a
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
FLINT & GENESEE COUNTY, MICHIGAN
REPORT 2022
COMMUNITY
HE A LT H NEEDS
ASSESSMENT
Cover Photo Courtesy of the Flint & Genesee Group
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
TABLE OF CONTENTS
EXECUTIVE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
I. INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Community Health Needs Assessment Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Flint/Genesee County Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Organizations Completing the CHNA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
II. COMMUNITY HEALTH NEEDS ASSESSMENT INFRASTRUCTURE & PARTNERSHIPS . . . . . . . . . . 11
Partnerships and Potential Resources to Address Community Health Needs . . . . . . . . . . . . . . . 11
III. DATA COLLECTION & ANALYSIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Data Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Indicators and Data Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Methods and Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Factors that Affect Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
IV. COMMUNITY HEALTH NEEDS IDENTIFIED & ASSESSMENT PRIORITIES . . . . . . . . . . . . . . . . . . 19
Addictions (including the opioid epidemic) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Mental Health (inclusive of stress, anxiety, and depression). . . . . . . . . . . . . . . . . . . . . . . . . . 24
Social Determinants of Health (including housing, employment, education,
food insecurity, safety, and poverty). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Obesity & Healthy Behaviors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38
Health Care Access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40
Chronic Disease Burden . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
Maternal & Child Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Health Inequities (including the burden of systemic racism). . . . . . . . . . . . . . . . . . . . . . . . . .50
Safe & Affordable Drinking Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
COVID-19. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
2022 CHNA Community Resident Survey Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
APPENDIX A: EVALUATION OF IMPACT FROM 2019 CHNA IMPLEMENTATION . . . . . . . . . . . . . . . . 57
Part 1: 2019-2021 CHNA Implementation Plan Accomplishments Conducted via Greater Flint Health
Coalition in Partnership with Ascension Genesys, Hurley, and McLaren . . . . . . . . . . . . . . . . . . . . . 57
Behavioral Health Emergency Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .58
Community-Wide Strategy to Address the Opioid Epidemic . . . . . . . . . . . . . . . . . . . . . . . . . 59
Genesee Community Health Access Program (CHAP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Commit to Fit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Children’s Oral Health Task Force . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Connecting Kids to Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Flint Healthcare Employment Opportunities Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Your Health Your Choice Advance Care Planning Project . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Sexual Health: Genesee County Health Department . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Part 2: 2019-2021 Ascension Genesys Accomplishments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .64
Part 3: 2019-2021 Hurley Medical Center Accomplishments . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Part 4: 2019-2021 McLaren Flint Center Accomplishments . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
APPENDIX B: 2022 CHNA IMPLEMENTATION PLAN DEVELOPMENT, RESOURCES TO
MEET COMMUNITY NEEDS, AND PUBLIC DISPLAY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
EXECUTIVE SUMMARY
The residents of Genesee County, Michigan, and its urban core, the City of Flint, are served by
three local hospital systems: Ascension Genesys Hospital, Hurley Medical Center, and McLaren
Flint. These hospital systems have collaborated with the 501(c)3 nonprofit Greater Flint Health
Coalition and a collection of multi-sector and community stakeholders, including the Genesee
County Health Department, to complete a joint Community Health Needs Assessment (CHNA)
for the Flint & Genesee County region. The identification of Flint & Genesee County’s most critical
health needs and issues is based upon data and information provided by community residents,
health care consumers, health care professionals, community stakeholders, and multi-sector
representatives. These individuals participated in meetings of the Greater Flint Health Coalition’s
network of community organizations and partners or responded to a community-wide survey of
individuals and stakeholders who live and/or work in Genesee County. The identified community
health needs are also informed by the Greater Flint Health Coalition’s Community Data Scorecard,
a collection of over 500 metrics reviewed annually and designed to measure health status and
chronic disease priorities, social and economic factors impacting residents, and healthcare delivery
system access and utilization trends experienced in the region.
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Identification and Prioritization of Community Health Needs
The joint Community Health Needs Assessment (CHNA) conducted by this collaboration has
identified ten priority health needs for the Flint & Genesee County community. The identified
health needs were selected based upon their potential to impact both short- and long-term
health outcomes, the ability of local health care systems to have an impact on addressing the
identified needs, current priorities and programs, and effectiveness of existing programs. The
2022 priority health needs of focus for the Flint & Genesee County community are:
y Addictions (including the opioid epidemic)
y Mental Health (inclusive of stress, anxiety,
and depression)
y Social Determinants of Health
y Obesity & Healthy Behaviors
y Health Care Access
y Chronic Disease Burden
y Maternal & Child Health
y Health Inequities (including the burden of
systemic racism)
y Safe & Affordable Drinking Water
y COVID-19
Implementation Plan Development
As a result of the completed 2022 CHNA, the Greater Flint Health Coalition will convene the
three local hospital systems to develop implementation plans that seek to individually and
collectively address identified community health needs identified in this assessment. While
each Genesee County hospital partner is required to have its own CHNA Implementation Plan,
the local partners have committed to collaborate via the Greater Flint Health Coalition to align
implementation plan activities where possible to leverage existing programs, avoid duplication,
build economies of scale, and maximize available resources through combined community
benefit investment. These collective implementation plans will form the basis of a shared
Community Health Improvement Plan to be implemented in collaboration with the members
and stakeholders of the Greater Flint Health Coalition.
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
I. INTRODUCTION
Community Health Needs Assessment Population
For the purpose of the 2022 Community Health Needs Assessment (CHNA), Ascension Genesys
Hospital, Hurley Medical Center, and McLaren Flint have defined their joint service area and
population as Genesee County, Michigan. This is the same population served by the Greater Flint
Health Coalition and Genesee County Health Department. Genesee County includes the city of
Flint and encompasses the following zip codes: 48502, 48503, 48504, 48505, 48506, 48507,
48532, 48509, 48519, 48529, 48420, 48423, 48430, 48433, 48436, 48438, 48439, 48449,
48451, 48457, 48458, 48463, 48473, 48411, 48418, 48421, 48429, 48437, 48442, 48480, 48501,
48551, 48553, and 48746.
Flint/Genesee County Demographics
Located 70 miles northwest of Detroit, Genesee County, which includes its major urban
core, the city of Flint, was at one time the national epicenter of automotive forethought and
production. As the birthplace of General Motors (GM) in 1908 and home to the United Auto
Workers’ (UAW) famous Sit-Down Strike of 1936-37, Flint & Genesee County helped define
the American auto industry. By the late 1970s, GM employed more than 80,000 workers in
the county. Impacted by national deindustrialization in the 1980s and thereafter, a period of
disinvestment, depopulation, and urban decay would follow as the automotive industry declined
rapidly. By 2010, less than 8,000 GM jobs remained, approximately 10% of what once defined
the community’s manufacturing and economic base.
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
According to U.S. Census Bureau data, Genesee County’s current population of 406,211 includes
a racial composition of 75.3% white, 20.3% African American, and 3.6% Hispanic/Latino. While
nearly 200,000 people once lived within the city of Flint during its peak in the 1960s and 1970s,
today only 81,252 residents remain, a majority being African American (54.1%).
Population outmigration has impacted Flint & Genesee County with decreased tax revenue
and an increase in urban decay and neighborhood blight, especially in the city of Flint. As of
2020, there are 15,929 vacant homes in Genesee County, with the majority in the city of Flint
(American Community Survey). Home values in Genesee County remain lower than the values
experienced a decade ago ($104,800 median home value for 2019 compared to the 2007 value
of $129,300, U.S. Department of Housing & Urban Development). The median home value in the
city of Flint was only $31,700 in the U.S. Census Bureau’s five-year average (2016-2020), far
lower than that of the broader county.
The unemployment rate in Genesee County has yet to fully recover from the impact of the
COVID-19 pandemic. Averaging 4.9% in 2019, Genesee County’s unemployment rate, which hit a
high of 30.9% in April 2020 in the first month of the COVID-19 pandemic Stay-at-Home orders,
was 6.1% as of December 2021 (Bureau of Labor Statistics). The city of Flint’s unemployment
rate remains approximately twice that of the county rate.
Meanwhile, the poverty rate in Genesee County has decreased from 19.8% to 18%, and the city of
Flint has also decreased from 41.2% to 38.8% (U.S. Census Bureau, five-year estimates). However,
poverty rates for both Genesee County and city of Flint remain much higher than state (13.7%)
and national (12.8%) rates. According to U.S. Census Bureau data from 2020, Flint has one of the
highest poverty rates when compared to cities of its size in the United States, with approximately
61.9% of the city’s young children (0-5 years) living below the federal poverty level, it remains
nearly three times the state average of 21.9%. Median household income in 2020 (five-year
estimates) was $30,383 in the city of Flint and $50,269 in Genesee County, compared to $59,234
in Michigan and $64,994 in the United States (U.S. Census Bureau). As of 2020 (five-year estimates),
19.6% of Genesee County households were receiving Supplemental Nutrition Assistance Program
(SNAP) benefits. Within the city of Flint, 89.2% of students were eligible for Free or Reduced-Price
Lunch, a significantly higher rate than Genesee County (60.3%) and the state of Michigan (23.5 %)
(Michigan Department of Health and Human Services).
Social, economic, and environmental factors impact the health status among residents throughout
Genesee County, with significant impact on residents of the city of Flint, where higher rates of poverty
are associated with poorer educational outcomes, employment rates, crime/incarceration, and lack
of health insurance. Residents who are low-income, minority, or uninsured are disproportionately
impacted by environmental issues such as pollution, crime, property abandonment, lack of areas to
exercise outdoors, and lack of access to healthy foods. For example, African Americans in Genesee
County have a 2019 age-adjusted death rate per 1,000 residents of 44.8 for homicide (compared to the
state’s overall rate of 6.3). Significant disparities exist in life expectancy across the county. Zip codes
within the city of Flint have shorter life expectancies, while out-county areas typically have longer
life expectancies. The disparity in life expectancies between zip codes county-wide has risen
from 12.5 years in 2000-2002 to 15 years in 2018-2020, exhibiting a lack of health equity among
Genesee County residents.
For three consecutive years, Genesee County has been ranked among the least healthy counties
in Michigan for health outcomes and health factors. The age-adjusted death rates for heart
disease, stroke, diabetes mellitus, and kidney disease are higher in the county than statewide.
While health status indicates poor overall population health, data for minority, low income, and
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
uninsured populations indicate these populations are experiencing worse health outcomes when
compared to the population as a whole. Specifically, this relates to life expectancy, sexually
transmitted infections, obesity, heart disease, and birth weight. African Americans in Genesee
County are experiencing significant health disparities compared to the total population. For
example, African Americans in Genesee County have a 2020 age-adjusted death rate per 100,000
residents of 301.3 for heart disease (compared to the state’s overall rate of 232.2), 60.2 for stroke
(compared to 49.9), and 58.9 for diabetes mellitus (compared to 36.4) as reported by the Michigan
Department of Health and Human Services. Racial disparities are profound in all Years of Potential
Life Lost (YPLL) categories reviewed in the assessment.
Residents of the region continue to be impacted by significant environmental health factors.
The city of Flint continues recovery efforts as a result of the Flint Water Crisis. In April 2014,
state-appointed emergency managers in the city of Flint severed a half-century relationship
with the Detroit Water and Sewage Department (a Great Lakes source) to begin drawing
drinking water from the local Flint River. As a result of failures by city and state agencies to
effectively and safely treat the Flint River water for human consumption, the city’s drinking
water was contaminated with excessive levels of lead from the damaged infrastructure. This
contaminated water supply was then consumed by the city’s population for over 18 months.
As of December 2021, a public health emergency declaration is still in effect. While recent water
testing results have shown that the quality of the water supply is within acceptable limits for
lead, residents justifiably remain skeptical and distrustful as all of the affected lead service lines
have not yet been replaced and state-supported free bottled water has now ended. The City of
Flint Fast Start Program, which will replace all lead service lines in the city, was scheduled to be
completed by 2020, however, as of December 2021 that process is ongoing.
It would be insufficient to discuss the Flint & Genesee County experience with health disparities
without mentioning the impact of COVID-19 on the community. Prior to the pandemic, health
disparities were a significant obstacle to a pathway of optimal health for all residents.
COVID-19 has only increased those disparities, as data from the Centers for Disease Control and
Prevention and Michigan Department of Health & Human Services showed the disproportionate
impact of COVID-19 infection, severe illness, and death in the early phases of the pandemic.
While significant efforts were undertaken by multi-sector community partners to combat
COVID-19 disparities impacting residents, the underlying root causes of health inequities are
deeply rooted and require significant attention on an immediate and long-term basis.
Organizations Completing the CHNA
The 2022 CHNA is a partnership of Greater Flint Health Coalition member organizations, led by
the three area hospital systems that serve the Flint & Genesee County population: Ascension
Genesys Hospital, Hurley Medical Center, and McLaren Flint.
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ASCENSION GENESYS HOSPITAL
As a Ministry of the Catholic Church, Ascension Genesys Hospital is a non-profit hospital governed
by a local board of trustees represented by residents and medical staff that provides medical care
to Genesee and neighboring counties. As a leading health care provider in Mid-Michigan, Ascension
Genesys is anchored by a 21st century, 412-bed inpatient facility, built both clinically and architecturally
around a patient-centered care philosophy. Employing a medical staff of 674 primary and specialty
care clinicians, Ascension Genesys had over 18,000 patient discharges and provided $28,180,734
in care of persons living in poverty and other community benefit programs in fiscal year 2021.
Serving Michigan since 1997, Ascension Genesys is continuing the long and valued tradition of
addressing the health of the people in our community, following in the footsteps of the Sisters of
St. Joseph legacy in 1920. After witnessing the success of the Sisters of St. Joseph’s Kalamazoo
hospital, Detroit Bishop Michael J. Gallagher asked the Sisters if they would come to Flint and
open a hospital for the rapidly growing population there. The Sisters arrived in Flint in September
1920, and opened St. Joseph Hospital in a former residence. The hospital expanded as health
needs grew. At the same time, other local hospitals in the Flint area were being built. Eventually,
hospital facilities became more and more costly to maintain and upgrade, and affiliations
developed. Finally, the local hospitals made history by consolidating four hospitals into one, with
the opening of Genesys Regional Medical Center. In 1999, The Daughters of Charity National Health
System and the Sisters of St. Joseph Health System in Michigan came together to form Ascension
Health, a national Catholic healthcare system, in order to extend into the future a shared healing
Mission — caring for those persons who are poor and most in need.
HURLEY MEDICAL CENTER
Hurley is a 443-bed premier public teaching hospital recognized as a regional leader in advanced
specialized health care. Every year, more than 20,000 people choose Hurley for their inpatient
hospital care and its Emergency Department handles over 80,000 annual emergency cases. As
the region's only Level 1 Trauma Center, and with the region's only Burn Unit, Neonatal Intensive
Care Unit, Pediatric Intensive Care Unit, and Pediatric Emergency Department, Hurley continues
to honor its commitment to provide the highest level of critical care to those who need its services.
As well as being a recognized leader in clinical care, Hurley Medical Center is a highly-regarded
educator of tomorrow’s professionals, maintaining affiliations with Michigan State University,
the University of Michigan-Ann Arbor, the University of Michigan-Flint, Children’s Hospital of
Michigan-Detroit Medical Center, Oakland University, Mott Community College, and Henry Ford
Health System. With over 2,500 employees, Hurley is also a major contributor to local economic
development and one of Genesee County’s largest and most consistent employers.
Over the past 110 years, much has changed, but Hurley’s standards of excellence and delivery
of exceptional care have not. However much more remains to be done. In these times where
healthcare economics are in flux and the health status of the region is poor, Hurley Medical
Center’s vision continues to include expanding beyond the walls of the hospital to provide the
best possible care to its patients and their families before they get sick and after they leave the
hospital’s care. Hurley’s job is to become a partner in caring so that people can stay well, live
healthier lives and, when they are sick, return to health faster and with better outcomes.
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McLAREN FLINT
McLaren Flint is a 378-bed tertiary teaching facility located in Flint, Michigan, serving the
medical needs of residents in greater Genesee County and Mideast Michigan. McLaren Flint
is a subsidiary of McLaren Health Care, one of the largest integrated health care systems in
Michigan. McLaren Flint is affiliated with Michigan State University College of Human Medicine
in its medical residency programs including family practice, internal medicine, general surgery,
and orthopedic surgery. McLaren Flint also maintains vascular surgery, health psychology, and
cardiology fellowship programs in partnership with Michigan State University.
McLaren Flint holds the following recognitions:
y Blue Distinction Center+ for Spine Surgery by Blue Cross Blue Shield of Michigan
y Blue Distinction Center+ for Cardiac Care by Blue Cross Blue Shield of Michigan
y Blue Distinction Center+ for Bariatric Surgery by Blue Cross Blue Shield of Michigan
y Blue Distinction Center+ for Maternity Care by Blue Cross Blue Shield of Michigan
y Bariatric Surgery Center of Excellence by the Metabolic and Bariatric Surgery Accreditation
and Quality Improvement Program
y Advanced Comprehensive Stroke Center Designation by the Joint Commission and 2021 Get
with the Guidelines Gold Plus Award for Stroke Care from the American Heart Association
y Karmanos Cancer Institute at McLaren Flint is accredited by:
− American College of Radiology Radiation Oncology Practice
− Quality Oncology Practice Initiative — American Society of Clinical Oncology and Michigan
Radiation Oncology Quality Consortium (MROQC) 2021 Gold Card.
− The McLaren Proton Therapy Center on the Karmanos Cancer Institute campus is one of
only 39 proton therapy centers in the United States
y Diagnostic Imaging Center of Excellence Designation from the American College of Radiology
y Breast Imaging Center of Excellence from the American College of Radiology
y McLaren Flint Laboratory Accreditation by the American College of Pathologists
McLaren Flint annually provides more than $20 million in free and uncompensated care to
people unable to pay for services. In other community benefit services, the hospital contributes
an additional value of $10 million in free and reduced-price community-based programs.
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GREATER FLINT HEALTH COALITION
Established in 1996, the Greater Flint Health Coalition (GHFC) is a Flint, Michigan-based non-
profit collective impact organization and partnership between Genesee County hospitals,
physicians, businesses, insurers, public health professionals, policymakers, government leaders,
educators, organized labor, community organizations, residents, and all those concerned about
the well-being of our community and its residents. The two-fold mission of the Greater Flint
Health Coalition is to improve the health status of Genesee County residents and to improve the
quality and cost-effectiveness of the health care system in the community.
Through serving those living in Flint and Genesee County, the vision of GFHC is a healthy
Genesee County community practicing healthy lifestyles with access to the best and most
cost-effective health and medical care. As Genesee County’s neutral convener and backbone
support organization for community, public health, and health care initiatives, the Greater
Flint Health Coalition works together to achieve collective impact to improve the health status
of Flint & Genesee County residents. Currently, the GFHC is the neutral convener of 25 multi-
sector coalitions in the following focus areas: Access & Environment, Health Improvement,
Health Policy, Cost & Resource Planning, Quality & Innovation, Social Determinants of Health
and Health Equity, and Racial Disparities & Anti-Racism Activities. In addition to its convener
role, the GFHC also operates a variety of community-based programs including Commit to Fit,
Genesee Community Health Access Program (CHAP), Connecting Kids to Coverage, and the Flint
Healthcare Employment Opportunities (FHEO) Program.
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II. COMMUNITY HEALTH NEEDS ASSESSMENT
INFRASTRUCTURE & PARTNERSHIPS
Partnerships and Potential Resources to Address
Community Health Needs
Each year, the Greater Flint Health Coalition facilitates a Community Data Scorecard Project
to collect, aggregate, and trend a variety of key public health, healthcare, and community
health needs. The Community Data Scorecard Project informs the Community Health Needs
Assessment (CHNA), which is conducted every three years.
The 2022 CHNA includes input and data from residents, subject matter experts, and key community
organizations representing the broad interests of Genesee County. Specifically, the 2022 CHNA
includes input from persons with expertise in public health, health care, and government programs,
with special emphasis on inclusive engagement of community leaders, residents, and members of
the medically underserved, low income, and minority populations. The following list represents
the 2022 CHNA participating organizations and potential community resources to address the
significant health needs identified in the CHNA (in alphabetical order):
y Ascension Genesys Hospital
y Blue Cross Blue Shield of Michigan
y City of Flint
y Genesee County Department of Health and
Human Services
y Genesee County Health Department
y Genesee County Medical Society
y Genesee County Osteopathic Society
y Genesee Health Plan
y Genesee Health System (Genesee County
Community Mental Health)
y Genesee Intermediate School District
y Greater Flint Health Coalition
y Health Alliance Plan
y Hamilton Community Health Network
y Hurley Medical Center
y Meridian Health Plan of Michigan
y McLaren Flint
y McLaren Health Plan
y Molina Healthcare of Michigan
y Mott Children’s Health Center
y Region 10 Prepaid Inpatient Health Plan (PIHP)
y United Way of Genesee County
Greater Flint Health Coalition's Commit
to Fit program engages at Hasselbring
Senior Center with City of Flint Mayor
Sheldon Neeley and community residents.
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The GFHC’s Community Referral Network and Outreach Strategy Workgroup, with
representation from approximately 50 community-based organizations as well as residents
(representing all community demographics), also have been convened to discuss and inform
relevant community health needs, data, resources, and programs.
The lead organizations completing the 2022 Community Health Needs Assessment included
the Greater Flint Health Coalition, Ascension Genesys Hospital, Hurley Medical Center,
and McLaren Flint. This collaborative worked together to collect data and input from the
participating organizations and data sources listed in 2022 CHNA Section III. These primary
partners represent existing health care facilities and resources within the community that are
available to respond to the health needs of the community as they include Genesee County’s
three major health system facilities (Ascension Genesys Hospital, Hurley Medical Center, and
McLaren Flint) and the Greater Flint Health Coalition, a neutral, non-profit health coalition whose
membership includes multi-sector participation from additional health care facilities and resources
in the community, including (but not limited to) Genesee County’s federally qualified health
centers, safety-net healthcare providers for mental health and children, physician organizations,
community and social service agencies, health insurers, policymakers, educators, and more.
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III. DATA COLLECTION & ANALYSIS
Data Sources
Greater Flint Health Coalition (GFHC) facilitates public and privately sourced data collection,
aggregation, and analysis to inform the completion of the Community Health Needs Assessment
(CHNA). The following list represents the 2022 CHNA data public sources:
y Centers for Disease Control and Prevention
− American Community Survey
− Behavioral Risk Factor Surveillance
System (BRFSS)
− National Center for Chronic Disease
Prevention and Promotion
− National Vital Statistics System
y Health Resources and Services Administration
y Michigan Department of Health and Human
Services (state public health department)
y Michigan Health & Hospitals Association
y National Center for Education Statistics
y National Center for Healthcare Statistics
y United States Department of Housing
and Urban Development
y United States Census Bureau
y United States Department of Agriculture
y United States Department of Education
y United States Department of Justice
y United States Department of Labor
y University of Wisconsin Population Health
Institute, County Health Rankings Report
y Annie E. Casey Foundation, Kids Count
Data Book
y Center for Applied Research
and Engagement Systems
y Feeding America
y U.S. News & World Report “Healthiest
Communities”
The 2022 CHNA leveraged and utilized the GFHC’s existing Community Data Scorecard Project, which is a
collaborative data collection project completed annually by the GFHC and its community and institutional
partners that consists of public and private data shared and analyzed by local hospitals, insurers,
physicians, government agencies, health departments, school systems, businesses, and residents.
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The GFHC’s Community Data Scorecard Project utilizes multiple types of data collection and
aggregation methods to complete data analysis, including:
1. Quantitative data, both public and private is provided by the sources listed in this section;
2. Literature reviews are completed to identify state and national benchmarks that relate to
the indicators/metrics measured through the quantitative data sources;
3. Social determinant of health (SDOH) needs screening data collected in aggregate from
partnering patient-centered medical home practices and GFHC programs (such as Genesee
CHAP) for aggregate analysis; and
4. Qualitative data provided through a community health needs assessment survey which
was distributed by the Greater Flint Health Coalition, the 2022 CHNA primary partner
organizations (to patients visiting clinical delivery sites as well as stakeholders), and the
GFHC Community Referral Network (to residents served in community locations). The
survey was also shared via social media channels and the network of the Greater Flint
Health Coalition. The 2022 CHNA’s utilization of multiple types of data collection and
aggregation methods allowed for data-driven input across a broad range of community
informed indicators relating to overall population health, social determinants of
health (including geographic/location differences in health outcomes), and the needs
of disadvantaged populations including uninsured persons, low-income persons, and
minority groups within the Genesee County community.
Indicators and Data Measures
The 2022 CHNA includes a significant amount of data measures across multiple categories
relating to health and health factors. The Community Data Scorecard/CHNA process includes
trend data for a total of over 500 different indicators.
15
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
2022 Genesee County Community Health Needs Assessment
PUBLIC HEALTH, HEALTHCARE, AND COMMUNITY INDICATORS REVIEWED INCLUDE:
SUBSTANCE USE
Binge Drinking Rate
Drug Overdose Deaths
Opioid Related Inpatient Discharges by Age
Grouping
Opioid Related Inpatient Discharges by
Insurance Type
Opioid Related Emergency Department
Visits by Age Grouping
Opioid Related Emergency Department
Visits by Insurance Type
MENTAL HEALTH
Number of Psychiatrists (Adult and Child)
Intentional Self-Harm (Suicide) Rates
Report Rarely or Never Receive Needed
Social & Emotional Support
Percentage of Adults Reporting Poor
Mental Health on At Least 14 Days in the
Past Month
Mental Health Inpatient Hospitalization
SOCIAL DETERMINANTS OF HEALTH
Average Life Expectancy by Zip Code
City of Flint Population
County Population
City of Flint Race & Ethnicity
County Race & Ethnicity
County English Language Limitations
Employment
y Unemployment Rate
y Underemployment Rate
y Total Residents in Labor Force
y Rate of Residents in Labor Force
Education
y Public School Enrollment
y Rate of Public School Enrollment
y Rate of Preschool Enrollment,
Children Age 3-4
y Genesee Fourth-Grade English Language
Arts — NOT Proficient
y Flint Fourth-Grade English Language
Arts — NOT Proficient
y Genesee Eighth-Grade MSTEP Math —
NOT Proficient
y Flint Eighth-Grade Math — NOT Proficient
y Genesee Students Not Graduating
On Time
y Flint Students Not Graduating On Time
y Flint Students Identified as Homeless at
Any Time During the Year
y Rate of Residents with Bachelor’s Degree
Income
y Genesee County Poverty Rates
y Flint City Poverty Rates
y Genesee County Median Household
Income
y Flint Median Household Income
y Income Inequality
y Genesee Child Poverty, Ages 0-17
y Flint Child Poverty, Ages 0-17
y Genesee Free or Reduced-Price
School Lunch
y Flint Free or Reduced-Price School Lunch
y Genesee Young Children Receiving Food
Assistance Program (FAP)
y Flint Young Children Receiving FAP
Home Values
Housing Units (Total)
Housing Units (No Vehicle)
Housing Units (No Heating Fuel)
Households with Children
Severe Housing Problems
Homeless Population
Families Assisted with Housing
Shelter Utilization
Utility Assistance
Medical Transportation Assistance
Non-Medical Transportation Assistance
Literacy
Disability Rate
Hazardous Waste Generated
Air Pollution — Particulate Matter
Water Pollution
PFAs Sites
Lead Detection in Drinking Water
Leaking Underground Storage Tanks
Park Acreage
Rates of Violent Crime in County
Rates of Violent Crime in City of Flint
Injury Deaths
HEALTH BEHAVIORS & OBESITY
Number of Residents Reporting No Leisure
Time Physical Activity (Sedentary Lifestyle)
Access to Exercise Opportunities
Percentage of Overweight Adults
Percentage of Obese Adults
Food Environment Index
Food Insecurity
Limited Access to Healthy Foods
Residents That Report Tobacco Use
Number of Residents, Businesses, Schools,
and Churches Participating in Commit to Fit
Programming
Seat Belt Usage
HEALTH CARE ACCESS & COVERAGE
Percentage of Residents Uninsured
Number Of Medicaid Recipients
y Temporary Assistance for Needy
Families (TANF)
y Disabled, Aged, and Blind
y Healthy Michigan
y MIChild
y Flint Medicaid Expansion Waiver
Medicaid Enrollment and Retention Trend
Number of Medicare Recipients
Percentage of Insured Individuals Who
Report Having Unmet Medical Needs in the
Last 12 Months
Primary Care Physicians
Specialty Physicians
Total Physicians
Total Active MDs
Total Active DOs
Physician Assistants
Nurse Practitioners
Nurse Midwives
CHRONIC DISEASE & PREVENTION
Age Adjusted Mortality Rates, Total
(Per 100,000 Residents)
y Heart Disease
y Cancer
y Chronic Lower Respiratory Diseases
y Stroke
y Unintentional Injuries
y Diabetes Mellitus
y Alzheimer’s Disease
y Pneumonia/Influenza
y Kidney Disease
y All Other Causes
Persistent Asthma Diagnosis
Asthma Medication Management
Diabetes
Cardiovascular Disease
COPD
High Blood Pressure
Stroke
Cancer Incidence
Breast Cancer Screening
Cervical Cancer Screening
Prostate Cancer Screening
Colorectal Cancer Screening
No Dental Visit in Past Year
Communicable Disease
Immunizations Among Adults Aged 65 Years
and Older: Had Flu Vaccine in Past Year
Immunizations Among Adults Aged 65 Years
and Older: Ever Had Pneumonia Vaccine
Number of Residents with Documented
Advance Directives
MATERNAL/ INFANT HEALTH
Birth Rates (Per 1,000 Residents)
Number of Live Births
Infant Death Rate — County (Total)
Infant Death Rate (African-Americans)
Infant Death Rate (Whites)
Infant Death Rate — Flint (Total)
Infant Death Rate (African-Americans)
Infant Death Rate (Whites)
16
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
MATERNAL/ INFANT HEALTH (cont'd.)
Infant Death Rate Disparity
Genesee Less Than Adequate Prenatal Care
Flint Less Than Adequate Prenatal Care
Genesee Low-Birthweight Babies
Flint Low-Birthweight Babies
Rate Preterm Births
Birth Defect Cases
Live Births by Weight Gain of Mother
% Gestational Diabetes
% Hypertension
C-Section Rates
CHILD MEASURES
Child Dependency Ratio
Mortality
Leading Causes Hospitalizations
Genesee Child / Teen Death, Ages 1-19
Flint Child / Teen Death, Ages 1-19
Children in Single-Parent Households
Genesee Children in Investigated Families
Flint Children in Investigated Families
Genesee Confirmed Victims of
Child Abuse/Neglect
Flint Confirmed Victims of
Child Abuse/Neglect
Flint Children In Out-Of-Home Care —
Abuse/Neglect
Genesee Births to Teens, Under Age 20
Flint Births To Teens, Under Age 20
Genesee Children Tested for Lead, Ages 1-2
Flint Children Tested for Lead, Ages 1-2
Infant/Child Immunization Rate
(Children 19-35 Months Old)
Well Child Visits — First 15 Months Of Life
Well Child Visits — Third, Fourth, Fifth, and
Sixth Years of Life
Well Child Visits — Adolescents
Number of Enrollees Who Received Weight
Assessment and Counseling
Total Number of Inpatient Discharges
(Excluding Psychiatric)
Total Number of Inpatient Days (Excluding
Psychiatric)
Persistent Asthma — Total Number of
Inpatient Discharges (Excluding Psychiatric)
Persistent Asthma — Total Number of
Inpatient Days (Excluding Psychiatric)
Total Number of Emergency Room Visits
Total Number Of Enrollees with 2 or More
ED Visits
Persistent Asthma — Total Number of
Emergency Room Visits
Persistent Asthma — Total Number of
Enrollees with 2 or More ED Visits
Otitis Media — Total Number of Emergency
Room Visits
HEALTH CARE ECONOMIC IMPACT
Total Healthcare Employment
Total Wages (Direct and Indirect Jobs)
Associated Tax Revenue Generated
Total Economic Impact of Health Care
Sector
HIV, STI’S, & TEEN PREGNANCY
Chlamydia Rate
Gonorrhea Rate
Teen Pregnancy Rate (Age 15-19)
HIV Testing Among Adults Aged 18-64
HIV Prevalence
HEALTH CARE UTILIZATION (HOSPITALS)
Inpatient Discharges (Total)
Inpatient Days (Total)
Inpatient Revenue (Total)
Inpatient Expenses (Total)
Observations (Total)
Observations Revenue (Total)
Observation Expenses (Total)
Emergency Department Utilization (Total)
ED Revenue (Total)
ED Expenses (Total)
Preventable ED Utilization
Value of Uncompensated Care
Medicare & Medicaid DSH Funding
Medicare & Medicaid GME Funding
Mission Related Funding Levels: Other State
And Local Funding
% Readmissions Within 30 Days — AMI
% Readmissions Within 30 Days — CABG
% Readmissions Within 30 Days —
Heart Failure
% Readmissions Within 30 Days —
Pneumonia
% Readmissions Within 30 Days — COPD
% Readmissions Within 30 Days — THA/TKA
% Readmissions Within 30 Days —
All Conditions
PHYSICIAN/PROVIDER CAPACITY
MDs Age 0-54 (Percentage of Total)
MDs Age 55+ (Percentage of Total)
Total Undergraduates (Primary Care)
Average Number of Undergraduates
Total Post-Graduates (Primary Care)
Total Post-Graduates (Specialty Care)
Total Number of Post-Graduates Who
Remain in Genesee County
Total Number of Post-Graduates Who
Relocate Somewhere Else in Michigan
Total Number of Post-Graduates Who
Relocate Outside of Michigan
HEALTH CARE UTILIZATION (PAYERS)
Total number of Genesee County
Commercial, Medicaid, and Medicare
Member Months
Total number of Genesee County Babies
Total Service Utilization by Genesee County
Commercial, Medicaid, and Medicare
Enrollees — Inpatient Discharges
Inpatient Days — Total
Average Length of Stay
Non-ER Outpatient Service Utilization
Total Outpatient Service Utilization
Professional Services Utilization by
Provider Specialty
Total Service Utilization by Provider Specialty
y Family Medicine
y General Practice
y Internal Medicine
y Cardiology
y Radiology
y Pediatrics
y Physical Medicine & Rehab
y Obstetrics/Gynecology
y Orthopedic Surgery
y Emergency Medicine
y Anesthesiology
y Dermatology
y Ophthalmology
y Surgery
y Social Work
y Pathology
y Urology
y Otolaryngology
y Adult Psychiatry
y Child Psychiatry
Professional Service Utilization by
Procedure Type
Total Service Utilization by Procedure Type
y Cardiovascular — Total
y Dialysis — Total
y Immunizations — Total
y Mammography — Total
y Office Visits — Total
y Outpatient Surgery — Total
y Radiology — Total
y Physical Medicine — Total
y Psychiatric — Total
y Well Baby Exams — Total
y C-Sections — Total
y Behavioral Health — Total
y Chiropractic — Total
y Genetic Testing — Total
y Podiatry — Total
y Telehealth — Total
Public Health, Healthcare, and Community
Indicators were collected, aggregated, and
analyzed to assess trends and inform community
health needs. For each metric, state and national
comparisons were reviewed to inform need
identification. A health need was identified
when the community indicator was significantly
below comparative norms. Indicators reviewed
by GFHC exceed those highlighted in the two-page
table above.
17
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Methods and Approach
Following the collection, aggregation, and analysis of more than 500 metrics within the CHNA,
the data was then shared strategically through the Greater Flint Health Coalition’s established
network of collaborative partners. As noted, the GFHC is a multi-sector coalition recognized
in Genesee County as the neutral convener of community and population health initiatives.
The GFHC regularly convenes residents, subject matter experts, and community/institutional
organizations representing multi-sector interests through the engagement of representatives
from business, education, public health, physicians, hospitals, health insurers, safety-net
providers, community-based organizations, residents, policymakers, foundations, labor, and
media. This network of collaborative partners is continuously engaged to review and prioritize
the health indicators and needs as detailed in the CHNA.
The following entities informed the collection and review of relevant CHNA data, measures, and
perspectives:
y Greater Flint Health Coalition’s Board of Directors, comprised of 35 executive and community
leadership representatives from sectors that include health care, health insurers, government,
business, education, organized labor, and the at-large community.
y Greater Flint Health Coalition’s established multi-sector Committees and Task Forces that
work on various projects and activities within the GFHC focus areas of Access & Environment,
Health Improvement, Health Policy, Cost & Resource Planning, Quality & Innovation, Social
Determinants of Health, and Health Equity. Collectively, these Committees and Task Forces
include approximately 300 members who each have special knowledge and subject matter
expertise specific to their sector of representation
y Greater Flint Health Coalition’s Community Referral Network, which represents a network
of approximately 50 community-based organizations and social service agencies that serve
residents, with special emphasis on minority groups, the uninsured, and low-income residents.
y Strategic planning representatives from the 2022 CHNA primary partners, specifically Ascension
Genesys Hospital, Hurley Medical Center, McLaren Flint, and Greater Flint Health Coalition.
y Greater Flint Health Coalition’s Data Review Subcommittee, which includes representatives
from the Genesee County Health Department, Blue Cross Blue Shield of Michigan, Meridian
Health Plan, McLaren Flint, Hurley Medical Center, Ascension Genesys Hospital, Genesee
Health System, Molina Healthcare of Michigan, Health Alliance Plan, and Genesee County
Osteopathic Society.
y Local government leaders from the City of Flint and Genesee County Board of Commissioners,
as well as locally elected representatives to the Michigan State Senate and House of
Representatives.
y More than 17,000 unique community residents surveyed through multiple survey
instruments (e.g. CHNA Community Resident Survey, GFHC program and partner-led
Social Determinants of Health Screening Surveys) relevant to developing a broad
collection of community informed input.
18
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Factors that Affect Health
Collectively, the sources, indicators, methods, and measures represent the continuum of
factors that affect community and personal health.
Figure 2: Social and Economic Factors Drive Health Outcomes
Economic
Stability
Neighborhood
and Physical
Environment Education Food
Community and
Social Context
Health Care
System
RACISM AND DISCRIMINATION
Employment
Income
Expenses
Debt
Medical Bills
Support
Housing
Transportation
Safety
Parks
Playgrounds
Walkability
Zip Code/
Geography
Literacy
Language
Early Childhood
Education
Vocational
Training
Higher
Education
Food Security
Access to
Healthy
Options
Social
Integration
Support
Systems
Community
Engagement
Stress
Exposure to
Violence/
Trauma
Health
Coverage
Provider
Availability
Provider
Linguistic
and Cultural
Competency
Quality of Care
Health Outcomes: Mortality, Morbidity, Life Expectancy, Health Care Expenditures,
Health Status, Functional Limitations
Table adapted courtesy of Kaiser Family Foundation
19
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
IV. COMMUNITY HEALTH NEEDS IDENTIFIED &
ASSESSMENT PRIORITIES
Following its partner-based data
collection and review process, data for
the Community Health Needs Assessment
(CHNA) was compiled from both public
and private sources gathering insight from
quantitative and qualitative data reported
by numerous community partners as
well as input from over 800 Genesee
County residents who participated in
community health needs surveys and
over 17,000 additional Genesee County
residents that have completed social
determinant of health surveys in more
than 50 clinical settings throughout the
county. As a result, a consolidated list of
priority health needs emerged. The three
Genesee County hospitals and Greater
Flint Health Coalition (GFHC) leadership
convened an ad-hoc Community Health
Needs Assessment Workgroup to further
analyze and prioritize the needs. Summary
data from all sources was aggregated
by priority need area and presented to
appointed CHNA Subgroup members.
Priorities were reviewed and finalized using the following additional criteria:
y Data trends, with an emphasis on disparities, comparing local, state, and national norms,
where possible;
y Resident input on how community, social, and environmental factors affect their health and
the health of the community;
y The hospital and health systems’ ability to have an impact on community health needs identified;
y Alignment with existing multi-sector efforts focusing on the same service area, population,
and priorities;
y Current hospital and GFHC community priorities and programs;
y Effectiveness of existing programs and a gap analysis of where additional efforts are needed; and
y How the GFHC and its partners responded to identified community health needs in the past.
Once priorities were identified, the CHNA was subject to a multi-level review process including
approval by the Greater Flint Health Coalition’s Board of Directors and each hospital’s Board.
Based upon the process and criteria described, the priority health needs for Ascension Genesys
Hospital, Hurley Medical Center, McLaren Flint, and the greater Flint and Genesee County region
resulted in ten priority community health needs identified.
20
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Addictions (including the opioid epidemic)
Substance use is a rapidly growing health behavior that contributes to poor health status, poor
health outcomes, and increased morbidity and mortality. In Genesee County, the number of
deaths attributed to drug use has been increasing. The rate of drug-induced deaths (all deaths
for which drugs are the underlying cause including drug overdoses and chronic drug use,
for both illicit and prescription or over-the-counter drugs) in Genesee County has more than
quintupled since 2000 and is well above the average for the state of Michigan.
0
10
20
30
40
50
Genesee County
Michigan
2020201920182017201620152014201320122011201020052000
Drug-Induced Crude Mortality Rate (per 100,000 estimated population)
Drug-Induced Crude Mortality Rate
Michigan Genesee County
9
8.9
13.8
13.7
26.3
17.5
20.6
17.3
24.9
16.4
21.4
18.3
25.9
20.5
32.6
23.5
38.4
27.5
41.2
30.3
55.1
28.5
25.4
47.8
29.4
Michigan Department of Health and Human Services, 2000-2020
Genesee County Quick Response Team members
engaging residents about available resources to
educate and support individuals experiencing
substance use issues.
21
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Like many communities across the United States, Genesee County is experiencing an opioid
epidemic. According to the latest data available from the Michigan Overdose Data to Action
Dashboard, the prescription opioid unit rate for Genesee County in 2021 was 11,233.4 opioid pills/
capsules/tablets per every 1,000 persons. Michigan Department of Health and Human Services
indicates that total overdose deaths declined from 2018 to 2019 but saw a slight increase in 2020.
It is important to note that since 2018, White residents dying of overdose has decreased, whereas
African American overdose deaths have increased by 51%. The COVID-19 pandemic has only
increased substance use, with the Centers for Disease Control and Prevention reporting in June of
2020 that 13% of Americans reported starting or increasing substance use as a way of coping with
stress or emotions related to the pandemic.
Michigan Death Certificates, Division for Vital Records and Health Statistics, MDHHS, 2020
Measure Genesee County Michigan United States
Drug overdose deaths per 100,000 population 44.7 24.5 21.6
CDC National Vital Statistics Program, 2019
Opioid-related inpatient hospital use is increasing in Genesee County. Data collected via the
Greater Flint Health Coalition’s Mental Health & Substance Use Task Force from Genesee
County’s three hospital systems indicates that inpatient hospitalizations related to opioid use
for all ages increased 14.4% between 2016 and 2019, surpassing the state’s rate in 2017. While
the rates of opioid-related inpatient hospitalizations for the 25 to 44-year-old age demographic
has started to slightly decline from 2017 to 2019, the rates for adults 45-64 years and 65 years
and older continue to rise and have surpassed that of their younger counterparts. For 2019, the
population 65 years and older had the highest rates of opioid inpatient hospitalizations at 5.08
per 1,000 residents followed by the rate for individuals 45-64 years at 4.85 per 1,000 residents,
with both being considerably higher than the respective state rates of 4.91 and 3.88.
0
40
80
120
160
200
Total
Black
White
2020201920182017201620152014
Genesee County Overdose Deaths (by race)
Number of Overdoses
White Black Total
13
10
21
24
38
39
59
43
56
62
73
114
137
130
161
176
221
133
175
120
184
22
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
In 2019, opioid-related Emergency Department (ED) utilization for all ages decreased after trending
upwards for several years, the result of multiple state policy initiatives and community-based
interventions to address the issue. While the rate of opioid-related ED use decreased over 25% in
2019 for individuals 25 to 44 years of age, this demographic remains of particular concern in Genesee
County, with rates far exceeding the state and national averages for opioid-related hospital use.
0
1
2
3
4
5
6
> 65 years45-64 years25-44 years0-24 years*
GFHC Community Data Scorecard, Aggregate Hospital Data Submission, Agency for Healthcare Research and Quality, 2017-2019
Genesee County Opioid Related Hospital Utilization
Inpatient Discharge per 1,000 by Age Group
0.77
4.25
3.55
5.38
0.50
4.63
5.47
3.85
0.58
4.18
4.04
3.92
0.55
4.25
4.36
5.33
0.43
4.23
5.01
3.51
0.52
4.02
4.02
3.70
0.35
4.85
5.08
4.81
0.32
3.88
4.91
3.24
2017 Genesee County 2017 (Q4) Michigan 2017 (Q4) U.S. 2018 Genesee County
2018 (Q4) Michigan 2018 (Q4) U.S. 2019 Genesee County 2019 (Q4) Michigan
23
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
In 2019, Genesee County’s 25 to 44-year-old age demographic had an opioid-related ED
utilization rate of 6.91 compared to the state rate of 4.82. The rate of opioid-related ED visits
for Medicaid recipients was the highest of all payers, increasing 33.7% between 2016 and 2019
as reported by the local hospitals. The rise in opioid-related deaths and ongoing opioid-related
hospital use emphasizes the need to continue efforts to connect individuals presenting to the
hospital Emergency Department with community resources for substance use treatment or
recovery support. These needs have only been exacerbated by the COVID-19 pandemic and
continue to underscore the importance of coordinated efforts to address the opioid epidemic at
a community-wide level (e.g. GFHC’s Community-Wide Strategy to Address the Opioid Epidemic).
COMMUNITY RESPONSE: When Genesee County residents were asked via the 2022
CHNA Community Resident Survey to identify the three most important health problems, 67%
of them identified addictions as one of the top three. When asked about the top three risky
behaviors, 58% identified drug abuse while 39% identified alcohol abuse.
0
2
4
6
8
10
2019 (Q4) Michigan
2019 Genesee County
2018 (Q4) U.S.
2018 (Q4) Michigan
2018 Genesee County
2017 (Q4) U.S.
2017 Genesee County
> 65 years45-64 years25-44 years0-24 years*All ages
Genesee County Opioid Related Hospital Utilization
Emergency Department Visits per 1,000 by Age Group
3.29
1.15
8.59
2.59
1.01
2.26
0.85
4.50
2.48
1.14
3.90
1.38
9.62
3.61
1.00
2.49
0.73
5.35
2.65
1.51
2.29
0.72
4.68
2.56
1.18
2.85
1.07
6.91
2.47
1.02
2.24
0.57
4.82
2.41
1.43
2017 Genesee County 2017 (Q4) U.S. 2018 Genesee County 2018 (Q4) Michigan
2018 (Q4) U.S. 2019 Genesee County 2019 (Q4) Michigan
GFHC Community Data Scorecard, Aggregate Hospital Data Submission, Agency for Healthcare Research and Quality, 2017-2019
24
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Mental Health (inclusive of stress, anxiety, and depression)
For Genesee County, as with many communities having significant health disparities and high
rates of poverty, mental health is a serious concern and was only exacerbated by the COVID-19
pandemic. Mental health indicators demonstrate that Genesee County residents report greater
numbers of poor mental health days and have higher rates of depression than their state and
national counterparts. Good mental health is critical for navigating the challenges of daily life,
education, and employment. Depression is often overlooked in treating chronic disease even
though it may have a great impact on health behaviors, morbidity, and health outcomes.
Measure Genesee County Michigan United States
Adults self-reporting more than 14 days within the
last 30 where their mental health was not good
19.5% 15.4% 13.1%
Medicare fee-for-service population with
depression
22.5% 20.9% 18.4%
Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System. Access via the Web Enabled Analysis Tool.
MIBRFSS Annual Report. 2018-2020
Centers for Medicare and Medicaid Services, 2020
In Genesee County, 19.5% of residents’ report having more than 14 poor mental health days
in the past month per the Behavioral Health Risk Factor Surveillance System (BRFSS), higher
than both statewide and national rates. Rates of depression within Genesee County’s Medicare
population have been trending upward at a rate that is greater than that for Michigan and the
United States. Evidence suggests that communities with more unhealthy days were likely to
have higher rates of unemployment and poverty, increased percentages of adults who did not
complete high school, and higher mortality rates (County Health Rankings).
13%
15%
17%
19%
21%
23%
25%
United States
Michigan
Genesee County
201820172016201520142013201220112010
Percentage of Medicare Population
with Depression by Year 2010 through 2018
Percentage of Medicare Population
with Depression
Genesee County Michigan United States
14.0%
15.0%
15.5%
15.9%
16.2%
16.7%
16.8%
17.9%
18.4%
14.6%
16.4%
17.7% 17.7%
18.4%
18.6%
19.3%
20.0%
20.9%
15.6%
17.1%
19.2% 19.2%
19.9%
20.3%
20.1%
21.4%
22.5%
Centers for Medicare and Medicaid Services, 2018. https://data.cms.gov/medicare-chronic-conditions/specific-chronic-conditions/data/
25
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Mental health related needs in Genesee County, particularly those within the city of Flint, were
already higher due to the community-wide trauma experienced as a result of the Flint Water
Crisis. The COVID-19 pandemic increased stress and anxiety levels within the whole population
and public health actions such as social distancing have led to increased feelings of isolation
and loneliness, further adding to emotional and mental health challenges. Genesee County has
been designated as a Health Professional Shortage Area for Mental Health (as reported by U.S.
Department of Health & Human Services, Health Resources and Services Administration). The
social determinants of health, as highlighted elsewhere in this report, further compound the
mental health issues and trends observed in the community.
COMMUNITY RESPONSE: Mental health was identified by community residents
completing the 2022 CHNA Community Resident Survey as the second most important
health problem in the community, as 42% of respondents to the survey question identified
“Access to mental and behavioral health services” as one of their top three health problems.
When Genesee County residents were asked which health issues they are dealing with, 45%
identified stress and 33% identified mental health problems such as depression, anxiety, etc.
Regarding social isolation, 24% of residents indicated they “sometimes” felt isolated from
others, and 18% “often” felt isolated from others.
26
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Social Determinants of Health
(including housing, employment, education, food insecurity, safety, and poverty)
According to the Robert Wood Johnson Foundation, 80% of the factors impacting health
outcomes fall outside traditional healthcare delivery. When these social determinants of health
(SDOH) needs are not met, more serious health concerns may emerge, while existing conditions
are often left untreated or undiagnosed. In Genesee County, this relationship could not be more
apparent. In the 2021 County Health Rankings & Roadmap Report, Genesee County ranked 36th
out of 83 counties in Michigan for clinical care and 80th in health outcomes. Despite a relatively
high ranking in quality of healthcare services, health outcomes experienced by Genesee County
residents are near the bottom of all counties in the state. This disparity is explained by the
county’s poor rankings in Social & Economic Factors (64th) and Physical Environment (80th)
emphasizing the impact that social and environmental conditions have on an individual’s health.
The need in Genesee County is so significant, support could be gathered around any number of
social needs, but for the purpose of this assessment, social needs were chosen that have the
most far reaching implications on the health of the community, as well as those being identified
by residents themselves. The 2022 CHNA Community Member & Stakeholder surveys were
distributed to over 800 community residents representing all Genesee County zip codes and
an additional 153 “stakeholders” which were defined as healthcare executives or managers, as
well as members of various leadership committees within the major health care institutions.
Residents were asked to identify the top healthcare, environmental, and socioeconomic
concerns in Genesee County.
Additionally, as part of the ongoing Genesee Community Health Innovation Region (CHIR)
Initiative of the Greater Flint Health Coalition, there has been a community-wide SDOH
screening effort in Genesee County since 2017. As a component of the Genesee CHIR Initiative,
Genesee County Patient-Centered Medical Home (PCMH) practices, in partnership with the
Greater Flint Health Coalition, Genesys PHO, McLaren Physician Partners, and Professional
Medical Corporation (PMC), developed and administered a standardized SDOH screening tool
that was collected for over 40,000 Genesee County-based patients by the end of January
2020. Results were uploaded monthly to a central data repository administered by Greater
Flint Health Coalition oversight, for detailed monitoring and analysis of Genesee County SDOH
needs sorted by age, gender, zip code, and type of health insurance coverage. SDOH screening
questions cover domains including food, utilities, housing, healthcare access, safety, substance
use, depression, water, child care, education, employment, stress, anxiety, and transportation
(medical and non-medical). Patients were asked to identify areas where they had a need, as well
as provided an opportunity to indicate if they desired assistance or support getting connected
to a community resource to address an indicated need.
The Figure 1 entitled “SDOH Screening Needs Identified” illustrates screening results from 7,877
Medicaid beneficiaries collected between January 1, 2019, and January 31, 2020.
27
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
HOUSING
Stable housing is critical to an individual’s health and well-being and provides the foundation for
social mobility and achieving positive health outcomes. In 2019, home values in Genesee County
experienced a decline with a median home value of $104,800 compared to $118,700 in 2018,
and a lack of safe and affordable housing for lower income residents continues to present as a
wide-spread problem. According to the U.S. Department of Housing and Urban Development
(HUD) Comprehensive Housing Affordability Strategy (CHAS) database, a severe shortage
exists in housing supply for very low-income individuals. For a total of 10,520 very low-income
households in Flint, roughly 2,000 affordable rental units were identified.
Affordability is not the only issue. For households in the low-moderate income range,
housing supply is sufficient, but many of the available units are in sub-standard condition
or in unsafe areas. Out of the 167,890 households in Genesee County, 51,060 or 30% are
considered sub-standard and of those 26,455 have severe problems. Approximately 55%
of renter occupied units in Flint are either sub-standard (e.g., lack of complete plumbing
or kitchen facilities), overcrowded, or cost burdened. Out of roughly 40,000 households,
8,900 in Flint are experiencing a severe cost burden. Severe cost burden is defined as
spending 50% or more of income on housing costs.
0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0%
Substance Abuse
Safety
Transportation Other
Childcare
Utilities
Health Literacy
Health Care Access
Housing
Job Training
Employment
Transportation Medical
Food
Clean Water
Depression
27.3%
Percentage of Respondents That Identified Need
Figure 1: SDOH Screening Needs Identified January 1, 2019 through January 31, 2020
Medicaid Beneficiaries (n = 7,877)
19.1%
13.1%
12.4%
11.6%
9.0%
8.7%
7.2%
6.0%
5.9%
5.5%
4.6%
4.4%
2.7%
28
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Housing that is both safe and affordable is hard to come by for most low-income residents.
In areas of Genesee County outside the city of Flint, an even greater shortage of affordable
housing exists, resulting in the county’s lowest income residents concentrated in urban areas.
Another shortage area is seen in both quality and supply of permanent supportive housing
for non-homeless special needs-residents, such as those who are mentally ill, developmentally
disabled, at-risk youth, elderly, victims of domestic violence, and persons with HIV/AIDS.
Housing supply for these groups is very limited and programs are often administered by
non-profit agencies, which are overburdened and consistently operating with inadequate
funding for service-delivery to meet demand. Where resources are available, a lack of effective
prioritization of need, as well as confusing and burdensome processes present significant
barriers to navigating these services. These factors have resulted in individuals living in
sub-standard housing, “couch-surfing,” or becoming homeless. Recently, the community’s
designated Continuum of Care organization has undergone a governance reorganization
and is in the process of implementing a new governance charter to support Genesee County
permanent supportive housing providers to improve the coordinated system of entry to ensure
available housing units are provided to those with greatest need.
Year
2014 2015 2016 2017 2018 2019 2020
Number of homeless individuals
635 488 377 420 438 450 349
Department of Housing and Urban Development, 2014-2020
COMMUNITY RESPONSE: When asked via the 2022 CHNA Community Resident
Survey about the three most important factors for a healthy community, 25% of residents
identified safe and affordable housing. When asked to identify the top three environmental
factors impacting the community, affordable housing received the second highest rate of
response out of all categories (49.5%) only behind clean water.
EMPLOYMENT
While unemployment has declined significantly since 2011, Genesee County and Flint continue to
exhibit an unemployment rate greater than state and national averages. As of December 2021,
residents in the city of Flint experienced an unemployment rate of 10.9%, more than double the
state (4.2%) and national (3.7%) averages. The unemployment rate for Genesee County at 6.1%
was also higher than the state and national rates.
At the onset of the COVID-19 pandemic, residents of the city of Flint and Genesee County
were hit exceptionally hard by unemployment due to Michigan’s stay-at-home orders. In April
2020, almost half the workforce was unemployed in the city Flint with an unemployment rate
of 45.7%, and almost one third the workforce in Genesee County with an unemployment rate
30.9%. Both these unemployment rates were significantly higher than the state and national
rates of 22.8% and 14.4%, respectively, for the same time period. While the unemployment rates
have since recovered, they remain above the pre-pandemic numbers.
29
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Coupled with unemployment, many employed residents are not earning a living wage. Genesee
County’s median household income in 2019, according to the U.S. Census, was around $50,389
which is notably lower than the state of Michigan median of roughly $59,584. The city of Flint
has a reported median household income of only $31,113, which is about half that of the state
of Michigan. Earning a living wage is not only instrumental to preventing homelessness, but it
also impacts every facet of an individual’s quality of life and their associated health outcomes.
Financial instability creates barriers to access including insurance coverage, health services,
healthy food, and other necessities that contribute to poor health status.
COMMUNITY RESPONSE: When the 2022 CHNA Community Resident Survey asked
community members to identify the top three health concerns in Genesee County that
government official should focus on over the next three years, employment ranked fifth in
the number of responses across all needs. When asked to identify the top three factors of a
healthy community, “good jobs and a healthy economy” received the fourth highest rate of
responses overall with a 31%.
0%
10%
20%
30%
40%
50%
United States
Michigan
Genesee County
Flint
202120202019201820172016201520142013
Bureau Labor & Statistics, 2011-2021
Unemployment Rates
Unemployment Rate
Flint Genesee County Michigan United States
18.6%
10.8%
11.3%
10.2%
9.1%
7.6%
7.3%
6.4%
6.8%
6.5%
6.9%
6.3% 6.3%
5.7%
6.0%
4.7%
8.7%
8.2%
9.8%
9.8%
8.4%
6.6%
6.1% 5.3% 5.8%
5.5% 5.3% 5.1%
4.8% 4.9%
5.0%
4.3%
7.1%
6.8%
8.5%
7.7%
7.0%
6.1%
5.6% 5.3% 5.1%
5.1% 4.6% 4.5%
4.1% 4.4%
4.0%
4.0%
6.8%
5.7%
19.3%
17.6%
15.9%
13.4%
12.9%
11.4%
12.1%
11.6%
12.3%
11.2% 11.2%
10.3%
10.7%
45.7%
30.9%
22.9%
14.4%
14.9%
13.2%
7.4%
8.5%
6.5%
30
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
EDUCATION
A quality education system is paramount to the health of a community. Educational achievement
affects not only employment and income, but access to health care, health literacy, and a person’s
ability to engage in healthy behaviors, making it one of the strongest predictors of health.
High school graduation rates for students in Genesee County consistently fall slightly below the
statewide average, while those for Flint Community School students are considerably lower
as demonstrated in the graph below. High school graduation rates for Flint Community School
students plummeted in 2019-2020 to 52.3%, a result of the challenges brought forth by the
COVID-19 pandemic related to remote learning and social and racial inequities.
High school dropout rates have been decreasing, with Genesee County’s rate of 7.4% falling
below the state average of 7.8% for the first time in recent history. Meanwhile, the dropout rate
for Flint students at 14.4% is still considerably higher than both the county and state.
50%
55%
60%
65%
70%
75%
80%
85%
Michigan
GISD
Flint
2019-20202018-20192017-20182016-20172015-20162014-20152013-2014
Flint GISD Michigan MISchoolData.org, 2013-2020
High School Graduation Rates
Percentage of Students Who Graduate
High School on Time (4 year cohort)
78.6%
76.2%
58.4%
79.7%
78.8%
64.1%
79.8%
78.5%
59.4%
80.2%
78.5%
67.0%
80.6%
79.0%
66.8%
81.4%
79.7%
64.9%
82.1%
79.7%
52.3%
COMMUNITY RESPONSE: When Genesee County residents were asked via the 2022
CHNA Community Resident Survey to identify the three most important factors for a healthy
community, 15% identified good schools. When asked about the three most important
socioeconomic factors impacting the community, 20% cited education attainment.
31
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Additionally, a large disparity continues to exist in Bachelor’s Degree attainment between Flint,
Genesee County, State of Michigan, and the United States. While all have slightly improved over
the course of the last three years, with state and national Bachelor’s Degree attainment at
29.1% and 32.1% respectively, the comparative rates for Flint (12.2%) and Genesee County (21.2%)
continue to lag behind. Levels of attainment in the city of Flint are nearly half the county rate
and a third of the national norm.
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
Michigan
GISD
Flint
20202019201820172016
High School Dropouts (percent of 4-year cohort)
Percentage of Students Who Dropped Out
8.9%
10.1%
9.9%
9.5%
8.5%
7.4%
18.5%
17.7%
17.4%
15.4%
14.4%
8.6%
8.7%
8.4%
7.8%
Flint GISD Michigan Kids Count Data Book, 2016-2020
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
United States
Michigan
Genesee County
Flint
United States Census, American Community Survey, 2015-2019
Bachelor's Degree Attainment 2015-2019 (5-year average)
Percentage of Persons Age 25+
with Bachelor's Degree
12.2%
Flint Genesee County Michigan United States
21.2%
29.1%
32.1%
32
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
In addition to low levels of educational attainment, Genesee County lags behind the state
average, as well as comparison communities, in eighth-grade math and fourth-grade English
Language Arts Proficiencies according to the Preliminary Standardized Assessment Test (PSAT)
and Michigan Student Test of Education Progress (M-STEP) respectively. Educational proficiency
for students in the Flint Community Schools is far lower, with nearly 85% of all eighth-grade students
lacking proficiency in math and almost 80% of fourth-grade students lacking proficiency in
English/language arts. Data was not reported for 2020 due to the COVID-19 pandemic and
county-wide scores trended lower in 2021 than what they were pre-pandemic.
0%
10%
20%
30%
40%
50%
Flint
Michigan
Genesee County
20212019
Kids Count Michigan Data Book, 2019-2021
PSAT: Students Proficient or Advanced in Grade 8 Math
Percentage of Students
37.3%
27.7%
41.4%
36.0%
14.9%
15.3%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Flint
Michigan
Gensee County
202120192018
M-STEP: Students Not Proficient in Grade 4 English & Language Arts
Percentage of Students
Genesee County Michigan Flint
Genesee County Michigan Flint
59.5% 59.0% 59.4%
55.0% 54.2%
55.8%
79.0%
75.2%
79.1%
Kids Count Michigan Data Book, 2019-2021
33
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
FOOD INSECURITY
Food insecurity is the household-level economic and social condition of limited or uncertain
access to adequate food. Flint and Genesee County’s food insecurity rate, which measures
the estimated percentage of the population that experienced food insecurity at some point
during the year, is higher than state and national averages. A higher number of Flint & Genesee
County households receive SNAP (Supplemental Nutrition Assistance Program) benefits and
are eligible for free and reduced-price school lunches. According to the Genesee County Health
Department, there were 17,504 residents enrolled in the special supplemental nutrition program
for Women, Infants, and Children (WIC) in 2020. Additionally, 89.2% of children attending the
Flint Community Schools are eligible for free and reduced-price lunches (2020).
Measure Genesee County Michigan United States
Food insecurity rate
1
15.2% 13.0% 10.9%
Percent population receiving SNAP benefits
2
18.8% 12.4% 10.7%
Food insecure children
1
19.4% 14.2% 14.6%
Children eligible for free/reduced price lunch
3
59.2% 50.0% 52.3%
1
Feeding America, 2019
2
US Census Bureau, Small Area Income and Poverty Estimates, 2015
3
National Center for Education Statistics, NCES — Common Core of Data, 2018-109
34
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
In 2019, Feeding America reported that approximately 27% of individuals in Genesee County
above 200% of the Federal Poverty Line (FPL) experience food insecurity, an increase of 22%
from the previous year. This percent is more than 2.5 times as high for individuals under 200%
of the FPL (73%). This data emphasizes the magnitude of this issue for individuals in low-income
households. Genesee County has better access to WIC and SNAP authorized retailers than
the average county in Michigan and a comparable number of grocery stores per population,
yet food insecurity continues to affect many people due to uneven distribution. In Genesee
County, over 36% of the population lives more than a half mile from the nearest grocery store,
creating barriers for those who do not have access to reliable transportation. Many city of Flint
residents lack convenient access to a full-service grocery store. For those living in food deserts,
the lack of access prohibits healthy choices. Additionally, Genesee County has 90 liquor stores
and roughly 311 fast food restaurants (Center for Applied Research and Engagement Systems).
Good nutrition and a healthy diet are increasingly important for children in the community,
compounded by their ability to help mitigate the effects of lead contamination and support
healthy development throughout childhood and into adolescence.
Measure Genesee County Michigan United States
Percent low income population with low
food access
1
11.0% 6.0% 6.0%
Households with no motor vehicle
2
9.0% 7.7% 8.6%
Population without access to a large
grocery store
3
36.4% 22.8% 21.6%
1
Food Access Research Atlas, 2021
2
US Census Bureau, Small Area Income and Poverty Estimates, 2019
3
U.S. News and World Report Healthiest Communities, 2021
Senior citizens are also disproportionately affected by food insecurity as many are homebound
and cannot take advantage of resources that may be available in the community. Programs that
offer services to accommodate these individuals, such as home delivered meal services or food
box delivery services, are overburdened, resulting in waitlists and associated challenges.
COMMUNITY RESPONSE: “Healthy Food Access” received the fourth highest rate
of response when Genesee County residents were asked via the 2022 CHNA Community
Resident Survey to identify the top environmental concerns impacting the community with
35% of respondents citing it as one of their top concerns.
35
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
SAFETY & COMMUNITY VIOLENCE
Safety was selected as a priority focus area consistent with previously completed Community
Health Needs Assessments. After experiencing a rise in violent crime in 2017, the county
has since exhibited a downward trend from 2018 through 2020 with a 19% decline in violent
crime in Genesee County. The county’s rate of violent crime is heavily influenced by the city
of Flint, which has a violent crime rate of almost four times the national average. Violent
crime includes homicide, rape, robbery, and aggravated assault. According to the Michigan
Incident Crime Reporting database, Genesee County had 2,353 violent crimes and 6,137
property crimes (including burglary, larceny, and motor vehicle theft) reported in 2020.
The total number of crimes reported across all categories was more than 24,750 incidents.
Representing less than a quarter of the Genesee County total population, the city of Flint
accounted for almost 52% of all violent crime.
A component of safety (blight) is a major concern of many residents, especially within the city
of Flint. Not only does blight lead to perceptions that make residents feel unsafe in their own
neighborhoods, but neighborhoods with a higher percentage of vacant homes are likely to
attract higher rates of crime. Since 2009, with the exception of 2020 (no foreclosures due to
the pandemic), the Genesee County Land Bank has accepted between 1,000-2,000 properties
per year that private owners have walked away from. In 2020, Genesee County Land Bank held
14,359 properties, 73% of which were vacant lots and 20% of which were structures in need of
demolition or major renovation. In 2020, the City of Flint announced a new campaign to fight
blight and over the course of the year, 1 million pounds of blighted waste was hauled away with
clean-up of blighted properties increasing 38% year over year.
0
500
1,000
1,500
2,000
2,500
3,000
United States
Michigan
Genesee County
Flint
2020201920182016201420122010
FBI.gov Uniform Crime Reporting System, 2017-2020; Michigan Incident Crime Reporting, 2010-2020
Rates of Violent Crime
Per 100,000 Residents
Flint Genesee County Michigan United States
2,355
1,786
1,583
1,898
1,437
1,505
2,730
708
635
516
684
581 579
908
492
427
459
453
439
478
454
404
366
386
383
381
399
387
36
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
COMMUNITY RESPONSE: When the 2022 CHNA Community Resident Survey asked
“What do you think are the three most important environmental factors that affect the
health of our community,” approximately 84% of respondents identified violent crimes or
neighborhood safety as a top factor.
POVERTY
Addressing poverty is critically important to improving population health. Poverty is the overarching
social condition that impacts every facet of an individual’s life and hinders a community’s ability to
achieve forward momentum. Most of the SDOH issues listed above are a direct result of poverty,
which is why low-income individuals face such tremendous barriers to achieving positive health
outcomes. As home to one of the most impoverished cities in the nation, few communities illustrate
this more clearly than Genesee County.
0
5,000
10,000
15,000
20,000
25,000
30,000
2020201920182017201620082000
US Census Bureau, American Community Survey, 2000-2020
Vacant Homes (Genesee County)
Number of Vacant Homes
13,805
24,037
23,809
26,640
23,113
23,729
15,929
37
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
The poverty rates in Genesee County and Flint have remained high in comparison to state and
national averages, and in recent years have trended upwards. The majority of Genesee County’s
lowest income households are concentrated in the city of Flint where over 40% of all residents
are living below the Federal Poverty Line (FPL) poverty limit. A devastating number of children
in Flint (63.5%) live in poverty. This is nearly twice the rate for Genesee County (36.7%) children
living in poverty, and nearly three times the national rate (20.3%). Income disparities not only
exist geographically, but also between ethnicities, as minority children experience poverty at
rates twice that of white children according to the U.S. Census Bureau.
Without a massive influx of community investment or new livable wage jobs, poverty cannot
be solved overnight. It is essential that healthcare systems begin to integrate a focus on the
documented SDOH needs of residents and patients, recognizing the impact on an individual’s
care plan and how SDOH needs impact the ability to effectively provide care that can be
adhered to. Without addressing these root causes, clinical approaches may be unsuccessful and
health outcomes will remain poor as demonstrated in Flint and Genesee County. Fortunately,
Genesee County healthcare providers are realizing this and taking meaningful action to
participate in initiatives to increase effective clinical/community linkages to address the social
determinants of health.
COMMUNITY RESPONSE: In the 2022 CHNA Community Resident Survey, when
Genesee County residents were asked to identify the top three socioeconomic factors that
impacted the community, 45% cited poverty/working poor, followed by basic needs (29%),
and income/wealth distribution (28%).
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Flint
United States
Michigan
Genesee County
20202018201620142012
Poverty Rates (5-year estimates ending in year identified)
Percentage of Individuals Living in Poverty
Genesee County Michigan United States Flint
39.7%
19.9%
14.9%
16.3%
41.9%
20.9%
15.1%
16.3%
41.6%
21.2%
15.6%
16.9%
41.2%
19.8%
14.1%
15.0%
38.8%
18.0%
12.8%
13.7%
US Census Bureau, 2020 (5-year estimate)
38
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Obesity & Healthy Behaviors
Genesee County’s health behaviors are some of the poorest in the state. Health behaviors are
associated with a combination of physical activity, food and nutrition, smoking rates, alcohol use,
access to exercise opportunities, and more. Genesee County’s obesity rate is significantly higher than
state and national averages, and the combined obesity and overweight rate for Genesee County is
72.4%. For comparison, in the 2019 CHNA Report, that combined rate was 67.1%.
As illustrated in the above graph, obesity and overweight prevalence has been trending upward
over the last five years. There are a number of reasons that this is a high priority concern for
the community. Children with obesity are two times more likely than their non-obese peers to
die before the age of 55 and obesity increases an individual’s risk of developing serious chronic
conditions such as diabetes, heart disease, cancer, etc. Obesity has also been a compounding
risk factor for complications and death associated with COVID-19 infection since 2020.
Flint & Genesee County’s physical environment presents many challenges for residents
attempting to incorporate physical activity into their daily routines including neighborhood blight,
high rates of crime, and limited recreation and fitness facilities. Safe environments to practice
regular physical activity are a major challenge for under-resourced and low-income populations.
Many low-income residents cannot afford access to fitness centers. Additionally, transportation
and other accessibility factors may present barriers to physical activity resources.
Measure Genesee County Michigan United States
Recreation and fitness facility access
(per 100,000 population)
1
5.17 8.59 12.23
Percent adults with no leisure time
physical activity
2
27.3% 21.7% 22.0%
1
US Census Bureau, County Business Patterns, CARES analysis, 2019
2
Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 2019
24%
26%
28%
30%
32%
34%
36%
38%
40%
United States
Michigan
Genesee County
2020201920182017201620152014201320122011
Obesity Prevalence
Genesee County Michigan United States
27.8%
27.6%
29.4%
29.6%
29.8%
29.9%
31.3%
30.9%
32.1%
31.9%
31.3% 31.1% 31.5%
30.7%
31.2%
32.5%
32.5%
33.0%
36.0%
35.2%
34.9% 34.9% 34.9%
32.8%
31.5%
32.7%
33.4%
32.5%
36.7%
38.5%
Centers for Disease Control and Prevention Behavioral Risk Factors Surveillance System (BRFSS), 2011-2020
39
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Food insecurity and inconsistent access to grocery stores within the county (with emphasis on
the city of Flint) compromises residents’ abilities to eat healthy. Current health behaviors are
determinants of future health, and unhealthy eating practices may cause significant health issues
such as obesity and diabetes. According to the most recent data from the Centers for Disease
Control and Prevention (CDC, 2019), 11.3% of residents in Genesee County had diabetes (Age-
Adjusted Rate) compared to 10.2% of Michigan residents and 8.3% of the United States. While
the national rate of diabetes has been on the decline, as well as the most recent numbers for the
state and county, diabetes remains a significant health status indicator and high-cost disease.
Genesee County’s smoking rate is higher than state and national averages. The smoking rate
among adults in Genesee County is almost 25% higher than the state’s rate. Smoking is a
significant risk factor for poorer health (e.g., pulmonary disease, cardiac disease, etc.) and higher
health care costs. There are minimal smoking cessation resources in Genesee County and those
that exist are underutilized.
COMMUNITY RESPONSE: When Genesee County residents were asked via the
2022 CHNA Community Resident Survey what the three most important health problems
were in our community, obesity had the fifth highest number of responses at 19%.
Residents also indicated poor eating habits (30%) and lack of exercise (18%) as top risky
behaviors in our community.
0%
5%
10%
15%
20%
25%
30%
Michigan
Genesee County
2018-20202017-20192016-20182015-20172014-20162013-20152012-2014
Adult Smoking Rate
Genesee County Michigan
22.0%
21.1%
20.8%
19.0%
19.0%
18.6%
24.2%
23.4%
23.5%
24.8% 24.8%
24.7%
24.5%
Michigan Department of Health and Human Services,
BRFSS, 2012-2014 through 2018-2020
19.6%
Percentage of Current Adult Smokers
40
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Health Care Access
Health care access is impacted by a variety of factors, such as whether one has healthcare
coverage, is uninsured, or underinsured. Furthermore, a community’s capacity to provide
primary, specialty, mental health, or dental care is important. Affordability and the social
determinants of health can also impact a resident’s ability to access and receive care. Relative
to health insurance, Genesee County is fortunate in that only 5.3% of its total population is
uninsured as indicated by the U.S. Census Bureau, lower than state and national rates. However,
a number of additional factors exist that raise concern regarding healthcare access in the
community. Reviewing coverage by type, the number of Genesee County residents eligible to
have Medicaid as their healthcare coverage type continues to grow each year.
Healthcare Coverage 2015 2016 2017 2018 2019 2020
% Recent
Change Trend
Medicaid Recipients
1
130,818 132,701 134,876 132,299 134,291 150,483 12.06%
Medicare Recipients
2
87,247 88,861 87,227 88,552 89,791 90,745 1.06%
Commercially Insured
Residents
3
192,329 184,250 184,851 185,274 180,254 * -2.71%
Uninsured Residents
3
22,186 24,925 25,665 19,124 21,466 * 12.25%
Genesee Health Plan
4
4,362 4,466 4,383 4,419 4,469 N/A 1.13%
1
Michigan Department of Health and Human Services (Green Book), 2015-2020
2
CMS Medicare Dashboard, 2015-2020
3
U.S. Census Bureau, 2015-2019
4
Genesee Health Plan, 2014-2019 (data not available for 2020)
*2020 Census Data had not been released as of March 2020
In 2020, over one-third of Genesee County residents (37%) received Medicaid healthcare
coverage. Healthy Michigan enrollment (Michigan’s Medicaid expansion program under the
Affordable Care Act) increased more than 12% between December 2016 (35,514) and December
2020 (39,827), contributing to the 13.4% rise in Medicaid enrollment. The Flint Medicaid
Expansion Waiver provides additional coverage to almost 27,000 individuals impacted by the
Flint Water Crisis. While the number of providers accepting Medicaid coverage has increased over
the past decade, the Medicaid reimbursement rate in Michigan is one of the lowest in the nation.
This payer mix can potentially impact a provider’s willingness to practice in the community.
Between 2018 and 2019, Genesee County experienced an 11.7% increase in the number of
uninsured residents. This may be a result of increases in the cost of coverage or changes in the
requirements to purchase coverage (individual mandate) that is no longer part of the Affordable
Care Act. While the release of 2020 census data has been delayed, it is expected the number of
uninsured residents will increase given the increase in the number of unemployed residents who
no longer would have health insurance coverage through their employer.
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
While Genesee County’s rate of Emergency Department (ED) visits decreased 11.2% between
2019 and 2020, during this same period, ED expenses only decreased 2.3% which may indicate
a continued higher level of acuity for ED visits. The rates of ED utilization for both Medicare and
Medicaid beneficiaries continue to be significantly greater than commercially insured residents.
In 2020, Medicaid beneficiaries utilized the ED at a rate over two times higher than their
commercially insured counterparts per locally aggregated data collected as part of the GFHC’s
Community Data Scorecard.
The higher ED utilization rate for Medicare beneficiaries can be explained by the prevalence
of chronic disease and illness in the older population. However, the high ED utilization rate for
Medicaid beneficiaries is often due to access issues, including the lack of a medical home. While
all Medicaid beneficiaries have a designated primary care provider, often residents are unaware
who their provider is or they are impacted by issues accessing primary care appointments,
including a lack of transportation or an inability to receive time off work. Initiatives focused on
reducing ED utilization by improving the connection to medical homes and addressing social
determinants of health needs (e.g., programs such as Genesee CHAP and the Genesee CHIR) will
continue to be important.
Genesee County’s Federally Qualified Health Centers, such as Hamilton Community Health
Network and the Genesee Community Health Center, provide sliding scale services to help
reduce the lack of access for the uninsured. The Genesee County Free Medical Clinic and
Mott Children’s Health Center also support residents who may otherwise lack access to care.
Furthermore, the millage-funded Genesee Health Plan can provide limited coverage for doctor
visits, prescriptions, and adult dental services to residents who otherwise lack coverage.
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Although utilization of safety-net services decreased 13% in 2020 due to the COVID-19
pandemic and statewide stay-at-home orders, Genesee County continues to experience an
ongoing demand for safety-net services with the total number of patient visits remaining
approximately 40% greater than what they were in 2007, highlighting the ongoing need for
community resources.
The onset of the COVID-19 pandemic did result in a transformation of how healthcare is
delivered via telehealth and remote monitoring services for patients, resulting in an increase
of telehealth visits increasing by 2,975% in 2020. Commercially insured residents had greater
utilization of telehealth visits than those with Medicaid coverage, which may be indicative of
a lack of internet and technology access for patients or a need for greater investment in the
capacity of safety-net providers impacted by Michigan’s low Medicaid reimbursement rates.
0
50,000
100,000
150,000
200,000
Visits
20202019
Total Telehealth Visits
GFHC Scorecard Aggregate Insurer Data, 2020- 2021
173,238
5,634
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
The capacity of the primary care workforce in Genesee County remains an issue of concern.
With an aging physician population, a provider shortage is possible in the near future. Genesee
County’s physician population continues to age with 45% of practicing physicians over the age
of 55 years in 2019. This number does not take into account the number of physicians whose
practices were impacted by the COVID-19 pandemic causing them to retire.
Since 2018, the number of future primary care physicians being trained in Genesee County
has declined, as has the number of primary care and specialty care post-graduates remaining
in Genesee County. More post-graduates are deciding to relocate elsewhere in Michigan. More
collaborative efforts are needed within the community’s health care system to retain medical
school graduates or to attract primary care providers that will sustain access to care.
COMMUNITY RESPONSE: The CHNA Community Resident Survey further asked
residents about barriers to healthcare access. In response, 40% Genesee County residents
identified an inability to get a timely appointment, 20% indicated not being able to get
time off work, and 14% reported not being able to afford prescriptions. A large percentage
of residents indicated “other,” with common responses including: COVID-19, money,
discrimination/bias, personal mental health, and lack of mental health services. Genesee
County residents also shared that when they have a health problem or are sick, they go to
a primary care provider (82%), urgent care clinic (32%), or treat themselves at home (31%).
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
201920182017201620152013201020082006200420022000
HRSA Area Resource File, 2000-2019
Percentage of MDs by Age in Genesee County
MDs, Total 75+
MDs, Total 65-74
MDs, Total 55-64
MDs, Total 45-54
MDs, Total 35-44
MDs, Total < 35
4% 6% 7% 8% 9% 8% 9% 10% 9% 10% 12% 12%
9%
15%
9%
10%
10%
11%
12%
14%
15%
16%
16%
14%
15%
25%
17%
17%
19%
20% 20%
21%
20%
19%
20%
18% 18%
26%
25%
25%
24%
22%
23%
23%
19%
18%
17% 16%
17%
20%
17%
21%
18%
20%
22%
22%
19%
18%
19%
18%
19%
24%
13%
23%
14%
24%
14%
15%
24%
19%
19%
20%
44
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Chronic Disease Burden
Genesee County residents experience higher rates of chronic disease and chronic disease
mortality than state and national averages for nearly all the most common chronic conditions.
Genesee County’s age-adjusted mortality rate for all causes increased almost 15% between
2017 and 2020. Heart disease, the top cause of death, which had been trending downward until
2017, increased 9.7% through 2020. The age-adjusted mortality rate for pneumonia/influenza
increased 31.75% in Genesee County from 2019 to 2020.
Age-Adjusted Mortality Rates (per 100,000 residents)
2015 2016 2017 2018 2019 2020
%
Recent
Change Trend
All Causes — Genesee County 880.4 897.2 909.8 923.4 891.3 1,044.6 17.20%
All Causes — Michigan 780.8 788.3 784.1 784.9 772.0 913.8 18.37%
Heart Disease — Genesee
County
224.1 222.4 211.7 215.3 226.2 232.2 2.65%
Heart Disease — Michigan 197.2 200.8 196.3 195.4 193.5 206.0 6.46%
Cancer — Genesee County 168.2 174.4 180.0 182.1 163.5 162.5 -0.61%
Cancer — Michigan 166.8 167.2 161.3 161.4 156.6 158.8 1.40%
Diabetes Mellitus — Genesee
County
29.4 28.8 34.9 37.0 38.4 36.4 -5.21%
Diabetes Mellitus — Michigan 22.4 21.5 22.1 22.0 22.2 26.3 18.47%
Pneumonia/Influenza —
Genesee County
17.9 11.2 12.6 11.8 12.6 16.6 31.75%
Pneumonia/Influenza —
Michigan
15.1 13.6 14.2 14.6 12.7 14.4 13.39%
Michigan Department of Health and Human Services (MDHSS), 2015-2020
The prevalence of chronic disease has consistently played a role in Genesee County being ranked
in the bottom quartile for health outcomes and length of life according to the Robert Wood
Johnson Foundation’s County Health Rankings initiative. Genesee County experiences numerous
factors that contribute to chronic disease: an aging population, obesity, the practice of unhealthy
behaviors, substance use, lack of healthcare access, and the many social determinants of health
needs (poverty, food insecurity, health literacy, etc.) previously highlighted.
45
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Premature death is measured by years of potential life lost (YPLL) before age 75 per 100,000
population (age-adjusted). Genesee County’s overall Years of Potential Life Lost rate has
increased to 10,100. Reviewing the disparity of YPLL, the YPLL rate for African American
residents is 14,800, compared to 9,500 for Hispanic residents, and 8,800 for white residents
of Genesee County (National Center for Health Statistics).
Preventative services such as well visits and routine screenings are critical for identifying
chronic conditions early and ensuring proper treatment is received. Centers for Disease Control
and Prevention data from the City Health Dashboard indicated that only 23.4% of Flint residents
over the age of 65 reported receiving preventative health services compared to an average of
30% for all 500 of the cities in the Dashboard. This is important because this is the age when
many chronic conditions are likely to begin manifesting or already exist. High rates of chronic
disease place a burden on communities in several ways. Individuals with chronic conditions
utilize exponentially more healthcare resources than the general population, making it far more
expensive to care for and insure them. When chronic conditions limit an individual’s ability to
work or maintain independence, it results in morbidity, lower quality of life, depression, lost
economic productivity, and added strain on social programs. This is evidenced by Genesee
County ranking in the lowest quartile for Michigan counties in the Quality-of-Life metric for
the 2021 County Health Rankings Report. This metric includes measures specific to poor or fair
health days, poor physical health days, poor mental health days, etc.
COMMUNITY RESPONSE: When Genesee County residents were asked to rank their
personal health, almost 20% self-reported having poor or fair health. When asked to identify
which health issues they are dealing with, 29% identified back or joint pain, 23% identified
high blood pressure, 10% identified diabetes, and 9% identified lung problems.
Genesee County residents participating in
physical activity at Max Brandon Park in Flint.
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Maternal & Child Health
Maternal & Child Health not only determines the health of the next generation, but can help
predict future public health challenges for families, communities, and the health care system.
Healthy birth outcomes and early identification and treatment of developmental delays and
disabilities among infants can prevent death or further disability and enable children to reach
their full potential.
Infant mortality has long been a concern for Genesee County. In 2010, the Flint and Genesee County
community celebrated the success of efforts leading to reductions in infant mortality. Many targeted
initiatives ended thereafter, and since then the community has struggled with an increase in infant
deaths. The infant death rate for Flint is more than double that of the United States.
The risks for infant mortality and morbidity are increased by low birth weight and preterm
birth. Low birth weight and preterm birth, with their associated economic and social costs, are
far reaching, particularly among the most vulnerable populations. Low birth weight infants
(under 2,500 grams) are at high risk for health problems. The average hospital cost for a low
birthweight infant is estimated to be $76,700 compared with $3,200 for a normal weight
newborn according to the United Health Foundation’s America’s Health Rankings. Genesee
County’s percentage of low birth weight and preterm babies is higher than both state and
national percentages. According to the Annie E. Casey Foundation’s 2020 Kids Count Data Book,
Genesee County ranks 77th out of 82 Michigan counties for low birth weight infants.
0
5
10
15
20
Flint
Genesee County
Michigan
2018-20
2017-19
2016-18
2015-17
2014-16
2013-15
2012-14
2011-13
2010-12
2009-11
2008-10
2007-09
2006-08
Three-year Average Infant Deaths Rates (per 1,000 live births)
Infant Death Rate
Michigan Genesee County Flint
THREE-YEAR AVERAGE
6.8
8.0
11.0
6.9
8.0
10.9
7.3
7.8
14.7
6.9
8.5
10.7
7.1
7.8
12.1
6.7
9.1
13.1
6.9
7.1
11.6
6.7
9.0
13.9
7.6
9.3
15.5
7.6
9.0
16.6
6.7
8.0
13.2
6.6
6.7
11.4
6.6
6.4
13.1
Michigan Department of Health and Human Services, 2006-2008 to 2018-2020
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Measure
Flint
Genesee
County
Michigan
United
States
Percentage of low birth weight infants 14.6% 9.9% 8.8% 8.3%
Percentage of preterm births 14.7% 11.9% 10.3% 10.2%
Percentage of Medicaid covered births 82.8% 56.6% 41.5% 42.1%
Michigan Department of Health and Human Services, 2019
Maternal health is closely linked to newborn survival, as vulnerabilities to illness can pass from
mother to child. Prenatal care is important to both the health of the mother and her unborn
child. Pregnant women in Flint receive prenatal care later in pregnancy than their county and
state level counterparts and the number has been trending upward. The same holds true for
less than adequate prenatal care.
Data indicates that demographically, Flint and Genesee County mothers are more often
teenagers, less educated, lack spousal support, and/or have poorer health behaviors than
Michigan mothers. These are all risk factors for poorer infant health outcomes.
0%
1%
2%
3%
4%
5%
6%
7%
8%
9%
Flint
Genesee County
Michigan
202020192018201720162015201420132012
Percent Births with Late or No Prenatal Care
Percent of Births Late or No Prenatal Care
Michigan Genesee County Flint
4.5%
4.6%
6.1%
4.8%
4.8%
6.7%
5.1%
5.2%
7.8%
5.3%
5.2%
8.0%
5.4%
5.5%
8.4%
5.4%
5.5%
8.1%
5.4%
5.8%
8.4%
5.6%
5.4%
8.0%
5.9%
5.7%
8.2%
Michigan Department of Health and Human Services, 2012-2020
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Measure Flint Genesee County Michigan
Births to teens under age 20 9.4% 6.0% 4.5%
Births to mothers with <12 years education 21.6% 12.3% 10.5%
Births to mothers with no diploma or GED 21.7% 12.1% 10.5%
Births to unwed mothers 80.6% 56.9% 41.5%
Births to mothers who smoked during
pregnancy
27.9% 20.6% 13.6%
Michigan Department of Health and Human Services, 2019
Approximately one quarter of Genesee County’s population is under the age of 18, which is similar
to state and national percentages. However, Genesee County’s children are at a significantly higher
risk for poor health outcomes and poor educational outcomes over the life course. In the city of
Flint, 53.2% of children (61.9% of those under age 5 years) are living below the federal poverty
level. This percentage is more than triple the percentages for the state of Michigan and United
States, and is more than 2.5 times the percentages for the state of Michigan and United States.
Measure
Flint
Genesee
County
Michigan
United
States
Percent of population, <18 24.8% 22.3% 21.5% 22.2%
Percent of children, <18, below
poverty level
52.3% 26.3% 18.8% 17.5%
US Census Bureau, 2020 (5-year estimate)
Analysis of data provided by several Genesee County commercial and Medicaid health plans has
identified that Genesee County children often lack preventive health services. Combination 10
immunization rates (at 2 years) are almost three times higher for commercially insured children
than children with Medicaid healthcare coverage. Lead testing rates have declined for children
insured by both Medicaid and commercial insurance. While not reflected in the data tables
reported here, the COVID-19 pandemic has had a significant impact on timely immunization and
lead screening for children, and efforts in the years ahead will require an emphasis on improving
those rates on a community-wide scale.
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Combination 10 Immunizations and Lead Testing
% Received: 2015 2016 2017 2018 2019 2020 % Recent Change Trend
Combination 10 Immunizations (2 years old)
Commercial 23.1% 26.4% 25.7% 27.0% 30.3% 34.0% 12.15%
Medicaid 23.3% 13.2% 12.6% 12.5% 12.3% 13.0% 5.47%
Lead Testing by 2nd Birthday
Commercial 33.6% 34.4% 28.4% 30.0% 27.6% 24.3% -11.96%
Medicaid 82.5% 75.9% 79.4% 73.5% 71.7% 62.0% -13.53%
GFHC Community Data Scorecard, Health Insurer Data Submission, 2015-2020
Children who lived, attended daycare, or attended school in Flint at an address serviced by the Flint
Water System between April 25, 2014 and October 15, 2015 were exposed to unsafe levels of lead in
their drinking water. Evidence-based research indicates that even a small amount of lead in a child’s
body can cause serious health problems. Studies have demonstrated lead’s compromising effects on
child health, the immune system, and association with impairments in neurobehavioral factors such
as a child’s learning skills, hearing, and self-regulatory ability resulting in delinquent behavior.
Further analysis of local health insurer data has identified trends indicating that Medicaid insured
children have different characteristics than their commercially insured counterparts in accessing
and utilizing healthcare resources. For instance, although inpatient utilization for all Genesee
County children has been decreasing since 2017, Genesee County children covered by Medicaid
were hospitalized at a rate 42% higher than those commercially insured. Additionally, local Medicaid
insured children had higher rates of acute care length of stays, which may indicate they are sicker
or delaying care resulting in additional harm. Furthermore, while the total rate of Emergency
Department (ED) utilization by Genesee County children decreased 38% in 2020, Genesee County
children covered by Medicaid utilized the hospital ED at 2.5 times the rate of commercially insured
children. Medicaid insured children had rates of emergency department use for otitis media (a
diagnosis most often treatable in the primary care setting) almost 2.5 times higher than their
commercially insured counterparts; had higher rates of ED utilization for asthma; and had lower
rates of utilization of well-child visits in the first 15 months of life (GFHC Community Data Scorecard).
Poverty and social determinant of health needs impacting Genesee County families can also generate
stress and anxiety, which in turn can lead to greater likelihood of child abuse or neglect. Parents
living in poverty often do not have access to the resources necessary to provide appropriate care
for children. The physical effects of child abuse and neglect create Adverse Childhood Experiences
(ACEs) with long-term consequences that may include impaired development, academic failure, social
and emotional problems, poor relationships, substance abuse and dependency, risky behaviors, and
juvenile delinquency. According to the Michigan Department of Health and Human Services, Children’s
Protective Services (2020), the confirmed number of child abuse and neglect victims (per 1,000
children) is 35.4 for Flint and 16.1 for Genesee County, compared to only 13.0 for all of Michigan.
Efforts to provide vulnerable children optimal child and health development, early childhood
education, continuous access to a pediatric medical home, access to infant and child behavioral
health services, nutrition education, healthy food access, as well as safe and healthy home living
environments are critical health needs to continue to address on a community-wide scale.
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Health Inequities (including the burden of systemic racism)
Every resident of Genesee County should have the opportunity to live a healthy life, no matter
who they are, where they live, or how much income they have. Health is about more than
medical care and genetics, and is more so defined by where residents live, learn, work, and
play. Genesee County has a significant disparity in life expectancy (2018-2020) of up to 15 years
based on resident zip code. Zip codes within the city of Flint have shorter life expectancy, while
out county areas often have longer life expectancy.
2015 - 2017 2017-2019 2018-2020 % Recent Change Trend
Genesee County 76.1 76.6 74.6 -2.6%
48420 — Clio 77.8 76.7 73.9 -3.7%
48423 — Davison 77.8 77.0 76.5 -0.6%
48430 — Fenton 83.3 82.3 82.1 -0.3%
48433 — Flushing 78.7 78.9 78.6 -0.4%
48438 — Goodrich 78.7 80.0 79.1 -1.1%
48439 — Grand Blanc 79.1 79.7 79.2 -0.7%
48451 — Linden 78.9 76.7 76.8 0.2%
48457 — Montrose 7 7.9 76.9 77.7 1.1%
48458 — Mt. Morris 72.7 73.1 72.1 -1.3%
48463 — Otisville 74.3 75.4 75.9 0.7%
48473 — Swartz Creek 78.2 78.1 78.0 -0.1%
48503 — Flint 74.3 73.0 72.9 -0.2%
48504 — Flint 72.4 71.6 70.1 -2.1%
48505 — Flint 68.9 68.9 67.1 -2.6%
48506 — Flint 72.7 72.6 72.0 -0.8%
48507 — Flint 73.9 73.6 72.6 -1.4%
48532 — Flint 74.4 73.1 72.3 -1.1%
48509 — Burton 75.6 73.3 73.2 -0.1%
48519 — Burton 72.9 72.5 71.1 -1.9%
48529 — Burton 70.8 71.1 70.8 -0.4%
Michigan Department of Health and Human Services
51
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Infant mortality is another indicator of health disparity in Genesee County. While infant
mortality is on the decline in Genesee County in total, the disparity between African American
and white infant mortality is increasing growing to an almost 4:1 disparity.
Infant Mortality 2016-2018 2017-2019 2018-2020 % Recent Change Trend
Total
8.0 6.7 6.4 -4.5%
African Americans
13.6 12.6 13.2 4.8%
Whites
5.4 4.1 3.5 -14.6%
Michigan Department of Health and Human Services, 2016-2020
In addition to the disparity in infant death rates, there is also a significant disparity in the age
adjusted mortality rates and low birth weight babies between African Americans and whites.
The 2021 County Health Rankings reports Genesee County African Americans experience an
age-adjusted mortality rate 51% higher than whites, child mortality rate 140% higher, and infant
mortality rate 180% higher.
Genesee County residents continue to face numerous challenges relating to environmental factors
(e.g., water quality, housing problems, blight, built environment issues), social and economic
factors (e.g., unemployment, multi-generational poverty, food insecurity), and education factors
(e.g., poor educational outcomes, literacy), all of which contribute to disparities in health outcomes.
Low income, minority, and aging populations are disproportionately affected as seen throughout
the 2022 Community Health Needs Assessment. Residents of the city of Flint experience
considerably lower health outcomes when compared to Genesee County overall, as well as a
higher prevalence of chronic conditions. Other factors impacting health equity include, but are not
limited to, COVID-19, gender, sexual orientation, and social injustices experienced as part of the
Flint Water Crisis. Community leaders and healthcare providers must continue to work as vocal
advocates for their patients and constituents ensuring equal access and opportunity to all the
factors affecting health.
COMMUNITY RESPONSE: When Genesee County residents were asked via the 2022
CHNA Community Resident Survey how often they felt that racial/ethnic groups such as
African Americans or Latinos were discriminated against, 50% of respondents indicated
“often” and 33% indicated “sometimes.”
52
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Safe & Affordable Drinking Water
It is the position of the American Public Health Association and many others in the public
health community that safe and affordable drinking water is the basic right of all people and
all communities.
In the years since the onset of the Flint Water Crisis, much work has been undertaken to make
the City’s water supply safe to drink and to mitigate the effects of residents’ exposure to lead
and other contaminants. In addition to the City working to replace all lead service lines and to
upgrade the infrastructure of its water treatment facility. The City of Flint’s Fast Start Program,
aimed to replace all lead service lines in the city of Flint. As of July 16, 2021, it had conducted
27,133 excavations, checked 17,074 copper service lines, and replaced 10,059 pipes. However, the
lead service line replacement program is not yet complete as of December 2021, slowed by the
COVID-19 pandemic.
Safety is coupled with the affordability of accessing the Flint Water System itself. Flint has
some of the highest water costs in the nation. Many residents ceased paying for water they
could not use during the Flint Water Crisis and for a period of time, the City suspended water
shut offs to maintain water flow necessary for restorative measures. While the City of Flint
has paused water shut offs during the COVID-19 pandemic, in early 2022 water shut offs and
collections have resumed, lifting up the need for sustainable solutions to accompany the trauma
and lifelong impacts resultant from the Flint Water Crisis.
COMMUNITY RESPONSE: When asked what the top health concerns Flint & Genesee
County should focus on in the next three years, Genesee County residents indicated clean
water as the top priority, followed by mental health, and crime.
COVID-19
The COVID-19 pandemic was unlike anything experienced in recent history and highlighted
the significant inequities that exist in our community. Early on in the pandemic, Michigan had
observed an alarming racial disparity in COVID-19 cases and deaths, with African Americans
consisting of 14% of the state’s population, but 33% of COVID-19 cases and 40% of deaths,
with cities such as Flint at the forefront of this disparity. To address these disparities, targeted
efforts such as church and community-based testing efforts, deployment of grassroots Public
Health Navigators and Community Health Workers, and mobile vaccination opportunities
prioritizing those areas with the greatest need were implemented. The success of these efforts
is reflected in the eventual elimination of the COVID-19 disparity among African Americans.
At the height of the COVID-19 pandemic, there was a significant decrease in preventative
healthcare services including annual physicals, immunizations, and screenings for diseases such
as cancer and diabetes. In response to this decrease, many local programs, health plans, and
physicians have worked to ensure residents are receiving any services that were previously
delayed. The long-term impacts of COVID-19 are unknown, however, the GFHC’s Data Review
Subcommittee is aligning data monitoring efforts with the Centers for Disease Control and
Prevention’s recommendations which include:
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
y Measuring and improving mental health outcomes in the public health workforce and other
frontline workforce populations;
y Implementing workplace policies and practices to improve worker resilience and reduce
adverse mental health effects of the COVID-19 pandemic;
y Measuring changes to other health epidemics and diseases impacted by the COVID-19
pandemic, including increases in drug-related overdoses, obesity, diabetes, STIs, and
decreases in vaccination coverage beyond COVID-19, and developing evidence-based health
communications and interventions to address these changes;
y Measuring prevalence and incidence of COVID-19 associated second-order consequences
among children, including orphanhood and caregiver death, poverty, food insecurity, violence,
adverse childhood experiences, mental health threats, and educational impacts;
y Understanding how the effect of the pandemic on income, housing, employment, caregiving,
childcare, and other factors have exacerbated health inequities in non-COVID-19 conditions; and
y Evaluating health and economic impacts to workers and families from changes in employment
status related to the COVID-19 pandemic.
COMMUNITY RESPONSE: The 2022 CHNA Community Resident Survey asked
residents about the most important health problems in our community, 19% of
respondents indicated COVID-19.
Genesee Community Health Center, Greater Flint Health
Coalition, and Genesee County Community Action
Resource Development partnering to provide increased
access to COVID-19 vaccines in the community.
PHOTO CREDIT: Tom Travis, East Village Magazine
54
COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
2022 CHNA — Community Resident Survey Highlights
The 2022 CHNA Community Resident Survey sought input on many questions. Below are
three question excerpts from the 2022 CHNA Community Member Survey that summarize
the community response when 819 Genesee County residents were asked about local priority
needs. For each question, respondents were asked to identify the top three priorities. The table
below illustrates the answers to each question and percent of total respondents that identified
each of the needs as one of the top three.
What do you think are the three most important “health problems” in our community?
Addictions (alcohol, drugs) 66%
Mental Health Problems 42%
Violence 27%
COVID-19 19%
Obesity 19%
What do you think are the three most important “environmental factors” that affect health
in our community?
Clean/Safe Drinking Water 54%
Affordable Housing/Homelessness 49%
Violent Crime 43%
Neighborhood Safety 41%
Healthy Food Access 35%
If you were asked by the mayor, governor, or president what the top health concerns Flint &
Genesee County should focus on in the next three years, what would your top priority activities be?
Clean Water 24%
Mental Health 21%
Access to Services 21%
Healthcare 19%
Affordable Housing 15%
In the following list, what do you think are the three most important factors for a “Healthy
Community?”
Access to Healthcare 57%
Access to Mental and Behavioral Health Services 42%
Low Crime and Safe Neighborhoods 32%
Good Jobs and Healthy Economy 31%
Safe and Affordable Housing 21%
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What do you think are the three most important “risky behaviors” in our community?
Drug Abuse 58%
Alcohol Abuse 39%
Poor Eating Habits 30%
Distracted Driving 23%
Unsecured Firearms 23%
What do you think are the three most important “socioeconomic factors” that affect health
in our community?
Poverty — Working Poor 45%
Basic Needs (clothing, furniture, household supplies) 39%
Income — Wealth Distribution 30%
Housing – Homelessness 27%
Family Support System 25%
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APPENDIX A: EVALUATION OF IMPACT FROM 2019
CHNA IMPLEMENTATION
The 2019 Community Health Needs Assessment (CHNA) Report prepared for the Flint &
Genesee County community identified twelve priority health needs affecting the community at
the time. In order to have the greatest impact improving health behaviors and health outcomes
related to the priority health needs, Genesee County’s three hospital systems (Ascension
Genesys Hospital, Hurley Medical Center, and McLaren Flint) each developed individual CHNA
Implementation Plan activities, as well as a number of shared CHNA Implementation Plan
activities in partnership with the Greater Flint Health Coalition (GFHC).
The 2019 Genesee County CHNA Implementation Plans sought to impact the following twelve
priority community health needs:
y Social Determinants of Health
y Substance Use (with emphasis on Opioid Misuse and Addiction)
y Child Health & Development
y Mental Health
y Obesity & Health Behaviors
y Safe & Affordable Drinking Water
y Healthcare Access
y Chronic Disease Burden
y Effective Care Delivery for an Aging Population
y Maternal & Infant Health
y Sexual Health
y Health Equity
It is important to note that the COVID-19 pandemic did impact the progress of many CHNA
Implementation efforts, however progress was still made in many strategies.
PART 1: 2019-2021 CHNA Implementation Plan Accomplishments Conducted via Greater Flint
Health Coalition in Partnership with Ascension Genesys Hospital, Hurley Medical Center, and
McLaren Flint.
Priority Health Need Addressed:
y Social Determinants of Health
The Genesee Community Health Innovation Region (CHIR) recognizes that 80% of the factors
that influence a person’s health are due to social, economic, and environmental factors and
that addressing these upstream factors can result in improved health outcomes and reduced
healthcare costs. As the backbone organization for the Genesee Community Health Innovation
Region (CHIR), a model for improving the well-being of a region and reducing unnecessary
medical costs through collaboration and systems change, the GFHC is the neutral convener of
a broad group of stakeholders seeking to improve the well-being of residents in a coordinated
approach to improving conditions where people live, work, learn, and play.
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In additional to the three Genesee County hospitals, partners include: three physician
organizations, the local public health department, the community’s federally qualified health
centers, community mental health, five Medicaid managed care plans, commercial health
insurers, the United Way, and dozens of community-based service providers that address a
multitude of SDOH. The main focus of the CHIR is to enhance cross-sector partnerships that
impact population health and connect residents with relevant community and social services to
address their SDOH. Reducing emergency department utilization and creating connectedness to
a patient centered medical home is a major goal of the project.
From 2019-2021, accomplishments include:
y Continued growth of the Clinical-Community Linkage model based on the success of
Genesee CHAP.
y Community-wide SDOH needs screening strategy that embedded a standardized SDOH
screening tool into more than 60 patient medical home practice’s electronic health record
systems. SDOH screening engages patients on needs related to food insecurity, access to
clean water, housing, transportation, utilities, health care access, depression, substance use,
health literacy, child care, safety, education, job training, employment, anxiety, and stress.
y Utilized four Clinical-Community Linkage Specialty Hubs via Genesee CHAP, Genesee
Health Plan, Genesee Health System, and New Paths to provide community-based care
coordination and case management services using community health workers, social
workers, behavioral health specialists, and peer recovery coaches to support referred
individuals.
y Expanded New Path’s “Opioid Overdose Recovery Program” to make peer recovery coaches
available in all three Genesee County hospitals’ EDs as well as community-based locations
for non-opioid substances.
BEHAVIORAL HEALTH EMERGENCY CENTER (BHEC):
Priority Health Needs Addressed:
y Mental Health
y Health Care Access
The COVID-19 pandemic significantly delayed the opening of the in-person Behavioral Health
Emergency Center. To address the behavioral health needs in the community, Genesee Health
System implemented a Virtual Behavioral Health Urgent Care (BHUC) that was launched in late
2020. The Virtual Behavioral Health Urgent Care is a remote, community based service that
provides face-to-face video chat services 24 hours a day, 7 days a week with a Licensed Mental
Health Professional. This service is open to all residents, regardless of insurance coverage,
and provides supports for residents experiencing COVID-19 related distress, mild to moderate
mental health symptoms, urgent mental health needs, and severe mental health symptoms.
The Virtual BHUC accepts referrals from anyone, including healthcare providers that know of a
person in Genesee County in need of urgent behavioral health care access to a Licensed Mental
Health Professional. In late 2021, the in-person Behavior Health Urgent Care was opened and
will operate in conjunction with the Virtual Behavioral Health Urgent Care (BHUC). All hospital
partners have information available for their patients to connect to the Behavioral Health
Urgent Care and working to develop formal referral partnerships.
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COMMUNITY-WIDE STRATEGY TO ADDRESS THE OPIOID EPIDEMIC
Priority Health Needs Addressed:
y Substance Use
y Health Care Access
The Greater Flint Health Coalition’s Mental Health & Substance Use Task Force has supported
the implementation of a Community-Wide Strategy to Address the Opioid Epidemic. This
multi-sector strategy has integrated care and treatment services that connect individuals
with substance use disorders to providers, resources, and community-based recovery and
addiction treatment; educate providers and patients on opioid use, risks, and best practice
prescribing strategy for target populations (especially seniors); and provided community-
based education and prevention activities through schools, providers, law enforcements, and
resident groups that are catered specifically to adolescents/teens, adults, and families; among
other interventions.
From 2019-2021, the Community-Wide Strategy to Address the Opioid Epidemic
accomplishments include:
y The integration of the Opioid Overdose Response Program (OORP) into all three local
hospitals (Ascension Genesys, Hurley Medical Center, McLaren Flint) to allow Peer Recovery
Coaches to be connected to patients in the Emergency Departments that had experienced
overdose or drug seeking utilization patterns. Peer Recovery Coaches meet with individuals
to discuss treatment options and assist with navigating entry to treatment. Since 2019, 1,174
unique clients have been served by the OORP program.
y Development and launch of KnowMoreGenesee.org, an interactive website that highlights
locally available resources, as well as physician and community-specific toolkits.
y Training of over 60 Genesee County physicians to obtain a Buprenorphine Waiver to
prescribe Medication Assisted Treatment, prior to the change in waiver requirements.
y In 2020, the Community-Wide Strategy was expanded to support prevention and
treatment efforts around non-opioid substances including alcohol, cocaine, heroin, and
methamphetamine.
y In 2021, a Genesee County Quick Response Team (QRT) was launched to connect overdose
survivors to harm reduction and treatment services, reduce repeat overdoses, and increase
community readiness to prevent overdose. The QRT has distributed 6,000 fentanyl testing
strips and 2,800 Naloxone kits as of December, 2021.
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GENESEE COMMUNITY HEALTH ACCESS PROGRAM (CHAP)
Priority Health Needs Addressed:
y Social Determinants of Health (SDOH)
y Substance Use, Child Health & Development
y Mental Health
y Obesity & Health Behaviors
y Safe & Affordable Drinking Water
y Healthcare Access
y Chronic Disease Burden
y Infant Maternal Health
y Health Equity
The Greater Flint Health Coalition’s Genesee Community Health Access Program (CHAP)
was established in 2015 as a collaborative effort to address the significant health disparities
experienced by low-income children enrolled in Medicaid via a collaborative, physician-driven,
community-based medical home initiative. In 2017, Genesee CHAP expanded and began to
serve adults. The three Genesee County hospital systems are all Genesee CHAP partners, each
identifying and referring patients from their affiliated primary care clinics for community-based
services, as well as providing leadership as members of the Genesee CHAP Steering Committee.
Genesee CHAP works to improve access to a medical home and community resources for
underserved, low-income children and adults through a transformation of service delivery at
the family, practice, and system levels. Genesee CHAP’s population-based approach emphasizes
use of a patient-centered medical home and prevention, including preventative visits and
immunizations. In addition to improving access to a medical home and use of prevention
and education services, Genesee CHAP seeks to improve health outcomes for Medicaid
covered children and adults, while reducing inappropriate emergency room visits and hospital
admissions, among other targeted efficiencies.
The community-based Genesee CHAP team, composed of nurses, social workers, and
community health workers, provide Genesee CHAP referred families with education, case
management, care coordination, patient navigation, referral to community and social resources,
transportation, and other associated support services that aid children and adults with
increased access and improved health outcomes. Genesee CHAP staff work to help patients and
their families overcome any barriers to healthcare access that they may be experiencing as well
as address other challenges related to social determinant of health needs so that they are able
to make healthcare a priority.
From 2019-2021, Genesee CHAP accomplishments include:
y Expansion of the number of partnering medical home practices from 29 to 42 referring
medical partners.
y Provided CHAP services in 2021 to an average of 1,490 unduplicated clients per month.
y Addressed over 9,000 Social Determinant of Health (SDOH) referral needs from 2019-2021.
y State of Michigan Medicaid Actuary Analysis on utilization and cost savings completed,
indicating significant savings for health plans.
y Implemented a OB/GYN Lead Risk Screening Program for Pregnant Women as a primary
prevention strategy.
y Provided clients with COVID-19 education, COVID-19 testing, and information regarding
COVID-19 vaccinations. Genesee CHAP also supported clients by providing free masks, at-
home COVID-19 tests, and Quarantine & Isolation boxes.
y Partnering with the United Way of Genesee County, Genesee CHAP developed and
implemented a Vaccine Hesitancy course for all community-based organizations and
residents to participate in free of charge.
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COMMIT TO FIT
Priority Health Needs Addressed:
y Obesity & Health Behaviors
y Social Determinants of Health (Food Insecurity)
y Child Health & Development
y Chronic Disease Burden
y Health Equity
Commit to Fit is a community-wide, health behavior improvement initiative focused on increasing
the practice of healthy behaviors (lifestyles) while improving physical activity and nutrition habits
among residents. Launched by the multi-sector partners of the GFHC, Commit to Fit aims to mobilize
all community sectors to support and utilize a common message and shared strategy for engaging
community residents in efforts that provide a number of no cost resources that support improved
health behaviors, including opportunities to engage in free physical activity and nutrition education
classes/sessions based in the community. In addition to the education and community-based resources
provided by Commit to Fit, local physicians, healthcare providers, and workplace wellness programs
partner via the GFHC to reinforce and promote efforts within their service delivery that supports health
behavior improvement and a reduction in sedentary lifestyles.
From 2019 — 2021, Commit to Fit accomplishments include:
y Conducted multi-method outreach that engaged the Genesee County community with
consistent physical activity and nutrition education messaging.
y Hosted free community physical activity and nutrition challenges throughout each calendar
year, as well as more than 70 free fitness classes each month with the support of community
partners, collectively increasing access to opportunities to be safe and active. During
the COVID-19 pandemic, Commit to Fit worked with community partners to support the
transition of physical activity classes to virtual platforms.
y Continued Commit to Fit Cooking with Kids, a free, evidence-based program that teaches families
about healthy eating and preparing affordable foods from diverse cultures. This evidence-based
program empowers children and families to make healthy food choices through hands-on
learning with fresh local foods and simple recipes. Commit to Fit also implemented SNAP-Ed
funded nutrition programs that include Fresh Conversations and The Learning Kitchen.
y Prepared and distributed a monthly Nutrition Resource Calendar that details free cooking
demonstrations, mobile food giveaways, food pantries, and food-related resources that are
offered throughout Flint and Genesee County each month at www.commit2fit.com. This
collection of resources facilitated by Commit to Fit was created in partnership with the Crim
Fitness Foundation, Flint Farmers’ Market, Food Bank of Eastern Michigan, Hurley Medical
Center, Michigan State University Extension, and local food pantries.
y Expanded the Commit to Fit Active Schools Challenge, designed to promote health and
wellness within local schools through a “healthy” competition in which students are
encouraged to perform 30 minutes of physical activity each day to 36 local elementary,
middle, and high schools across 116 school districts. During the month of March 2021, over
4,569 students participated in the Active Schools Challenge logging more than 4.3 million
minutes of physical activity.
y Implemented the “Certified Healthy Workplace Designation” for Genesee County businesses
and organizations that participate in health and wellness promoting activities for their
employees. A total of 14 businesses in Genesee County have been certified “Healthy.”
y Promoted physical activity in the parks by implementing the Walk with Ease Program. This
program (designed by the Arthritis Foundation) combines self-paced walks with information
about related topics. This program allows participants to work on their own at their own pace
to increase their physical activity. Since its launch in 2018, over 183 adults have participated.
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CHILDREN’S ORAL HEALTH TASK FORCE
Priority Health Needs Addressed:
y Child Health & Development
y Healthcare Access
y Maternal & Infant Health
y Health Equity
Convened by the Greater Flint Health Coalition, the Children’s Oral Health Task Force is designed
to improve the oral health of children in Genesee County through the development and
implementation of an educational campaign focused on families and caregivers of all children.
The strategy also seeks to improve access to dental care for all children with a special emphasis
on children at high-risk for developing dental caries/tooth decay. The campaign educates
providers on children’s oral health issues and utilizes them as a vehicle for disseminating the
campaign message.
From 2019 to 2021, the Children’s Oral Health Task Force accomplishments include:
y Distributed over 9,475 “Baby Those Baby Teeth” Oral Health Wheels to residents throughout
Genesee County, as well as organizations across the United States.
y Distributed over 100 maternal and child oral health bags in Genesee County.
y The Children’s Oral Health Task Force has monitored the number of dental offices in Genesee
County accepting infants and toddlers as patients. COVID-19 did impact the number of
offices that were open and accepting new patients, with a total of 45 locations available in
Genesee County. The Task Force updated the Dentist Referral Guide for Infants and Toddlers
to inform community families where to take their young children for dental services.
CONNECTING KIDS TO COVERAGE
Prioritized Health Needs Addressed:
y Healthcare Access
y Health Equity
The Greater Flint Health Coalition launched the Connecting Kids to Coverage Outreach and
Enrollment Program to support and coordinate Medicaid and Children’s Health Insurance
Program (CHIP) outreach and enrollment efforts in Flint and Genesee County Michigan. This
effort not only includes children, but also parents and pregnant women impacted by the Flint
Water Crisis. This program leads the coordination of a community-wide effort to promote
utilization and retention of Medicaid benefits. The Connecting Kids to Coverage program seeks
to not only provide outreach to children and their families, but to assist families with the
enrollment and retention process.
From 2019 to 2021, Connecting Kids to Coverage accomplishments include:
y Nearly 27,000 children and adults have been provided with new enrollment and
redetermination support.
y More than 37,500 health coverage education materials have been directly distributed to
community residents.
y More than 275 community-based outreach events as well as virtual enrollment cafes were
held to support Connecting Kids to Coverage outreach and enrollment assistance resources.
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FLINT HEALTHCARE EMPLOYMENT OPPORTUNITIES (FHEO) PROGRAM
Prioritized Health Need Addressed:
y Social Determinants of Health (Education, Employment, Poverty)
The Flint Healthcare Employment Opportunities (FHEO) Program was designed to assist
unemployed and underemployed residents of Flint and Genesee County with obtaining training
and employment in the healthcare industry. FHEO Program participants receive:
y Career readiness and “fit” assessments;
y 120 hours of Healthcare Life Skills Training and Career Exploration Workshops;
y Credential Training;
y Assistance with tuition, books, uniforms, exam/license fees, and work supplies;
y A career advisor to assist with decision making and goal achievement;
y Resume, interview skills, and financial literacy workshops;
y Employer connections and job search assistance; and
y Subsidized employment opportunities for out of school youth.
Nearly 1,500 participants have been trained in the FHEO Program to date, of which 85% are
employed with a 97% employment retention rate over the past five years.
YOUR HEALTH YOUR CHOICE ADVANCE CARE PLANNING PROJECT
Prioritized Health Need Addressed:
y Effective Care Delivery for an Aging Population
The Your Health Your Choice Advance Care Planning (ACP) Project seeks to create a community-wide,
standardized approach to advance care planning, which is defined as a person-centered, ongoing
process of communication that facilitates individuals’ understanding, reflection, and discussion of
their goals, values, and preferences for future healthcare decisions. Implemented via the GFHC
and its hospital, physician, insurer, business, and community-based partners, the ACP Project
emphasizes the creation of comprehensive, effective advance care plans to ensure an individual’s
wishes are followed in end-of-life healthcare treatment, resulting in a better quality of life, less
anxiety, less pain and suffering, and improved satisfaction among family members, decision
makers, and the medical community. ACP Project partners are implementing processes to ensure
a complete patient record reflecting the patient’s advance care plan, including advance directive, is
available when needed in medical records across the community’s health systems and healthcare
provider sites. The importance of having a completed advance directive has been reinforced during
the COVID-19 pandemic.
From 2019 to 2021, Advance Care Planning Project accomplishments include:
y Refinement of a single advance directive document used at community-wide scale.
y The community’s ACP workforce and infrastructure necessary for ongoing program
development has been expanded to include the Respecting Choices certification of over
80 ACP facilitators. The program currently includes 70 active facilitators, 7 ACP instructors,
and 1 ACP faculty member.
y Implementation of an Advance Care Planning Outreach Week, highlighting locally available
resources, as well as the importance of National Healthcare Decisions Day.
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SEXUAL HEALTH: GENESEE COUNTY HEALTH DEPARTMENT
Priority Health Need Addressed:
y Sexual Health
Led by the Genesee County Health Department, efforts were made to destigmatize sexual health
and decrease STI/HIV rates in Genesee County by working with multiple resources. A primary
strategy included the Genesee County Health Department hosting free STI testing at the Genesee
County Free Medical Clinic on a weekly basis. Additionally, a large-scale campaign was launched
entitled “SEX: We Get It,” designed to encourage confidential family planning and sexual health
services to teens and young adults living in and around Genesee County. The GCHD’s Family
Planning & Sexual Health Clinic is a trusted source for teens and young adults in Genesee County,
giving them access to high-quality reproductive and sexual health services at low or no cost.
Part 2: 2019-2021 Ascension Genesys Accomplishments
PRIORITIZED NEED: Mental Health, including Substance Use
OPIOID USE DISORDER SAFE ACCESS PROJECT
Genesys launched the Opioid Use Disorder Safe Access Project in the summer 2021. Funded by
a Michigan Opioid Partnership Grant from the Community Foundation of Southeast Michigan,
the purpose of this initiative is to build the capacity of the Ascension Genesys Emergency
Department to serve as a point of access to equitably and effectively identify, assess, provide
medication assisted treatment, and facilitate community-based treatment referrals for people
with Opioid Use Disorder (OUD); and also extend best practice Medication for Opioid Use
Disorder (MOUD) treatment to patients who are identified in the Emergency Department
or during their hospitalization. Stewardship with community OUD treatment partners is an
important component to the initiative; Ascension Genesys engages peer recovery coaches from
New Paths, a Flint-based center that works with an array of partners to address OUD, if the
patient wants to pursue recovery. Upon discharge, the navigators (peer recovery coaches) help
ensure the patient returns to the hospital daily for Suboxone treatment for three days until they
are placed for community-based treatment.
HILLSIDE CENTER FOR BEHAVIORAL HEALTH
Ascension Genesys Hillside Center for Behavioral Health offers a wide range of services to
address prevention, interventions, treatments, and recovery support to improve behavioral
and mental health in a safe environment for patients and clients. The highly-experienced care
team offers confidential, high-quality care that specializes in the evaluation and treatment of
behavioral and emotional difficulties. Outpatient behavioral and mental health services provide
treatment for all age groups and includes: abuse (sexual, psychological, physical), anxiety and
depression, attention deficit disorders (behavior, social skills), eating disorders, perinatal mood
and anxiety disorders (baby blues), post-traumatic stress disorder (PTSD), schizophrenia, and
self-harm. The intensive outpatient treatment is designed to provide short-term intensive
therapy for clients who are in a crisis situation, where weekly outpatient visits are not adequate
to stabilize symptoms.
Since the tele-behavioral health program pilot was launched November 2019, and offered to
new and existing patients in November 2019, 7,410 patients have been seen and a total of
72,224 visits had (in-personal and virtual).
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HUMAN TRAFFICKING EDUCATION & AWARENESS
Ascension Genesys utilizes an established protocol to identify, assess, treat, and refer victims of
Human Trafficking (HT) to supportive community services who present for care in the Emergency
Department or who are identified while receiving inpatient services. To support the recovery
of victims who are identified, referrals are made to established community partners across the
continuum of care including law enforcement, child protective services, substance use disorder
treatment, housing, mental health, and advocacy. Ascension Genesys Hospital has combined efforts
with Ascension Southwest Michigan Community Health and other Ascension hospitals throughout
Michigan to offer hospital-wide associate education with an Ascension internal MyLearning
education module to increase awareness and recognition of the signs and symptoms of Human
Trafficking via the lens of Trauma Informed Care, and community resources to support victims. Over
500 in-patient providers (nurses and physicians) have completed the training since its launch in Fall
2020. Ascension Genesys Hospital also conducts bi-annual HT Multidisciplinary Team meetings with
community partners to support HT survivors across the continuum of care. Additionally, Ascension
Genesys was honored to participate in the community discussion with 300+ individuals which
followed a showing of "Ring of Silence'' hosted at Grand Blanc High School in November 2019.
PRIORITIZED NEED: Obesity and Health Behaviors
DREAM (DIABETES RESOURCES FOR EDUCATION AND MOTIVATION) PROJECT
Ascension DREAM (Diabetes Resources for Education And Motivation) Project embeds a computer-
assisted Motivational Interviewing (MI) enhancement into Diabetes Self-Management Education
(DSME) to guide patients in setting behavior change goals to support improved behavior change
readiness and sustained self-directed health behavior change. This project was made possible
through a grant award from the Michigan Health Endowment Fund’s 2019 Community Health
Impact program to the Ascension Genesys Diabetes Nutrition and Learning Center.
Although COVID-19 created challenges in the quantity of diabetes self-management groups
which Ascension Genesys was able to launch and thus impacting the total number of individuals
served, the Project Team has successfully launched the Motivational Interviewing process
within its diabetes self-management curriculum and has shown some initial encouraging short-
term outcomes. Outcomes include an increase in the percentage of patients who completed
a health behavior change goal and an increase in the percentage of patients who sustained
health behavior goal progress at 50-100% at three-month follow-up. Throughout the pandemic,
as people have become more accustomed to virtual services (currently required for diabetes
self-management classes), the Project Team continues to see an increase in virtual program
enrollment. The Project Team also developed a compendium of Motivational Interviewing
resources to support program sustainability and replication to additional Ascension sites.
PRIORITIZED NEED: Healthcare Access
emPOWER GENESEE
emPOWER Genesee is a strategic initiative of Ascension Genesys Hospital, Consumers Energy,
and Huntington Bank designed to address social determinants of health (SDOH) that adversely
influence the health outcomes of each institution’s most vulnerable clients. The three institutions
came together to leverage their shared resources and commitment to the community, engaging
Genesee Health Plan to provide navigation that connects residents with essential services
including energy, basic needs, healthcare, and financial assistance. The program recognizes that
vulnerable populations have needs spanning all partner organizations and utilizes a Genesee
Health Plan community navigator to help residents access SDOH-related services. Prior to
COVID-19, the community navigator was located at the Consumers Energy direct payment center
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in Flint to help residents with real-time, in-person access to navigation services. Since then, the
program has continued to safely provide virtual navigation services to Consumers customers and
has expanded its scope to include a virtual kiosk located at Ascension Genesys Downtown Health
Center where patients with SDOH needs can access navigation services confidentially.
Since program launch in October 2019 through December of 2021, the Community Navigator
has facilitated 3,007 client interactions. Of these clients, 805 received direct healthcare and
energy assistance referrals; and 351 received community service referrals. Overall, the most
needed services are daily essentials including food, water, and clothing; housing; and completion
of State Emergency Relief (SER) applications that qualify individuals to receive energy
assistance. In 2021 alone, 239 SERs were completed with 98% of applicants served by the
navigator receiving some type of financial assistance.
Ascension Genesys Hospital, Consumers Energy, and Huntington Bank together received the
2021 Health Care Hall of Fame Community Partnership award given in gratitude for partnership
with Genesee Health Plan to ensure that Plan members receive quality, affordable health
care. Program representatives were also invited to the 2021 Root Cause Coalition’s National
Conference to present emPOWER Genesee as a best practice model to address SDOH, and as an
example of how public and private organizations are working together to meet people where
they are to navigate complex systems to access needed essential services.
MEDICAL MISSION AT HOME
Ascension’s Medical Mission at Home events provide a real-time delivery of organized health and
social services to those who would not have access to care with follow-up care and continuity
as needed. Due to the coronavirus outbreak and out of concern for the health and safety of our
community members, patients, and hospital associates, Ascension Genesys Hospital chose to
postpone the Genesee County event originally scheduled to be held in March 2020.
PRIORITIZED NEED: Chronic Disease Burden
GENESYS SUPPORTIVE CARE CLINIC
The mission of the Genesys Supportive Care Clinic is to improve the quality of life for people
facing chronic or life-threatening conditions. The clinic, which is a part of Ascension Medical
Group — Genesys, provides services to help patients manage their pain, and meet any physical,
psychosocial, and spiritual needs from diagnosis through the process of living and dying.
Palliative care providers offer support to both the patient and to their family and/or caregivers
by concentrating on what the needs of the patient are and what the family and caregivers
need to help support the patient. Palliative care providers can help with symptom management
through medications or tools such as raised toilet seats, walkers, or other physical needs, as
well as coordinate with all other providers which can be beneficial in that there is another
person the patient and family can reach out to for information and care.
Launched in January 2020 in Ascension Genesys Hospital campus, the initial outpatient palliative
care program launched in four offices through Genesys Physician Hospital Organization (PHO),
with special focus patients with the following diagnoses: Congestive heart failure, chronic
obstructive pulmonary disease, and chronic kidney disease. The clinic is open to all qualifying
patients, but focused on the above diagnosis to best collect and evaluate data related to patient
experience, patient satisfaction, and volume of utilization.
In summer 2021, the Genesys Supportive Care Clinic relocated to the Genesys Family Health
Center — East Flint Campus due to the impact of COVID-19 and hospital response. Currently, the
clinic is available on Wednesdays from 8:00 a.m. — 12:00 p.m.
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Part 3: Hurley Medical Center Accomplishments
PRIORITIZED NEED: Social Determinants of Health
EDUCATION & EMPLOYMENT
As a teaching hospital, Hurley Medical Center is a highly-regarded educator of the health
care professionals of the future, maintaining affiliations with Michigan State University, the
University of Michigan-Ann Arbor, the University of Michigan-Flint, Children’s Hospital of
Michigan-Detroit Medical Center, Mott Community College, and Henry Ford Health System. With
over 2,700 employees, Hurley is also a major contributor to local economic development and
one of Genesee County’s largest and most consistent employers.
FOOD INSECURITY: HURLEY FOOD FARMacy
The Food FARMacy department opened in autumn of 2017, with Hurley screening all patients
for food insecurity and opening a physical location for patients in need. Currently, the Food
FARMacy focuses on patients who have both chronic disease and food insecurity. Patients
receive a referral to visit up to six times for healthy food to feed their entire household. They
also get referred/enrolled into additional local/state programs that can help them address many
other social needs.
All Patients (Unique & Follow Up): 4,931 Visits / 11,902 People Served
Unique Patients: 2,322 Visits / 4,372 People Served
ADDITIONAL EFFORTS:
y Starting in October 2021, patients at the Hurley OB/GYN prenatal clinic have also been
receiving $15 fruit and vegetable prescriptions that are redeemable at the Flint Farmers’
Market and Flint Fresh.
COMMUNITY SAFETY
Hurley actively works with local partners to help improve community safety. They have partnered
with other organizations on a project to address Human Trafficking. The focus is to work directly
with patients who have been affected by violence through their Trauma Resource Center.
Additionally, in partnership with the University Avenue Corridor Alliance, patients have access to
resources regarding personal safety, housing, and economic development initiatives.
HURLEY INJURY PREVENTION
Hurley Medical Center is the lead organization for the Safe Kids of Greater Flint Coalition. Safe
Kids and Hurley Injury Prevention provide over 20 active programs to promote risk reduction
in the community. Programs include Child Passenger Safety car seat inspections, distracted
driving, drinking and driving, fire and burn safety, First Aid, Stop the Bleed, traumatic brain
injury, fall prevention, home alone, cooking and poison safety, water safety and drowning
prevention, dog bite safety and prevention, bullying, cyberbullying, internet and cyber safety,
assault and abuse prevention, high risk behaviors, sports safety, seasonal safety, and more. Bike
helmets, gun locks, smoke detectors, car seats, and other giveaways are made available through
various grants.
Injury prevention spans all ages and saves significant dollars in health care spending. Community
partners include schools, social services agencies, regional hospitals, and an array of childhood
stakeholders and senior service agencies. Hurley helps to navigate vital safety information, gain
access to resources, and holds regularly scheduled injury prevention events.
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PRIORITIZED NEED: Substance Use
HURLEY MEDICATION FOR OPIOID USE DISORDER (MOUD) CLINIC
Services through Hurley’s Emergency Department are available for those who seek treatment
with opioid use addiction. Patients receive consultations with a social worker, telemedicine
appointments, medications, and referrals to New Paths (a local substance use disorder treatment
program). Goals of the clinic include facilitating safe withdrawal by relieving symptoms and
controlling cravings, reducing the risk of death due to overdose, increasing retention in treatment
with medications, and working to decrease decline health associated with the drug use.
PRIORITIZED NEED: Child Health & Development
HURLEY ASTHMA CLINIC/HOME MANAGEMENT PROGRAM
Physicians and Respiratory Therapists work with patients and families to manage asthma with
a focus on taking medications properly, trigger reduction, and include home visits. Roughly
80-90 children are seen in their homes. This program is facilitated by the Hurley Asthma Nurse
Case Manager.
CAMP EASY BREATHERS
Through a partnership with the YMCA of Greater Flint Camp Copneconic, and various sponsors,
Hurley is able to provide the annual four-day daytime camp which focuses on giving children
with asthma the experience of going to camp with the safety of having a Respiratory Therapist
and medical team nearby, 25-30 children participate yearly. This program is facilitated by the
Hurley Asthma Nurse Case Manager.
PEDIATRIC DIABETES EDUCATION PROGRAM
Hurley offers the only diabetes pediatric education and management program of its kind in Genesee
County. The program treats children with type 1 diabetes, type 2 diabetes, and prediabetes.
ADDITIONAL EFFORTS:
y Focusing on child abuse prevention, Hurley Medical Center has one of only six board
certified child abuse specialists in Michigan.
y Conducting Teen Heart Screenings in partnership with the Thomas Smith Memorial
Foundation, Hurley offers Teen Heart Screening events two to three times per year, with
200-350 screenings at each event. Due to the COVID-19 pandemic, Hurley Medical Center
has paused the heart screening events, completing the last one in October of 2019. These
efforts will likely be resurrected post-pandemic.
PRIORITIZED NEED: Mental Health
Hurley continues to care for its mental health and substance abuse patient population at the
Hurley Mental Health Associates building, as well as through the inpatient behavioral health unit
and through collaborations with Genesee Health System.
ADVANCED NEUROPSYCHOLOGY & PEDIATRIC PSYCHOLOGY SERVICES (ANPPS)
Hurley’s ANPPS (formerly Brain Function Assessment Center) offers assessment and treatment
services for brain injuries, neuropsychological evaluations for individuals of all ages, and
psychology services for children and adolescents who are dealing with the effects of chronic
medical conditions.
HURLEY TRAUMA RECOVERY CENTER
Hurley Medical Center provides a free, confidential, non-insurance billed, Trauma Recovery
Program for both adult and pediatric patients that have been impacted by trauma, violence,
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sexual assault, etc. Hurley coordinates immediate crisis support alongside medical care, follows
up with patients after discharge, assists patients with continued symptom management, and
connects patients to appropriate services (emergency shelter, food resources, legal support, etc.)
when necessary.
ADDITIONAL EFFORTS:
y Hurley offers Pediatric Psychology Services and offers evaluation, treatment planning, and
therapy for an array of diagnoses and behavioral needs.
y Hurley opened a Pediatric Psychology Unit in 2022 to better serve the needs of the youth.
y Hurley offers employees Employee Assistance Programs, mindfulness and wellness
programs for coping and stress reduction, as well as a calm and relaxing weekly experience
for employees to attend to provide them a brief reprieve from daily stressors.
PRIORITIZED NEED: Obesity & Health Behaviors
THE KOHL’S HEALTHY KIDS GRANT
The Kohl’s Healthy Kids Grant focuses on healthy living for children and families, including large-scale
events and school assemblies reaching 3,000-4,000 kids each year as well as more targeted
programs such as free family nutrition counseling with a Registered Dietician reaching between
400-800 kids each year. Grant programs were accessible to the community through 2021.
CAMP MOVE IT
Through a partnership with the YMCA of Greater Flint Camp Copneconic and various sponsors,
Hurley is able to provide an annual camp for 8 to 12-year-old children who would benefit from
healthy lifestyle changes. They learn about the importance of nutrition, movement, sports,
gardening and growing food, mindful eating, preparing and cooking food, as well as stress and
coping techniques. They also participate in many of the existing Camp Copneconic activities,
such as swimming, hiking, and zip-lining.
Each year 30-40 kids attend. Camp Move It was a six-day overnight night, temporarily halted due
to the COVID-19 pandemic in 2020. Camp Move It resumed in 2021 as a five-day daytime camp.
ADDITIONAL EFFORTS:
y Hurley provides sponsorship and support for several run/walks in the community, including
the YMCA Santa Run, the Burton Veteran’s Run, and remains the lead medical sponsor for
the Crim Festival of Races.
y Diabetes Self-Management Education and medical nutrition therapy offered for patients
with chronic disease with over 4,000 visits per year. Virtual appointments are available.
y Nutrition seminars/healthy cooking demos for Cardiac Rehab patients, offered monthly,
reaching 300 patients annually.
y Low-Dose CT Lung Screenings are preventative screenings for current or former smokers to
aid in finding lung cancers in the earliest stages.
y The Wellness Department maintains ongoing programs and activities for 2,700 employees;
including fitness challenges, nutrition information, blood pressure/A1c/ECG screenings, a
robust internal resource website, and the access to a free, onsite fitness room and exercise
equipment at select off-site locations.
y Monthly support groups are offered for various patients with the goal of health
maintenance and continued support (Bariatric, diabetes, etc.).
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
PRIORITIZED NEED: Safe & Affordable Drinking Water
WATER RESOURCES FOR PATIENTS
Hurley Medical Center has provided its patients with pertinent resources such as water
distribution sites, registration information for the Flint Registry, and the Flint Cares website link.
PEDIATRIC PUBLIC HEALTH INITIATIVE (PPHI)
In partnership with Michigan State University, in 2016 Hurley Medical Center established
the Pediatric Public Health Initiative (PPHI) as a model public health program to improve the
outcomes of Flint children. Through community and clinical programs, childhood health policy/
advocacy, and robust evaluation, the Pediatric Public Health Initiative works with the primary
goal of mitigating the impact of the Flint Water Crisis and serving as a national resource for best
practices. In connection with many local partners, including Flint’s parents and kids, as a center
of excellence, PPHI works to wrap Flint children in a nutrient-rich environment of development-
promoting interventions.
HURLEY’S CHILDREN’S CENTER
Hurley Children’s Center (Pediatric clinic) at the Flint Farmers’ Market offers many long-term
services and resources to foster healing in response to the water crisis: A Fruit and Vegetable
prescription program, Literacy/reading programs, positive parenting, recruiting families to
enroll in the Flint Lead Registry, social needs screenings/referrals, including referrals to the
Hurley Food FARMacy.
y More than 45,000 fruit and vegetable prescriptions have been distributed since beginning in
February 2016. Prescriptions have roughly a 37% redemption rate.
y Imagination Library: over 251,000 books have been distributed in Flint through the program.
y The Born to Read program at the hospital is giving literacy bundles to every newborn before
discharge and connects the family to Early On if they consent. Over 4,000 bundles have
been distributed since 2018.
y The Hurley Children’s Center also offers the Video Interaction Project (VIP). The VIP is an
evidence-based parenting program that uses videotaping and developmentally-appropriate
toys, books, and resources to help parents utilize pretend play, shared reading, and daily
routines as opportunities for strengthening early development and literacy in their children.
Since 2017, the VIP team has delivered 1,833 toys in 1,457 video sessions to over 300 Flint-
area families.
y The First Five Fresh program was implemented in 2021 through a partnership between
Hurley Children’s Hospital and Michigan State University with funding from No Kid Hungry
and Support through the Flint Fresh organization. Families receive a voucher from the
Hurley Children’s Clinic in which they can redeem through Flint Fresh for a produce and
protein box that is delivered directly to their homes to address transportation barriers and
minimize COVID exposures. Through the Hurley Children’s Clinic, vouchers were distributed
to over 3,400 children (birth through 5 years of age).
PRIORITIZED NEED: Healthcare Access
Hurley continues to provide care to everyone who walks through their doors in addition to
those who cannot. As a response to the COVID-19 pandemic, access to Urgent Care/Health
Centers has expanded by offering virtual Telehealth services for non-emergent needs.
Telehealth services began as a response to patients being unable or unwilling to leave their
home, though the access and availability of Telehealth has accelerated access for many people
who would not seek care otherwise.
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
PRIORITIZED NEED: Chronic Disease Burden
HURLEY’S PATIENT RESOURCE AND COMMUNITY ADVOCATE
A new Hurley position was developed in 2020 with the intention of identifying minority populations
and engaging in communication to improve healthcare literacy, reduce disparities, identify access to
care opportunities, reduce readmission rate, and improve patient experience through education and
understanding. This community-based job positions a Registered Nurse into community centers (such
as churches, businesses, and neighborhoods) to nurture relationships and strengthen communication.
Providing equitable healthcare access to the vulnerable residents of Genesee County endeavors to reduce
chronic disease burden amongst residents (with a focus on Heart Health, Diabetes, Kidney disease, etc.).
ADDITIONAL EFFORTS:
y The Breast Navigation Program helps to directly relieve disease burdens by helping
patients plan care, clinical visits, answer questions, and obtain funding to assist with extra
bills that may arise. This program allows cancer patients to concentrate on treatment,
wellness, and healing.
y The Congestive Heart Failure and Renal Nurse Navigator is available to patients with an
overall goal of reducing readmissions. The Nurse Navigator helps answer questions, assists
with symptom management, taking medications properly, promptly follows up with patients
after discharge, and helps to schedule their follow-up appointments. The Nurse Navigator
is on-call 24/7. Within 30 days of discharge, Heart Failure patients had readmission rates of
26% in 2017, since declining to 13% in 2021.
y A Lung Health Navigator is available during each step of patient’s lung related health care
needs, providing information, knowledge, support, and guidance as needed to manage lung
health. The Lung Navigator works with Primary Care Physicians and specialists to develop
specialized treatment plans for patients.
y A Joint Navigator and support team cares for patients during their entire joint replacement
journey, assisting with appointment scheduling, rehabilitation, and improving patient
compliance and outcomes.
y Hurley’s Annual Vaccination fair is held every November. It was held as a drive-thru clinic
due to the COVID-19 pandemic. Partnerships and sponsors make it possible to create more
access to vaccinations.
PRIORITIZED NEED: Effective Care Delivery for an Aging Population
y Exemplar status for NICHE (Nurses Improving Care for Health-System Elders). Certified Geriatric
Nurse Specialists see all patients 65 and older.
y Hurley continued to grow Palliative Care Services, with additional staff and added hours
outpatient and at the Genesys Hurley Cancer Institute.
y Continuation of “HELP” (Hospital Elder Life Program) which places volunteers with elderly
patients 70 years and older (similar to Child Life model in pediatrics). It is a proactive
measure to protect against the risk of delirium and functional declines while hospitalized.
y Fast Track Emergency Room for Seniors/Bone Health program. All patients 65 years and older
do not wait in the emergency department waiting room. Upon arrival, they are immediately
fast-tracked into a room so they can be monitored. Hurley is awarded Level III status by
the American College of Emergency Physicians, certifying that there are advanced policies,
protocols, and procedures to insure the best emergency health care delivery for older patients.
y Continued a partnership with Valley Area Agency on Aging on Transitions to Care, with 340
patients in the program.
y Senior Caregiver Event offered annually with 150-200 people in attendance. The Caregiver
Event was temporarily halted in 2020 due to COVID-19, but resumed in 2021.
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
PRIORITIZED NEED: Maternal & Infant Health
Hurley operates the region’s only Level III Neonatal Intensive Care Unit, with over 1,400 — 1,700
discharges per year and supports many programs that promote healthy pregnancies and positive
infant health outcomes.
MATERNAL INFANT HEALTH PROGRAM (MIHP)
The MIHP is Michigan’s largest evidence-based home visitation program for Medicaid eligible
pregnant women and infants with a long-term goal to reduce maternal and infant morbidity
and mortality. Hurley’s program promotes healthy pregnancies, positive birth outcomes, and
healthy infant growth and development. It is a supplement to regular prenatal/infant care and
serves infants up to 12 months in their homes by a team of Registered Nurses, Licensed Social
Workers, Registered Dieticians, Infant Mental Health Specialists, and Lactation Consultants. In
combination with the Nurse Family Partnership, Hurley assists over 300 new moms/pregnant
women and their babies up to age two.
NURSE FAMILY PARTNERSHIP (NFP)
The NFP is a free program for first-time moms who are pregnant with their first child, reside
in eligible service areas, and whose income level falls within specific requirements. Under the
mentorship of a personal nurse, new moms will build maternal confidence in activities such as
breastfeeding, nutrition, child development, safe sleep techniques, and more. New moms will
also get necessary referrals for healthcare, childcare, job training, and other programs which
will help their family be more successful. In combination with MIHP, Hurley assists over 300
new moms/pregnant women and their babies up to age two. This program has implemented a
virtual aspect during the COVID-19 pandemic.
DIABETES DURING PREGNANCY EDUCATION PROGRAM
Pregnant or soon-to-be pregnant women are offered diabetes education and medical
management during their pregnancy. Virtual classes are available.
PHOTOTHERAPY LIGHTS
Five phototherapy lights (large enough to cover the infant from head to toe) were purchased for
Hurley’s Neonatal Intensive Care Unit. Preterm babies commonly need treatment for jaundice
and light therapy lowers bilirubin quickly and safely.
ADDITIONAL EFFORTS:
y Continued hiring and training of Certified Lactation Consultants. Hurley maintains an
ongoing weekly breastfeeding clinic as well as provide lactation support over the phone.
y Hurley starting “rooming in” for Neonatal Abstinence Syndrome (NAS) babies to give
mothers time to bond with the baby until they are discharged.
y Supporting patients with parenting/breastfeeding classes for pregnant/new moms. Classes
were taught in person until the COVID-19 pandemic, and continue with virtual learning
modules for patients.
y The Community Baby Shower which is offered annually at Flint Farmers' Market provides
many resources to pregnant/new moms, with 120-150 participants each year. The yearly
event was paused due to COVID-19 but will resume when appropriate.
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
PRIORITIZED NEED: COVID-19 Response/Relief
Hurley Medical Center worked closely with the Genesee County Health Department and other
community stakeholders to support pandemic response efforts throughout Genesee County.
In 2020, Hurley developed a drive through COVID-19 testing station at Atwood stadium in partnership
with Kettering University. The site was open for two months and provided residents of the community
efficient access to free viral swabbing, with results provided within 1-2 days.
Hurley Medical Center offered numerous COVID-19 vaccination clinics, administering both Pfizer
and Moderna vaccines to over 20,000 individuals. Hurley also provided shared vaccine storage
space to local partners without adequate freezer capacity, helping improve vaccine access
within the community.
Hurley also opened a Monoclonal Antibody Clinic in 2021. Monoclonal Antibody Infusions were
identified as a treatment option which resulted in milder symptoms for those infected with the
COVID-19 virus. Over 2,400 doses have been administered.
Part 4: 2019-2021 McLaren Flint Accomplishments
NOTE: Along with the initiatives outlined in this document, McLaren Flint also participates in
collaborative initiatives with other health partners through the Greater Flint Health Coalition,
including Hurley Medical Center, Ascension Genesys Hospital and the Genesee County Health
Department, to collectively address community health needs identified in the 2019 Community
Health Needs Assessment Report for Flint and Genesee County. These initiatives are outlined in
a shared Community Health Improvement Plan, with the goal of aligning implementation plan
activities where possible to leverage existing programs, avoid duplication, build economies of
scale, and maximize available resources through combined community benefit investment.
PRIORITY HEALTH NEED: Social Determinants of Health (SDOH)
INITIATIVE: Increase public safety and community engagement and reduce blight in neighborhoods
in the University Corridor and College Cultural Neighborhood in Flint.
y Recognizing the need to maintain safe, clean, blight-free, and engaged neighborhoods for
residents of Flint, McLaren Flint provided resources to maintain the Flint Urban Safety Corps
initiative in the University Corridor and College and Cultural Neighborhood in Flint.
y McLaren Flint donated $48,000 over the three-year period to support the University
Corridor program.
y With McLaren Flint’s support, 14 full and part-time AmeriCorps members worked in the
University Corridor neighborhood to build capacity of community watch groups, radio patrol
groups, bike watch groups, and to organize and implement board-ups of blighted buildings.
y Outcomes realized to reduce blight, decrease crime and increase community engagement include:
y 2 community watch groups formed
y 54 community patrol shifts performed
y 5 block clubs supported
y 14 homes boarded up
y 7 lots cleaned
y 18 canvassing events held
y 21 safety education events held
y 108 volunteers recruited
y 6,000 informational brochures
distributed to residents
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
PRIORITY HEALTH NEED: Social Determinants of Health (SDOH)
INITIATIVE: Provide vulnerable individuals with food insecurity in Genesee County access to
healthy food resources and linkages to additional programs that can address related needs.
y On a weekly basis, McLaren Flint donated over-produced food that was prepared in the hospital
nutritional services department to the Genesee County Food Rescue Program for distribution to
people in need through their soup kitchen and food pantry at the New Life Center.
y 33,442 pounds of food was donated to the Genesee County Food Rescue Program to increase
its capacity to provide healthy food and meals for people with food insecurity who are served
through the New Life Center.
y The value of this donation (estimated $1 per pound) is $33,442.
y McLaren Flint donated 700 pounds of unperishable food to the Food Bank of Eastern Michigan
through the annual Harvest Gathering Food Drive in 2019 and 2020. Employees provided food
donations which the hospital collected and then coordinated with the Food Bank of Eastern
Michigan for pick-up and distribution to those in need. The 2021 food drive was an online
donation program due to COVID-19 restrictions.
PRIORITY HEALTH NEED: Social Determinants of Health
INITIATIVE: To identify and address SDOH barriers that impact medical care and recovery
for patients discharged to Skilled Nursing Facilities (SNF) with goal of resource provision and
reduction in hospital readmissions.
y McLaren Flint Case Management met with all patients being discharged to SNF and screened
them for Social Determinants of Health using a SDOH screening tool. Screening results were
shared with the appropriate SNF to promote continuum of care in addressing patient needs,
connecting patients to resources, and reducing hospital readmission. From 2019-2021, case
management screened 3,240 patients.
y McLaren Case Management further provided a daily list of patients whose physicians are part
of McLaren Physician Partners (MPP) to MPP case managers, with SDOH screening results.
These case managers utilized these results for additional follow-up with the appropriate SNF
for each patient. From 2019-2021, 342 patients were referred to MPP to support improved
care and resource connection for patients discharged to Skilled Nursing Facilities.
y Reduction in hospital readmission for patients referred to SNF will be measured moving
forward through McLaren’s newly implemented Cerner software application.
PRIORITY HEALTH NEED: Child Health & Development
INITIATIVE: Provide medical and psychosocial examinations to children who are suspected
victims of child sexual abuse with the goal of gaining forensic evidence to bring perpetrators to
justice as well as providing children and their families with supportive services.
y McLaren Flint operates the Child Evaluation Clinic in coordination with the Voices for Children
Child Advocacy Center in Flint, providing medical examinations of children who are suspected
victims of sexual abuse. McLaren funds a specially-trained, dedicated physician and trained
nursing staff to support the Clinic along with specialized equipment for a value of approximately
$42,000 per year.
y 58 children who were suspected victims of sexual abuse received specialized medical services
from physicians and nurses trained to provide these forensic medical examinations.
y Physical evidence gained through these exams resulted in successful prosecution of
25 perpetrators, with others awaiting trial.
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
PRIORITY HEALTH NEED: Mental Health
INITIATIVE: To provide improved access and expanded services to serve a growing demand for
mental health services for adolescent and adult residents of Genesee County.
y McLaren Flint recruited and hired two additional psychiatrists in 2019 to increase the total
number of employed board-certified psychiatrists to four. A board-certified psychiatric nurse
practitioner joined the staff in 2021, thus further expanding specialist capacity to serve
patients in need of behavioral health services.
y McLaren Flint added two new beds to its 36-bed inpatient adult psychiatric unit in 2019 to
increase operational capacity in behavioral health services and received Certificate of Need
approval in 2021 for new 12-bed Geriatric Psychiatry Unit designed to serve the needs of the
older adult population.
y McLaren Flint contracted with Reliable Transportation in 2019 and 2020 and with the
Flint Mass Transportation Authority in 2021 to provide free transportation to the Partial
Hospitalization Program for 1,325 patients to remove transportation as a barrier to receiving
service. The cost of these contracts was $150,000.
y McLaren Flint operates the area’s only Partial Hospitalization Program (PHP) for Adolescents
age 12-18, recording 7,320 adolescent visits from 2019-2021. To provide an academic resource
for patients, McLaren arranged for a teacher from Genesee Intermediate School District to
work daily with adolescent patients.
y Along with the adolescent PHP volumes, McLaren Flint served 3,255 people in the adult
inpatient unit; recorded 13,909 adult PHP visits and 8,858 outpatient visits from 2019-2021.
INITIATIVE: To provide integrated behavioral health services to primary care and cancer
patients to address behavioral health issues with early intervention and treatment and improve
the care continuum.
y During patient visits to the McLaren Family Practice or Internal Medicine Residency Group
practice programs, if the medical provider determined the patient would benefit from a
behavioral health assessment, the psychologist/psychology fellow was contacted and provided
an immediate same-day assessment with the patient to determine a behavioral health
intervention and treatment plan (coping skills, stress management, sleep strategy, etc.) This
service was offered at no charge to patients. During 2019-2021, 842 patients were referred for
behavioral health assessments. This number was impacted by COVID-19 interference as well as
clinics having reduced hours due to COVID-19.
y A similar program was offered to patients at the McLaren’s Cancer Center in 2019, and 109
patients received services.
INITIATIVE: Suicide Prevention
y McLaren Flint participates in the Emergency Department Suicide Risk Screening Program utilizing
the Columbia Suicide Severity Rating Scale, screening all patients 10 and older. From 2019-2021,
165,092 patients were screened in McLaren Emergency Departments at the Flint hospital and
in the Fenton Emergency Center to promote early intervention to address suicidal behaviors or
thoughts with appropriate treatment and follow-up. If identified as potentially suicidal, patients
were referred to a McLaren clinical psychologist or for a psychiatric consult as appropriate.
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PRIORITY HEALTH NEED: Obesity & Health Behaviors
INITIATIVE: To provide programs to address obesity and healthy behaviors for Genesee
County residents.
y The McLaren Bariatric and Metabolic Institute offers a comprehensive/multidisciplinary
surgical weight loss program, including two surgical options, and a behavioral health and
nutrition component. From 2019-2021, 469 patients underwent bariatric surgery to address
obesity issues and reduce co-morbidities.
y Sixty percent of those undergoing bariatric surgery attended post-surgical telehealth follow-up
for one year for support in maintaining and managing their health.
y 360 patients participated in bariatric support groups facilitated by the program’s clinical
psychologist.
y A dedicated Facebook page was established for bariatric patients which was facilitated by
the bariatric nurse and dietitian with the goal of providing information and support in helping
patients manage and address any health concerns as well as provide information regarding
additional resources.
y Twenty-one patients from the McLaren Bariatric Program annually were funded by McLaren to
participate in the Crim Fitness Foundation Training Program through a dedicated group led by
a member of the McLaren Bariatric Program staff. McLaren invested $2,730 per year ($8,190)
to support this program and provide opportunities for patients to remain active and sustain a
healthy lifestyle.
y McLaren also maintains a clinically monitored fitness center for bariatric patients to provide a
safe environment for post-surgical exercise in the maintenance of weight and lifestyle changes.
PRIORITY HEALTH NEED: Health Behaviors
INITIATIVE: To provide Flint residents access to health information and resources that address
health behaviors.
y McLaren Family Practice residents (18) and the Medical Director of Behavioral Services met
twice per month at Eisenhower School in Flint with school staff, parent liaisons, Genesee
Health Plan and Crim Youth Program to assess needs and plan programming at the school to
address those needs.
y McLaren Flint residents staffed an “Ask the Doctor” monthly series at Eisenhower to discuss
various health topics and resources for parents and public. 144 families at Eisenhower
participated in the “Ask The Doctor” series to gain access to timely health information and
resources through medical professionals.
y Approximately 360 students were impacted through the Eisenhower School program.
y McLaren Flint expanded this program in late 2021 to include families and mentors of the Boys
and Girls Club of Genesee County.
y McLaren Flint provided a grant of $6,000 for the purchase of laptop, projector and connection
chords to support the "Ask the Doctor" virtual program and other virtual learning opportunities
at Eisenhower.
y Physician residents from McLaren’s Family Practice Program donated $450 and 42 items
including toiletries, gloves, socks, hand/foot warmers, to support student needs.
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
PRIORITY HEALTH NEED: Healthcare Access
INITIATIVE: To increase access to medical services for uninsured adults (ages 18 through 65)
who are eligible residents of Genesee County and to assist with transition to sustaining programs
of healthcare.
y McLaren Flint internal medicine residents and faculty physicians staff the Genesee Free
Medical Clinic three days per week, and provide medical care and services to uninsured clients,
at no charge to patients. During 2019-2021, 9,700 people were served by physicians at the
Clinic, with 1,200 referrals to physician specialists, diagnostic services, and other resources. The
value of these services provided by McLaren physicians was approximately $175,000 per year
or $525,000 over the three-year period.
y McLaren Flint Laboratory Services receives lab specimens from the Free Medical Clinic and
performs testing services/results at no-charge. The value of these free tests was almost
$200,000 per year, or $600,000 over the three-year period.
y McLaren Family Medicine program physicians staffed free monthly Women’s Health Clinic to
support maternal and child health needs in 2019 and part of 2020 but was discontinued due to
COVID-19 restrictions.
y McLaren Flint Psychologists and psychology fellows held free monthly Lifestyle Clinics for
patients at the Free Medical Clinic in 2019 and into 2020 but the program was suspended after
participation stopped due to the impact of COVID-19.
PRIORITY HEALTH NEED: Healthcare Access
INITIATIVE: To provide transportation to and from healthcare services for patients unable to
drive themselves, seek other means of transportation or afford transportation costs.
y Through the Patient Care Fund at McLaren Flint, the hospital funded $217,420 in cab fares, bus
fares, and other means of transportation for patients to be safety transported to their home or
appropriate setting after discharge from the hospital.
PRIORITY HEALTH NEED: Healthcare Access
INITIATIVE: To provide access to health screenings, information and resources for Genesee
County residents.
y McLaren Family Practice Residency Center provided physician coverage and health screenings
for participants at the Our Lady of Guadalupe Church Health Fair in Flint to enhance access
to health information and resources for the Flint Latino American Community. A total of 319
individuals participated in free health screenings in diabetes, hypertension, obesity, and mood
disorder, along with an “Ask the Doctor” booth for health information. The Health Fair was
cancelled in 2020 and 2021 due to COVID-19 restrictions.
INITIATIVE: To connect residents of Genesee County with resources available in the community
to address health needs and related issues.
y McLaren Case Management coordinated with community agencies to facilitate their participation
in the Community Resource Day, held each October in McLaren Flint's Auditorium. The goal is
to provide community residents with awareness and opportunities to connect with resources
to serve a variety of health-related needs. A total of 256 community residents attended the
Community Resource Days in 2019 and 2021, while more than 250 people participated in a virtual
Community Resource Day in 2020 (due to COVID-19).
y Twenty-five agencies participated in the annual Community Resources Day, including: McLaren
Health Management Group; MedStar Ambulance; McLaren Advance Care Planning; Disability
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
Network; Valley Area Agency on Aging; Genesee County Health Department; Genesee Health
System; McLaren Outpatient Coumadin; Wound and Diabetic Education Clinics; Alternative
Elder Care; The Lodges of Durand; Department of Veteran’s Services; United Way; Legal
Services of Eastern MI; Visiting Physicians Assoc.; Families Against Narcotics; Building Stronger
Women; Caretel Inns of Linden; Greater Flint Health Coalition; Home Town Heroes; Hamilton
Community Health Network; Durand Senior Care and Visiting Physicians Association.
PRIORITY HEALTH NEED: Healthcare Access
INITIATIVE: To provide medications for individuals who are being discharged from the hospital
and cannot afford to pay for their prescriptions.
y Through the Patient Care Fund at McLaren Flint, $77,076 in medications was provided to allow
patients who could not afford prescription costs to have access to needed medications to
support treatment and recovery. McLaren employees made donations to the fund through a
special campaign entitled “Every Little Change Makes A Big Difference."
y The process for patients to quality for the fund involves an initial screening evaluation through
which case management staff identified patients in financial need. Case managers sent patient
prescriptions to Walgreen’s for a cost estimate of the patient portion of their prescription.
The case manager then met with the patient to assess if the patient could meet the financial
obligation. If not, the case manager worked with the physician to determine if there was a less
expensive but effective prescription. If no other alternative was identified, patient medications
were funded through Patient Care Fund, and the patient was connected with community
resources for further support.
PRIORITY HEALTH NEED: Chronic Disease Burden
INITIATIVE: To provide resources that assist people with chronic health conditions in managing
their condition, preventing complications and improving health outcomes.
y To assist patients with resources to better manage their diabetes and improve health
outcomes, McLaren Flint provided an Outpatient Diabetes Education Program involving weekly
one-on-one and group sessions for patients with diabetes. A team including a dietitian, nurse,
pharmacist and physician provide education to patients. The program was open to the public,
with a physician referral.
y 853 patients participated in the Outpatient Diabetes Management Program from 2019-2021
to better manage their diabetes and improve health outcomes.
y The Outpatient Diabetes Management Program was successful in reducing patients’ HgbA1C
hemoglobin by 1.5%, exceeding the national benchmark of .6%.
y McLaren Flint provided a Pulmonary Rehabilitation Program for patients with Chronic
Obstructive Pulmonary Disease, featuring weekly classes and exercise. The program was
open to the public with a physician referral. From 2019-2021, 175 patients participated
in the program to manage their COPD. Outcomes from the Pulmonary Rehabilitation
Program include:
y Improvement in walking capacity from 981 feet in 6 minutes to 1,242 feet in 6 minutes
y 42% decrease in shortness of breath
y 25% decrease in oxygen use
y 33% increase in self-reported quality of life
y High-risk COPD inpatients received a free assessment with a Respiratory Therapist for lifestyle
and health behaviors, with recommendations and resource referral.
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
PRIORITY HEALTH NEED: Effective Care Delivery for an Aging Population
INITIATIVE: Provide Medicare patients with resources to prevent hospital readmissions, ensure
continuum of care, and meet basic needs.
y McLaren Flint Case Management participated in a collaborative program with the Valley Area
Agency on Aging Care Transition Program, identifying Medicare patients who were at potential
high risk for re-admission. Case managers worked with these patients’ physicians to coordinate
a referral to the VAAA program. The patient was seen at home the day after discharge by a
nurse practitioner through VAAA who could identify/treat medical issues and connect the
patient to resources. McLaren Flint referred an average of 21 patients per week to the VAAA
program. This program was more limited during the pandemic as VAAA suspended “in-home”
services for a period of time but continued to call patients and provide resources.
PRIORITY HEALTH NEED: Effective Care for an Aging Population
INITIATIVE: To provide information and resources in support of Advance Care Planning for
Genesee County residents.
y McLaren Flint’s Advance Care Planning Educator provided 1,174 people with information and
assistance in completing Advanced Care Directives through one-on-one sessions, community
presentations, and community outreach events.
PRIORITY HEALTH NEED: Infant and Maternal Health
INITIATIVE: To improve breastfeeding initiation and duration rates among Women, Infants, and
Children (WIC) participants and WIC-eligible mothers.
y McLaren Flint implemented a Memorandum of Understanding (MOU) with the Genesee County
Health Dept. and the Special Supplemental Nutrition Program for Women, Infants, and Children
(WIC) to make the services of the WIC Breastfeeding Peer Counselor available to WIC eligible
mothers who deliver infants at McLaren Flint for breastfeeding education, resources, and support.
y During 2019-early 2020, 98 new mothers participated in the program, with the goal of
improved infant health. During COVID, the WIC counselor did not visit mothers in the hospital,
and hospital nursing staff provided breastfeeding support.
PRIORITY HEALTH NEED: Infant and Maternal Health
INITIATIVE: Identify and address variation in obstetric care in the State of Michigan and utilize
best practices in support of quality outcomes.
y McLaren Flint participated in the Obstetrics Initiative (OBI) Funded by Blue Cross Blue Shield of
Michigan/Blue Care Network, which included 74 hospitals statewide.
y OB Nursing Staff participated in a Skills Fair class (30 staff members; 1 hour class) each year.
y OB/GYN physician, midwives, OB educator, OB nursing manager, OB data abstractor
participated in conferences and workgroups with colleagues across the state.
y McLaren Flint realized the following reductions in C-section rates:
y Primary C-section rate decreased from 23.1% in 2019 to 11.8% in 2021.
y C-section after induction rate decreased from 33.3% in 2019 to 15.7% in 2021.
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COMMUNITY HEALTH NEEDS ASSESSMENT REPORT
INITIATIVE: Increase access to childbirth education and resources for women in the Genesee
County community.
y McLaren Flint Family Birthplace offered free childbirth classes to expectant mothers and their
support persons as well as free breastfeeding counseling. Classes included: Natural Comfort
Techniques, Childbirth Preparation, Baby Care, and Breastfeeding.
y 1,319 new mothers received access to breastfeeding counseling.
y 102 families participated in childbirth classes in 2019-April 2020. On-site classes were not held
during the COVID-19 pandemic.
PRIORITY HEALTH NEED: Substance Use
INITIATIVE: Implement a comprehensive strategy to provide access to substance use treatment,
prevention, and education regarding opioid misuse throughout Genesee County.
NOTE: McLaren Flint participates with the Greater Flint Health Coalition, Hurley Medical Center,
Genesys Health System, and other partners in a collaborative community-wide task force to
address the Opioid Epidemic (see detailed strategy, actions, and input in the collaborative section
of the report).
APPENDIX B: 2022 CHNA IMPLEMENTATION PLAN
DEVELOPMENT, RESOURCES TO MEET COMMUNITY
NEEDS, AND PUBLIC DISPLAY
A Community Health Needs Assessment Subgroup to the Greater Flint Health Coalition’s Cost &
Resource Planning Committee has been established to formulate aligned CHNA Implementation
Plans for each priority health need identified. These aligned CHNA Implementation Plans will
include how Ascension Genesys Hospital, Hurley Medical Center, and McLaren Flint will each
individually address priority health needs to provide community benefit, as well as developed
shared strategies to implemented and supported via the Greater Flint Health Coalition.
Upon completion of each hospital’s Implementation Plan, Appendix B will be populated with
additional information for public consumption, including resources to meet community health
needs identified.
The finalized Community Health Needs Assessment Report and Implementation Plans are
available to the community on each of the following websites:
y Greater Flint Health Coalition: www.gfhc.org
y Ascension Genesys Hospital: www.ascension.org
y Hurley Medical Center: www.hurleymc.com
y McLaren Flint: www.mclaren.org/flint
y Genesee County Health Department: www.gchd.us
The websites of the Greater Flint Health Coalition and Genesee County Health Department each
provide descriptions of a variety of targeted initiatives that are available to support community
health needs to be addressed.
For additional information or questions, please contact the Greater Flint Health Coalition
at gfhc@flint.org.
120 W. First Street
Flint, Michigan 48502-1815
Business: 810-232-2228
Fax: 810-232-3332
E-mail: gfhc@flint.org | www.gfhc.org