HANCOCK MEDICAL CENTER
BAY ST. LOUIS, MS
2013 COMMUNITY HEALTH NEEDS ASSESSMENT AND
IMPLEMENTATION PLAN
ADOPTED BY BOARD RESOLUTION
Dear Community Resident:
Hancock Medical Center (HMC) welcomes you to review this document as we strive to meet the
health and medical needs in our community. All not-for-profit hospitals are required to develop this
report in compliance with the Affordable Care Act.
The “2013 Community Health Needs Assessment” identifies local health and medical needs and
provides a plan to indicate how HMC will respond to such needs. This document suggests areas
where other local organizations and agencies might work with us to achieve desired improvements
and illustrates one way we, HMC, are meeting our obligations to efficiently deliver medical services.
HMC will conduct this effort at least once every three years. As you review this plan, please see if, in
your opinion, we have identified the primary needs and if our intended response should make
appropriate needed improvements.
We do not have adequate resources to solve all the problems identified. Some issues are beyond the
mission of the hospital and action is best suited for a response by others. Some improvements will
require personal actions by individuals rather than the response of an organization. We view this as a
plan for how we, along with other organizations and agencies, can collaborate to bring the best each
has to offer to address the more pressing, identified needs.
The report is a response to a federal requirement of not-for-profit hospitals to identify the
community benefit it provides in responding to documented community need. Footnotes are
provided to answer specific tax form questions. For most purposes, they may be ignored. Of greater
importance, however, is the potential for this report to guide our actions and the efforts of others to
make needed health and medical improvements.
Please think about how to help us improve the health and medical services our area needs. I invite
your response to this report. We all live and work in this community together and our collective
efforts can make living here more enjoyable and healthier.
Thank You
Hancock Medical Center
Bay St. Louis, MS
Community Health Need Assessment
Page i
Table of Contents
Executive Summary ........................................................................................................................................... 1 Project Objectives ......................................................................................................................................... 2 Brief Overview of Community Health Needs Assessment .................................................................... 2 Approach............................................................................................................................................................. 5 Findings .............................................................................................................................................................10 Definition of Area Served by the Hospital Facility ................................................................................11 Demographic of the Community ..............................................................................................................12 Leading Causes of Death ...........................................................................................................................15 Primary and Chronic Disease Needs and Health Issues of Uninsured Persons, Low-Income
Persons, and Minority Groups ..................................................................................................................16 Conclusions from Public Input to Community Health Needs Assessment .......................................21 Summary of Observations from Hancock County Compared to All Other State Counties, in
Terms of Community Health Needs ........................................................................................................22 Summary of Observations from Hancock County Peer Comparisons ...............................................22 Conclusions from the Demographic Analysis Comparing Hancock County to National Averages
........................................................................................................................................................................24 Key Conclusions from Consideration of the Other Statistical Data Examinations ..........................25 Existing Health Care Facilities, Resources and Implementation Plan .....................................................27 Significant Needs .........................................................................................................................................29 Other Needs Identified During the CHNA Process .............................................................................38 Overall Community Need Statement and Priority Ranking Score:......................................................39 Appendices........................................................................................................................................................41 Appendix A – Local Expert Advisor Opinion about Significant Needs ............................................42 Appendix B – Process to Identify and Prioritize Community Need ...................................................46 Appendix C – Illustrative Schedule H (Form 990) Part V B Potential Response .............................52 Hancock Medical Center
Bay St. Louis, MS
Community Health Need Assessment
Page 1
EXECUTIVE SUMMARY
Hancock Medical Center
Bay St. Louis, MS
Community Health Need Assessment
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Executive Summary
Hancock Medical Center ("HMC" or the "Hospital") is organized as a not-for-profit hospital. A
Community Health Needs Assessment (CHNA) is part of the required hospital documentation of
“Community Benefit” under the Affordable Care Act (ACA), required of all not-for-profit hospitals
as a condition of retaining tax-exempt status. A CHNA assures HMC identifies and responds to the
primary health needs of its residents.
This study is designed to comply with standards required of a not-for-profit hospital1. Tax reporting
citations in this report are superseded by the most recent 990 H filings made by the hospital.
In addition to completing a CHNA, and funding necessary improvements, a not-for-profit hospital
must document the following:

Financial assistance policy and policies relating to emergency medical care;

Billing and collections; and

Charges for medical care.
Further explanation and specific regulations are available from Health and Human Services (HHS),
the Internal Revenue Service (IRS), and the U.S. Department of the Treasury2.
Project Objectives
HMC partnered with our CHNA Consultant for the following3:

Complete a CHNA report, compliant with Treasury – IRS;

Provide the Hospital with information required to complete the IRS – 990h schedule; and

Produce the information necessary for the Hospital to issue an assessment of community
health needs and document its intended response.
Brief Overview of Community Health Needs Assessment
Typically, non-profit hospitals qualify for tax-exempt status as a Charitable Organization, described
in Section 501(c) 3 of the Internal Revenue Code; however, the term 'Charitable Organization' is
undefined. Prior to the passage of Medicare, charity was generally recognized as care provided to the
Part 3 Treasury/IRS – 2011 – 52 Notice … Community Health Needs Assessment Requirements…and
https://www.federalregister.gov/articles/2013/04/05/2013-07959/community-health-needs-assessments-forcharitable-hospitals
2 As of the date of this report Notice of proposed rulemaking was published 6/26/2012 and available at
http://federalregister.gov/a/2012-15537
3 Part 3 Treasury/IRS – 2011 – 52 Section 3.03 (2) third party disclosure notice
1
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Bay St. Louis, MS
Community Health Need Assessment
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less fortunate without means to pay. With the introduction of Medicare, the government met the
burden of providing compensation for such care.
In response, IRS Revenue ruling 69-545 eliminated the Charitable Organization standard and
established the Community Benefit Standard as the basis for tax-exemption. Community Benefit
determines if hospitals promote the health of a broad class of individuals in the community, based
on factors including:

Emergency room open to all, regardless of ability to pay;

Surplus funds used to improve patient care, expand facilities, train, etc.;

Controlled by independent civic leaders; and

All available and qualified physicians are privileged.

Specifically, the IRS requires:

Effective on tax years beginning after March 23, 2012, each 501(c) (3) hospital
facility is required to conduct a CHNA at least once every three taxable years and
adopt an implementation strategy to meet the community needs identified through
such assessment;

The assessment may be based on current information collected by a public health
agency or non-profit organization and may be conducted together with one or more
other organizations, including related organizations;

The assessment process must take into account input from persons who represent
the broad interests of the community served by the hospital facility, including those
with special knowledge or expertise of public health issues;

The hospital must disclose in its annual information report to the IRS (Form 990
and related schedules) how it is addressing the needs identified in the assessment,
and, if all identified needs are not addressed, the reasons why (e.g., lack of financial
or human resources);

Each hospital facility is required to make the assessment widely available and ideally
downloadable from the hospital web site;

Failure to complete a CHNA in any applicable three-year period results in a penalty
to the organization of $50,000. For example, if a facility does not complete a CHNA
in taxable years one, two, or three, it is subject to the penalty in year three. If it then
fails to complete a CHNA in year four, it is subject to another penalty in year four
(for failing to satisfy the requirement during the three-year period beginning with
taxable year two and ending with taxable year four); and
Hancock Medical Center
Bay St. Louis, MS
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4
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An organization that fails to disclose how it is meeting needs identified in the
assessment is subject to existing incomplete return penalties4.
This report was developed under the guidance of IRS/Treasury 2011-52 as modified by the
Draft Federal Regulations published in the April 5, 2013 Federal Register.
Section 6652
Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
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APPROACH
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Bay St. Louis, MS
Community Health Needs Assessment
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Approach
To complete a CHNA, the hospital must:


Describe the processes and methods used to conduct the assessment;

Sources of data and dates retrieved;

Analytical methods applied;

Information gaps impacting ability to assess the needs; and

Identification of with whom the Hospital collaborated.
The proposed regulations provide that a hospital facility’s CHNA report will be considered
to describe how the hospital facility took into account input if the CHNA report:
1) Summarizes, in general terms, the input provided and how and over what time
period such input was provided;
2) Provides the names of organizations providing input and summarizes the nature and
extent of the organization’s input; and
3) Describes the medically underserved, low income, or minority populations being
represented by organizations or individuals providing input.

Describe the process and criteria used in prioritizing health needs;

Describe existing resources available to meet the community health needs; and

Identify the programs and resources the hospital facility plans to commit to meeting each
identified need, and the anticipated impact of those programs and resources on the health
need.
Our consultant takes a comprehensive approach to assess community health needs. We perform
several independent data analyses based on secondary source data, augment this with local survey
data, and resolve any data inconsistency or discrepancies from the combined opinions formed from
local experts. We rely on secondary source data, and most secondary sources use the county as the
smallest unit of analysis. We asked our local expert area residents to note if they perceived the
problems or needs identified by secondary sources to exist in their portion of the county5.
Most data used in the analysis is available from public internet sources. Critical data needed to
address specific regulations or developed by the individuals cooperating with us in this study is
displayed in the report of the appendix. Data sources include6:
5
6
Response to Schedule H (Form 990) Part V B 1 i
Response to Schedule H (Form 990) Part V B 1 d
Hancock Medical Center
Bay St. Louis, MS
Web Site or Data Source
Community Health Needs Assessment
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Data Element
Date
Accessed
Data Date
www.countyhealthrankings.org
Assessment of health needs of Hancock
County compared to all MS counties
June 19, 2013
2002 to
2010
www.communityhealth.hhs.gov
Assessment of health needs of Hancock
County compared to its national set of
“peer counties”
June 19, 2013
1996 to
2009
Truven (formerly known as Thomson)
Market Planner
Assess characteristics of the hospital’s
primary service area, at a zip code level,
based on classifying the population into
various socio-economic groups,
determining the health and medical
tendencies of each group and creating an
aggregate composition of the service area
according to the contribution each group
makes to the entire area; and, to access
population size, trends, and socioeconomic characteristics
June 19, 2013
2012
www.capc.org and
www.getpalliativecare.org
To identify the availability of Palliative
Care programs and services in the area
June 19, 2013
2012
www.caringinfo.org and iweb.nhpco.org
To identify the availability of hospice
programs in the county
June 19, 2013
2012
www.healthmetricsandevaluation.org
To examine the prevalence of diabetic
conditions and change in life expectancy
June 19, 2013
1989
through
2009
www.dataplace.org
To determine availability of specific
health resources
June 19, 2013
2005
www.cdc.gov
To examine area trends for heart disease
and stroke
June 19, 2013
2008 to
2010
www.CHNA.org
To identify potential needs among a
variety of resource and health need
metrics
June 19, 2013
2003 to
2010
www.datawarehouse.hrsa.gov
To identify applicable manpower
shortage designations
June 19, 2013
2013
www.worldlifeexpectancy.com/usahealth-rankings
To determine relative importance among
15 top causes of death
June 19, 2013
2010
published
11/29/12
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Bay St. Louis, MS
Community Health Needs Assessment
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
In addition, we deployed a CHNA “Round 1” survey to our local expert advisors to gain
local input as to local health needs and the needs of priority populations. Local expert
advisors were local individuals selected to conform to the input required by the Federal
guidelines and regulations7;

We received community input from 19 local expert advisors. Survey responses started
Monday, July 1, 2013 at 9:53 a.m. and ended with the last response on Monday, July 29, 2013
at 2:08 p.m.;

Information analysis augmented by local opinions showed how Hancock County relates to
its peers in terms of primary and chronic needs and other issues of uninsured persons, lowincome persons, and minority groups. Respondents commented on if they believe certain
population groups (or people with certain situations) need help to improve their condition,
and if so, who needs to do what8; and

When the analysis was complete, we put the information and summary conclusions before
our local group of experts9, who were asked to agree or disagree with the summary
conclusions. They were free to augment potential conclusions with additional statements of
need, and a new need did emerge from this exchange10. Consultation with 19 local experts
occurred again via an internet-based survey (explained below) during the period beginning
Monday, July 22, 2013 at 12:05 p.m. and ending Friday, August 9, 2013 at 9:52 a.m.
With the prior steps identifying potential community needs, the local experts participated in a
structured communication technique called a Delphi method, originally developed as a systematic,
interactive forecasting method that relies on a panel of experts. Experts answer questionnaires in a
series of rounds. We contemplated and implemented one round as referenced during the above
dates. After each round, we provided an anonymous summary of the experts’ forecasts from the
previous round, as well as reasons provided for their judgments. The process encouraged experts to
revise their earlier answers in light of the replies of other members of their panel. Typically, this
process decreases the range of answers and moves the expert opinions toward a consensus "correct"
answer. The process stops when we identify the most pressing, highest priority, community needs.
In the HMC process, each local expert allocated 100 points among all identified needs, having the
opportunity to introduce needs previously unidentified and challenge conclusions developed from
the data analysis. A rank order of priorities emerged, with some needs receiving none or virtually no
support, and other needs receiving identical point allocations.
We dichotomized the rank order into two groups: high priority needs and low priority needs. The
determination of the break point – high as opposed to low – was a qualitative interpretation by our
Response to Schedule H (Form 990) Part V B 1 h; complies with 501(r)(3)(B)(i)
Response to Schedule H (Form 990) Part V B 1 f
9 Part response to Schedule H (Form 990) Part V B 3
10 Response to Schedule H (Form 990) Part V B 1 e
7
8
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Bay St. Louis, MS
Community Health Needs Assessment
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consultant and the HMC executive team, where a reasonable break point in rank occurred, indicated
by the amount of points each potential need received and the number of local experts allocating any
points to the need. When presented to the HMC executive team, the divided need rank order
identified which needs the Hospital considered high responsibility to respond vs. low responsibility
to respond. The result provided a matrix of needs and guided the Hospital in developing its
implementation response11.
The proposed regulations provide that, in order to assess the community it serves, a hospital facility
must identify significant health needs of the community, prioritize them, and then identify potential
measures and resources available to address them, such as programs, organizations, and facilities in
the community12. The proposed regulations clarify a CHNA need only identify significant health
needs, and need only prioritize, and otherwise assess, those significant identified health needs. A
hospital facility may determine whether a health need is significant based on all of the facts and
circumstances present in the community it serves13. By definition, the high priority needs are deemed
“significant” needs as defined by the regulations.
Response to Schedule H (Form 990) Part V Section B 6 g, h and Part V B 1 g
Draft regulations page 30
13 Draft regulations page 32
11
12
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Bay St. Louis, MS
Community Health Needs Assessment
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FINDINGS
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Bay St. Louis, MS
Community Health Needs Assessment
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Findings
Definition of Area Served by the Hospital Facility14
HMC, in conjunction with our consultant, defines its service area as Hancock County in MS, which
includes the following ZIP codes:
39520
39556
Bay Saint Louis
Kiln
39525
39572
Diamondhead
Pearlington
39529
39576
Stennis Space Center
Waveland
In 2011, the Hospital received 81% of its patients from this area15.
14
15
Responds to IRS Form 990 (h) Part V B 1 a
Truven MEDPAR patient origin data for the hospital; Responds to IRS Form 990 (h) Part V B 1 a
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Bay St. Louis, MS
Community Health Needs Assessment
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Demographic of the Community16
The 2013 population for Hancock County is estimated to be 38,72217 and expected to increase at a
rate of 4.7%. This is higher than the 1.2% projected MS growth and the 3.3% national growth.
Hancock County anticipates a population of 40,555 by 2018.
According to the population estimates utilized by Truven, provided by The Nielsen Company, the
2013 median age for the county is 41.5 years, which is older than the State median age (36.2 years),
and the national median age (37.5 years). The 2013 Median Household Income for the area is
$45,911 which is higher than the State median income of $36,723 but lower than the national
median income of $49,233. Median Household Wealth value is above both the National and the
State values. The Median Home Values for the area is $133,171 which is higher than the State value,
but lower than the National value. Hancock County’s unemployment rate as of April, 2013 was
7.7%18, which is better than the 9.1% statewide but worse than the 7.5% national civilian
unemployment rates.
The portion of the population in the county over 65 is 17%, above the State and national average.
The portion of the population of women of childbearing age is 17.6%, below the State average of
20.1% and national average of 19.8%. 7.9% of the population is Black non-Hispanic and 84.7% is
White non-Hispanic. The Hispanic population comprises 3.7% of the total.
Responds to IRS Form 990 (h) Part V B 1 b
All population information, unless otherwise cited, sourced from Truven (formally Thomson) Market Planner
18http://research.stlouisfed.org/fred2/graph/?g=jBD
16
17
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Bay St. Louis, MS
Community Health Needs Assessment
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The population also was examined according to characteristics presented in the Claritas Prizm
customer segmentation data. This system segments the population into 66 demographically and
behaviorally distinct groups. Each group, based on annual survey data, is documented as exhibiting
specific health behaviors. The makeup of the service area, according to the mix of Prizm segments
and its characteristics, is contrasted to the national population averages to discern the following table
of probable lifestyle and medical conditions present in the population. Items with red text are
viewed as statistically important, potentially adverse findings. Items with blue text are viewed as
statistically important, potential beneficial findings. Items with black text are viewed as either not
statistically different from the national normal situation, or not considered either favorable or
unfavorable in our use of the information.
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Bay St. Louis, MS
Community Health Needs Assessment
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Hancock Medical Center
Bay St. Louis, MS
Leading Causes of Death
Community Health Needs Assessment
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Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
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Primary and Chronic Disease Needs and Health Issues of Uninsured Persons, LowIncome Persons, and Minority Groups
Some information is available to describe the size and composition of various uninsured persons,
low income persons, minority groups, and other vulnerable population segments. Specific studies
identifying needs of such groups, distinct from the general population at a county unit of analysis,
are not readily available from secondary sources.
The National Healthcare Disparities Report results from a Congressional directive to the Agency for
Healthcare Research and Quality (AHRQ). This production is an annual report to track disparities
related to "racial factors and socioeconomic factors in priority populations." The emphasis is on
disparities related to race, ethnicity, and socioeconomic status. The directive includes a charge to
examine disparities in "priority populations," which are groups with unique healthcare needs or
issues that require special attention19.
Nationally, this report observes the following trends:


19
Measures for which Blacks were worse than Whites and are getting better:

Diabetes – Hospital admissions for short-term complications of diabetes per 100,000
population;

HIV and AIDS – New AIDS cases per 100,000 population age 13 and over; and

Functional Status Preservation and Rehabilitation. Female Medicare beneficiaries
age 65 and over, who reported ever being screened for osteoporosis with a bone
mass or bone density measurement.
Measures for which Blacks were worse than Whites and staying the same:

Cancer – Breast cancer diagnosed at advanced stage per 100,000 women age 40 and
over ; breast cancer deaths per 100,000 female population per year; adults age 50 and
over who ever received colorectal cancer screening; colorectal cancer diagnosed at
advanced stage per 100,000 population age 50 and over; colorectal cancer deaths per
100,000 population per year;

Diabetes – Hospital admissions for lower extremity amputations per 1,000
population age 18 and over with diabetes;

Maternal and Child Health – Children ages 2-17 who had a dental visit in the
calendar year; Children ages 19-35 months who received all recommended vaccines;
http://www.ahrq.gov/qual/nhdr10/Chap10.htm 2010
Hancock Medical Center
Bay St. Louis, MS
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
Mental Health and Substance Abuse – Adults with a major depressive episode in the
last 12 months who received treatment for depression in the last 12 months; people
age 12 and over treated for substance abuse who completed treatment course;

Respiratory Diseases – Adults age 65 and over who ever received pneumococcal
vaccination; hospital patients with pneumonia who received recommended hospital
care;

Supportive and Palliative Care – High-risk long-stay nursing home residents with
pressure sores; short-stay nursing home residents with pressure sores; adult home
health care patients who were admitted to the hospital; hospice patients who
received the right amount of medicine for pain;

Timeliness – Adults who needed immediate care for an illness, injury, or condition in
the last 12 months, who received care as soon as they wanted; emergency
department visits where patients left without being seen; and

Access – People with a usual primary care provider; people with a specific source of
ongoing care.
Measures for which Asians were worse than Whites and getting better:

Cancer – Adults age 50 and over who ever received colorectal cancer screening; and

Patient Safety – Adult surgery patients who received appropriate timing of
antibiotics.
Measures for which Asians were worse than Whites and staying the same:

Respiratory Diseases – Adults age 65 and over who ever received pneumococcal
vaccination; hospital patients with pneumonia who received recommended hospital
care; and

Access – People with a usual primary care provider.
Measures for which American Indians and Alaska Natives were worse than Whites for the
most recent year and staying the same:

Heart Disease – Hospital patients with heart failure who received recommended
hospital care;

HIV and AIDS – New AIDS cases per 100,000 population age 13 and over;

Respiratory Diseases – Hospital patients with pneumonia who received
recommended hospital care;
Hancock Medical Center
Bay St. Louis, MS
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Community Health Needs Assessment
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
Functional Status Preservation and Rehabilitation – Female Medicare beneficiaries
age 65 and over who reported ever being screened for osteoporosis with a bone
mass or bone density measurement;

Supportive and Palliative Care – Hospice patients who received the right amount of
medicine for pain; high-risk, long-stay nursing home residents with pressure sores;
adult home healthcare patients who were admitted to the hospital; and

Access – People under age 65 with health insurance.
Measures for which American Indians and Alaska Natives were worse than Whites for the
most recent year and getting worse:

Cancer – Adults age 50 and over who ever received colorectal cancer screening; and

Patient safety – Adult surgery patients who received appropriate timing of
antibiotics.
Measures for which Hispanics were worse than non-Hispanic Whites for the most recent
year and getting better:

Maternal and Child Health – Children ages 2-17 who had a dental visit in the
calendar year;

Lifestyle Modification – Adult current smokers with a checkup in the last 12 months
who received advice to quit smoking; adults with obesity who ever received advice
from a health provider about healthy eating; and

Functional Status Preservation and Rehabilitation – Female Medicare beneficiaries
age 65 and over who reported ever being screened for osteoporosis with a bone
mass or bone density measurement.
Measures for which Hispanics were worse than non-Hispanic Whites for most recent year
and staying the same:

Cancer – Women age 40 and over who received a mammogram in the last 2 years;
adults age 50 and over who ever received colorectal cancer screening;

Diabetes – Adults age 40 and over with diagnosed diabetes who received all three
recommended services for diabetes in the calendar year;

Heart Disease – Hospital patients with heart attack and left ventricular systolic
dysfunction who were prescribed angiotensin-converting enzyme inhibitor or
angiotensin receptor blocker at discharge; hospital patients with heart failure who
received recommended hospital care;

HIV and AIDS – New AIDS cases per 100,000 population age 13 and over;
Hancock Medical Center
Bay St. Louis, MS
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Community Health Needs Assessment
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
Mental Health and Substance Abuse – Adults with a major depressive episode in the
last 12 months who received treatment for depression in the last 12 months;

Respiratory Disease – Adults age 65 and over who ever received pneumococcal
vaccination; hospital patients with pneumonia who received recommended hospital
care;

Lifestyle Modification – Adults with obesity who ever received advice from a health
provider to exercise more;

Supportive and Palliative Care – Long-stay nursing home residents with physical
restraints; high-risk, long-stay nursing home residents with pressure sores; short-stay
nursing home residents with pressure sores; adult home health care patients who
were admitted to the hospital; hospice patients who received the right amount of
medicine for pain;

Patient Safety – Adult surgery patients who received appropriate timing of
antibiotics;

Timeliness – Adults who needed care right away for an illness, injury, or condition in
the last 12 months and got care as soon as wanted;

Patient Centeredness – Adults with ambulatory visits who reported poor
communication with health providers; children with ambulatory visits who reported
poor communication with health providers; and

Access – People under age 65 with health insurance; people under age 65 who were
uninsured all year; people with a specific source of ongoing care; people with a usual
primary care provider; people unable to get or delayed in getting needed care due to
financial or insurance reasons.
Measures for which Hispanics were worse than non-Hispanic Whites for the most recent
year and getting worse:

Maternal and Child Health – Children ages 3-6 who ever had their vision checked by
a health provider.
We asked a specific question to our local expert advisors about unique needs of priority populations.
We reviewed their responses to identify if any of the above trends were obvious in the service area.
Accordingly, we place great reliance on the commentary received to identify unique population
needs to which we should respond. Specific opinions from the local expert advisors are summarized
as follows20:
20
All comments and the analytical framework behind developing this summary appear in Appendix A.
Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
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
It is difficult to reach low-income persons who are uninsured through traditional public
health and mental health education and there is a scarcity of professionals available to
provide the educational services;

Obesity, poor diet that has a heavy emphasis on fried foods, and alcoholic beverages that
leads to cardiovascular problems, stroke etc. Obesity and diabetes are prevalent and I believe
that programs addressing childhood obesity are needed;

Our children's health care must be addressed. School nurses make a huge impact. Parental
support and training would help. Prenatal Care for expectant mothers is important; and

Community outreach is needed from the sources, to educate the uninsured, low income and
minority households, as to the available resources, rather than those residents utilizing the
ER as a walk in medical clinic.
Statistical information about special populations follows:
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Bay St. Louis, MS
Community Health Needs Assessment
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Findings
Upon completion of the CHNA, our consultant identified several issues within the Hancock
community:
Conclusions from Public Input to Community Health Needs Assessment
19 area residents participated in a survey asking opinions about their perception of local healthcare
needs. In descending order of opinion, seven topics were identified as being of "Major Concern" or
"Most Important Issue to Resolve":
1. Affordable health and medical care for all residents of the county;
2. Lack of availability of health care beyond the emergency room for those who are uninsured;
3. Obesity with an increase of Diabetes Type 2 and Heart Disease, smoking, and alcohol;
4. Lack of medical doctors practicing along the Coast causes great concern for future growth;
5. Lack of mental health services in Hancock County;
6. Unhealthy lifestyles precipitating long-term health conditions; and
7. Specialists, such as more OB/GYN, pediatric dentist and more pediatricians are needed.
Recreational facilities were parents can bring children in a safe environment, would help
meet the social needs of the community.
Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
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Summary of Observations from Hancock County Compared to All Other State
Counties, in Terms of Community Health Needs

In general, Hancock County residents are above average health for State;

In a health status classification termed "Health Outcomes," County ranks 10th among 81
counties (best being #1). On measures of morbidity and mortality, Hancock County
performs better than State average, but does not meet National benchmarks for premature
death (death before the age of 75), poor or fair health and low birth weight. On measures of
poor physical and mental health days, Hancock County performs below State averages and
does not meet National benchmarks; and

In another health status classification "Health Factors," Hancock County fares slightly
worse, ranking 17th among the 81 counties. The clinical measures for preventable hospital
stays and mammography screening are better than State averages, but do not meet National
benchmarks. Hancock County performs worse than State averages and does not meet
National benchmarks for uninsured and supply of primary care physicians and dentists.
Conditions where improvement remains to achieving state average rates and then national
goals include:

Adult smoking;

Adult obesity; and

Limited access to healthy foods.
Summary of Observations from Hancock County Peer Comparisons
The federal government administers a process to allocate all counties into "peer" groups. County
"peer" groups have similar social, economic, and demographic characteristics. Health and wellness
observations when Hancock County is compared to its national set of peer counties and compared
to national rates make the following observations:
UNFAVORABLE – observations occurring at rates worse than national AND worse than among
peers:

Premature Births (>37 weeks);

Births to Women under 18;

Births to Unmarried Women;

Black non Hispanic Infant Mortality;

Post-neonatal Infant Mortality;
Hancock Medical Center
Bay St. Louis, MS

Homicide;

Lung Cancer;

Motor Vehicle Injuries;

Stroke;

Suicide; and

Unintentional Injury.
Community Health Needs Assessment
Page 23
SOMEWHAT A CONCERN – observations because occurrence is EITHER above national
average or above peer group average:

Coronary Heart Disease; and

Births to Women age 40-54.
BETTER PERFORMANCE – better than peers and national rates:

Low Birth Weight (<2500 g);

Very Low Birth Weight (1500 g);

No Care in First Trimester;

Infant Mortality;

White non Hispanic Infant Mortality;

Neonatal Infant Mortality;

Breast Cancer (Female); and

Colon Cancer.
Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
Page 24
Conclusions from the Demographic Analysis Comparing Hancock County to
National Averages
Hancock County in 2013 comprises 38,722 residents. During the next five years, it is expected to see
a population increase of 4.7% to achieve 40,555 residents. This is higher than the anticipated state
(1.2%) and national growth (3.3%). The population is older and has a higher median income than
state, but lower than national comparisons. 17% of the population is age 65 or older, higher than MS
and national comparisons. 1% is non-Hispanic White, Asian, and Pacific Island origin; Hispanics
constitute 3.7% of the population; Blacks comprise 7.9% of the population; Whites 84.7%. Females
ages 15 to 44 comprise 17.6% of the population, less than the percentage in MS (20.1%) or the
nation (19.8%).
The following areas were identified comparing the county to national averages. Metrics impacting
more than 30% of the population and that are statistically significantly different from the national
average:

Pap/Cervix Screening was 8.1% below average, impacting 55.3% – an adverse finding;

Vigorous Exercise was 5.6% below average, impacting 47.9% – an adverse finding;

Routine Cholesterol Screening was 6.9% below average, impacting 47.3% – an adverse
finding;

OB/GYN 1+ Visit was 9.6% below average, impacting 40.6% – an adverse finding;

Compliance with Treatment Recommendations was 7.2% below average, impacting 37.4% –
an adverse finding; and

Tobacco Use: Cigarettes was 18% above average, impacting 30.6% – an adverse finding.
Situations and conditions statistically significantly different from the national average, but impacting
less than 30% of the population include:

Chronic High Blood Pressure was 10.7% above average, impacting 29.1% – an adverse
finding;

BMI: Morbid Obese was 13.1% above average, impacting 28.9% – an adverse finding;

Healthy Eating Habits was 8.8% below average, impacting 27% – an adverse finding;

Chronic Lower Back Pain was 5.5% above average, impacting 23.8% – an adverse finding;

Routine Screen: Cardiac Stress 2 years was 7.4% below average, impacting 14.5% – an
adverse finding;

Chronic Diabetes was 13.1% above average, impacting 11.8% – an adverse finding;

Chronic Osteoporosis was 12.5% above average, impacting 10.9% – an adverse finding;
Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
Page 25

Chronic Heart Disease was 22.3% above average, impacting 10.2% – an adverse finding;

Chronic COPD was 14.4% above average, impacting 4.4% – an adverse finding; and

Very Unhealthy Eating Habits was 8.2% above average, impacting 3% – an adverse finding.
Key Conclusions from Consideration of the Other Statistical Data Examinations
Additional observations of Hancock County found:

Palliative Care programs (programs focused not on curative actions but designed to relieve
disease symptoms pain and stress arising from serious illness) do not exist in the county; and

Hospice: 8 programs exist in the county.
Ranking the causes of death in County finds the leading causes to be the following (in descending
order of occurrence):

Heart Disease #1 cause of death statewide and in County – 224/100,000 ranking #80
among 82 MS Counties;

Cancer #2 cause of death statewide and in County – 192/100,000 ranking #60 MS County;

Accidents #3 cause of death in County, statewide #10 – 101.3/100,000 ranking #1 MS
County – significantly higher than expected;

Lung Disease #4 cause of death in County, statewide #3 – 59.8/100,000 ranking #18 MS
County – significantly higher than expected;

Stroke #5 cause of death in County, statewide #4 – 44.5/100,000 ranking #69 MS County –
significantly lower than expected;

Blood Poisoning #6 cause of death in County, statewide #13 – 20.3/100,000 ranking #30
MS County – significantly higher than expected;

Kidney Disease #7 cause of death in County, statewide #9 – 17.9/100,000 ranking #69 MS
County – significantly higher than expected;

Flu-Pneumonia #8 cause of death in County, statewide #12 – 16.2/100,000 ranking #62 MS
County – significantly lower than expected;

Suicide #9 cause of death in County, statewide #16 – 14.6/100,000 ranking #19 MS County
– significantly higher than expected;

Diabetes #10 cause of death in County, statewide #8 – 13.9/100,000 ranking #64 MS
County – significantly lower than expected; and
Hancock Medical Center
Bay St. Louis, MS

Community Health Needs Assessment
Page 26
Among other leading causes of death, Parkinson's is significantly higher than expected.
Alzheimer's and Hypertension are significantly lower than expected.
The overall, all race incident of Heart Disease death is below state average, but higher than national
average. The incident of Heart Disease death for Blacks in Hancock County is also below state
average, but above national average. The overall, all race incident of Stroke deaths is below state and
national averages. The incident of Stroke deaths among Blacks is also below state and national
values. Diabetes is below state average.
Life expectancy for Hancock County males in 1989 was 70.7 years, 0.7 years behind the top
counties, improving in 2009 to 73.3 years, 1.9 years behind the top counties.
Life expectancy for Hancock County females in 1989 was 78.5 years, 0.5 years behind the top
counties, improving in 2009 to 79.6 years, 1.3 years behind the top counties.
Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
Page 27
EXISTING HEALTH CARE FACILITIES, RESOURCES AND
IMPLEMENTATION PLAN
Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
Page 28
Significant Health Needs
We used the priority ranking of area health needs by the local expert advisors to organize the search
for locally available resources as well as the response to the needs by Hancock Medical Center21. The
following list includes:

Identifies the rank order of each identified Significant Need;

Presents the factors considered in developing the ranking;

Establishes a Problem Statement to specify the problem indicated by use of the Significant
Need term;

Identifies Hancock Medical Center current efforts responding to the need;

Establishes the Implementation Plan programs and resources Hancock Medical Center will
devote to attempt to achieve improvements;

Documents the Leading Indicators Hancock Medical Center will use to measure progress;

Presents the Lagging Indicators Hancock Medical Center believes the Leading Indicators will
influence in a positive fashion, and

Presents the locally available resources noted during the development of this report as
believed to be currently available to respond to this need.
In general, Hancock Medical Center is the major hospital in the service area. Hancock Medical
Center is a 47 bed, acute care medical facility located in Bay St. Louis, MS. The next closest facilities
are outside the service area and include:

Memorial Hospital at Gulfport – 360 bed acute care medical facility in Gulfport, MS; 16.6
miles away from Bay St. Louis (21 minutes);

Garden Park Medical Center – 105 bed acute care medical facility in Gulfport, MS; 22.8
miles away from Bay St. Louis (29 minutes); and

Ochsner Medical Center - Northshore – 165 bed acute care medical facility in Slidell, LA; 26
miles away from Bay St. Louis (33 minutes).
All data items analyzed to determine significant needs are “Lagging Indicators”, measures presenting
results after a period of time, characterizing historical performance. Lagging Indicators tell you
nothing about how the outcomes were achieved. In contrast the Hancock Medical Center
Implementation Plan utilizes “Leading Indicators”. Leading Indicators anticipate change in the
Lagging Indicator. Leading Indicators focus on short-term performance, and if accurately selected,
21
Response to IRS Form 990 h Part V B 1 c
Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
Page 29
anticipate the broader achievement of desired change in the Lagging Indicator. In the application,
Leading Indicators also must be within the ability of the hospital to influence and measure.
Significant Needs
1. AFFORDABILITY – Local Experts cite lack of access and affordability concerns. Hancock’s
uninsured rate is above MS and US averages.
Problem Statement: Local residents are not denied access to care because of limited payment
ability.
HANCOCK SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE:

Hancock Medical business office and financial policy for financial arrangements

Social services and case managers assist patients financial assistance and continuum of care
HANCOCK IMPLEMENTATION PLAN PROGRAMMATIC INITIATIVES:

HMC will continue to recruit to expand practice settings and expand the types of services
nurse practitioners may provide in settings to reach the uninsured population.

HMC may expand use of scholarship dollars for employees to advance health care related
education.

HMC will recruit competent health care professionals.

HMC will encourage enrollment in existing programs such as Medicaid via
outreach/education and expedited enrollment.
ANTICIPATED RESULTS FROM HANCOCK IMPLEMENTATION PLAN

Hancock efforts can help address the symptoms of and results from problems of
affordability and access in order to have positive impact on the underlying causes of this
problem which stem from unemployment, limited education, adverse lifestyle choices and
other factors.
LEADING INDICATOR HANCOCK WILL USE TO MEASURE PROGRESS:

Volume of patient financial assistance efforts should increase from 2012 volumes. HMC will
develop a tracking method for this measure
 2012 patients provided applications for charity care = 110
LAGGING INDICATOR HANCOCK WILL USE TO IDENTIFY IMPROVEMENT

22
Percent of population below 100% of the federal poverty level in Hancock county is
18.77%22
http://assessment.communitycommons.org/CHNA/Report.aspx?page=2&id=779
Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
Page 30
Other Local Resources identified during the CHNA process which are believed available to
respond to this need include the following:
Coastal Family Health
109 Hospital Drive, Bay St. Louis, MS 39520
228-463-9666
Diamond Med Urgent Medical Care
Center
4540 Shepherd Square, Diamondhead, MS 39525
228-255-8216
Primary and Family Care
4540 Shepherd Square, Diamondhead, MS 39525
228-395-1200
Mississippi Medicaid
1845 Cooper Road, Picayune, MS 39466
601-798-0831
Hancock Medical Pediatrics
151 Thames Avenue, Bay St. Louis, MS 39520
228-467-1320
Hancock County Health Department
3856 Highway 90, Bay St. Louis, MS 39520
228-467-4510
Hancock County School District
17304 Highway 603, Kiln, MS 39556
228-255-0378
Mammography Assistance Program
(MAP)
HMC Foundation, 149 Drinkwater Blvd, Bay St.
Louis, MS 39520
228-467-8790
2. MENTAL HEALTH/SUICIDE/SUBSTANCE ABUSE including Alcohol – #2 resident
concern; Suicide is the 9th leading cause of death Hancock county; higher than expected.
Problem Statement: There is a lack of resources in Hancock County to address mental health
and substance abuse problems.
HANCOCK AREA HEALTH SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE:

Depression Screening in ED; and

Employee Assistance Program (EAP) for employees and local businesses.
ANTICIPATED RESULTS FROM IMPLEMENTATION PLAN OF OTHERS

Hancock efforts can help clinical staff recognize symptoms of mental health issues and
substance abuse, and refer to appropriate resources; and

Increased awareness of mental health services and prevention.
LEADING INDICATOR HANCOCK AREA HEALTH SERVICES WILL USE TO MEASURE PROGRESS:

HMC will develop a tracking system to measure the number of depression screenings:
 2012 volunteers/participants in depression screening programs = 0
LAGGING INDICATOR HANCOCK AREA HEALTH SERVICES WILL USE TO IDENTIFY
IMPROVEMENT
Hancock Medical Center
Bay St. Louis, MS

Community Health Needs Assessment
Page 31
Suicide death rate in Hancock County of 14.6%
Other Local Resources identified during the CHNA process which are believed available to respond
to this need include the following:
Gulf Coast Mental Health Center
819 Central Avenue Bay St. Louis, MS
(228) 467-1881
HMC EAP and Social Services
149 Drinkwater Blvd., Bay St. Louis, MS
(228) 467-8600
Memorial Behavioral Health
11150 Highway 49, Gulfport, MS 39503
(228) 831-1700
Gulf Oaks Hospital
180 DeBuys Rd. Biloxi, MS
(228) 388-0600
Hancock County Senior Citizens Center
601 Bookter Street, Bay St. Louis, MS 39520
(228) 467-9292
Veterans Mental Health Care – VA
Hospital
Biloxi, MS
(228) 523-5000
3. OBESITY/OVERWEIGHT – Local experts listed nutritional educational needs; Adult
obesity – 13% above average, impacting 29% per 100,000, significantly higher than MS avg.
Engage in Vigorous Exercise below avg. impacts 47.9% of pop.; Very Unhealthy Eating Habits
impacts 3% of pop.; Healthy eating habits below avg. impacts 27% of pop.;
Problem Statement: There is a lack of awareness of maintaining a healthy weight and lifestyle.
HANCOCK AREA HEALTH SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE:

Hancock dietitian provides nutritional counseling;

HMC cafeteria provides healthy food choices;

HMC Cardiac Rehab program; and

HMC physical therapy program.
HANCOCK IMPLEMENTATION PLAN PROGRAMMATIC INITIATIVES:

Hancock will establish an integrated approach to obesity by coordinating its efforts with
other local resources on obesity prevention initiatives;

Hancock will provide wellness screenings for their employees;

Hancock provides yearly health fairs for employees and the community members; and

HMC cafeteria provides healthy choice options with nutritional content information.
ANTICIPATED RESULTS FROM HANCOCK IMPLEMENTATION PLAN

HMC anticipates increased community awareness of healthy lifestyle programs by promoting
local resources activities.
LEADING INDICATOR HANCOCK WILL USE TO MEASURE PROGRESS:
Hancock Medical Center
Bay St. Louis, MS

Community Health Needs Assessment
Page 32
HMC will develop a tracking method to determine the number of patients counseled by the
dietician.
 Number of patients counseled by Hancock dietician. 2012 = 0
LAGGING INDICATOR HANCOCK WILL USE TO IDENTIFY IMPROVEMENT

Reduction in the percent of Hancock residents having an obesity (BMI) value greater than
30 from 29%.
Other Local Resources identified during the CHNA process which are believed available to
respond to this need include the following:
Overeaters Anonymous
PO Box 44020, Rio Rancho, New Mexico 87174
(228) 832-3489
Weight Watchers
12200 Dedeaux Rd, Gulfport, MS 39503
(800) 651-6000
Taking off Pounds (TOPS)
4575 South Fifth Street, Milwaukee, WI 53207
(414) 482-4620
Bariatric Surgery Center
15200 Community Rd., Gulfport 39503
(228) 575-7000
Gulf Coast Health Educators
212 East Second St.- Suite A, Pass Christian, MS
39571
(228) 860-7530
HMC Dietetic Services
149 Drinkwater Blvd., Bay St. Louis, MS
(228) 467-8600
805 S. Wheatley St - Suite 400, Ridgeland, MS 39157
(601) 991-6000
Head Start
WIC
4. Coronary Heart Disease – #1 cause of death in Hancock; A top concern of local experts;
Hancock rate is worse than the MS and U.S. average; chronic heart disease is higher than the
U.S. average and impacts 10.2% of the population of Hancock county.
Problem Statement: Hancock county community members have many complications related to
heart disease.
HANCOCK SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE:

Blood pressure screening by HMC volunteers;

HMC yearly cholesterol screenings at health fair;

HMC provides Body Mass Index measurement for community; and

HMC has Advanced Cardiac Life Support certified ER staff and physicians.
HANCOCK IMPLEMENTATION PLAN PROGRAMMATIC INITIATIVES:

HMC participates in county yearly programs to screen employees and community members;

HMC offers free blood pressure screening to community organizations;
Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
Page 33

HMC offers personalized exercise programs to Cardiac Rehab members; and

HMC to develop educational articles on healthy eating and lifestyle.
ANTICIPATED RESULTS FROM HANCOCK IMPLEMENTATION PLAN

Hancock residents will experience lower rates of morbid obesity in the county.
LEADING INDICATOR HANCOCK WILL USE TO MEASURE PROGRESS:

Number of participants enrolled in Cardiac Rehab:
 2012 participants = 30 in rehab program, 24 in Stay Fit
LAGGING INDICATOR HANCOCK WILL USE TO IDENTIFY IMPROVEMENT

Hancock death rate due to heart disease moves closer to the U.S. rate
 2012 value = 224 of the U.S. rate.
Other local resources identified during the CHNA process which are believed available to respond
to this need include the following:
HMC Cardiac Rehab and Physical
Therapy
149 Drinkwater Blvd., Bay St. Louis, MS
(228) 467-8600
Gulf Coast Cardiology
290 B Hancock Square, Bay St. Louis, MS 39520
(228) 466-2700
American Heart Association
2159 E Pass Rd, Gulfport, MS 39507
(800) 242-8721
HMC Volunteers
149 Drinkwater Blvd., Bay St. Louis, MS
(228) 467-8600
American Medical Response
12020 Intraplex Parkway, Gulfport, MS 39503
(228) 897-1196
5. Maternal & Infant Issues – Cited as a top concern by local of experts; Hancock County is
worse than the U.S Premature Births (<37 weeks); Births to Women under 18; Births to
Unmarried Women; Black non Hispanic Infant Mortality and Post-neonatal Infant Mortality.
Problem Statement: Hancock County residents do not access comprehensive obstetrical
care during the first trimester or later during pregnancy.
HANCOCK SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE:

HMC will provide childbirth classes to the community;

HMC clinic provides pregnancy screening and referrals to providers; and

HMC will acquire additional OB/GYN providers as needed.
HANCOCK IMPLEMENTATION PLAN PROGRAMMATIC INITIATIVES:
Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
Page 34

Coordinating efforts with the organizations listed below which offer resources responding to
this need by identifying how Hancock services can benefit their initiatives; and

Increase awareness of the HMC’s childbirth classes.
ANTICIPATED RESULTS FROM HANCOCK IMPLEMENTATION PLAN

An increase in the number of mothers obtaining initial care during their first trimester of
pregnancy.
LEADING INDICATOR HANCOCK WILL USE TO MEASURE PROGRESS:

Volume of patients enrolled in the Hancock childbirth classes.
 2012 patients = 22
LAGGING INDICATOR HANCOCK WILL USE TO IDENTIFY IMPROVEMENT

Lower the percent of births to women under the age of 18 from 6.2% in Hancock County.
Other Local Resources identified during the CHNA process which are believed available to
respond to this need include the following:
Memorial Hospital
4500 13 Street, Gulfport, MS 39507
228-867-4000
Costal Family Health
109 Hospital Dr., Bay St. Louis, MS 39520
228-463-9666
Dr. Yanez and Dr. Duplantier
1009 Benigno St, Bay St. Louis, MS 39520
228-467-2555
Dr. Lori McNeal
4540 Shephard Square, Diamondhead, MS
228-395-1234
Medicaid Services
550 High Street - Suite 1000, Jackson, MS 39201-1399
601-359-6050
Woman, Infant, Children (WIC)
805 S. Wheatley St - Suite 400, Ridgeland, MS 39157
601-991-6000
6. Diabetes – #10 cause of death in County, statewide #8 – 13.9/100,000 ranking #64 MS
County – significantly lower than expected for Hancock co.; Chronic Diabetes above avg.
impacts 11.8% of pop.; screening rate is higher than MS avg. and US goal
Problem Statement: There is a decrease in the compliance of Diabetes self management
in Hancock County.
HANCOCK SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE:

HMC provides blood sugar screenings at annual health fairs and referrals to local providers;
and

HMC provided diabetic nutritional support for patients.
HANCOCK IMPLEMENTATION PLAN PROGRAMMATIC INITIATIVES:
Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
Page 35

Hancock will initiate efforts by contacting each organization to establish a forum for effort
collaboration; and

Hancock will establish an integrated approach to Diabetes management by coordinating its
efforts with other local resources.
ANTICIPATED RESULTS FROM HANCOCK IMPLEMENTATION PLAN

Increase in compliance with Diabetes management initiatives.
LEADING INDICATOR HANCOCK WILL USE TO MEASURE PROGRESS:

HMC will develop a tracking method to measure this progress. Volume of patient
interactions should increase from 2012 volumes.
 2012 number of blood sugar screenings at annual health fair will increase = 0
LAGGING INDICATOR HANCOCK WILL USE TO IDENTIFY IMPROVEMENT:

Diabetic death rate of 13.9%.
Other Local Resources identified during the CHNA process which are believed available
to respond to this need include the following:
Gulf Coast Health Educators
212 East Second Street - Ste. A, Pass Christian, MS
(228) 234-2046
Hancock Medical Lab
149 Drinkwater Blvd., Bay St. Louis, MS
(228) 467-8600
HMC Dietician
149 Drinkwater Blvd., Bay St. Louis, MS
(228) 467-8600
NP’s diabetic counseling
1278 Ocean Springs, MS 39564
(228) 875-3606
7. Smoking/Tobacco Use – Cigarette Expenditures at 91% US Counties; 30.6% of pop. in
Hancock use Tobacco; above national avg. use for co. and MS.
Problem Statement: The number of local residents who smoke or otherwise uses
tobacco products needs to decline.
HANCOCK SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE:

HMC provides smoking cessation program, Freedom from Smoking, smoking cessation
assistance; and

Hancock provides a smoke-free campus.
HANCOCK IMPLEMENTATION PLAN PROGRAMMATIC INITIATIVES:

HMC smoking cessation classes; and

Referrals to other smoking cessation resources.
Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
Page 36
ANTICIPATED RESULTS FROM HANCOCK IMPLEMENTATION PLAN

A decline in tobacco products usage in county.
LEADING INDICATORS HANCOCK WILL USE TO MEASURE PROGRESS:

Hancock will develop a tracking system to record the number of smoking cessation classes
offered to the community.
 2012 number of enrolled in smoking cessation classes = 6
LAGGING INDICATOR HANCOCK WILL USE TO IDENTIFY IMPROVEMENT

Tobacco expenditures ranking of Hancock Co within MS (#54)
Other Local Resources identified during the CHNA process which are believed available
to respond to this need include the following:
American Cancer Society
417 Security Sq., Gulfport, MS 39507
Freedom from Smoking (online)
http://www.ffsonline.org/
American Lung Association - Gulf State
Region
731 Pear Orchard Rd, Ridgeland, MS 39157
(228) 896-7024
(601) 206-5810
8. COMPLIANCE BEHAVIOR – Local experts cite education and prevention as needs; “I am
responsible for my health” below avg. impacts 57.2% of pop.; “Follows treatments” below
normal impacts 37.4% of pop.; – High School Graduation rate is 80% while Some College is at
60% for Hancock co.
Problem Statement: Not enough residents engage in immunization compliance
according to the CDC guidelines.
HANCOCK SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE:

HMC provides public awareness through marketing mediums;

HMC provides Flu shots to community and staff during flu season; and

HMC provides pneumonia vaccines to community members.
HANCOCK IMPLEMENTATION PLAN PROGRAMMATIC INITIATIVES:

Hancock will increase awareness on Flu and Pneumonia prevention for community
members.
ANTICIPATED RESULTS FROM HANCOCK IMPLEMENTATION PLAN

Increased immunization compliance for Hancock county residents.
LEADING INDICATOR HANCOCK WILL USE TO MEASURE PROGRESS:
Hancock Medical Center
Bay St. Louis, MS

Community Health Needs Assessment
Page 37
CMS Core Measure of Preventative Care, Percent of patients assessed and given pneumonia
vaccine.
 2012 number of Pneumonia vaccines provided = 50
LAGGING INDICATOR HANCOCK WILL USE TO IDENTIFY IMPROVEMENT

Medicare Hospital Comparison for Timely and Preventive Care citations for Preventative
Care
 2012 – Patients assessed and given pneumonia vaccination was 63.10%
Other Local Resources identified during the CHNA process which are believed available
to respond to this need include the following:
CDC
1600 Clifton Rd., Atlanta, GA 30333
800-CDC-INFO
(800-232-4636)
Local Pharmacies
Bay St. Louis, MS
HMC Pharmacy
149 Drinkwater Blvd., Bay St. Louis, MS
Local MD offices and clinics
Bay St. Louis, MS
MS Health Department
570 East Woodrow Wilson Drive, Jackson, MS
39216 web@HealthyMS.com
866-HLTHY4U
HMC Infection Control Dept.
149 Drinkwater Blvd., Bay St. Louis, MS
(228) 467-8600
(228) 467-8600
9. ACCIDENTS – #3 cause of death in County, statewide #10 – 101.3/100,000 ranking #1 MS
County – significantly higher than expected; death rates worse than US AND Peers for Motor
Vehicle Injuries; Approximately better than Peers and US rates for Unintentional Injury; Motor
Vehicle Crash Death Rate higher than MS or US avg.
Problem Statement: Reduce the number of deaths caused from motor vehicle accidents.
HANCOCK SERVICES AVAILABLE TO RESPOND TO THIS NEED INCLUDE:

HANCOCK Emergency service; and

HMC public awareness campaign on distracted driving.
HANCOCK IMPLEMENTATION PLAN PROGRAMMATIC INITIATIVES:

HANCOCK will initiate an awareness campaign on distracted driving; and

HANCOCK will take a leadership role in child restraints for newborns.
ANTICIPATED RESULTS FROM HANCOCK IMPLEMENTATION PLAN

Decreased distracted drivers; and
Hancock Medical Center
Bay St. Louis, MS

Community Health Needs Assessment
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Decreased fatal automobile crashes.
LEADING INDICATOR HANCOCK WILL USE TO MEASURE PROGRESS:

Number of AARP safe driving class participants:
 2012 AARP class participants = 35
LAGGING INDICATOR HANCOCK WILL USE TO IDENTIFY IMPROVEMENT

Accidental death rate 77.73 per 100,000 populations in Hancock, significantly above the MS
and US rates.
Other Local Resources identified during the CHNA process which are believed available
to respond to this need include the following:
MS Highway Patrol
PO Box 958, Jackson, Mississippi 39205
(601) 987-1212
Gulf Coast Trauma Committee
2512 Redwood Avenue, Pascagoula, MS 39567
(228) 712-2866
HMC ED
149 Drinkwater Blvd., Bay St. Louis, MS
(228) 467-8600
Hancock County Law Enforcement
agencies
Bay St. Louis, MS
AARP safe driving course
33500 Hwy. 63 E, Marked Tree, MS
(870) 239-9696
Mississippi Public Ed Driving
108 E Northside Dr., Jackson, MS
(601) 982-4188
Other Needs Identified During the CHNA Process
10. CANCER – #2 cause of death statewide and in County – 192/100,000 ranking #60 MS
County. Local experts cite Cancer as a concern also; Obtained a Pap/Cervix test in last 2 years is
was 8.1% below average, impacting 55.3%of the pop.; Mammogram above avg. impacts 43.8%
of pop.; Unfavorable rates worse than US AND Peers for Breast Cancer, Colon Cancer, Lung
Cancer
11. EMERGENCY SERVICES – Emergency Room use above avg. impacts 34.5% of pop.
12. PRIORITY POPULATIONS – 27.62% of children live in poverty; 19% of low incomes have
low food access; local experts note low income and children need better education on healthy
food choices and concerns about the number of uninsured in their community
13. CHOLESTEROL (HIGH) – Chronic high cholesterol affects 22% of the pop.; Routine
cholesterol screening below avg. impacts 47% of pop.
14. DENTAL – 5.65% of adult residents have no History of dental exams, exceeds MS avg.;
Dentists to Population Ratio significantly higher (adverse) than MS avg. and US goal
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Bay St. Louis, MS
Community Health Needs Assessment
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15. STROKE – #5 cause of death in County, statewide #4 – 44.5/100,000 ranking #69 MS County
– lower than expected for Co, and MS; Unfavorable rates worse than US and Peers for Stroke
16. BLOOD PRESSURE (HIGH) – Hypertension 15th cause of deaths in Co., death rate lower
than expectations; 15% above average, impacting 3.7% of the population
17. CHRONIC COPD/LUNG DISEASE/PULMONARY – Lung Disease affects 59.8 out of
100,000, and is 4th leading cause of death in Hancock county.; Chronic COPD is above average,
impacting 4.4% of the pop.; Chronic allergies above avg. impacts 24.6% of pop.
18. PREVENTABLE HOSPITALIZATION – Preventable Hospital Stays slightly higher than
MS avg. and US goals
19. PALLIATIVE CARE & HOSPICE – Palliative care programs do not exist in co., 8 facilities
provide Hospice services
20. PHYSICIANS – 90.5% of pop have used a Primary care physician at least once; Primary Care
Physician to Population Ratio significantly higher (adverse) than MS avg. and US goal
21. LIFE EXPECTANCY/PREMATURE DEATH – Life expectancy increased but females
improved better than males; Premature Death rate (death prior to age 75) in Hancock County is
statistically above the state average and the national goal
22. POLLUTION – Air particulate matter better than MS avg. but worse than US goal; Water,
drinking water safety worse than MS and US goal
23. CHRONIC OSTEOPOROSIS (bone disease) – Chronic Osteoporosis above avg. impacts
10.9% of pop.
24. ALZHEIMER'S – #6 cause of death statewide; 11.1 per 100,000 ranking #65 MS Counties;
lower than expected
25. LOW BACK PAIN (Chronic) – Chronic low back pain above avg. impacts 23.8% of pop.
26. FLU-PNEUMONIA – #8 cause of death in County, statewide #12 – 16.2/100,000 ranking
#62 MS County – significantly lower than expected
27. KIDNEY DISEASE – #7 cause of death in County, statewide #9 – 17.9/100,000 ranking #69
MS County – significantly higher than expected
Overall Community Need Statement and Priority Ranking Score:
Significant Needs Where Hospital Has Implementation Responsibility
1. AFFORDABILITY
2. MENTAL HEALTH/SUICIDE/SUBSTANCE ABUSE
3. OBESITY/OVERWEIGHT/Access to healthy food
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Bay St. Louis, MS
Community Health Needs Assessment
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4. CORONARY HEART DISEASE
5. MATERNAL AND INFANT MEASURES
6. DIABETES
7. SMOKING/TOBACCO USE
8. COMPLIANCE BEHAVIOR/PREDESPOSING CONDITIONS
9. ACCIDENTS
Significant Needs Where Hospital Did Not Develop Implementation Plan
None
Other Needs Where Hospital Developed Implementation Plan
None
Other Identified Needs Where Hospital Did Not Develop Implementation Plan
10. CANCER
11. EMERGENCY SERVICES
12. PRIORITY POPULATIONS
13. CHOLESTEROL (HIGH)
14. DENTAL
15. STROKE
16. BLOOD PRESSURE (High)
17. CHRONIC COPD/LUNG DISEASE/PULMONARY
18. PREVENTABLE HOSPITALIZATION
19. PALLIATIVE CARE & HOSPICE
20. PHYSICIANS
21. LIFE EXPECTANCY/PREMATURE DEATH
22. POLLUTION
23. CHRONIC OSTEOPOROSIS
24. ALZHEIMER'S
25. LOW BACK PAIN (Chronic)
26. FLU-PNEUMONIA
27. KIDNEY DISEASE
Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
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APPENDICES
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Bay St. Louis, MS
Community Health Needs Assessment
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Appendix A – Local Expert Advisor Opinion about Significant Needs
A total of 19 local expert advisors participated in an online survey offering opinions regarding their
perceptions of community health needs. The following is an analysis of their responses:
The first question was open-ended. “What do you believe to be the most important health or
medical issue confronting the residents of your County?” Answers were placed in a “Word Cloud”
format for analysis and generated the following image:
Word Clouds are analytical tools, which give greater visual prominence to words appearing more
frequently in the source text. This information visualization establishes a portrait of the aggregate
responses, presenting the more frequently used terms with greater text size and distinction in the
visual depiction. Common article word (i.e., “a,” “the,” etc.), non-contextual verbs (i.e., “is,” “are,”
etc.) and similar words used when writing sentences are suppressed by this application.
Specific verbatim comments received were as follows:

One of the most critical issues underlying many of the negative health statistics in our area is
lack of knowledge about human development and well being and the lack of support
systems to address those issues.. This is one of the causes underlying many of the local
negative health statistics: obesity, teen pregnancy, smoking, drug and alcohol abuse. In
Hancock County in 2010 35% of adults were obese, 30% reported lack of physical activity,
24% smoke and 14% reported excessive drinking. To turn these trends around will require
focused community education and medical support systems to encourage behavioral change;

They do not have good health insurance. And, they do not have confidence in their medical
center nor do they know when to count on the local hospital for services. Many people
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Bay St. Louis, MS
Community Health Needs Assessment
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move in from New Orleans and this is a detriment to the local health care provider since
they would rather go to Ochner's or some other trusted institution;

I believe the lack of medical doctors practicing along the Coast is a problem and causes great
concern for our future growth. We need competition in the medical field and more
specialists to choose from in our area;

Obesity, smoking, and alcohol;

Obesity with an increase of Diabetes Type 2 and Heart Disease;

Access to care;

Affordable health and medical care for all residents of the county. Everyone would benefit
from health/nutrition education, learning how to prepare meals, what to eat, would
definitely help healthy persons as well as, those diagnosed with a chronic disease;

We have zero hospitals providing mental health services here in Hancock County;

Obesity and proper nutrition and basic health care. The county must have school nurses as
this is often the only health care that the children receive;

Quality care for the underprivileged;

Unhealthy lifestyles precipitating long-term health conditions. Lack of pro-active health
screenings and follow-up to doctor care;

Lack of availability of health care beyond the emergency room for those who are uninsured;

Cardio-vascular disease;

Lack of resources for those who do not have health insurance or Medicaid; and

Hancock County suffered greatly during Hurricane Katrina and has been very slow to
recover in certain areas. Specialists, such as more OB/GYN, pediatric dentist and more
pediatricians are needed. Recreational facilities including a skating rink, Movie Theater and
indoor facilities were parents can bring children for birthday parties in a safe environment,
would help meet the social needs of the community.
Our second question to the local experts was, “Do you perceive there are any primary and/or
chronic disease needs, as well as potential health issues, of uninsured persons, low-income persons,
minority groups and/or other population groups (i.e. people with certain situations), which need
help or assistance in order to improve? If you believe any situation as described exists, please also
indicate who you think needs to do what.”
The responses generated the following image:
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Bay St. Louis, MS
Community Health Needs Assessment
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Specific verbatim comments received were as follows:

The mental health impact of Hurricane Katrina, the BP oil spill and the economic recession
have been profound in this community. In child care centers and schools teachers report low
social-emotional maturity as demonstrated in behavioral problems. Roughly 22% of
Hancock County residents are uninsured and there is often a waiting list for mental health
services should someone overcome the stigma of admitting to a mental health problem and
seek treatment for it. It is difficult to reach low-income persons who are uninsured through
traditional public health and mental health education and there is a paucity of professionals
available to provide the educational services;

Obesity, poor diet that has a heavy emphasis on fried foods, and alcoholic beverages that
leads to cardiovascular problems, stroke etc.;

Not that I am aware of but potentially there are a few concerns with people being over
medicated with use of prescriptions for ADHD or ADD, parents and children;

Tooth decay. Fluoridation of water;

A need for increased Health Educational Programs focused on Healthy Lifestyles;

All of the above;

There is a growing number of diagnosed diabetes patients in the state, and our area. All of
these patients need assistance with managing this diabetes, many of these diabetics are
elderly and, or uninsured, yet they need assistance in managing their disease;
Hancock Medical Center
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Community Health Needs Assessment
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
Hancock Medical desperately needs to provide services for the Mentally Ill and those with
Addictions. Our county has very little transportation, yet clients must go to a neighboring
county for inpatient mental health/substance abuse services. In addition, because of the lack
of inpatient services an out of control patient is often given sedatives & then their family
must provide transportation to another county;

Our children's health care must be addressed. School nurses make a huge impact. Parental
support and training would help. Prenatal Care for expectant mothers is important. But it is
an issue of getting the people to the care or the care to the people and education is again the
key;

Community outreach is needed from the sources, to educate the uninsured, low income and
minority households, as to the available resources, rather than those residents utilizing the
ER as a walk in medical clinic;

As the United States as a whole, Hancock County residents have potential for high blood
pressure, diabetes, cardiovascular disease, dental carries, and cancer. Those with inadequate
health insurance; low education level and limited access to services are most at risk;

Mississippi needs to participate in the Affordable Health Care act which would extend
Medicaid coverage low income persons;

There is a large populace that is uninsured. Many of them are obese and have diabetes and
other illnesses related to poor diet. Preventative care and easy access to nutrition education is
of prime importance;

Those patients without insurance need to have more resources available to them for health
care needs; and

Mississippi is 49th in state health rankings. Obesity and diabetes are prevalent and I believe
that programs addressing childhood obesity are needed. More information on lifestyle,
general health and prevention, etc. are necessary, with an emphasis on the approach used to
reach the population.
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Bay St. Louis, MS
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Appendix B – Process to Identify and Prioritize Community Need23
Individuals Participating as Local Expert Advisors
23
Responds to IRS Schedule H (990) Part V B 1. g. and V B 1. h.
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Bay St. Louis, MS
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Advice Received from Local Experts
Q. Do you agree with the observations formed about the comparison of Hancock County to all
other State counties?

I also consider second hand smoke to be a serious issue;

I agree with the above observation based on several years of study at the Cooper Institute in
Dallas, TX;

As far as healthy foods are concerned they are usually more expensive. For example if I am
feeding my children on a limited budget and I have to choose between a bag of apples or hot
dogs and French fries I am going to choose the hot dogs since this can fill them up for a
meal;

These numbers actually seem very low. It would seem that smoking and obesity are much
more widespread. If limited access to healthy food includes money to buy healthy food, I
would agree. But- since the grocery stores opened in the last year, I do believe it is accessible
from a logistic standpoint;

I have no idea how to estimate this percentage; and

2013 County Health Rankings shows 24% of the population smokes and about the same as
the state for adult obesity. That said, both of these issues need to be addressed. Food
insecurity is definitely a problem in the northern and southwestern part of the county. In the
last few years two additional grocery stores were built in south Hancock County making
food more accessible for many.
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Q. Do you agree with the observations formed about the comparison of Hancock County to its peer
counties?

The areas that we fare poorer than peer groups do not seem to fit with observed trends.
There are such a small percentage of blacks in Hancock County perhaps that is a small
denominator issue. Also- it would be of interest to look at access to neonatal services as a
contributing factor since Hancock has no NICU services available. I would also consider
access to a cath. lab as an issue for coronary artery disease. I don't think infants born to
unmarried women are relevant at all. So many couples live together as a family without
being married, that number is completely unreliable;

However, I would have to take another look at the breast cancer incidence; and

Births to unmarried women have become the norm and teen pregnancy is a serious issue for
our whole state. The ongoing stress from Hurricane Katrina, the recessions, the Oil Spill and
Hurricane Isaac has continued to impact many residents of the county and, in turn, impacts
physical health.
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Community Health Needs Assessment
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Q. Do you agree with the observations formed about the population characteristics of Hancock
County?

A need that should be considered is education with statistical data of Mississippi rankings in
areas. Teach us the importance of change and how to change to improve our overall well
being;

I am surprised that the median income is that thought it would be lower. We have so many
families getting section 8 housing due to low income;

Unemployment is deceiving because those on disability or trying to get disability are not
included, nor are those that are underemployed. I think the issue with most of the issues
with access to care has to do with insurance and availability of services;

The unemployment figure is not an accurate figure as it does not take into consideration the
many individuals of working age who are no longer seeking employment. We routinely deal
with people who have not worked for one year or more and are not registered and are not
counted. If those individuals were included the true level of unemployed would be closer to
15%; and

I think there's a typo – only 4% of the population is Hispanic. Hancock County has a very
low minority population compared to the rest of the state. The other statistics seem
consistent with data I've reviewed.
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Community Health Needs Assessment
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Q. Do you agree with the observations formed about the opinions from local residents?

I also feel that the single most critical issue impacting the quality of health care in Hancock
County is the certificate of need process. We need a cath. lab and an NICU, which is an
impossible task due to Memorial's monopoly on these services;

Lack of medical doctors practicing on the Coast who see uninsured patients; and

Addressing the issues cited here would go a long way towards improving the health of
county residents.
Q. Do you agree with the observations formed about the additional data analyzed about Hancock
County?
Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
Page 51

Coastal Family Health Center – Hancock Clinic, FQHC, offers access to primary healthcare
for adults and children. With the clinic located next to the hospital, it is centrally located and
takes fee-for-service, according to the National Poverty Guidelines, as well as Medicaid,
Medicare and other insurances. However, I do agree with the lack of affordable dental
services available to residents; and

These statistics are alarming in many ways. I'd like to know more about contributors to some
of the leading causes of death, i.e. blood poisoning.
Hancock Medical Center
Bay St. Louis, MS
Community Health Needs Assessment
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Appendix C – Illustrative Schedule H (Form 990) Part V B Potential
Response
Illustrative IRS Schedule H Part V Section B (form 990)24
Community Health Needs Assessment Answers
1. During the tax year or any prior tax year, did the hospital facility conduct a
community health needs assessment (CHNA)? If "No," skip to line 9
Illustrative Answer – Yes
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a. A definition of the community served by the hospital facility
b. Demographics of the community
c. Existing healthcare facilities and resources within the community that are
available to respond to the health needs of the community
d. How the data was obtained
e. The health needs of the community
f. Primary and chronic disease needs and health issues of uninsured persons,
low-income persons, and minority groups
g. The process for identifying and prioritizing community health needs and
services to meet the community health needs
h. The process for consulting with persons representing the community’s
interests
i. Information gaps that limit the hospital facility’s ability to assess the
community’s health needs
j. Other (describe in Part VI)
Illustrative Answer – check a. through i. Answers available in this report are found as
follows:
1. a. – See Footnotes #15 (page 11) & #16 (page 11)
1. b. – See Footnotes #18 (page 12)
1. c. – See Footnote #22 (page 28)
1. d. – See Footnotes #7 (page 6)
1. e. – See Footnotes #11 (page 8)
1. f. – See Footnotes #9 (page 8)
24
Questions are drawn from 2012 f990sh.pdf Forms and may change when the hospital is to make its 990 h filing
Hancock Medical Center
Bay St. Louis, MS
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1. g. – See Footnote #12 (page 9) & #22 (page 69)
1. h. – See Footnote #12 (page 9) & #22 (page 69)
1. i. – See Footnote #6 (page 6)
1. j. – No response needed
2. Indicate the tax year the hospital facility last conducted a CHNA: 20 _ _
Illustrative Answer – 2013
See Footnote #1 (Title page)
3. In conducting its most recent CHNA, did the hospital facility take into account
input from representatives of the community served by the hospital facility, including
those with special knowledge of or expertise in public health? If “Yes,” describe in
Part VI how the hospital facility took into account input from persons who represent
the community, and identify the persons the hospital facility consulted
Illustrative Answer – Yes
See Footnotes #10 (page 8), #11 (page 8)
4. Was the hospital facility’s Need Assessment conducted with one or more other
hospital facilities? If “Yes,” list the other hospital facilities in Part VI.
Illustrative Answer – No
5. Did the hospital facility make its CHNA widely available to the public? If “Yes,”
indicate how the Needs Assessment was made widely available (check all that apply)
a. Hospital facility’s website
b. Available upon request from the hospital facility
c. Other (describe in Part VI)
Illustrative Answer – check a. and b.
The hospital will need to obtain Board approval of this report, document the date of
approval, and then take action to make the report available as a download from its web site.
It may also be prudent to place a notice in a paper of general circulation within the service
area noting the report is available free upon request.
6. If the hospital facility addressed needs identified in its most recently conducted
CHNA, indicate how (check all that apply to date):
a. Adoption of an implementation strategy that addresses each of the
community health needs identified through the CHNA
b. Execution of an implementation strategy
c. Participation in the development of a community-wide plan
d. Participation in the execution of a community-wide plan
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e. Inclusion of a community benefit section in operational plans
f. Adoption of a budget for provision of services that address the needs
identified in the CHNA
g. Prioritization of health needs in its community
h. Prioritization of services that the hospital facility will undertake to meet
health needs in its community
i. Other (describe in Part VI)
Illustrative Answer – check a, b, g, and h.
6. a. – See footnote #23 (page 29)
6. b. – See footnote #23 (page 29)
6. g. – See footnote #12 (page 9)
6. h. – See footnote #12 (page 9)
7. Did the hospital facility address all of the needs identified in its most recently
conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and
the reasons why it has not addressed such needs?
Illustrative Answer – Yes
Part VI suggested documentation – See Footnote #25 (page 54)
8. a. Did the organization incur an excise tax under section 4959 for the hospital
facility's failure to conduct a CHNA as required by section 501(r)(3)?
b. If “Yes” to line 8a, did the organization file Form 4720 to report the section 4959
excise tax?
c. If “Yes” to line 8b, what is the total amount of section 4959 excise tax the
organization reported on Form4720 for all of its hospital facilities?
Illustrative Answers – 8. a, 8 b, 8 c – No