July 2018
Allen County
Community Health
Improvement Plan
2018-2020
This project was funded by the Ohio Department of Health and written in partnership with Center
for Public Health Practice at The Ohio State University’s College of Public Health
Table of Contents
I. Executive Summary ....................................... 2
II. Vision Statement ............................................ 4
III. Letter from the Health Commissioner .......... 5
IV. Introduction .................................................... 6
V. The Process ..................................................... 7
VI. Priority 1: Substance Use & Mental Health . 11
VII. Priority 2: Chronic Disease Prevention ....... 12
VIII. Priority 3: Maternal & Infant Health ............. 13
IX. Priority 4: Housing & Public Transportation 14
X. Next Steps and Call to Action .................... 15
XI. Appendix A: List of Key Terms..................... 16
XII. Appendix B: List of Community Partners.... 17
XIII. Appendix C: MAPP Assessment Results..... 19
XIV. Appendix D: Assets and Resources ........... 31
XV. Appendix E: Work Plans ............................... 32
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 2 OF 44
Executive Summary
Early in 2018, Allen County Public Health (ACPH), in collaboration with Activate Allen County
(AAC), convened a group of community partners to serve as the committee to oversee the
Mobilizing for Action through Planning and Partnerships (MAPP) process. MAPP is a nationally
respected community health assessment and improvement planning framework that includes
defining a vision for health in the community, comprehensively assessing the community’s
health, and creating detailed work plans to improve upon priorities identified as a result of that
assessment. ACPH contracted with the Center for Public Health Practice at the Ohio State
University (CPHP) to facilitate the process.
28 community partners comprised the MAPP committee and provided oversight for the
development of this community health improvement plan (CHIP). The committee was tasked
with providing inputs to inform the vision for health, contributing to the assessments, examining
the data provided in those assessments and utilizing their knowledge of the community to select
health priorities. The CHIP is part of a long-term plan that details those identified health priorities,
and their associated goals, objectives, and action steps. It can be used by a community to
guide the development and implementation of projects, programs, and policies aimed at
improving the health of the residents of Allen County. Health priorities selected by community
partners included: Substance Use and Mental Health, Chronic Disease Prevention, Maternal and
Infant Health, and Housing and Public Transportation.
Workgroups created individual work plans to address each health priority. The work plans detail
the specific goals, objectives, and measures that will be used to address these priorities and
track progress. The workgroups considered several overarching principles as they further refined
the health priorities and created action plans. The principles included the Health Impact
Pyramid, the concepts of evidence based public health practice, and priority alignment with
Ohio’s State Health Improvement Plan.
July 2018 is the starting date of the implementation of this CHIP. Allen County is fortunate to have
a large group of dedicated community members that will oversee the implementation and
evaluation of the CHIP until the next planning cycle commences in 2020.
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 3 OF 44
Allen County Community Health Improvement Plan 2018-2020
Work Plan Summary
Priority Area 1: Substance Use and Mental Health
To increase mental health wellness and decrease substance use in youth, the following
objectives are recommended:
1. Establish Medicaid funded behavioral health services in middle and high schools,
2. Operationalize afterschool pro-social activities, and
3. Provide prevention and early intervention services in schools.
Priority Area 2: Chronic Disease Prevention
To reduce chronic disease rates and tobacco use, the following objectives are recommended:
1. Increase community participation in Activated Allen County Challenges
2. Expand local produce access,
3. Implement recommended strategies in the Allen County Active Transportation Plan,
4. Distribute a faith-based community resource guide,
5. Implement a sustainable tobacco cessation service model,
6. Take steps toward passing a Tobacco 21 policy, and
7. Implement Health in All Policies processes.
Priority Area 3: Maternal and Infant Health
To improve coordination of pre- and postnatal services, the following objectives are
recommended:
1. Increase the number of women entering prenatal care in the first trimester,
2. Form a home visiting committee, and
3. Create a resource map linking women with services.
Priority Area 4: Housing and Public Transportation
To reduce the stock of substandard housing, and increase access to public transportation
services, the following objectives are recommended:
1. Create a strategic plan to address affordability and substandard housing, and
2. Develop a system to track use of social programs to reduce the need for frequent rent
assistance.
3. Create a strategic plan to develop the necessary funding needed to ensure public
transportation services are available and accessible to those that need such services.
4. Increase the number of passengers able to access and use RTA’s services.
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 4 OF 44
Vision Statement
“A vibrant environment where health, safety, and overall
wellness are the priority and a place where we value our
differences and diversity.”
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 5 OF 44
Letter from the Health Commissioner
July 2018
To Allen County Residents:
We are pleased to release the 2018-2020 Community Health Improvement Plan
(CHIP). This is the third such plan for Allen County and builds on the progress made
and lessons learned from the Allen County Community Health Improvement Plan for
2014-2016, and the 2017-2018 CHIP Addendum.
The Allen County CHIP is a community driven and collectively owned plan that
continues our efforts to make our community a vibrant environment that supports
health, safety and overall wellness. Data from the 2017 Allen County Health Risk and
Community Needs Assessment report as well as other community data were used to
inform the planning process.
Within this Plan, you will notice a commitment by a variety of community members,
groups, and agencies to improve collaboration throughout the community in order
to address root causes of the health issues that concern us the most. Evidence-
based activities as well as environmental and policy changes have the potential to
impact not only our lives, but the lives of those who come after us. This type of
change does not happen overnight. All of our partners are committed to long-term
action to make our vision of health a reality for all those who visit, live, learn, work,
worship, and play here.
We believe the 2018-2020 CHIP positions Allen County for greater success to
improve the quality of life for all of our residents. Allen County citizens and local
agencies deserve thanks for their support of our health improvement plan priorities
and the planning process. Community support is critical both now, as we address
the issues in this plan, and long-term, as we evaluate our progress and identify
additional priorities. Watch for our annual progress reports.
Community planning is an on-going activity. It is never too late for individuals and
communities to get involved to improve the conditions that impact our wellbeing. If
something in this plan sparks your interest or re-ignites your passion, please consider
joining our efforts with what matters most to you.
Respectfully submitted,
Kathleen A Luhn, MS, RD, LD, MCHES
Health Commissioner, Allen County Combined Health District
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 6 OF 44
Introduction
In 2018, community partners in Allen County, Ohio, again embarked on a process known as
Mobilizing for Action through Planning and Partnerships (MAPP); the first MAPP Process took
place in 2013. The MAPP framework includes four separate assessments that informed the
development of the Community Health Improvement Plan (CHIP). These assessments provided
data on disease rates, quality of life issues, morbidity, mortality, the effectiveness of the local
health system, and community resources to paint a picture of the health of Allen County.
Following these assessments, as part of the MAPP process, a group of community stakeholders
convened to define a vision of health for Allen County, review the assessment data, select
health priorities based on the health data, and collectively create a plan of action, known as
the CHIP. The CHIP is comprehensive and long term, detailing action steps that will be used by
agencies, organizations, and individuals as they implement projects, programs, and policies in
Allen County.
This report begins with a description of the process used to engage the community and
stakeholders in the development of the CHIP. Following the process summary is a section
identified for each priority. This report lists the goals and key measures selected for the health
priorities, accompanied by data that is evidence of its significance. Detailed work plans that
include objectives, action steps, and evidence-based strategies for each priority are in
Appendix E. This report concludes with a discussion of next steps relative to implementation,
ongoing monitoring, and evaluation of the CHIP. Appendix A includes a list of key terms that are
used in this report.
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 7 OF 44
The Process
Allen County Public Health (ACPH), in collaboration
with Activate Allen County (AAC), chose to utilize
the Mobilizing for Action through Planning and
Partnerships (MAPP) framework to create the Allen
County CHIP. MAPP is a community-driven strategic
planning process for improving community health
and a nationally recognized best practice for
conducting CHAs and CHIPs. Figure 1 displays the
six phases of the MAPP framework. ACPH entered
into a contract with the Center for Public Health
Practice at the Ohio State University’s College of
Public Health (CPHP) to assist with the facilitation of
the CHIP. In that role, CPHP was responsible for
planning input collection for three of the four MAPP
assessments, organizing and leading CHIP project
meetings and designing the work plan creation process.
The overall CHIP process occurred over the course of six months. Figure 2 shows the timeline of
CHIP development.
Organizing
In Allen County, ACPH and AAC convened a group of 28 partners to serve as the committee for
MAPP (MAPP Committee). This MAPP Committee included agencies, organizations, and
individuals that represent the community and provided vital insight into the complex health
•Community Health Needs Assessment (Community Health
Status Assessment) completed & released
2017
•Community Themes and Strengths Assessment
February 2018
•Local Health System Assessment and Forces of Change
Assessment
Early March 2018
•Visioning and Prioritization meeting
Mid-March 2018
•Work plan creation
April-May 2018
•CHIP implementation begins
July 2018
•CHIP released to the community
August 2018
Figure 1: Phases of MAPP
Figure 2: Allen County CHIP development timeline
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 8 OF 44
issues that occur in Allen County. Appendix B includes a list of community partners that
comprised the MAPP Committee.
Assessments
Following the organization of the MAPP Committee, the assessment phase of MAPP began.
MAPP includes four separate assessments that gather data on different aspects of the health of
the community. These assessments are:
1. Community Health Status Assessment (CHSA) -collects data on morbidity and mortality in
the community, as well as health behaviors of community residents,
2. Community Themes and Strengths Assessment (CTSA)- collects inputs from residents on
quality of life issues and community resources,
3. Local Health System Assessment (LHSA)- assesses the extent to which the entire local
health system is addressing the essential public health services, and
4. Forces of Change Assessment (FOCA)-collects inputs on how external events and trends
are impacting the health of community residents.
In 2017, AAC, ACPH, Lima Memorial Health System, the Mental Health and Recovery Services
Board of Allen, Auglaize, and Hardin Counties, Mercy Health St. Rita’s Medical Center, and the
United Way of Greater Lima completed a high quality CHSA, called the Allen County Health Risk
and Community Needs Assessment. A link to this assessment can be found in Appendix C. In
February 2018, the MAPP Committee participated in a distance-based discussion group to
conduct the CTSA. Following the CTSA, an electronic survey was conducted of community
members to inform the LHSA. During an in-person meeting on in March 2018, the MAPP
Committee reviewed the results of the LHSA survey as well as provided inputs for the FOCA.
Appendix C includes an overview of the results of the four MAPP assessments.
Visioning
At the conclusion of the assessment portion of MAPP, the MAPP Committee came together
again to define what a healthy community means to Allen County. This definition, also known as
a vision of health, then served as the guiding principle for the development of the CHIP. The
approved vision for health in Allen County is:
“A vibrant environment where health, safety, and overall wellness are the priority and a place
where we value our differences and diversity.”
Developing Priorities
Identifying Health Priorities
Next, the MAPP Committee engaged in large and small processes to analyze data from the four
assessments in order to determine the most pressing health issues impacting Allen County. MAPP
Committee members applied the following criteria to identify priorities:
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 9 OF 44
1. What is the magnitude of this health issue? Does the health issue impact a high number
of residents or high percentage of the population?
2. What is the seriousness of this health issue? Does the health issue lead to premature
death or serious illness across the population?
3. What is the feasibility of having a positive impact on this health issue? Given the current
state of the community’s health system, are the resources needed to address the health
issue available or easily attainable?
4. What is the impact of the health issue on vulnerable populations? Considering the social
determinants of health, does the health issue disproportionally affect certain
subpopulations or geographic areas within the community?
5. How does this health issue align with Ohio’s priorities? Does the health issue align with the
current State Health Improvement Plan (SHIP) priorities of Mental Health and Addiction,
Maternal and Infant Health, and Chronic Disease? See Figure 3 for CHIP alignment with
state and national priorities.
The MAPP committee determined that the most pressing health priorities in Allen County are:
1. Substance Use and Mental Health
2. Chronic Disease Prevention
3. Maternal and Infant Health
4. Housing and Public Transportation
An overview of these priorities, including a summary of the Allen County goals and objectives, is
located in the next section of the CHIP.
Allen County CHIP
Substance Use and Mental
Health
Chronic Disease Prevention
Maternal and Infant Health
Housing and Public
Transportation
Ohio SHIP
Mental Health and
Addiction
Chronic Disease
Maternal and Infant Health
Crosscutting factors: Social
Determinants of Health
National Priorities
National Prevention
Strategy: Preventing Drug
Abuse and Excessive
Alcohol Use
Healthy People 2020:
Physical Activity, Nutrition,
and Tobacco use
Healthy People 2020:
Maternal and Infant Health
HUD Strategic Plan; The
Community Guide: Public
Transit Infrastructure and
Access
Figure 1: Allen County CHIP alignment with state and national priorities.
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 10 OF 44
After the health priorities were approved, the MAPP Committee brainstormed a list of existing
assets and resources in Allen County that could be leveraged to help address the health issues.
See Appendix D for the list of Assets and Resources.
Work Plan Creation
Next, work groups created work plans that will address the approved health priorities over the
next two years. Work groups first conducted a root cause analysis on the health priorities. During
this activity, the work groups generated potential root causes for the identified health priorities,
focusing on what causes related to existing policies, environmental supports and resources were
currently in the community and what policy, environment and resources were needed in the
community. Following the root cause analysis, groups conducted a gap analysis of the priority in
order to show where gaps in services and initiatives might exist. Work groups used the results of
both the root cause analysis and the gap analysis to formulate goals and objectives to address
those priorities.
Work groups considered the following when formulating those goals and objectives:
The Health Impact Pyramid: The Health
Impact Pyramid describes the effectiveness
of different types of public health
interventions. Interventions focusing on
socioeconomic factors, at the base of the
pyramid, have the greatest potential to
improve health. Although interventions at
the higher levels have less of an impact on
health, the likelihood of long-term success is
maximized when intervention occurs at all
levels.
Policy, System, and Environmental Changes:
These are changes in laws, rules, and the environment that impact the health of a community
and change the context to make the healthy choice the default choice. Policy, systems and
environmental changes are sustainable and long lasting. In particular, work groups considered
policy changes that would most greatly impact vulnerable populations and address the causes
of higher risks on those populations.
Evidence Based Public Health Practices: These are tested programs, policies, and interventions
that are proven to be most effective in successfully changing behavior. They create sustainable
changes to improve health.
The following pages summarize the work plans for each of the priority areas. See Appendix E for
the complete work plans.
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 11 OF 44
Priority 1: Substance Use & Mental Health
Substance Use, specifically opiate abuse, and Mental Health, specifically suicide, are major
community health issues in Allen County. The stigma associated with both mental health issues
and substance use, a lack of accountability to complete treatment, and high turnover among
providers contribute to underutilized resources and a treatment system that is not as effective as
it could be. We want to see a community where all residents can easily access behavioral
health services. Community leaders are engaged in prevention efforts and working together
through the Allen County Opiate Action Commission to address many of these issues. As early
intervention is the best prevention, this CHIP will focus on leveraging our existing community
partnerships to improve access to mental health services for youth, and increase substance use
prevention efforts for youth in Allen County.
Why it’s important in Allen County:
Eight percent (8%) of all youth reported that someone had offered, sold, or given them
an illegal drug on school property*
Five percent (5%) of youth used medications that were not prescribed for them or took
more than prescribed to feel good or get high at some time in their lives*
Over one-quarter (27%) of youth reported they felt so sad or hopeless almost every day
for two weeks or more in a row that they stopped doing some usual activities*
Youth who experienced 3 or more adverse childhood experiences (ACEs) were more
likely to have used marijuana in the past 30 days compared to youth who did not
experience any ACEs (26% vs 5%); and were more likely to have seriously attempted
suicide in the past 12 months (33% vs 4%).
Goal: Increase mental health wellness and decrease substance use among middle and high
school students in Lima City Schools
Key Measure: High School Graduation Rates
Vulnerable Population(s) Impacted by CHIP: Youth, residents with reduced access to Mental
Health Care Services (uninsured/underinsured)
Objectives:
Establish Medicaid funded behavioral health services in Lima City middle and high
schools (with technical assistance to county schools)
Operationalize after school pro-social activities in Lima City public and parochial schools
Provide prevention and early intervention services to Lima City Schools students (and
expand to other school districts)
*Source: 2017 Allen County Health Risk and Community Needs Assessment
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 12 OF 44
Priority 2: Chronic Disease Prevention
Chronic diseases, including cardiovascular disease, diabetes, and obesity, are leading health
issues affecting Allen County. Despite there being many activities and coalition work currently
happening dedicated to prevention efforts, there is a lack of policies and stakeholder
engagement that prohibits the efforts from expanding. We would like to implement policy and
environmental changes impacting physical activity, nutrition, and tobacco use among residents
to make the healthy choice the easy choice and to improve active transportation options,
including public transportation services for Allen County residents. We would like to capitalize on
current efforts to further wellness and chronic disease prevention efforts in our community, to
institute sustainable policy changes, and to create lasting changes in the lifestyles of Allen
County residents.
Why it’s important in Allen County:
Eighteen percent (18%) of adults ate 0 servings of fruits and vegetables per day; 25% for
African American adults*
More than two-thirds (70%) of Allen County adults were either overweight (35%) or obese
(35%) by Body Mass Index (BMI)*
34% of residents have been diagnosed with high blood pressure*
Almost one-fifth (18%) of Allen County adults were current smokers,* increasing to 30% of
adults with annual incomes less than $25,000
Goals: Reduce chronic disease in Allen County; Reduce tobacco use in Allen County; Establish
Health in All Policies processes in Allen County
Key Measures: Cardiovascular Disease rates, Diabetes rates, Obesity rates, Adult tobacco use,
Youth exposed to secondhand smoke, Low income adults who smoke, e-cigarette Use
Vulnerable Population(s) Impacted by CHIP: Low-income residents (food insecure, reduced
access to transportation)
Objectives:
Increase community participation in Activated Allen County Challenges
Expand local produce access
Implement recommended strategies in the Allen County Active Transportation Plan
Distribute a resource guide for the faith-based community
Implement a sustainable tobacco cessation service model
Take steps toward passing a Tobacco 21 policy
Implement Health in All Policies processes
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 13 OF 44
*Source: 2017 Allen County Health Risk and Community Needs Assessment
Priority 3: Maternal & Infant Health
Maternal and Infant Health is key to the overall health of a community. Allen County has a
variety of community resources available to help pregnant women and infants live the healthiest
lives possible. Despite these resources, too few pregnant women access early, consistent
prenatal care and parenting education. This has a multitude of implications, including increased
risk of infant mortality. We want to see healthy women delivering full term, healthy weight infants
that thrive through their first birthday. To this end, we will leverage resources to increase
collaboration and improve linkages for needed care and education.
Why it’s important in Allen County:
During their last pregnancy, Allen County women experienced the following:
o Got a prenatal appointment in the first 3 months (57%)*,
o Took a multi-vitamin with folic acid during pregnancy (49%)*,
o Received WIC benefits (19%)*,
o Smoked cigarettes (10%)*,
o Used opioids (1%)*
Only 4% of African American infants slept in a crib or bassinette without bumper pads,
blankets or stuffed animals, compared to 60% of infants overall.
Goals: Improve coordination of pre-and postnatal services
Key Measures: Percentage of women who received prenatal care in the first trimester
Vulnerable Population(s) Impacted by CHIP: Women, low-income residents (reduced access to
prenatal care)
Objectives:
Increase the number of women entering prenatal care in the first trimester
Form a home visiting committee for the coordination of services for families with infants
Create a resource map linking women with services
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 14 OF 44
*Source: 2017 Allen County Health Risk and Community Needs Assessment
Priority 4: Housing & Public Transportation
Substandard housing and reduced access to public transportation are major public health issues
in Allen County. Poor housing conditions are associated with many health problems, including
asthma, lead poisoning, and injury; reduced access to public transportation affects quality of
life, including the ability to access jobs, education, and medical care. We want to promote safe,
accessible, appropriate, and affordable housing to sustain healthy and vibrant residents and
neighborhoods, and to assure that people needing public transportation services have access
to them. To this end, we will capitalize on community organizations and partnerships to increase
the community’s investment in housing stock and public transportation.
Why it’s important in Allen County:
The Community Themes and Strengths Assessment noted that poor quality housing was
considered a major health issue, and that complex regulatory systems prevent significant
action on improving housing.
15% of households reported having at least one of the following problems: overcrowding,
high housing costs, or lack of kitchen or plumbing facilities
African American adults were more likely to have spent 50% or more of their household
income on housing (45% compared to 14% of the rest of Allen County).
African American adults were more likely to have transportation issues (37% compared to
6% of the rest of the county).
Goals: (1) Create a strategic plan to address substandard housing and Improve coordination
between agencies on service delivery. (2) Create a strategic plan to develop the necessary
funding needed to ensure public transportation services are available and accessible to those
that need such services.
Key Measures: (1) Creation of strategic plan, implementation of social services tracking system;
(2) Creation of a strategic plan, increase the number of passengers able to access and use the
RTA services.
Vulnerable Population(s) Impacted by CHIP: Low income, homeless
Objectives:
Create a strategic plan to address affordability and substandard housing,
Develop a system to track use of social programs to reduce the need for frequent rent
assistance.
Create a strategic plan to develop the necessary funding needed to ensure public
transportation services are available and accessible to those that need such services.
Increase the number of passengers able to access and use RTA’s services.
*Source: 2017 Allen County Health Risk and Community Needs Assessment
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 15 OF 44
Next Steps and Call to Action
ACPH and AAC will continue to monitor the CHIP on a regular basis over the next 27 months. The
work plans located in Appendix E includes the agencies and individuals responsible for
implementing each of the objectives outlined in this CHIP. AAC will collect quarterly updates
from each responsible party in order to gauge the progress of the CHIP. Goals and objectives
will be monitored to assure that timeframe targets are being met. To allow the CHIP to evolve
with the community, goals and objectives will be adjusted or amended if needed. AAC will
publicly release an annual update, highlighting the success of the CHIP and providing any
information about major changes that have been made.
This CHIP represents the work of a dedicated group of community representatives. If you or your
agency are interested in becoming involved with CHIP initiatives and community health
improvement planning in Allen County, please contact:
Josh Unterbrink, Activate Allen County
junterbrink@activateallentcounty.com
Kayla Monfort, Activate Allen County
kmonfort@activateallencounty.com
Monica Harnish, Allen County Public Health
mharnish@allenhealthdept.org
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 16 OF 44
Appendix A: List of Key Terms
AAC – Activate Allen County
ACPH – Allen County Public Health
CHA – Community Health Assessment; the collection, analysis, and distribution of information on
the health status and health needs of the community, including statistics on health status,
community health needs/gaps/problems, and assets.
CHIP – Community Health Improvement Plan; a long-term and systematic plan to address health
priorities that were drafted as a result of the CHA.
MAPP – Mobilizing for Action through Planning and Partnerships; a community-driven strategic
planning process for improving community health.
EBPHP – Evidence Based Public Health Practice; the implementation, and evaluation of effective
programs and policies in public health through application of principles of scientific reasoning,
including systematic uses of data and information systems, and appropriate use of behavioral
science theory and program planning models.
HIP – Health Impact Pyramid; An organization of health interventions that places greater public
value on interventions that impact socioeconomic factors, and less public value on individual
education.
HiAP – Health in All Policies; a collaborative approach to improving the health of a community
by incorporating health, sustainability, and equity considerations into decision-making across
sectors and policy areas.
HP2020 – Healthy People 2020; the federal government’s prevention agenda that is updated
every 10 years.
National Prevention Strategy – From the office of the Surgeon General, lays out a prevention-
oriented society where communities work together to achieve better health for all Americans.
ODH – Ohio Department of Health
OSU CPHP – The Ohio State University Center for Public Health Practice
SHIP – State Health Improvement Plan; a CHIP completed at the State level.
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 17 OF 44
Appendix B: List of Community Partners
John Snyder
Executive Director, Activate
Allen County; Professor,
School of Health and
Rehab. Sciences, College of
Medicine, OSU Lima
Activate Allen County
Josh Unterbrink
Coordinator
Activate Allen County
Kayla Monfort
Coordinator
Activate Allen County
Jay Begg
County Commissioner
Allen County Commissioners
Kathy Luhn
Health Commissioner
Allen County Public Health
Deb Roberts
Director of Nursing
Allen County Public Health
Bill Kelly
Director of Environmental
Health
Allen County Public Health
Monica Harnish
Director, Health Planning
Services; Accreditation
Coordinator
Allen County Public Health
Shelly Miller
Coordinator, Creating
Healthy Communities
Program
Allen County Public Health
Tami Gough
Director, Prevention and
Health Promotion Services
Allen County Public Health
Jeanetta Francy
Epidemiologist
Allen County Public Health
Beth Siebert
Storm water and Watershed
Programs Coordinator
Allen County Soil and Water
Conservation District
Jeff Sprague
President/CEO
Allen Economic
Development Group
Keisha Drake
Executive Director
Bradfield Community Center
David Berger
Mayor
City of Lima
Sharetta Smith
Chief of Staff
City of Lima
Susan Crotty
Director, Community
Development
City of Lima
Jennifer Clark
Chief Population Health
Officer
Health Partners of Western
Ohio
Jed Metzger
President
Lima Allen County Chamber
of Commerce
Thom Mazur
Executive Director
Lima Allen County Regional
Planning Commission
Jeff Utz
Director, Lima Memorial
Physicians
Lima Memorial Health
Systems
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 18 OF 44
Mike Schoenhofer
Executive Director
Mental Health and Recovery
Services Board of Allen,
Auglaize and Hardin
Counties
Tammie Colon
Associate Executive Director
Mental Health and Recovery
Services Board of Allen,
Auglaize and Hardin
Counties
Amy Marcum
Regional VP Mission and
Values Integration
Mercy Health St. Rita's
Medical Center
Carol Braden-Clarke
President
United Way of Greater Lima
Nell Lester
Coordinator
West Central Ohio Health
Ministries Program
Robin Johnson
Executive Director
West Central Ohio Regional
Healthcare Alliance
Jackie Fox
CEO
West Ohio Community
Action Partnership
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 19 OF 44
Appendix C: MAPP Assessment Results
1. Community Health Status Assessment
The 2017 Allen County Health Risk and Community Needs Assessment served as our Community
Health Status Assessment, using community survey and secondary data sources. In this
assessment, health topics were reviewed. The categories were:
Healthcare Access
Health Behaviors
Chronic Disease
Social Conditions
African American Health
Youth Health
The complete Assessment can be found on Allen County Public Health’s website at
www.allencountypublichealth.org under Vital Statistics.
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 20 OF 44
2. Community Themes and Strengths Assessment
Inputs were collected during a distance-based listening session with community stakeholders on
February 21, 2018. Participants were asked three questions; their responses were recorded and
themed and are summarized below.
QUESTION 1: How is quality of life perceived in Allen County?
QUESTION 2. What do you believe are the most important issues that must be addressed
to improve quality of life in Allen County?
QUESTION 3: What assets do we have that can be used to improve community health?
QUESTION 1: HOW IS QUALITY OF LIFE PERCEIVED IN ALLEN COUNTY?
POLITICAL ISSUES
There are political divides - conservative rural/progressive city; annexation issues
HOUSING
Affordable, though certain housing related issues exist (blight, yard issues, etc.)
ECONOMY
Affordable place to live
POVERTY:
Perception of poverty and housing in city
Recent United Way study: 40% of households in Allen County are ALICE (Asset Limited.
Income Constrained. Employed)
RACIAL ISSUES
Allen County has racial issues that need to be addressed
EDUCATION & OPPORTUNITIES
There are multiple opportunities for post-secondary education, though we are a
stepping stone community (“I’ll start here to move elsewhere”)
PERCEPTION
There are challenges in trying to redefine the image of the community
o Hard to get people involved
o Some smaller communities within Allen County have community pride, but not
all
o People perceive negative aspects more quickly than the positive aspects and
rush to judgement
There is diversity in Allen County: e.g. racial; urban vs. rural
Broader perception of county is it’s a great place to raise a family, though some see
lack of opportunities from an entertainment standpoint (concerts, attractions,
museums, restaurants)
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 21 OF 44
QUESTION 2. WHAT DO YOU BELIEVE ARE THE MOST IMPORTANT ISSUES THAT MUST BE ADDRESSED
TO IMPROVE QUALITY OF LIFE IN ALLEN COUNTY?
SERVICES
Supportive services for children: interventions and leadership to build resilience in
children
Lack of funding for support services
Transportation (county wide)
EDUCATION
Need for strong education and strong graduation rates
EMPLOYMENT
Workforce participation rates
Cycle – great communities attract high quality jobs; economic development depends
on quality workforce
HOUSING
Housing and blight contributes to health issues and overall perception of community;
Housing quality is a disincentive – expensive to build/return on investment to remodel;
there is not attractive land to build on
Decreasing percentage of owner occupied housing units
Complex regulatory systems prevent significant action on improving housing
ECONOMY
Breaking the cycle of poverty
Demographics: aging population; shrinking population and tax base issues;
HEALTH ISSUES
Need policies to improve quality of life - Health in All Policies
Drugs and alcohol and mental health issues; the opioid crisis is real
FAMILY
Family structure/single parent families
3. WHAT ASSETS DO WE HAVE THAT CAN BE USED TO IMPROVE COMMUNITY HEALTH?
HEALTHCARE
Hospitals
World class healthcare available here
ECONOMY/EMPLOYMENT
Diversity – of employment; of employees; of thought
Geographic - key location - within 1 day’s drive of 60% of manufacturing in US; a lot of
vacant office space and land
COMMUNITY SERVICES
Parks and recreation - under used - phenomenal resource
EDUCATION
5 colleges and universities
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 22 OF 44
Early childhood education - child care - at market saturation rates for preschool
opportunities
FAITH COMMUNITY
Faith community - strong percentage of population are involved in organized religion
and churches are involved in the community
COMMUNITY COLLABORATIONS
Allen County has a strong history of collaborations and working together to move the
needle to improve health
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 23 OF 44
3. Local Health System Assessment
An electronic survey was distributed to community stakeholders in February 2018. Results of the
survey were reviewed and revised, as needed, by MAPP Committee on March 2, 2018 for
accuracy. Following the review, the MAPP Committee prioritized the results to indicate which
essential services were in highest need of improvement.
The Local Health System Assessment (LHSA) answers the questions, "What are the components,
activities, competencies, and capacities of our local health system?" and "How are the Essential
Services being provided to our community?" This assessment involves the use of a nationally
recognized tool called the National Public Health
Performance Standards Local Instrument.
This
section reviews the instrument, the process used, and top priorities identified.
Public health systems are commonly defined as “all public, private, and voluntary entities that
contribute to the delivery of essential public health services within a jurisdiction.” This concept
ensures that all entities’ contributions to the health and well-being of the community or state are
recognized in assessing the provision of public health services. For this reason, during the MAPP
process, this assessment was referred to simply as the “Local Health System Assessment.”
The local health system includes:
Public health agencies at state
and local levels
Healthcare providers
Public safety agencies
Human service and charity
organizations
Education and youth
development organizations
Recreation and arts-related
organizations
Economic and philanthropic
organizations
Environmental agencies and organizations
The 10 Essential Public Health Services
The 10 Essential Public Health Services describe the
public health activities that all communities should
undertake. These services serve as the framework for
the survey instrument used for this assessment. Public
health systems should:
1. Monitor health status to identify and solve
community health problems.
2.
Diagnose and investigate health problems and
health
hazards in the community
.
3.
Inform, educate, and empower people about
health issues.
4. Mobilize community partnerships and action to
identify and solve health problems.
5. Develop policies and plans that support
individual and community health efforts.
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 24 OF 44
6. Enforce laws and regulations that protect health and ensure safety.
7. Link people to needed personal health services and assure the provision of health care
when otherwise unavailable.
8. Assure competent public and personal health care workforce.
9.
Evaluate effectiveness, accessibility, and quality of personal and population-based
health services.
10. Research for new insights and innovative solutions to health problems.
(Source: Centers for Disease Control; National Public Health Performance Standards; The Public
Health System and the 10 Essential Public Health Services;
http://www.cdc.gov/nphpsp/essentialservices.html)
The National Public Health
Performance Standards Local Instrument was used to create a survey
that was administered to community stakeholders in February 2018. At the March 2
nd
MAPP
meeting, small groups reviewed the results of the survey and suggested changes if they thought
necessary.
The overall score of each of the 10 Essential Services (ES) is listed in the graph below.
After discussion, the MAPP Committee prioritized the results to indicate which measures were in
highest need of improvement. The performance measures were given an improvement priority
value of 1 to 10, with 1 being the lowest need for improvement and 10 being the highest need
for improvement. For example, a score of 10 indicates that there is a lot of improvement
needed. The following measures were identified as the highest need for improvement (priority
scores of 9 or 10 out of 10).
70.6
80.6
81.9
72.2
71.9
68.8
62.5
81.3
68.0
66.7
52.1
0.0 20.0 40.0 60.0 80.0 100.0
Average Overall Score
ES 1: Monitor Health Status
ES 2: Diagnose and Investigate
ES 3: Educate/Empower
ES 4: Mobilize Partnerships
ES 5: Develop Policies/Plans
ES 6: Enforce Laws
ES 7: Link to Health Services
ES 8: Assure Workforce
ES 9: Evaluate Services
ES 10: Research/Innovations
Summary of Average ES Performance Score
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 25 OF 44
Performance Measure
Performance
Score*
Priority of
Improvement
Needed*
Notes
2.1.3
Ensure that the best available
resources are used to support
surveillance systems and
activities, including information
technology, communications
systems, and professional
expertise?
50
10
3.1.2
Coordinate health promotion
and health education activities
at the individual, interpersonal,
community, and societal levels?
50
10
Super important to get
education out
3.1.3
Engage the community
throughout the process of
setting priorities, developing
plans, and implementing health
education and promotion
activities
50
10
Need for creating more
opportunities to involve the
"community" in program/plan
development. I.e.: Bridging
the gap planning groups is
currently working with new
partnerships to improve
program/process, needs to
be more targeted; look at
needs assessment
5.1.2
See that the local health
department is accredited
through PHAB's voluntary,
national public health
department accreditation
program?
75
10
5.3.1
Establish a CHIP, with broad-
based diverse participation,
that uses information from the
CHA, including the perceptions
of community members?
75
9
Need more racial diversity
6.2.2
Participate in changing existing
laws, regulations, and
ordinances, and/or creating
new laws, regulations, and
ordinances to protect and
promote public health?
50
10
8.3.4
Create and support
collaborations between
organizations within the LHS for
training and education?
50
9
8.4.1
Provide access to formal and
informal leadership
development opportunities for
employees at all organizational
levels?
50
9
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 26 OF 44
8.4.4
Provide opportunities for the
development of leaders who
represent the diversity of the
community?
25
10
No diversity
9.1.2
Assess whether community
members, including vulnerable
populations, are satisfied with
the approaches taken toward
promoting health and
preventing disease, illness, and
injury?
25
9
9.3.3
Assess how well the
organizations in the LPHS are
communicating, connecting,
and coordinating services?
50
9
10.1.3
Keep up with information from
other agencies and
organizations at the local, state,
and national levels about
current best practices in public
health?
75
9
To see the full results of the LHSA, please contact Allen County Public Health.
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 27 OF 44
4. Forces of Change Assessment
Theme
Force
Threat
Opportunity
Economic Factors
Poverty
Discrimination
Lack of Upward
Mobility
Devaluing public
health and
public education
Provide living
wage
innovations to
address poverty
Housing
Poor quality
(available)
Attracting
people to
community
Disincentive to
invest
Health (mold,
lead, running
water)
Unsafe
Accessibility
New models (co-
ops, more
affordable)
Regulations
Policy
improvement
Rehab and
reconstruction
Job Market/Work Force
Turnover
Service based
economy
Shrinking funds for local
infrastructure
Growing income
inequality
Safety and Violence
Youth Violence
Safety
Loss of
generations
Loss of
productivity/Work
Force
Development
Fear/Personal
safety
Improvement on
engagement
Political voice on
national events
Youth
programming
Substance
Abuse/Drugs
Drug Culture Drug
Addiction
Crime
Violence
Lost Family
Structure
Attitude
Reframe problem
as a chronic
disease
Partnerships
(needle
exchange, etc.)
Reduce stigma
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 28 OF 44
Promoting pills as
"fixes"
Legalization of
Marijuana
Gateway to
addiction
Employee safety
Enforcement
Lower opioid rates
Lower
incarceration
rates
Economic
Social Factors
Changing family
structure
Lack of stability
Basic support
Adults in
household
Negative impact
on children
Expanding the
idea of normal
family
Diversity
Building a sense of
community
Parent
connections
Expanding
support systems
Shrinking/Aging
population
Not enough
people for
workforce
Fresh ideas
Leaving baby
boomers
Retaining talent
Utilize strong
educational
system
Improving work
force
development
New class of
young leaders
Identify talents of
aging population
Political Climate
Lack of trust
state/federal
social media
Collaborate on
large issues
Well educated
population
Religious/Spiritual Shift
Intolerance
End of life prep
Handling of
medical issues
Education for
tolerance
Learning from
different groups
Organ donations
Nurture sense of
community
Racial and cultural
divide
Difficult to have
conversations
Nurture
relationships/
partnerships
Inclusivity
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 29 OF 44
Study circles
Difference between
city and county
Inconsistent
policies
Perception of
how resources
are used
Work together
Technology and
Communication
Technology changes
Economic base
Online shopping
Loss of human
connection -
sense of reality
Cost
Social media
Aging population
Embrace new
startups, etc.
medical
technology
ability for
connections
social media
new way to
communicate
reduces barrier for
entry of new
business
Advancement
Technology
Social
Media/Communication
Access Issues
Reduction of support
services (federal
support)
Reduction of
block grants
Individual
services
Policy
changes/living
wages
more efficient with
available funds
RTA cuts/lack of
transportation
Decrease in
services, time,
not able to get to
jobs or services
educate
community about
importance of
transportation
Access to prenatal
care
Infant mortality
rate
Immunization
rates
Lack of
community
knowledge
Better
connections/partn
ership
education
Safety and
support
Access to quality food
Bad food is
cheap and easy
to access
Ruler
foods/convenienc
e stores have
better food
Affordable Care Act
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 30 OF 44
Infectious disease
antibiotic
resistance
Environmental
Climate related
disasters
Housing (lead, water
quality, etc.)
Loss of homes
Community
infrastructure
Support services
Housing
conditions
Back up
plans/systems
engagement
opportunities
Federal programs
for relocation
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 31 OF 44
Appendix D: Assets and Resources
Cross-cutting Collaboratives
Activate Allen County
Bridging the Gap Group
TAC- Transportation Advisory Group
Greater Lima Region
LINK Lima
Downtown Lima, Inc.
Chronic Disease
Allen County Bike and Pedestrian Task Force
Food Policy Council
Worksite Wellness Collaborative
Lima Allen County Neighborhoods in
Partnership
Creating Healthy Communities
Breast Cancer Awareness Coalition
Colorectal Cancer Coalition
Mental Health and Substance Use
Allen County Opiate Action Commission
and subcommittees
Maternal and Infant Health
Maternal Infant Task Force
Housing and Public Transportation
Allen County Housing Consortium
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 32 OF 44
Appendix E: Work Plans
Priority # 1: Substance Use/Mental Health
Substance Use, specifically opiate abuse, and Mental Health, specifically suicide, are major
community health issues in Allen County. The stigma associated with both mental health
issues and substance use, a lack of accountability to complete treatment, and high turnover
among providers contribute to underutilized resources and a treatment system that is not as
effective as it could be. We want to see a community where all residents can easily access
behavioral health services. Community leaders are engaged in prevention efforts and
working together through the Allen County Opiate Action Commission to address many of
these issues. As early intervention is the best prevention, this CHIP will focus on leveraging our
existing community partnerships to improve access to mental health services for youth, and
increase substance use prevention efforts for youth in Allen County.
Alignment with National Priorities: National Prevention Strategy: Preventing Drug Abuse and
Excessive Alcohol Use; Mental and Emotional Well-being
Alignment with SHIP: Mental Health and Addiction; Suicide, Drug dependency/abuse
Objective(s) that address policy change(s) needed to accomplish goal: 1.1.1, 1.1.2, 1.1.3
Goal 1.1: Increase mental health wellness and decrease substance use among middle and
high school students in Lima City Schools
Key Measure(s): Graduation rates
Baseline: 85% (Data Source: County Health Rankings)
Objective 1.1.1:
Measure
Timeframe
Lead
By December 31, 2018, establish Medicaid
funded behavioral health services in 75% of
middle and high schools in Lima City
Schools.
Baseline:
unknown
Target: 75%
Start: 5/2018
End: 12/2018
Tammie
Colon,
MHRSB
Action Steps:
Establish baseline
Obtain technical assistance from State of Ohio on how to obtain Medicaid Behavioral Health
Services in Middle and High schools within Lima City Schools.
Approach Lima City School Board to promote policy change to implement Medicaid
behavioral health services
Present policy to Lima City School Board for approval
Assist Lima City Schools in implementing policy change
Offer technical assistance to other county schools
Status:
Date
Update
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 33 OF 44
Objective 1.1.2:
Measure
Timeframe
Lead
By September 30, 2020, operationalize after
school pro-social activities in 75% of middle
and high schools in all public and parochial
schools in the city of Lima.
Baseline:
unknown
Target: 75%
Start: 5/2018
End: 9/2020
Sharetta
Smith
City of
Lima
Action Steps:
Establish baseline
Complete program
Collaborate with the Mayor’s Commission on Youth to implement policies
Meet with Lima City School Board to obtain permission to use buildings for after-school
activities
Pass shared use agreement with Lima City Schools to allow afterschool activities
Seek funding to support afterschool programming
Status:
Date
Update
Objective 1.1.3:
Measure
Timeframe
Lead
By December 31, 2019, Provide prevention
and early intervention services to 100% of
Lima City Schools Students.
Baseline:
unknown
Target:
Start: 5/2018
End: 12/2019
Tammie
Colon,
MHRSB
Action Steps:
Establish baseline
Meet with Lima City School Board to promote policy change to allow for all students to
receive behavioral and mental health screening
Present policy proposal to Lima City School Board for approval
Identify tools to use in both prevention and intervention
Approach curriculum committee to program usage
Expand to other Allen County school districts
Status:
Date
Update
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 34 OF 44
Priority # 2: Chronic diseases, including cardiovascular disease, diabetes, and obesity, are
leading health issues affecting Allen County. Despite there being many activities and
coalition work currently happening dedicated to prevention efforts, there is a lack of policies
and stakeholder engagement that prohibits the efforts expanding. We would like to
implement policy and environmental changes impacting physical activity, nutrition, and
tobacco use among residents to make the healthy choice the easy choice and to improve
active transportation, including public transportation, options among Allen County residents.
We would like to capitalize on current efforts to further wellness and chronic disease
prevention efforts in our community to institute sustainable policy changes to creating
lasting changes in the lifestyles of Allen County residents.
Alignment with National Priorities: Healthy People 2020: Physical Activity (PA-2); Nutrition and
Weight Status (NWS-14); Tobacco Use (TU-1, TU-2)
Alignment with SHIP: Chronic disease; Heart disease, Diabetes
Objective(s) that address policy change(s) needed to accomplish goal:
Goal 2.1: Reduce chronic disease in Allen County
Key Measure(s): Cardiovascular disease rates, Diabetes rates, Obesity rates
Baseline: Adults diagnosed with high blood pressure- 34%, Adults that have had a heart
attack- 5%, Adults that are obese- 35%, Adults diagnosed with diabetes- 13%, up to 19%
for those with less than $25,000 annual income, Adults eating less than 1 vegetable
serving per day- 53%, Adults reporting no fruit servings in past 7 days- 18%, up to 25% of
African Americans (all measures from 2017 Allen County Community Health Assessment)
Objective 2.1.1:
Measure
Timeframe
Lead
By September 30, 2020,
increase by 25% the number
of workplaces, schools,
childcare, and community
residents participating in
Activated Allen County
Challenges.
Baseline:
Activated Business
Challenge: 24 workplaces,
4500 employees
Activated Schools
Challenge: 10 schools,
______ children
Activated Childcare
Challenge: 0
Activated Neighborhood
Challenge: 0
Target:
Activated Business
Challenge: 5 additional
Activated Schools
Challenge: 2 additional
schools
Activated Childcare
Challenge: 3
Activated Neighborhood
Challenge: 2
Start: 7/2018
End: 9/2020
Kayla
Monfort/Josh
Unterbrink
Activate
Allen County
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 35 OF 44
Action Steps:
Activated Business Challenge
1. Continue to recruit workplaces to join the challenge with the assistance of the Workplace Wellness
Collaborative
2. Assess workplace applications and provide technical assistance for improvement
3. Celebrate successes of new workplaces joining the challenge with twice a year ceremony
4. Evaluate and modify challenge as needed to meet the needs of the community and employers
Activated School Challenge
1. Recruit schools to participate in the challenge
2. Provide technical assistance for schools to create feasible action plans
3. Evaluate plans for funding with established core group, including St. Rita's as the funder
4. Implement approved plans at schools
5. Celebrate successes
6. Evaluate and modify challenge as needed to meet the needs of funders and schools
Activated Childcare Challenge
1. Create application and guidelines for the challenged based off of current Activated School
Challenge, previous childcare challenge and evidenced based resources
2. Recruit childcare facilities to apply
3. Provide technical assistance for childcare facilities to create feasible action plans
4. Evaluate plans for funding with established core group, including Paramount as the funder
5. Celebrate successes
6. Evaluate and modify challenge as needed to meet the needs of funders and childcare facilities
Activated Neighborhood Challenge
1. Create application and guidelines for the challenged based off of evidenced based resources,
model communities and local needs
2. Recruit neighborhood partners/residents to apply
3. Provide technical assistance for neighborhoods to create feasible action plans
4. Evaluate plans for funding with established core group, including Paramount as the funder and
LACNIP as a main partner in monitoring projects
5. Celebrate successes
6. Evaluate and modify challenge as needed to meet the needs of funders and community residents
Status:
Date
Update
Objective 2.1.2:
Measure
Timeframe
Lead
By September 30, 2020,
expand local produce access
by 10% through the Allen
County Farmer’s market and
local garden initiatives
including community gardens
and urban gardens.
Baseline:
Produce vendors at Allen
County farmers market- 5
Pounds of produce
produced at urban farms-
0
Community gardens- 9
# of residents
participating in SNAP/EBT
at FM- 0
Target:
Produce vendors at Allen
County farmers market- 7
Pounds of produce
produced at urban farms-
250 pounds
Start: 7/2018
End: 9/2020
Kayla
Monfort/Josh
Unterbrink,
Activate
Allen County
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 36 OF 44
Community gardens- 11
# of residents
participating in SNAP/EBT
at FM- 15
Action Steps:
Produce Vendors at Allen County Farmers Markets- no baseline yet
1. Establish baseline measurement by researching all produce vendors at Allen County FMs
(Downtown, Bluffton, Delphos)
2. Recruit new produce vendors each market season
3. Track increase in vendors at Allen County FMs each year
Pounds of Produce Gathered at Urban Farms- Baseline 0
1. Farmers/Entrepreneurs will track pounds of produced harvested
2. Research/determine best system to track this data
3. Report monthly the amount harvested
Number of Community Gardens- Baseline- will get from LACNIP and pass along to you
1. Map/plot current community garden locations on Allen County Map
2. Determine gaps or areas where community gardens could be started taking special consideration
to food deserts and vacant lands that could be re-purposed
3. Recruit new growers to work community gardens and promote the community gardens with the
assistance of LACNIP who is currently recruiting, training and providing resources for our community
gardens
4. Track new locations of gardens each year
Number of Community Residents Participating in SNAP/EBT at FMs- Baseline 0
1. Implement SNAP/EBT as planned at the Downtown Lima FM in 2018
2. Track number of people using this service each week and record
3. Promote SNAP/EBT availability to all community residents
4. Evaluate for success
5. Recruit other FMs in Allen County to provide SNAP/EBT at their markets
6. Track number of community members using SNAP/EBT at county markets each season
Status:
Date
Update
Objective 2.1.3:
Measure
Timeframe
Lead
By September 30, 2020
Increase or enhance by 6 the
number of policies, systems,
and environmental changes
in place to support active
living and social
connectedness as outlined in
the Allen County Active
Transportation Plan.
Baseline: 26% of adults
reported no participation
in physical
activity/exercise during
the last 30 days (2017
CHA)
Target: 22%
Start: 7/2018
End: 9/2020
Allen County
Bike and
Pedestrian
Task Force
Action Steps:
Engineering
Increase the number of schools that develop a Safe Routes to School Program School
Travel Plan. Baseline: 6; Target 8 Lead: CHC
Increase pedestrian and bicycle facilities by 1 mile per year. Baseline miles: TBD; Target:
Baseline +3 Lead: RPC
Increase bike and pedestrian connectivity via maintenance and expansion of the Rotary
Riverwalk and/or the Miami Erie Canal. Measure: # miles maintained annually; number of
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 37 OF 44
new community connections made. Partners: Johnny Appleseed Park District; City of
Lima, RPC
Develop and Implement ADA Transition Plans. Baseline jurisdictions with plans developed:
0; Target 4; Baseline jurisdictions with projects implemented in plans: 0; Target 2 Lead: RPC
Encouragement
Expand the mission of the Allen County Bike and Pedestrian Task Force to make formal
recommendations to local governments regarding the advancement and support of
proposed Active Transportation options for on-road. off road, and transit projects. Lead: Bike
and Pedestrian Task Force (BPTF) Steering Committee
1. Steering Committee establishes guidelines / bylaws for a BPTF Advisory Council, including
representation from law enforcement.
2. Once established, advisory Council makes formal recommendations. Baseline: 0; Target 3
Enforcement
Increase the number of Allen County law enforcement personnel trained in Enforcement for
Pedestrian and Bicycle Safety. Baseline: 8; Target 20 Lead: CHC Program
Education
Increase the number of Allen County residents reached through the MoveSafe Allen
County bike/pedestrian safety messaging. Measure: # billboards, # social media shares, #
print and television media coverage. Lead: CHC Program
Hold a bike rodeo in a different community annually. Target: 3 Lead: Activate Allen County
Evaluation
Increase by 20% from the number of volunteers assisting with the biannual Bicycle
Documentation Project (Baseline September 2017 numbers) Lead: BPTF Steering Committee
Implement with local law enforcement a process to improve data generated for bicycle and
pedestrian crash reports. Lead: RPC
Produce detailed operational analysis detailing the extent of public transportation services
provided in terms of types of service, service area, ridership levels and funding. Lead: RTA
and RPC.
Status:
Date
Update
Objective 2.1.4:
Measure
Timeframe
Lead
By September 30, 2020, distribute a faith-
based community resource guide to 10
faith-based organizations in Allen
County.
Baseline: 0
Target: 10
Start: 5/2018
End: 9/2020
Nell Lester,
Health
Ministries
Action Steps:
Create faith based resource guide with health ministries, Activate Allen County, and core
group of leaders
Engage a larger core group of faith based leaders
Promote guide to the broader county organizations (faith based)
Evaluate how organizations are using the guide
Status:
Date
Update
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 38 OF 44
Goal 2.2: Reduce tobacco use in Allen County
Key Measure(s): Adult tobacco use, youth exposed to second hand smoke, low income
adults who smoke, e-cigarette use
Baseline: Adult smokers- 18%, Youth smokers- 6%, Youth exposed to second hand smoke-
56%, Adult smokers with income over $25,000 annually- 14%, Adult smokers with income
less than $25,000 annually- 30% (all measures based on 2017 Allen County Community
Health Assessment)
Objective 2.2.1:
Measure
Timeframe
Lead
By September 30, 2020, implement a
sustainable tobacco cessation service
model in Allen County.
Baseline: 0
Target: 1
Start: 7/2018
End: 9/2020
Josh
Unterbrink,
Activate
Allen County
Action Steps:
Recruit members and establish task force to address need
Develop model with stakeholders task force to provide cessation service to the county
Locate funding for model established
Pilot program and evaluate
Status:
Date
Update
Objective 2.2.2:
Measure
Timeframe
Lead
By September 30, 2020, adopt tobacco
free public spaces policies in 3 Allen
County jurisdictions.
Baseline:
unknown
Target: 3
additional over
baseline
Start: 7/2018
End: 9/2020
Josh
Unterbrink,
Kayla
Montfort
Action Steps:
1. Establish a baseline number for tobacco free parks in Allen County
2. Research and develop a plan to approach stakeholders and council members concerning
tobacco free parks
3. Schedule meetings with appropriate officials (including park officials) to discuss policy
4. Establish a plan to roll out tobacco free parks
5. Encourage Activate Allen County Executive Council to advocate for tobacco free parks
6. Educate community residents concerning tobacco free parks
7. Promote and celebrate successes of all policy change around tobacco free parks
Status:
Date
Update
Objective 2.2.3:
Measure
Timeframe
Lead
By September 30, take two action steps
towards passing a Tobacco 21 policy in
an Allen County jurisdiction.
Baseline: 0
Target: 1
Start: 7/2018
End: 9/2020
Tobacco
Coalition
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 39 OF 44
Action Steps:
1. Obtain community support for Tobacco 21.
2. Determine language for a Tobacco 21 policy.
3. Introduce a Tobacco 21 ordinance.
4. Educate retailers and the community
Status:
Date
Update
Goal 2.3: Improve health for all residents by incorporating “Health in All Policies” into local agency
decision-making processes for policies, programs, and practices.
Key Measure(s): Number of decision-making processes established that consider health impacts, with a
focus on health equity and sustainability.
Baseline: 0 (Local data source: ACPH)
Objective 2.3.1:
Measure
Timeframe
Lead
By September 30, 2020, at least one agency will
utilize a locally developed Health in All Policies
(HiAP) checklist in a decision-making process.
Baseline: 0
Target: HiAP
checklist utilized in
one decision
making process
Start: 7/2018
End: 9/2020
Activate
Allen
County
staff
Action Steps:
1. Work group convened to:
a. Develop an HiAP checklist to assist decision-makers with considering the potential
impact of a policy, program, or process on health, health equity and/or sustainability.
b. Develop a process to track how often the checklist is utilized, whether the checklist has
impacted the decision made, and the outcome of the resulting policy, program, or
process.
2. Training session(s) held with partner agencies. Training topics to include how to use the
checklist and how to report on its impact on decisions and outcomes.
3. Commitment obtained from at least one partner agency to adopt the checklist for a decision-
making process.
4. Quarterly - track how often the checklist is used, and the impact it had on decision-making.
5. Annually – agencies report on the outcome of implemented processes.
Status:
Date
Update
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 40 OF 44
Priority # 3: Maternal and Infant Health is key to the overall health of a community. Allen
County has a variety of community resources available to help pregnant women and
infants live the healthiest lives possible. Despite these resources, too few pregnant women
access early, consistent prenatal care and parenting education. This has a multitude of
implications, including increased risk of infant mortality. We want to see healthy women
delivering full term, healthy weight infants that thrive to their first birthday. To this end, we will
leverage resources to increase collaboration and improve linkages between women and
infants and needed care and education.
Alignment with National Priorities: Healthy People 2020: Maternal and Infant Health (MICH-1,
MICH-10)
Alignment with SHIP: Maternal and Infant Health
Objective(s) that address policy change(s) needed to accomplish goal: 3.1.1
(implementation of case management system)
Goal 3.1: Improve coordination of pre-and postnatal services
Key Measure(s): Percent of Allen County women who have their first prenatal appointment
in the first 3 months
Baseline: 57% (Local Data Source: Allen County CHA)
Objective 3.1.1:
Measure
Timeframe
Lead
By September 30, 2020 the rate of women
entering prenatal care in the first trimester
will increase by 5% over the rate in 2018.
Baseline: 57%
Target: 62%
(Local Data
Source: Allen
County CHA)
Start: 5/2018
End: 9/2020
ACPH;
MITF
Action Steps:
Establish partnership with DJFS to participate and/or educate and hear our concerns
Implement case management system to include DJFS, transportation, managed care
organizations, and other enabling services
Create resource list/Database for managed care representation
Survey OB offices on appointment availability (time and card status)
Status:
Date
Update
Objective 3.1.2:
Measure
Timeframe
Lead
By December 31, 2018, in an effort to
increase the number of children that
receive the appropriate well-baby care in
their first year of live, a Home-Visiting
Committee will be formed as a sub-group
of the Maternal-Infant Task Force for
coordination of services available for
families with infant.
Baseline: no
active Home
Visiting (HV)
Committee
Target: active HV
Committee
(Local Data
Source: MITF)
Start: 7/2018
End: on-going
Maternal-
Infant
Task
Force
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 41 OF 44
Action Steps:
MITF will invite family-serving agencies to participate on the HV Committee, including DJFS,
HMG, Moms and Babies First, ACPH – Safe Sleep Program and HPWO
HV Committee will meet regularly to plan and implement strategies to better serve families
Status:
Date
Update
Objective 3.1.3:
Measure
Timeframe
Lead
By September 30, 2020, Allen County will
have an accurate resource map to make
linking women with services easier.
Baseline: not
currently
updated
Target: updated
annually
(Local Data
Source: AAC)
Start: 5/2018
End: 9/2020
AAC
Action Steps:
ID gaps in resource lists by 7/31/2018
Review and update 211 data
Promote collaborations, social media and managed care
Update map annually
Status:
Date
Update
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 42 OF 44
Priority # 4: Substandard housing and reduced access to public transportation are major
public health issues in Allen County. Poor housing conditions are associated with many
health problems, including asthma, lead poisoning, and injury; reduced access to public
transportation affects quality of life, including the ability to access jobs, education, and
medical care. We want to promote safe, accessible, appropriate, and affordable housing
to sustain healthy and vibrant residents and neighborhoods, and to assure that people
needing public transportation services have access to them. To this end, we will capitalize
on community organizations and partnerships to increase the community’s investment in
housing stock and public transportation.
Alignment with National Priorities: National Prevention Strategy (Healthy and Safe
Community Environments); HUD Strategic Plan (Strategic Objective 3C: Health and Housing
Stability)
Alignment with State Priorities: Ohio Housing Authority: Expand and preserve affordable
housing opportunities (1.1-1.4)
Objective(s) that address policy change(s) needed to accomplish goal: 4.1.1
Goal 4.1: Create a strategic plan to address substandard housing
Key Measure(s): # 0 strategic plans
Baseline: 1 strategic plan
Objective 4.1.1:
Measure
Timeframe
Lead
By September 30, 2020, create a
strategic plan to address affordability
and substandard housing in Allen
County.
Baseline: 0
completed
strategic plans
Target: 1
completed
strategic plan
Start: 5/2018
End: 9/2020
Housing
Consortium
and
regional
housing
commission
Action Steps:
work with the housing consortium to plan for the plan
convene stakeholders, including the Landlord Association, local governments, state housing
officials, development services agency to collaborate on the plan
Review existing plan(s)
Obtain consultant to facilitate the creation of the plan
Initiatives to consider:
o Adopt a neighborhood/adopt a house
o Zoning revisions
o Increase housing choices
o Tax abatement – City of Lima
o Work with local businesses (E.I Home Depot) to help with home improvement costs by
educating consumers
o Increase educational programs for home ownership
o Increase local capacity for affordable housing development.
Status:
Date
Update
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 43 OF 44
Goal 4.2: Develop a system to track use of social programs to reduce the need for frequent
assistance.
Key Measure(s): 0 systems (2018); Target: system implemented (2020)
Objective 4.2.1:
Measure
Timeframe
Lead
By September 30, 2020, develop a system
to better track use of social programs to
reduce the need for frequent assistance.
Baseline: 0
systems
Target: 1
implemented
system
Start: 5/2018
End: 9/2020
Housing
Consortium
Action Steps:
Identify partners and create a planning group of agencies
Universal release of information
Implement an MOU of agencies for tracking and sharing data
Universal ROI
Universal tracking for all parties (centralized registry)
Establish for standards or baseline referral to services to break dependency
Increase the effectiveness of rent assistance programs to maintain housing stability.
Status:
Date
Update
Goal 4.3: Increase access to public transportation
Key Measure(s): Ridership on the Allen County Regional Transit Authority (RTA) Fixed Route
system
Objective 4.3.1:
Measure
Timeframe
Lead
By September 30, 2020, create a
strategic plan to develop the necessary
funding needed to ensure public
transportation services are available and
accessible to those that need such
services.
Baseline: 0
completed
strategic plans
Target: 1
completed
strategic plan
Start: 5/2018
End: 9/2020
RTA & RPC
Status:
Date
Update
ALLEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN
PAGE 44 OF 44
Objective 4.3.2:
Measure
Timeframe
Lead
By September 30, 2020, the number of
passengers able to access and use RTAs
services will increase by 1%.
Baseline: 386,000
Target: 390,000
Local Data
Source: Lima
Allen County
Regional
Planning
Commission
(LACRPC), 2017
Start: 7/2018
End: 9/2020
RTA & RPC
Action Steps:
Develop strategies to support and expand public transportation services.
The RTA will work with local governments to improve pedestrian access to the fixed route
system.
The RTA will ensure all its Fixed Route vehicles are equipped with bike carriers.
The RTA will ensure all its vehicles will be ADA accessible.
The RTA will maintain the quality of the RTA rolling stock and ensure that less than 25% is
beyond its expected life expectancy.
Status:
