The Washoe County Health District’s (WCHD) Community Health Improvement Plan (CHIP) is a plan of action to identify and address local conditions that are causing or adding to poor health in Washoe County.
A large panel of health officials, including health district officer Kevin Dick and other representatives from WCHD, Quest Counseling, other community partners and Nevada Senator Julia Ratti held a virtual discussion on Thursday to talk about the achievements of the 2018-2020 CHIP and what goals remain to be fulfilled for 2021.
The national nonprofit Public Health Accreditation Board defines a CHIP as “a long-term, systematic effort to address health problems on the basis of the results of assessment activities and the community health improvement process.”
But how do stakeholders that create a CHIP determine what the needs of the communities are?
Traditionally, every three years the health district collaborates with community stakeholders to assess the needs of the community. This is done by gathering input from communities and residents through online surveys. These surveys are shared with partners to get a good representation of the population in Washoe County. Renown also did a similar survey last year, said Sen. Ratti.
Information is also gathered from 250 health indicators and sources like the Centers for Disease Control and Prevention. These data are analyzed and then discussed with community partners for chalking out programs to address the needs of the community.
Over the last three years, the CHIP and WCHD have been focused on behavioral health, housing and homelessness, and physical activity and nutrition. 
Current reality in Washoe County and CHIP goals
As northern Nevada witnesses growth because of corporations like TESLA and Panasonic, Apple, Switch and Google opening shop here, more people are moving to Washoe County. The influx of people is driving housing prices up. Nevada welcomes growth, yet it also recognizes that the most vulnerable populations who are at risk of homelessness need protection from rising prices and a scarcity of affordable housing.
“Currently, the average hourly wage in Reno remains 8% lower than the national average. As a result, households are often forced to pay a larger percentage of their income on housing,” said a WCHD document on the CHIP.
Many in the county are low income and spend 50% or more of their wages on housing. This is a tough situation, made worse by the COVID-19 pandemic and an economic recession. Many of these workers face impending homelessness.
Housing and Homelessness
The CHIP will continue to build upon some of the progress in affordable housing made in the last three years. Stakeholders have continued to work on a regional strategy on housing affordability, that was led by the nonprofit Truckee Meadows Healthy Communities.
The program continues to advocate for building new affordable housing. It also observes that the community should support more policies to preserve existing affordable housing so as not to lose some of those subsidized units, said Ratti.
The CHIP’s work groups of stakeholders aim to achieve most of these goals by Dec. 31, 2021.
Ratti also said there’s been talk about a 1915i Medicaid waiver, which would allow programs to bill Medicaid for support services that are necessary for seriously mentally ill individuals to remain housed.
There has been a lot of focus on raising the case-management ratio for individuals experiencing homelessness to national best practice standards.
It is rallying around the “Built for Zero” program to end homelessness through system-wide changes.
It is working toward providing more training to homeless service providers and better integrating these providers in emergency service response systems.
Ratti said we not only need to provide someone a place to stay but also provide staff and help so that they can successfully go onto the next step.
Behavioral health
Health care data remains somewhat opaque, but CHIP stakeholders have collected data to “make better decisions,” said Ratti.
The plan calls for stakeholders to “recommit and refocus” to address isolation and suicide during the pandemic that remain a significant focus.
Those involved with CHIP are also dedicated to improving crisis response, to include more helpful tools to better respond to mental health needs in the community. Ratti said, as a nation and community, we are experiencing that better tools for mental health crisis situations can be included in the county’s crisis response system.
The new CHIP will also expand prevention and care targeting adolescents. It is planned to:
- By Dec. 31, 2021 fill gaps in the system of care to meet both the behavioral and physical health needs of individuals with serious mental illness and/or complex diagnoses. (New objective and strategies)
- By Dec. 31, 2021 implement early intervention care to individuals experiencing a first episode of psychosis to prevent psychological and medical deterioration and improve medical and social outcomes. (New objective and strategy)
- By June 30, 2021 finalize the Regional Behavioral Health Emergency Response plan and increase the number of individuals available to assist with response. (New objective and strategies)
- By June 30, 2021, fully implement COVID-19 resiliency response. (New objective and strategy).
Nutrition/Physical activity
CHIP stakeholders’ nutrition and physical activity goals are responsive to the realities of Washoe County’s communities–including many who are food insecure. That food insecurity was heightened for students who are at home during the pandemic and unable to access breakfast and lunch provided at school.
CHIP has already met some of the crucial goals in this area. By July 2019, access and availability of nutrition and physical activity opportunities was improved through creation of three Family Health Festivals in zip codes with high Community Needs Index (CNI) scores. In that same timeframe the nutrition environment in targeted parks was improved with increases in the number of environmental cues related to healthy food and beverage consumption, and by improving the nutritional offerings in vending machines and concession stands in schools, workplaces and community settings.
Health District updates
Dick updated the county on achievements made by the health district, as the district is an integral part of the CHIP’s planning and implementation.
Since the start of the pandemic, 340,000 COVID-19 tests have been done and more than 19,000 doses of COVID-19 vaccine have been dispensed.
The district also employed 24 additional staff in its call center, a response to mitigation and vaccination efforts for COVID-19. While with testing and vaccination the call center efforts are visible, what is not easily visible but commands tremendous amounts of work by staff is the back office data entry, including into WebIZ and phoning people with test results, said Dick.
The district increased the number of disease investigators from 30 to over 50 as part of its contact tracing efforts.
Public Information Officer Scott Oxarart has also held 60 media briefings, built two new websites to share COVID-19 information and managed the district’s social media to get important COVID-19 information out to the public.
More Information and updates on CHIP and Washoe County Health District’s work will be published in March this year.
