Community Service Plan 2013
Saratoga Hospital Community Service Plan 2013
Table of Contents
Introduction ..................................................................................................................... 2
New York State’s Prevention Agenda 2013 - 2017 ......................................................... 2
The Adirondack Rural Health Network ............................................................................ 3
Saratoga Hospital’s Mission, Vision, and Values ............................................................ 4
Saratoga Hospital Service Area ...................................................................................... 7
Public Participation & Health Needs Assessment Process ........................................... 11
Three Year Action Plan ................................................................................................. 11
Dissemination of the Report .......................................................................................... 20
Maintaining Engagement and Tracking Progress .......................................................... 20
Appendix 1: Methodology and Data Sources ............................................................... 22
Appendix 2: Community Health Needs Assessment Process – Data Consultants ....... 28
Appendix 3: Adirondack Rural Health Network – Membership Affiliation, Steering
Committee & Community Health Planning Committee .................................................. 29
Appendix 4: Community Health Planning Committee – Meeting Schedule and
Attendance List ............................................................................................................. 30
Appendix 5: ARHN Survey Response List ................................................................... 31
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Saratoga Hospital Community Service Plan 2013
Introduction
In keeping with the New York State Department of Health’s efforts to reform health and
healthcare in New York, local health departments and hospitals were requested to collaborate in
community health assessment and community health improvement planning in 2013. In
conjunction with the development of the state’s new health regional planning hospitals and local
health departments were asked to work together with community partners to assess the health
challenges in communities, identify local priorities and develop and implement plans to address
them. Hospitals and local health departments were charged with working together and with
other partners to identify and develop a plan for addressing at least two priorities in the new
Prevention Agenda.
New York State’s Prevention Agenda 2013 - 20171
The Prevention Agenda 2013-17 is New York State’s health improvement plan for 2013 through
2017, developed by the New York State Public Health and Health Planning Council (PHHPC) at
the request of the Department of Health, in partnership with more than 140 organizations across
the state. This plan involves a unique mix of organizations including local health departments,
health care providers, health plans, community based organizations, advocacy groups,
academia, employers as well as state agencies, schools, and businesses whose activities can
influence the health of individuals and communities and address health disparities. This
unprecedented collaboration informs a five-year plan designed to demonstrate how
communities across the state can work together to improve the health and quality of life for all
New Yorkers. Recent natural disasters in New York State that have had an impact on health
and wellbeing re-emphasize the need for such a roadmap.
In addition, the Prevention Agenda serves as a guide to local health departments as they work
with their community to develop mandated Community Health Assessments and to hospitals as
they develop mandated Community Service Plans and Community Health Needs Assessments
required by the Affordable Care Act over the coming year. The Prevention Agenda vision is New
York as the Healthiest State in the Nation. The plan features five priority areas:
Prevent Chronic disease
Promote healthy and safe environments
Promote healthy women, infants and children
1
Excerpt from New York State Department of Health web site
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Saratoga Hospital Community Service Plan 2013
Promote mental health and prevent substance abuse
Prevent HIV, sexually transmitted diseases, vaccine-preventable diseases and
healthcare-associated Infections
The Prevention Agenda establishes goals for each priority area and defines indicators to
measure progress toward achieving these goals, including reductions in health disparities
among racial, ethnic, and socioeconomic groups and persons with disabilities.
Working within the framework provided by New York State’s Prevention Agenda, Saratoga
Hospital and Saratoga County Public Health Nursing Service collaborated in the development of
a Community Health Needs Assessment. Additionally, Saratoga Hospital and Saratoga County
Public Health Nursing Service participated in regional health assessment and planning efforts
conducted by the Adirondack Rural Health Network
The Adirondack Rural Health Network
The Adirondack Rural Health Network is a program of the Adirondack Health Institute, Inc.
(AHI). AHI is a 501c3 not-for-profit organization that is licensed as an Article 28 Central Service
Facility. AHI is a joint venture of Adirondack Health (Adirondack Medical Center), Community
Providers, Inc. (Champlain Valley Physicians Hospital Medical Center) and Hudson Headwaters
Health Network. The mission of AHI is to promote, sponsor, foster and deliver programs,
activities and services which support the provision of comprehensive health care services to the
people residing in the Adirondack region.
Established in 1992 through a New York State Department of Health Rural Health Development
Grant, the Adirondack Rural Health Network (ARHN) is a regional multi-stakeholder coalition
that conducts community health planning activities by providing the forum for local public health
services, community health centers, hospitals, community mental health programs, emergency
medical services, and other community-based organizations to assess regional needs and the
effectiveness of the rural health care delivery system. ARHN plans, facilitates and coordinates
many different activities required for successful transformation of the health care system
including: conducting community health assessments, provider education and training, patient
and family engagement, identifying and implementing best practices to optimize health care
quality, and publishing regional and county-specific data and reports at www.arhn.org.
Since 2002, the ARHN has been recognized as the leading sponsor of formal health planning
for Essex, Fulton, Hamilton, Saratoga, Warren and Washington Counties. During 2011- 2012
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Saratoga Hospital Community Service Plan 2013
the ARHN expanded its regional community health planning efforts to include Clinton and
Franklin counties, and currently includes critical stakeholders from all eight counties in the
regional planning process. The ARHN provides a neutral, trusted mechanism through which
key stakeholders throughout the region can plan, facilitate and coordinate the activities
necessary to complete their required community health planning documents, and strategize on
a regional level to address common health care concerns.
The ARHN provides guidance and technical assistance to the Community Health Planning
Committee (CHPC), a regional forum for hospitals, county health departments and community
partners, who provide oversight of planning and assessment activities. The group is further
comprised of subcommittees developed to address areas specific to hospital, public health and
data-specific requirements. Regular meetings of each subcommittee and the full CHPC have
resulted in a systematic approach to community health planning and the development of
regional and local strategies to address health care priorities.
Saratoga Hospital’s Mission, Vision, and Values
Saratoga Hospital, located in the city of Saratoga Springs, is an acute-care hospital licensed for
171 beds, including 129 medical/surgical, 12 pediatric, 14 maternity and 16 psychiatry beds.
Saratoga Hospital also offers emergency medical and ambulatory surgery services, as well as a
full range of other outpatient services. The Hospital also operates a 36-bed skilled nursing
facility on-site. Additionally, the Hospital operates hospital-based extension clinics as well as
Saratoga Surgery Center, a free-standing ambulatory surgery center.
Saratoga Hospital encompasses an integrated delivery system that includes the acute-care
Hospital as well as the following outpatient facilities listed below. These facilities offer an array
of convenient, accessible diagnostic and treatment programs, including outpatient medical
imaging, occupational health, urgent care, and rehabilitation.
Galway Family Health Center
Malta Medical Arts
Regional Therapy Center at Malta
Regional Therapy Center of Saratoga Hospital
Saratoga Family Health Center
Saratoga Hospital Outpatient Physical Therapy Center
Saratoga Surgery Center
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Schuylerville Family Health Center
Wilton Medical Arts
Saratoga Outpatient Center on Care Lane
Saratoga Outpatient Center at One West
Saratoga Medical Oncology/Hematology
Scotia-Glenville Family Medicine
Mission
To serve the people of the Saratoga region by providing them access to excellence in
healthcare in a supportive and caring environment.
Vision
Saratoga Hospital will be the preeminent provider of the highest quality healthcare for Saratoga
region residents.
We will be a regional provider for certain service lines and, as an organization, will occupy a
niche between traditional community hospitals and tertiary medical centers.
We will be both a high-quality and high-service provider and will be known for our timely
acquisition of cutting-edge technology.
We will increase inpatient capacity to keep pace with our growing region. Eventually, all
inpatient rooms will be private to help provide the privacy and dignity that all patients deserve.
We will develop, over time, the Saratoga Medical Park at Malta into an integrated healthcare
campus to serve the growing needs of the Saratoga region.
We will continue to expand outpatient services, choosing the most convenient locations
possible. Our goal is for the majority of Saratoga residents to be within 10 minutes of a Saratoga
Hospital-affiliated facility.
We will recruit and retain highly skilled physicians. We will build relationships with physicians
and other providers to help ensure their long-term commitment to the Saratoga region.
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Saratoga Hospital Community Service Plan 2013
We will be recognized as a community leader. Employees will be encouraged to assume
leadership roles in community-based organizations. The Hospital will partner with other worthy
organizations whose goals are to improve the communities we serve.
We will be known as an innovative organization—one that is always looking for a better way to
provide a service or meet a community need.
We will generate sufficient operating margin to allow it to meet community needs.
Values
QUALITY:
Saratoga Hospital continuously evaluates and monitors our quality against performance
benchmarks from regional and national organizations.
Saratoga Hospital continuously cultivates a culture of quality whereby every employee is always
focused on the delivery of high-quality care and encouraged to make suggestions when
improvements are possible.
SERVICE:
Saratoga Hospital places the highest priority on providing outstanding customer service to our
patients, physicians, and visitors. Service excellence is part of the culture at Saratoga Hospital,
and the organization is committed to constantly enhancing the patient experience.
PEOPLE:
Saratoga Hospital understands that people are our most valued resource and, as such, every
employee, physician, and volunteer deserves respect.
Saratoga Hospital offers a caring and supportive environment for its employees and one that
cultivates leadership development.
GROWTH:
Saratoga Hospital remains ready to meet the needs of a growing Saratoga region, through
expansion of existing services or the development of new services and sites when justified.
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Saratoga Hospital Community Service Plan 2013
FINANCE:
Saratoga Hospital maintains financial strength in order to provide resources for a growing
Saratoga region.
Saratoga Hospital recognizes the important role that our community plays in philanthropic
support. We nurture the partnership between Saratoga Hospital and the community to meet the
growing healthcare needs of the Saratoga region.
Saratoga Hospital Service Area2
The service area for Saratoga Hospital is composed of all of the ZIP codes in Saratoga County
and the ZIP codes for Greenwich and Fort Edward which are in Washington County.
Historically, about 90% of Saratoga Hospital’s patients reside within this geography.
Saratoga Hospital’s Service Area
2
Saratoga Hospital’s service area is defined as all of the ZIP codes in Saratoga County plus two ZIP codes that lie in Washington
County along the Saratoga County border. The demographic characteristics of these two Washington County ZIP codes closely
resemble those of Saratoga County. Over 84% of Saratoga Hospital’s inpatients reside in Saratoga County. For the purposes of
determining the health needs of the community, Saratoga Hospital assumed that the needs identified for Saratoga County reflect the
health needs for the two Washington County ZIP codes as well.
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Saratoga Hospital Community Service Plan 2013
In 2012, almost 22,600 residents of Saratoga Hospital’s service area required hospitalization.
Of this total, over 7,600 (34%) were discharged from Saratoga Hospital. These 7,600
discharges represented 87% of the total discharges from Saratoga Hospital. The following table
shows the patient distribution by ZIP Code for Saratoga Hospital.
2008 Patient Origin for Saratoga Hospital3
ZIP Code
Of Patient
Residence
Saratoga
Hospital
Saratoga
Hospital
Saratoga
Hospital
Percent of
Cumulative
Market
Hospitals
From
Saratoga
Hospital
Total
Dependency
Share
Discharges
From All
NYS
Town Name
Discharges
12866
Saratoga Springs
3,648
2,486
28.2%
28.2%
68.1%
12020
Ballston Spa
3,126
1,795
20.4%
48.6%
57.4%
12831
Gansevoort
1,530
698
7.9%
56.6%
45.6%
12822
Corinth
772
322
3.7%
60.2%
41.7%
12118
Mechanicville
1,551
301
3.4%
63.6%
19.4%
12871
Schuylerville
488
272
3.1%
66.7%
55.7%
12833
Greenfield Center
386
264
3.0%
69.7%
68.4%
12065
Clifton Park
3,494
240
2.7%
72.5%
6.9%
12019
Ballston Lake
1,082
197
2.2%
74.7%
18.2%
12834
Greenwich
624
195
2.2%
76.9%
31.3%
12170
Stillwater
493
164
1.9%
78.8%
33.3%
12850
Middle Grove
277
161
1.8%
80.6%
58.1%
12859
Porter Corners
188
107
1.2%
81.8%
56.9%
12074
Galway
12828
Fort Edward
12835
12803
240
90
1.0%
82.8%
37.5%
1,362
76
0.9%
83.7%
5.6%
Hadley
322
68
0.8%
84.5%
21.1%
South Glens Falls
901
48
0.5%
85.0%
5.3%
12027
Burnt Hills
318
46
0.5%
85.5%
14.5%
12863
Rock City Falls
63
32
0.4%
85.9%
50.8%
12188
Waterford
1,181
29
0.3%
86.2%
2.5%
12148
Rexford
509
24
0.3%
86.5%
4.7%
12151
Round Lake
66
21
0.2%
86.7%
31.8%
22,621
7,636
Service Area Total
Other Areas
Saratoga Hospital Total
3
33.8%
1,167
13.3%
8,803
100.0%
100.0%
Source: HANYS Market Expert On-Line System based on SPARCS Data
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Saratoga Hospital Community Service Plan 2013
Based on estimates for 2013, 234,048 people live within Saratoga Hospital’s service area of
which 49% are male and 51% are female. Of the total female population, approximately 36%
are of child-bearing age. People over the age of 65 constitute 15% of the population and
children under the age of 15 make up 18% of the population. The average household income is
$81,850 which is 15% higher than the national average of $69,637. Ethnically, 92% of the
population is white, non-Hispanic and 35% of the population over the age of 25 has achieved an
educational level of Bachelor’s degree or higher. By 2018 the population of this area is
expected to grow by 1.8% making it one of the fastest growing regions in New York State. The
greatest growth will be for people 65 years and older. This segment of the population is
expected to grow by over 15% within the next five years. The following tables summarize the
socio-demographic profile for the residents of Saratoga Hospital’s service area.4
4
Copyright © 2013, The Nielsen Company, © 2013 Truven Health Analytics
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Saratoga Hospital Community Service Plan 2013
DEMOGRAPHIC CHARACTERISTICS
Service Area
231,313
234,048
238,294
1.8%
$81,850
20010 Total Population
2013 Total Population
2018 Total Population
% Change 2013 - 20138
Average Household Income
2013
115,078
118,970
42,699
Total Male Population
Total Female Population
Females, Child Bearing Age (15-44)
USA
308,745,538
314,861,807
325,322,277
3.3%
$69,637
2018
117,029
121,265
41,769
% Change
1.7%
1.9%
-2.2%
Age Distribution
2018
% of Total
40,506
17.0%
10,079
4.2%
21,498
9.0%
25,859
10.9%
63,040
26.5%
35,523
14.9%
41,789
17.5%
238,294
100.0%
USA %
20.1%
4.3%
9.8%
13.4%
28.6%
11.0%
12.7%
100.0%
HH Count
7,907
7,699
19,171
18,973
14,642
25,983
Income Distribution
% of Total
8.4%
8.2%
20.3%
20.1%
15.5%
27.5%
USA %
12.8%
10.7%
26.4%
19.5%
12.0%
18.6%
94,375
100.0%
100.0%
POPULATION DISTRIBUTION
Age Group
0-14
15-17
18-24
25-34
35-54
55-64
65+
Total
2013
41,939
9,972
19,798
25,452
68,941
32,590
35,356
234,048
% of Total
17.9%
4.3%
8.5%
10.9%
29.5%
13.9%
15.1%
100.0%
HOUSEHOLD INCOME DISTRIBUTION
2008 Household Income
<$15K
$15-25K
$25-50K
$50-75K
$75-100K
Over $100K
Total
EDUCATION LEVEL
2013 Adult Education Level
Less than High School
Some High School
High School Degree
Some College/Assoc. Degree
Bachelor's Degree or Greater
Total
Pop Age 25+
3,925
8,345
44,123
49,293
56,653
162,339
Education Level Distribution
% of Total
2.4%
5.1%
27.2%
30.4%
34.9%
100.0%
USA %
6.2%
8.4%
28.4%
28.9%
28.1%
100.0%
RACE/ETHNICITY
Race/Ethnicity
White Non-Hispanic
Black Non-Hispanic
Hispanic
Asian & Pacific Is. Non-Hispanic
All Others
Total
2013 Pop
216,161
3,214
6,058
4,401
4,214
234,048
Race/Ethnicity
Distribution
% of Total
92.4%
1.4%
2.6%
1.9%
1.8%
100.0%
USA %
62.3%
12.3%
17.3%
5.1%
2.9%
100.0%
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Saratoga Hospital Community Service Plan 2013
Public Participation & Health Needs Assessment Process5
The process of identifying the important healthcare needs of the residents of Saratoga County
involved both data analysis and consultation with key members of the community. The data
was collected from multiple sources including publically available health indicator data, data
collected from a survey conducted by the Adirondack Rural Health Network and a survey
conducted by Saratoga Hospital. The results have been published in the Saratoga County
Community Health Needs Assessment 2013 (CHNA).
The health indicator data is collected and published by New York State and contains over 300
different health indicators. Since 2003, The Adirondack Rural Health Network has been
compiling this data for the region and producing reports to inform healthcare planning on a
regional basis. Last year, ARHN undertook a project to systemize this data into a relational
database to provide improved access and analysis. The results of this analysis provide a
statistical assessment at the health status for the region and each county therein.
In December 2012 and January 2013, the Adirondack Regional Health Network (ARHN)
conducted a survey of selected stakeholders representing health care and service-providing
agencies within the eight-county region. The results of the survey are intended to provide an
overview of regional needs and priorities, to inform future planning and the development of a
regional health care agenda. The survey results were presented at both the county and
regional levels.
Saratoga Hospital also conducted a survey of the residents of Saratoga County to solicit
information regarding attitudes about healthcare and healthcare challenges people face in their
daily lives.
Using the results of the indicator analysis and the surveys, a community health assessment
team (CHAT) was convened to identify and prioritize the current healthcare challenges for the
residents of Saratoga County. The CHAT consisted of representatives from Saratoga Hospital
and the Saratoga County Public Health Nursing Service.
Three Year Action Plan
To address health needs identified, Saratoga Hospital will engage key community partners in
implementing evidence-based strategies across Saratoga County. Acknowledging that many
5
See Appendix 1 for details
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Saratoga Hospital Community Service Plan 2013
organizations and resources are in place to address the health needs of our community,
Saratoga Hospital has strategically reviewed both internal and external resources. This
implementation strategy will explain how Saratoga Hospital will address health needs identified
in the CHNA by continuing existing programs and services and by implementing new strategies.
The implementation strategy will also explain why the Hospital cannot address all the needs
identified in the CHNA and, when applicable, how Saratoga Hospital will support other
organizations in doing so.
How Saratoga Hospital will address health needs
The following Saratoga Hospital Community Health 2013 plan outlines the challenges,
strategies, activities, and outcomes for each of the five Prevention Agenda focus areas
identified as needs in the CHNA. The plan includes existing Hospital programs, services, and
resources that will continue to address priority health needs. Some activities will require
Saratoga Hospital to secure grant funding before they can be implemented.
Many of the strategies and activities address risk factors associated with multiple health
problems. For example, strategies to reduce obesity will affect heart disease and diabetes.
These strategies also might have a positive impact on mental health, as will strategies to reduce
substance abuse.
The strategies and activities outlined here will be implemented in coordination with Saratoga
County Public Health Nursing Service. Many of these strategies align closely with those of other
community-based organizations.
I.
New York State Prevention Agenda Topic: Prevent Chronic Disease
Focus Area: Increase access to high-quality chronic-disease preventive care and
management in both clinical and community settings
Community Health Need: The rate of diabetes deaths is increasing in Saratoga
County. Many residents are at risk for developing diabetes or have poorly controlled
diabetes. Disparities exist for diabetes management, care, and education.
Coordination of care for diabetes patients is not optimal.
Saratoga Hospital’s Strategy: Through the Saratoga Center for Endocrinology and
Diabetes, Saratoga Hospital continues to meet the needs of diabetic patients in the
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Saratoga Hospital Community Service Plan 2013
community. Saratoga Hospital will increase screening rates for diabetes by providing a
diabetes risk-assessment “quiz” to communities at health fairs and refer at-risk patients
to primary care providers for follow-up. Saratoga Hospital will also provide evidencebased programs addressing strategies for diabetes prevention to high-risk patients by
researching, designing, and implementing new programs to meet the standards set by
the CDC. Nutrition & Diabetes Education Services staff will be trained to deliver CDC
Prevention Programs in community settings. Saratoga Hospital will offer high-quality
diabetes education and support for all diabetes patients by using evidence-based
resources for education programs and support groups. Staff will be qualified and
credentialed in their fields. To reduce disparities, Saratoga Hospital will improve
access to diabetes management programs for residents of outlying areas and will
include provision of nutrition and diabetes education services in plans for new primary
care sites. To improve access to diabetes management education for low-income
patients, Saratoga Hospital will offer nutrition and diabetes education services at the
new Saratoga Community Health Center and the Hospital’s three family health
centers. With our community partners, Saratoga Hospital will provide vouchers for the
purchase of fresh fruits, vegetables, diabetes medication, and testing supplies for
those people needing assistance. Saratoga Hospital will reduce language and cultural
barriers to diabetes care and education by providing diabetes educational services in
Spanish as needed and continuing to offer interpreter services for many languages,
including sign language for those with hearing impairments. Saratoga Hospital will
improve diabetes patient care by disseminating advanced automated medical record
systems among providers, enhancing the collection of program data and streamlining
communication. Inpatient Clinical Nutrition will refer appropriate patients to Outpatient
Nutrition for counseling.
Community Partners: Primary care providers, health fair sponsors, CDC, NYSDOH,
Center for Excellence in Aging & Community Wellness (SUNY Albany), Cornell
Cooperative Extension, Diabetes Program Advisory Board, Saratoga County Public
Health Nursing Service, Lions Club, Saratoga Farmers’ Market, Price Chopper, and
Novo Nordisk (Spanish-speaking diabetes educator and dietitian, and electronic
medical records system developers).
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Saratoga Hospital Community Service Plan 2013
Outcomes: Reduce the rate of short-term diabetes hospitalizations and increase the
number of patients with diabetes whose blood glucose is well-controlled .
Community Health Need: Heart disease and cancer are the leading causes of death
in Saratoga County. Heart disease and cancer patients in Saratoga County need more
access to high-quality care and support services. The number of malignant melanoma
cases is increasing in Saratoga County. Almost 30% of adults in the community are
obese.
Saratoga Hospital’s Strategy: Saratoga Hospital will enhance the management of
congestive heart failure (CHF) patients, reducing readmissions by moving CHF
patients to the high nutrition-risk category of care. Community programs will be offered
twice a year to reinforce CHF self-management concepts and address diet more
thoroughly. Saratoga Hospital will continue the NYSDOH grant-funded, Cancer
Screening Program which engages community partners in providing a robust program
of outreach to build demand for cancer screening utilizing the existing partnerships of
31 providers to offer screening services and continue to build new partnerships and
facilities that will ensure coverage for all residents of Saratoga County. By working
with community partners to establish and maintain a breast cancer support group,
Saratoga Hospital will offer support for breast cancer patients in Saratoga Springs.
Saratoga Hospital will help defray the cost of treatment for financially challenged
cancer patients by conducting annual fundraising events, such as the Run for the
ROC, to support oncology patients. A grant from the Capital Region Special Surgery
Race for Hope will help support cancer patients in need. Saratoga Hospital will help
cancer patients find support services by providing the services of a licensed social
worker who is training as an American Cancer Society Patient Navigator. Saratoga
Hospital will also offer a comprehensive skin cancer detection and screening program
to increase screening rates and educate patients on skin cancer prevention and the
benefits of early detection. Saratoga Hospital will continue to develop a comprehensive
obesity prevention and management program. The Hospital will reinstate bariatric
surgery services, will achieve accreditation as a Bariatric Center of Excellence, and will
design evidence-based services and outreach programs to address weight
management.
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Saratoga Hospital Community Service Plan 2013
Community Partners: Saratoga Cardiology Associates, Saratoga County Office for
Aging, primary care physicians, patients and their families, Breast Cancer and
Women’s Health Education & Support, Get Your Rear in Gear Colon Cancer Coalition
of Saratoga County, Leukemia and Lymphoma Society, Rainbow Access Initiative for
LGBT health, Southern Adirondack Tobacco-Free Coalition and Cancer Survivors
Ambassadors American Cancer Society, Capital Region Special Surgery, The
Community Foundation for the Greater Capital Region, American Academy of
Dermatology, Saratoga County Public Health Nursing Service, community-based
psychologists, and GRENO Industries, Adirondack Trust, Hudson River Community
Credit Union, Longfellows/Olde Bryan Inn, Empire State College, Fort Miller, and other
community sponsors.
Outcomes: Improve quality and transition from inpatient care to home/other care
settings for CHF patients. Decrease the death rate for cancer; reduce the rate of
malignant melanoma; reduce the rate of obesity among adults.
Community Health Need: The community does not have adequate access to the full
continuum of care. Healthcare providers need to form more strategic partnerships to
address gaps in care.
Saratoga Hospital’s Strategy: Saratoga Hospital will continue to explore and
establish partnerships with other providers, including a collaborative relationship
between the Hospital’s bariatric program and the program at a tertiary-care facility.
Saratoga Hospital will engage in physician-centered dialogues regarding future
coverage of critical care. Saratoga Hospital will work to standardize the process for the
transfer of cardiac patients to higher levels of care and establish a joint task force to
guide collaborative efforts. Saratoga Hospital will develop a shared Tumor Board with
another local hospital and meet quarterly. Saratoga Hospital will also develop
collaborative research activities with another local hospital. Saratoga Hospital will
explore the feasibility of developing a partnership with home care and communitybased providers to give Saratoga Hospital patients appropriate and timely access.
Community Partners: Tertiary care providers, local hospitals, home care agencies,
and community-based providers.
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Outcomes: Continue the development of tertiary relationships on a service-specific
basis; develop a new collaborative relationship with a hospital partner; develop a
community-linked case management system.
II.
New York State Prevention Agenda Topic: Prevent HIV/STDs, Vaccine-Preventable
Diseases, and Healthcare-Associated Infections
Focus Area: Vaccine-Preventable Diseases
Community Health Need: Pertussis cases are increasing; adults and children are not
receiving adequate vaccinations against pertussis.
Saratoga Hospital’s Strategy: Saratoga Hospital will continue its program to increase
pertussis vaccination rates by vaccinating all parents and other caregivers of infants
born at Saratoga Hospital.
Community Partners: Primary care providers, OB/GYN physicians, Saratoga County
Public Health Nursing Service.
Outcomes: All infants born in Saratoga County vaccinated against pertussis; all
parents and caregivers of infants born at Saratoga Hospital vaccinated against
pertussis.
Focus Area: Healthcare-Associated Infections
Community Health Need: The number of patients contracting infection due to contact
with the healthcare system is increasing. Overuse of antibiotics is resulting in the
emergence of antibiotic-resistant strains of disease. Infection control measures on the
part of healthcare providers must be constantly taught, improved, and enforced.
Infection can be spread by the use of medical devices.
Saratoga Hospital’s Strategy: Saratoga Hospital will continue to encourage the
reduction of antibiotic use at Saratoga Hospital and in the community by developing
programs, policies, and procedures aimed at reducing the use of antibiotics. Saratoga
Hospital will continue to include infection control education as part of mandatory staff
education. Hand hygiene and isolation practices will be monitored. Saratoga Hospital
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Saratoga Hospital Community Service Plan 2013
will enforce the policy of using medical devices only when necessary by performing
daily nursing assessments for the necessity of devices. Saratoga Hospital will ensure
proper maintenance of medical devices by following maintenance schedules and
routines. Saratoga Hospital will provide ongoing education programs for all clinical staff
on the proper methods of insertion and maintenance of devices.
Community Partners: Granting agencies, community-based providers, equipment
providers.
Outcomes: Decrease antibiotic use and C. diff rates; decrease healthcare-associated
C. diff; reduce infections transmitted via medical devices.
III.
New York State Prevention Agenda Topic: Promote Healthy Infants and Children
Focus Area: Child Health
Community Health Need: Children in Saratoga County, especially low-income
children, do not receive adequate preventive healthcare. Saratoga Hospital’s service
area covers a large geographic area, and some rural areas or areas located outside
population centers have insufficient access to preventive care. Almost 40% of all 3rd
graders in Saratoga County have untreated tooth decay. This is especially true for lowincome children.
Saratoga Hospital’s Strategy: Saratoga Hospital will continue to improve access to
ambulatory care services throughout the community by opening new extension clinics
or acquiring practices that offer ambulatory care. Saratoga Hospital will improve
access to high-quality dental care for low-income members of the community by
offering dental services at Saratoga Community Health Center. Saratoga Hospital will
continue to offer facilitated enrollment services for Child Health Plus and Family Health
Plus to assist low-income families obtain health insurance.
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Community Partners: Town officials, primary care providers, dentists, school
systems, Saratoga County Public Health Nursing Service, New York State Department
of Health.
Outcomes: Increase the rates of well-child visits; reduce the rate of untreated tooth
decay in 3rd graders to 21.6% (Prevention Agenda Goal).
IV.
New York State Prevention Agenda Topic: Promote Mental Health and Prevent
Substance Abuse
Focus Area: Mental Health
Community Health Need: Alcohol abuse poses a threat to the health and well-being
of residents of Saratoga County. Too many adults engage in binge drinking. Rates of
alcohol-related accidents are higher than expected, and too many residents die of
alcohol-related injuries. Many residents suffer from serious mental illness. Rates for
treatment of children and teens in the emergency department are above the stateside
benchmarks. Rates of suicide and self-inflected injuries in Saratoga County are also
above statewide benchmarks.
Saratoga Hospital’s Strategy: Saratoga Hospital will increase access to quality
outpatient mental health services by providing comprehensive mental health
counseling at Saratoga Community Health Center.
Community Partners: Primary care providers, mental health providers, Saratoga
County Public Health Nursing Service, Saratoga County law enforcement agencies.
Outcomes: Reduce rates of alcohol abuse in Saratoga County; decrease the rate of
emergency department visits for mental health patients; reduce the rates of suicide
and self-inflicted injuries.
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Needs not addressed in the Saratoga Hospital Plan
Saratoga Hospital intends to address needs within the five Prevention Agenda focus areas
identified as significant needs in Saratoga County; however, some of the challenges identified
for those focus areas will not be addressed directly by Hospital-led initiatives.
The Saratoga County CHNA notes that only 62.3% of children 19 to 35 months of age receive
the recommended vaccinations. This is 28% below the Prevention Agenda Goal of 80%.
Additionally, 33.4% of females age 13 to 17 received the HPV vaccine in 2011. This is almost
50% below the Prevention Agenda goal of 50%. Vaccinations are handled in the context of wellbaby care by pediatricians in private practice or by public health. Any community activity around
this should come from public health (or community health centers). In general this is not a
Hospital system-centered activity. The key to improving vaccination compliance is improving
access to primary care. Therefore Saratoga Hospital focuses efforts on improving access to
primary care by subsidizing the local pediatrician group for coverage of our labor and delivery
and aggressively recruiting family practice physicians, primary care pediatricians, and
obstetricians. Access to continuity of care ensures that deadlines for vaccination are not missed
and the necessary education of the importance of and relative safety of vaccination is provided.
The CHNA also notes that too few children in Saratoga County are screened for exposure to
lead. Saratoga County Public Health Nursing Service has a very robust lead screening program
that is grant-funded. Saratoga Hospital supports this public health program and will assist the
public health efforts led by the County.
Alcohol abuse also poses a threat to the health and well-being of residents of Saratoga County.
While Saratoga Hospital’s mental health programs address the needs of patients impacted by
alcohol abuse, Saratoga Hospital does not plan any Hospital-led initiatives for alcohol abuse.
Residents of Saratoga County have access to programs sponsored by other agencies whose
missions include addressing substance abuse. These include the Saratoga County Alcohol
and Substance Abuse Services, private psychologists and psychiatrists, The Alcohol and
Substance Abuse Prevention Council, and others. Saratoga Hospital supports the work of these
agencies.
Other health issues include the promotion of a healthy and safe environment, as well as
preventing Lyme disease, chlamydia, and rabies. These issues will not be directly addressed by
Saratoga Hospital; however Saratoga Hospital is committed to improving the health and
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wellness of our communities, and fully supports local governments and wellness coalitions in
their efforts to impact these issues.
Dissemination of the Report
There are three ways you can obtain information about Saratoga Hospital’s Community Service
Plan:
Saratoga Hospital’s website home page, www.saratogahospital.org includes access to
Saratoga Hospital’s Community Service Plan.
The January 2014 edition of Saratoga Hospital’s community newsletter, Access, will
contain a full page dedicated to health care in our community which will include
information about this Community Service Plan. This newsletter is mailed to almost
50,000 households in the greater Saratoga Region. Additionally, copies are given out to
newcomers to the community, new hospital employees, physician offices and other
community locations.
Saratoga Hospital’s website home page, www.saratogahospital.org now includes a link
to The ARHN website homepage www.ARHN.org where you can read and download
more information about the Community Health Planning Committee and regional
programs it sponsors.
Maintaining Engagement and Tracking Progress
Saratoga Hospital is committed to achieving the goals set forth in this Community Service Plan
and intends to remain an active member of ARHN‘s Community Health Planning Committee.
This group meets at least quarterly each year and has become an important forum for sharing
views, ideas and feed-back for stakeholders throughout the region. Saratoga Hospital and
Saratoga County Public Health Nursing Service are also exploring ways to convene a
Community Health Stakeholder group in Saratoga County to provide continuous community
input and guidance at a more local level.
Saratoga Hospital’s new Community Health Center is supported by grant funds provided by the
City of Saratoga Springs. This grant requires the reporting of outcomes data that will be used to
track progress in meeting the needs of the uninsured and underinsured using this new facility.
Another grant-funded program for cancer screening also requires collection of data which will
also be used to assess progress in that area. Saratoga Hospital carefully tracks heart patients
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in the interest of reducing avoidable readmissions and that data will be the source for assessing
those results. Saratoga Hospital has a very robust Infection Control program that carefully
tracks hospital-acquired infection rates and all of our primary care physicians track patient visits.
Since the ultimate goal of these plans is to improve the health of the residents of Saratoga
County, in 2016 Saratoga Hospital will conduct another Community Health Needs Assessment.
The results of that assessment will be used to compare benchmarks and results from this most
recent assessment. It is hoped that Saratoga Hospital’s efforts and those of other community
stakeholders will have had a positive impact on the overall health of the people we serve.
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Appendix 1: Methodology and Data Sources
The Center for Health Workforce Studies at the University at Albany School of Public Health
(the Center) under contract with the Adirondack Rural Health Network, a program of the
Adirondack Health Institute, identified and collected data from a variety of sources on the nine
counties in the Adirondack region. Those counties include: Clinton, Essex, Franklin, Fulton,
Hamilton, Montgomery, Saratoga, Warren, and Washington.
The initial step in the process was identifying which data elements to collect. Center staff
received an initial list of potential data elements from the ARHN Data Subcommittee and then
supplemented that information with data from other sources. Since most of the health behavior,
status, and outcome data were only available at the county level, the Center in conjunction with
the ARHN Data Subcommittee concluded that all data used for the project would be displayed
by county and aggregated to the ARHN region.6 Additionally, other data were collected to
further enhance already identified data. For example, one Prevention Agenda indicator was
assault-related hospitalizations. That indicator was augmented by other crime statistics from the
New York State Division of Criminal Justice.
The overall goal of collecting and providing these data to ARHN members was to provide a
comprehensive picture of the individual counties within the Adirondack region, including
providing an overview of population health as well as an environmental scan. In total, counties
and hospitals were provided with nearly 450 distinct data elements across the following four
reports:
Demographic Data;
Educational Profile;
Health Behaviors, Health Outcomes, and Health Status; and
Health Delivery System Profile.
Data was provided to all counties and hospitals as PDFs as well as in Excel files. All sources for
the data were listed and made available to the counties and hospitals. The sources for the data
elements in the Health Behaviors, Health Outcomes, and Health Status report were listed in a
separate file and included their respective internet URL links. The data in each of the four
6
Aggregated data for the ARHN region included Clinton, Essex, Franklin, Fulton, Hamilton, Saratoga, Warren, and
Washington counties but did not include Montgomery County.
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reports were aggregated, when feasible, into the ARHN region, Upstate New York (all counties
but the five in New York City), and statewide.
Demographic Data
Demographic data was primarily taken from the 2007 - 2011 American Community Survey,
supplemented with data from the Bureau of Labor Statistics, Local Area Unemployment
Statistics for 2011; the New York State Department of Health (NYSDOH) Medicaid Data for
2011; and employment sector data from the 2009 – 2011 American Community Survey. Among
the information incorporated into the demographic report included:
Race/Ethnicity;
Age by groups (0 – 4, 5 – 17, 18 – 64, and 65 plus);
Income and poverty, including the percent who received Medicaid;
Housing stock;
Availability of vehicles;
Education status for those 25 and older;
Employment status; and
Employment sector.
Educational Profile
The education profile was taken mainly from the New York State Education Department
(NYSED), School Report Card for 2010 – 2011, supplemented with data from the National
Center for Education Statistics, Integrated Post-Secondary Data System on Post-Secondary
graduations for 2010 – 2011 and registered nurse graduations from the Center. Among the data
displayed in the educational profile included:
Number of school districts;
Total school district enrollment;
Number of students on free and reduced lunch;
Dropout rate;
Total number of teachers;
Number of and graduations from licensed practical nurse programs; and
Number of and graduations from registered nurse programs.
Health Behaviors, Health Outcomes, and Health Status
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The vast majority of health behaviors, outcomes, and status data come from NYSDOH. Data
sources included the:
Community Health Indicators Report (http://www.health.ny.gov/statistics/chac/indicators/);
County Health Indicators by Race/Ethnicity
(http://www.health.ny.gov/statistics/community/minority/county/);
County Dashboards of Indicators for Tracking Public Health Priority Areas, 2013 - 2013
(http://www.health.ny.gov/prevention/prevention_agenda/20132017/indicators/2013/indicator_map.htm); and
2008 – 2009 Behavioral Risk Factor Surveillance System (BRFSS)
(http://www.health.ny.gov/statistics/brfss/).
Information on NYSDOH’s methodologies used to collect and display data from the above
sources can be found on their respective data pages.
NYSDOH data used in this report are updated annually, with the exception of BRFSS data, and
most of the data were for the years 2008 – 2010. Cancer data were for the years 2007 – 2009,
and BRFSS data were from the 2008 and 2009 survey. Data displayed in this report included an
average annual rate or percentage and, when available, counts for the individual three years.
The years the data covered were listed both in the report as well as in the sources document.
NYSDOH data also was supplemented from other sources such as the County Health rankings,
the New York State Division of Criminal Justice Services, the New York State Institute for Traffic
Safety Management and Research, and the New York State Office of Mental Health Patient
Characteristics Survey, among others. To the extent possible, Center staff used similar years for
the additional data that were collected. Nearly 300 data elements are displayed in this report
broken out by the Prevention Agenda focus areas.
Data were downloaded from their various sources and stored in separate Excel files, based on
their respective focus area. The Health Behaviors, Health Outcomes, and Health Status report
was created in Excel and linked to the raw data, and population rates were recalculated based
on the number of cases as well as the population listed in the data source.
Data in the report were organized by the six priority areas as outlined by NYSDOH at
http://www.health.ny.gov/prevention/prevention_agenda/2013-2017/. The data were also
separated into two subsections, those that were identified as Prevention Agenda indicators and
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those that were “other indicators.” The data elements were organized by 17 focus areas as
outlined in the table below.
Number of Indicators
Prevention
Agenda
Other
Health Disparities
8
11
Injuries, Violence, and Occupational Health
7
21
Outdoor Air Quality
2
0
Built Environment
4
0
Water Quality
1
0
Obesity in Children and Adults
2
35
Reduce Illness, Disability, and Death Related to
Tobacco Use and Secondhand Smoke Exposure
1
13
Increase Access to High Quality Chronic Disease
Preventive Care and Management
6
28
Maternal and Infant Health
9
19
Preconception and Reproductive Health
9
20
Child Health
6
29
HIV
2
2
STDs
5
10
Vaccine Preventable Diseases
3
6
Healthcare Associated Infections
2
0
Substance Abuse and other Mental, Emotional, and
Behavioral Disorders
3
20
Other Illnesses
0
9
Focus Area
Those data elements that were Prevention Agenda indicators were compared against their
respective Prevention Agenda benchmarks. “Other indicators” were compared against either
Upstate New York benchmarks, when available or then New York State benchmarks when
Upstate New York benchmarks were not available. The report also included a status field that
indicated whether indicators were met, were better, or were worse than their corresponding
benchmarks. When indicators were worse than their corresponding benchmarks, their distances
from their respective benchmarks were calculated. On the report, distances from benchmarks
were indicated using quartiles rankings, i.e., if distances from their corresponding benchmarks
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were less than 25%, indicators were in quartile 1, if distances were between 25% and 49.9%
from their respective benchmarks, indicators were in quartile 2, etc.
The Health Behaviors, Health Outcomes, and Health Status Report also indicated the
percentage of total indicators that were worse than their respective benchmarks by focus area.
For example, if 21 of the 35 child health focus area indicators were worse than their respective
benchmarks, the quartile summary score would be 60% (21/35). Additionally, the report
identified a severity score, i.e., the percentage of those indicators that were either in quartile 3
or 4 compared to all indicators which were worse than their corresponding benchmarks. Using
the above example, if 9 of the 21 child health focus indicators that were worse than their
respective benchmarks were in quartiles 3 or 4, the severity score would be 43% (/9/21).
Quartile summary scores and severity scores were calculated for each focus area as well as for
Prevention Agenda indicators and for “other indicators” within each focus area. Both quartile
summary scores and severity scores were used to understand if the specific focus areas were
challenges to the counties and hospitals. In certain cases, focus areas would have low severity
scores but high quartile summary scores indicating that while not especially severe, the focus
area offered significant challenges to the community.
Health Delivery System Profile
The data on the health system came from NYSDOH list of facilities, NYSED licensure file for
2011, the UDS Mapper for 2011 Community Health Center Patients, the Health Resources and
Services Administration Data Warehouse for health professional shortage (HPSAs) areas for
2012, and Center data on 2011 physicians. Among the data incorporated into this report
included:
Hospital, nursing home, and adult care facility beds;
Number of community health center patients;
Number of and population within primary care, mental health, or dental care HPSAs;
Total physicians and physicians by certain specialties and sub-specialties; and
Count of individuals licensed.7
Community Provider Survey
7
County is determined by the main address listed on the licensure file. The address listed may be a private residence
or may represent those with active licenses but not actively practicing patient care. Therefore, the information
provided may not truly reflect who is practicing in a profession in the county.
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A survey of providers was conducted by the Center for Human Services Research (CHSR) at
the University at Albany School of Social Welfare between December 5, 2012 and January 21,
2013. The purpose of the study was to provide feedback from community service providers in
order to: 1) guide strategic planning, 2) highlight topics for increased public awareness, 3)
identify areas for training, and 4) inform the statewide prevention agenda, including rating the
relative importance of five of the New York State Prevention Agenda Priority areas8. Results
were presented for each of the eight ARHN counties9 and aggregated for the region.
The 81 question survey was developed through a collaborative effort by a seven-member ARHN
Subcommittee during the fall of 2012. The seven volunteer members are representatives of
county public health departments and hospitals in the region that are involved in the ARHN.
Subcommittee members were responsible for identifying the broad research questions to be
addressed by the survey, as well as for drafting the individual survey questions.
Subcommittee members were also charged with identifying potential respondents to participate
in the survey. Because each county in the region is unique in its health care and serviceprovision structure, ARHN members from each of the counties were asked to generate a list of
relevant stakeholders from their own communities who would represent the full range of
programs and service providers. As such, the survey population does not necessarily represent
a random sampling of health care and service providers, but an attempt at a complete list of the
agencies deemed by the ARHN to be the most important and representative within the region.
The survey was administered electronically using the web-based Survey Monkey program and
distributed to an email contact list of 624 individuals identified in the stakeholder list created by
the Subcommittee. Two weeks before the survey was launched on December 5, 2012, an
announcement was sent to all participants to encourage participation. After the initial survey
email, two reminder notices were also sent to those who had not yet completed the survey.
Additionally, participation was also incentivized through an opt-in gift card drawing, with 20
entrants randomly selected to receive a $25 Stewart’s gift card at the conclusion of the survey.
Ultimately, 285 surveys were completed during the six-week survey period, a response rate of
45.7%. Response rates varied by Individual County, respondents may have been counted in
more than one county depending on the extent of their service area.
8
At the time of the survey, the New York State had identified five priority areas (1) Promote a Health and Safe Environment; (2)
Preventing Chronic Disease; (3) Promoting Healthy Women, Infants, and Children; (4)Prevent HIV/STDs, Vaccine-Preventable
Disease, and Health Care-Associated Infections; and (5) Promote Mental Health and Prevent Substance Abuse. The sixth priority
area, Improve Health Status and Reduce Health Disparities, had not yet been identified and was not included as part of the provider
survey.
9
Montgomery County was not included in the survey.
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Appendix 2: Community Health Needs Assessment Process – Data
Consultants
Center for Health Workforce Studies, University at Albany School of Public Health
Tracey Continelli, PhD, Graduate Research Assistant
Robert Martiniano, MPA, MPH, Research Associate
Center for Human Services Research, University at Albany
LuAnn McCormick, Ph.D., Senior Research Scientist
Bradley Watts, Ph.D., Senior Research Scientist
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Appendix 3: Adirondack Rural Health Network – Membership
Affiliation, Steering Committee & Community Health Planning
Committee
Name and Organization
Christina Akey, Health Educator, Fulton County Public Health
Pat Auer, RN, Director, Warren County Health Services
Linda Beers, Director, Essex County Public Health
Sue Cridland, RN, BSN, Director of Community Education, HealthLink Littauer
Jessica Darney-Buehler, CGS Public Health, Essex County Public Health
Josy Delaney, MS, CHES, Community Wellness Specialist, Alice Hyde Medical
Center
Dan Durkee, Health Educator Warren County Health Services
Denise Frederick, Director, Fulton County Public Health
Peter Groff, Executive Director, Warren-Washington Association for Mental
Health
Katie Jock, Champlain Valley Physicians Hospital Medical Center
Chip Holmes, Chief Executive Officer, Inter-Lakes Health
Jane Hooper, Director of Community Relations, Elizabethtown Community
Hospital
Travis Howe, Director, Mountain Lakes Regional EMS Council
Patty Hunt, Director, Washington County Health Services
Lottie Jameson, Executive Director, Hudson Mohawk AHEC
Dot Jones, Director of Planning, Saratoga Hospital
Robert Kleppang, Director, Hamilton County Community Services
Karen Levison, Director, Saratoga County Public Health
Ginger Carriero, VP of Medical Practices, Alice Hyde Medical Center
Cheryl McGratten, VP of Development, Nathan Littauer Hospital
Tracy Mills, Director, Research & Planning, Glens Falls Hospital
Megan Murphy, Grants & Strategic Projects Director, Adirondack Health
Sue Patterson, Public Health Educator, Franklin County Public Health
Jeri Reid, Director, Clinton County Health Department
John Rugge, MD, Chief Executive Officer, Hudson Headwaters Health Network
Beth Ryan, Director, Hamilton County Public Health
Paul Scimeca, Vice President, Physician Practices and Community Health,
Glens Falls Hospital
Trip Shannon, Chief Development Officer, Hudson Headwaters Health
Network
Steering
Committee
X
X
X
X
X
X
X
X
X
X
X
X
X
CHPC
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
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Appendix 4: Community Health Planning Committee – Meeting
Schedule and Attendance List
Participating Organization
Adirondack Health
Alice Hyde Medical Center
CVPH Medical Center
Clinton County Health
Department
Elizabethtown Community
Hospital
Essex County Public Health
Franklin County Public Health
Fulton County Public Health
Glens Falls Hospital
Hamilton County Public Health
Hudson Headwaters Health
Network
Hudson Mohawk AHEC
Inter-Lakes Health
Nathan Littauer Hospital
Saratoga County Public Health
Saratoga Hospital
Tri-County United Way
Warren County Health Services
Washington County Health
Services
Meeting Date
2/28/12
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Appendix 5: ARHN Survey Response List
Name
William Holmes
Ginny Cuttaia
Sylvia King Biondo
Gregory Freeman
Stellla M Zanella
Jessica Lowry
Kelly Hartz
Mary Lee Ryan
Bryan Amell
Carol M. Greco
Steven Serge
Duane Miller
Victor Giulianelli
Daniel Towne
Richard Flanger
Michael L. Countryman
Julie Paquin
Irene Snyder
Patrice McMahon
Patricia McGillicuddy
Kelly Landrio
Margaret Luck
Laura O'Mara
Lynn Hart
Julie Demaree
Michelle Schumacher
Deborah J. Ruggeri
John M. Kanoza, PE,
CPG
Tammy J Smith
Susan Schrader
Rick LeVitre
Cheryl
Barry Brogan
Maryann Barto
Sharon Reynolds
Jerie Reid
Deborah Byrd-Caudle
Julie Marshall
Hans Lehr
Karen Levison
Lesley B. Lyon
Christina Akey
Mary Rickard
Organization's Name
Inter-Lakes Health
Franklin County Public Health
Planned Parenthood of the North Country New York
CVPH Medical Center
Fulmont Community Action Agency, Inc.
CVPH Medical Center
Nathan Littauer hospital
Clinton County Health Dept. WIC Program
St. Joseph's Addiction Treatment and Recovery Centers
St. Mary's Healthcare
Fulton County YMCA
St. Mary's Healthcare- Behavioral Health
St. Mary's Healthcare
Gloversville Housing Authority
Fulton County YMCA Residency
The Family Counseling Center
Franklin County Public Health Services
Harrietstown Housing Authority
Nathan Littauer
Franklin County Public Health
Fulton County YMCA
Nathan Littauer Hospital Lifeline Program
Saratoga Hospital Nursing Home
Saranac Lake Middle School
Saratoga Hospital
YMCA
Greater Johnstown School District
Clinton County Health Department
Inter-Lakes Health
Association of Senior Citizens
Cornell Cooperative Extension
Nathan Littauer
North Country Behavioral Healthcare Network
Clinton County Department of Health, Healthy Neighborhoods Program
PRIDE of Ticonderoga, Inc.
Clinton County
Parent to Parent of NYS
Alice Hyde Medical Center
Saratoga County Community Services Board / Mental Health Center
Saratoga County Public Health Nursing Service
Franklin County Dept. of Social Services
Fulton County Public Health
Saratoga County Office for the Aging
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Name
Chattie Van Wert
Maryalice Smith
Anne Mason
Leisa Dwyer
Penny Ruhm
Dale Woods
Jackie Skiff
Krista Berger
Margaret Cantwell
Julie Tromblee, RN
Mildred Ferriter
Melinda Drake
Michael Vanyo
William Viscardo
Kate Fowler
Joe Keegan
Megan Johnson
John Aufdengarten
Sue Malinowski
Misty Trim
Sarah Louer
Dan
Amanda West
Christie Sabo
Debra Pauquette
Cynthia Ford-Johnston
Jennifer McDonald
Vicky Wheaton-Saraceni
Chrys Nestle
William Larrow
Lisa Griffin
Valerie Capone
Denis Wilson
Donna Beal
Doug DiVello
Judy Zyniecki
Cathlyn Lamitie
Joan Draus
Kelli Lyndaker
Jane Hooper
Sandra Geier
Janet L. Duprey
a
Miki L. Hopper
Tammy Kemp
Scott Osborne
Organization's Name
Ticonderoga Revitalization Alliance
Saranac Lake Central School
Whitehall Family Medicine
Malone Central Schools
Adirondack Rural Health Network
Fulton County Public Health
Joint Council for Economic Opportunity of Clinton and Franklin Counties, Inc.
WIC
Franklin County Public Health Services
Elizabethtown Community Hospital
Community Health Center
St. Joseph's Addiction Treatment & Recovery Centers
Gloversville Enlarged School District
Adirondack Health
SMSA
North Country Community College
Warren-Washington Office of Community Services
Alice Hyde Medical Center
CAPTAIN Youth and Family Services
Brushton-Moira Central School
Mountain Lake Services
Warren County Health Services
council for prevention of alcohol and substance abuse
Warren-Hamilton Counties Office for the Aging
Granville Family Health/ Glens Falls Hospital
Keene Central School
Skidmore College
Adirondack Health Institute -- Adirondack Rural Health Network
Cornell Cooperative Extension
Moriah Central School
Franklin County DSS
Warren-Washington ARC
Fulmont Community Action Agency
Mercy Care for the Adirondacks
Alice Hyde Medical Center
Center for Disability Services/Clover Patch early intervention services
Alice Hyde Medical Center
Mental Health Association In Fulton & Montgomery Counties
Washington County Public health
Elizabethtown Community Hospital
Gloversville enlarged School District
NYS Assembly
c
ACAP, Inc. EHS/HS
Senior Citizens Council of Clinton County Inc.
Elizabethtown-Lewis Central School
32 of 37
Saratoga Hospital Community Service Plan 2013
Name
Amanda Hewitt
TJ Feiden
Kim Crockett
Trip Shannon
Brandy Richards
Robin Nelson
Deborah Ameden
Betsy brown
Theresa Intilli Klausner
Penny
Nancy Welch
Cathy Valenty
Norma Menard
Michael Piccirillo
Peter Whitten
Keith R. Matott
Melissa Engwer
Theresa Cole
Janine Dykeman
Margot Gold
Cynthia Summo
Pam Merrick
Jamie Basiliere
Michele Armani
Lia Mcfarline
Sue Cridland
Cathleen Kerman
Brian Bearor
Linda Scagel
Priscilla Wheeler
Megan Murphy
Sue Frasier
Deborah Skivington
Sue Ann Caron
Leslie Beadle
Jean Wiseman
Susan Patterson
Kathy Varney
Kelly Owens
Crystal Carter
Stephanie Seymour
Jamie Konkoski
Patty Hunt
Bonnie Sue Newell
Beth Lawyer
Suzanne M. Goolden
Organization's Name
Senior Citizen Service Center of Gloversville and Fulton County, Inc
Minerva Central School
Clinton County Youth Bureau
Hudson Headwaters Health Network
Hamilton County Community Services
Families First in Essex County
Hamilton County Community Action Agency
PPNCNY Planned Parenthood
Nathan Littauer Hospital
HCPHNS
Cornell Cooperative Extension, Hamilton County
Saratoga County EOC - WIC
Literacy Volunteers of Clinton County
Saratoga Springs City School District
Shelters of Saratoga, Inc
The Development Corporation
Warren Washington Hamilton County Cancer Services Program at Glens Falls
Hospital
Akwesasne Housing Authority
Mental Health Association in Fulton and Montgomery Counties
North Country Healthy Heart Network, Inc.
Keene Central School
Malone middle school
Child Care Coordinating Council of the North Country, Inc.
North Country Workforce Investment Board
Inter-Lakes Health
Nathan Littauer Hospital - HealthLink
Glens Falls Hospital
Family YMCA of the Glens Falls Area
Community Health Center of the North Country
Saratoga County Public Health
Adirondack Health
Mountain Valley Hospice
The Family Counseling Center
Essex County Department of Social Services
Nathan Littauer Hospital Nursing Home
Capital District Child Care Council
Franklin Co. Public Health
Glens Falls Hospital
HM AHEC
Clinton County Office for the Aging
Saratoga Hospital
North Country Healthy Heart Network
Washington County Public Health Nursing Service
Mental Health Association of Clinton and Franklin Counties
Citizen Advocates, Inc., North Star Behavioral Health Services
Franklin County
33 of 37
Saratoga Hospital Community Service Plan 2013
Name
Roseann Doran
Katie Strack
Ginelle Jones
Ann Rhodes
Patricia Gero
Chandler M. Ralph
Kim McElwain
Gerald Goldman
Elizabeth Zicari
Bonnie Yopp ANP
Stacey Beebie
Vicki Driscoll
L. Jameson
Beth Ryan
Rebecca Carman
Lisa Harrington
Genevieve Boyd
Tracy Mills
Robert York
Shelley Shutler
Dot Jones
Maria Burke
Gina CantanucciMitchell
Ernest J. Gagnon
S. Cooper
Pam Dray
Patricia Auer
Laurence Kelly
Susan Dufel
Sharon Schaldone
Kristen Sayers
Tari Botto
Carol Underwood
Sheri Sauve
Susan M. Wilson-Sott
Laurie Williams
Jessica Darney Buehler
Sharon Luckenbaugh
Peter Groff
James Seeley
Josh Wilson
Rachel Truckenmiller
Diane Whitten
Justin Hladik
Steve Peters
Sheila Kapper
Organization's Name
Cornell Cooperative Extension in Fulton & Montg. Co.
Franklin County Public Health Services
Warren County Health Services
HFM Prevention Council
Adirondack Health
Adirondack Health
Saint Regis Mohawk Tribe
Saranac Lake CSD
HCR Home Care
Community Link
Clinton County MH and AS
Clinton County Health Department
HM AHEC
Hamilton County Public Health Nursing Service
Shenendehowa Central School District
Wait House
Long Lake Central School
Glens Falls Hospital
Office of Community Services for Warren and Washington Counties
Mental Health Assoc. of Clinton & Franklin Counties
Saratoga Hospital
Literacy Volunteers of Essex/Franklin Counties
Washington County ADRC
Fulton County Mental Health
Fulton County Department of Social Services
Saratoga County EOC Head Start
Warren County Health Services
Nathan Littauer Hospital
NYS Department of Labor
Warren County Health Services
NYSDOH
Franklin County Department of Social Services
Center for Lung and Chest Surgery
Plattsburgh One Worksource/NYSDOL Manager
Office for the Aging in Franklin Co.
Clinton County Health Department
Essex County Public Health
Glens Falls Hospital
Warren Washington Association for Mental Health
Cornell Cooperative Extension
North Country Healthy Heart Network, Inc.
ASAPP's Promise
Cornell Cooperative Extension Saratoga County
Reality Check of Hamilton, Fulton, and Montgomery Counties
City of Plattsburgh
Elizabethtown-Lewis Central School
34 of 37
Saratoga Hospital Community Service Plan 2013
Name
Greg Truckenmiller
Stuart G. Baker
Sarah Kraemer
John Nasso
L. Daniel Jacobs
Darlene Spinner
Pam LeFebvre
Sarina Nicola
Lythia Vera
Martin Nephew
Barbara DeLuca
Cecily Dramm
Tracey
Patricia Godreau Sexton
Deborah Roddy
John Sawyer
Nichole Louis
Stephen Pavone
Jackie Mulcahy
Anita Deming
Frederick Goldberg, MD
David A Alloy
Annie McKinley
Bonnie Black
Eric Day
Douglas Huntley
Rebecca Evansky
James Dexter
Steven Bowman
Susan Kelley
Marjorie Irwin
Robert E. Shay
Vanetta Conn
Patty Bashaw
Cheryl L. Brown
Wes Carr
Marjorie Tierney
Barbara Sweet
Kari Cushing
Paul Berry
Brian Post
Erin Krivitski
Lorraine Kourofsky
Susan Delehanty
Linda L. Beers
Dr Stan Maziejka
Organization's Name
Fulton-Montgomery Community College
Town of Queensbury
Catholic Charities of Fulton & Montgomery Counties
Catholic Charities of Fulton and Montgomery Counties
St. Regis Mohawk Health Services A/CDP Outpatient
Literacy Volunteers of Essex/Franklin Counties
Clinton County Health Department
Essex County Public Health Nursing Services
Eastern Adirondack Health Care Network
Mountain Lake Services
Nathan Littauer Hospital
Saranac Lake High School
Planned Parenthood Mohawk Hudson
St. Regis Falls Central School
The Adirondack Arc
Hudson Headwaters Health Network
HCR Home Care
Gloversville School District
Queensbury union free school district
Cornell Cooperative Extension - Essex County
Nathan Littauer Hospital
Glens Falls Hospital
Essex County Mental Health
BHSN
Clinton County Office of Emergency Services
Queensbury Union Free School District
STARS
Washington-Saratoga-Warren-Hamilton-Essex BOCES
Clinton County Veterans Service Agency
STOP Domestic Violence/BHSN
Washington County WIC
Town of White Creek
Cornell Cooperative Extension Franklin County
Essex County Office for the Aging
Oppenheim-Ephratah Central School District
Saratoga County Youth Bureau
Ticonderoga central school
Tri County United Way
Franklin Community Center
Hadley-Luzerne CSD
Upward Bound
Glens Falls Hospital
Chateauguay Central School
Citizen Advocates,Inc.
Essex County Public Health
Stillwater CSD
35 of 37
Saratoga Hospital Community Service Plan 2013
Name
Dawn Tucker
Margaret Sing Smith
KEITH TYO
Antoinette P Roth
Cathie Werly
Dale Breault Jr.
Linda Ferrara
Julie Wright
Lori Thompson
Robert Kleppang
Cora Clark
Amy Brender
Donna DiPietro
Chris Hunsinger
Barbara Vickery
Paul Williamsen
Andrew Cruikshank
Sandra McNeil
Garry Douglas
Steve Valley
Timothy Farrell
Patrick Dee
Kimberly Mulverhill
Elizabeth St John
Valerie Muratori
Denise Benton
Melissa Chinigo
Vanessa Ross
Claire Murphy
Dustin Swanger
Janice Fitzgerald
Cheryl A Murphy
Andrea Fettinger
Donn Diefenbacher
Jodi Gibbs
Cynthia Trudeau
John Redden
Ellen Gordon
michele
Heidi
Wayne C. Walbridge
Heidi Parisi
Susan Menke
Susan Sherman
Jane havens
Stephanie LaPlant
Organization's Name
Fort Edward Internal Medicine
Warren County Youth Bureau
SUNY PLATTSBURGH
Warren County WIC
FRANKLIN COUNTY PUBLIC HEALTH SERVICES
Chateauguay Central School
Adirondack Cardiology - A Service of Glens Falls Hospital
Glens Falls Hospital
St Regis Mohawk Health Services
Hamilton County Community Services
Lake Placid Middle High School
HHHN-Ryan White Part C Program
Bolton Central School
Warren County Employment & Training
Capital District Child Care Coordinating Council
Mayfield Central School District
Fort Hudson Health System
Glens Falls Hospital
North Country Chamber of Commerce
Essex County Mental Health Services
Minerva Central School
Lake George Central Schools
Malone Central School District
Washington County Public Health
Saratoga Bridges NYSARC , Inc. Saratoga Chapter
Catholic Charities of Fulton and Montgomery Counties
Glens Falls Hospital
Washington County CARES
Washington County Economic Opportunity Council, Inc.
Fulton-Montgomery Community College
Parent to Parent of NYS
American Red Cross
Fulton County Office for Aging
Mountain Valley Hospice
Inter-Lakes Health
Inter-Lakes Health
Clinton County Social Services
ACAP/OneWorkSource
Malone central school
NCHHN
Malone Central School District
Nathan Littauer Hospital
Wells Central School
Gloversville High School
Community, Work and Independence,, Inc.
St. Joseph's Community School
36 of 37
Saratoga Hospital Community Service Plan 2013
Name
MARY DICKERSON
Fred Wilson
Richelle Beach
Marie Capezzuti
Scott Harding
Suzanne Hagadorn
Deborah Battiste
Kari Scott
Denise C. Frederick
Clark Hults
Lorine Heroth
Organization's Name
LONG LAKE CENTRAL SCHOOL
Hudson Headwaters Health Network
Clinton County Child Advocacy Center
Washington County Public Health
Church of the Messiah
Cancer Services Program of Fulton & Montgomery Counties
Town of Kingsbury Recreation
Willsboro Central School
Fulton County Public Health
Newcomb Central School District
Gloversville Middle School
37 of 37