Suicide is a foundational belief that suicides for those individuals within the behavioral health care settings are preventable. The Zero Suicide Initiative is designed to help behavioral health organizations create a system-wide transformation toward safer suicide care.
Washington County offers free suicide prevention and Mental Health First Aid trainings throughout the year. In 2018 over 1,000 Washington County residents were trained in suicide prevention or Mental Health First Aid. For more information please go to Get Trained To Help.
—Help is always available.—
If you or someone you know is thinking about suicide, please call the Washington County Crisis Line at 503-291-9111 or the National Suicide Hotline at 1-800-273-TALK (8255); press 1 for veterans or service members.
In 2017 Oregon had the 19th highest suicide rate in the country and Washington County’s rate has historically been similar. Suicide is the 7th leading cause of death in Washington County. Like many other communities, Washington County’s population with the highest suicide rates are veterans, and non-Hispanic white males age 65 and older. Washington County experiences a death by suicide every five days. For every 2 male deaths by suicide, the county has one female death. 49% of our suicides happen with a firearm. In the county, 91% of suicides are in non-Hispanic whites, but only 69% of the community is non-Hispanic white. Of the younger county residents, 17% of 11th graders seriously consider attempting suicide, and 6% of the 8th graders attempted suicide. Suicide in our county has directly or indirectly affected all ages, races, and veteran statuses. In late 2012, Washington County began serious efforts to reduce suicide in our community, which have since achieved national recognition and a 40% drop in suicide rate.
• Promote responsible media reporting of suicide, accurate portrayals of suicide and mental illness in the entertainment industry, and the safety of online content related to suicide.
• Integrate and coordinate suicide prevention activities across multiple sectors and settings.
• Promote efforts to reduce access to lethal means of suicide among individuals with identified suicide risk.
• Develop, implement and monitor effective programs that promote wellness and prevent suicide and related behaviors.
• Promote suicide prevention as a core component of health care services.
• Evaluate the impact and effectiveness of suicide prevention interventions and systems and synthesize and disseminate findings.
Primary Care Physician data is from the Area Health Resource File/American Medical Association. Mental Health Provider data is from CMS, National Provider Identification. Dentist data is from Area Health Resource File/National Provider Identification file. In all three cases, the data was accessed via County Health Rankings and Roadmaps.
Drug Overdose Mortality data was queried from CDC Wonder via the following parameters: Underlying Cause of Death, ICD-10 codes: X40–X44, X60–X64, X85, Y10–Y14. Suicide Mortality data was queried from CDC Wonder via the following parameters: Underlying Cause of Death, ICD-10 codes: X60-X84, Y87.0.
Low Access to Grocery Store data is from the United States Department of Agriculture's Food Environment Atlas.