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TAKING CHARGE:
Progress Measures & Program Prioritization 2009 - 2010

Taking Charge: Progress Measures & Program Prioritization 2009 - 2010

Citywide Outcome Priority #3: Healthy & Productive People

Priority Goal #1: Maintain the community's health status.

Issues:

Prevention: Comprehensive prevention activities prevent disease, reduce morbidity, reduce mortality, reduce treatment costs and improve quality of life. Prevention activities, such as fully immunizing children as required by state law and protecting the public from communicable diseases maintain the community's health status. Preventing and controlling chronic diseases significantly reduces medical costs.

Crash Safety: Bike/auto/pedestrian crashes impact community health resources and the quality of life. Nebraska Hospital Association discharge data indicate a 40% reduction in the number of children (0 up to 14 years) injured from bike/auto/pedestrian crashes from 2003 to 2005.

Tobacco Use: Tobacco is the leading cause of preventable death in the United States. Preventing tobacco use reduces the incidence of chronic disease. Risks for chronic disease from tobacco use are higher if the individual began the use before age 21. According to the Lancaster County Youth Risk Behavior Survey of high school students, youth smoking rates have decreased over the past 10 years.

Obesity: Adult obesity is one of the critical risk factors for developing chronic disease and is the second leading cause of preventable death in the United States. According to the 2007 Behavioral Risk Factor Survey (BRFS), in Lancaster County, 21.9% of adults are obese, as compared to 26.5 in Nebraska, and 26.3% nationally.

Program Indicators:

  1. Reduce the number of children (0 up to 14 years) injured from bike/auto/pedestrian crashes to less than 350 per year.
  2. Decrease adult and youth smoking rate to less than 20%.
  3. Reduce to 20% the incidence of obesity among Lancaster County adults.
  4. Ensure all children have access to recommended immunizations.
Goal #1 Tier 1 Programs Departments
Immunization clinic Health
Communicable disease program and STD program Health
Goal #2 Tier 2 Programs Departments
Tobacco prevention Health
Injury prevention/Safe Kids Lincoln-Lancaster County Health
Child Care Program: Small family and center permits and certificates; child care health consultation Health
Chronic disease: Worksite health promotion; cancer prevention, diabetes prevention; Lincoln in Motion - children at risk for obesity and chronic disease - Racial & ethnic minorities at risk for specific chronic diseases (e.g. diabetes) Health
Goal #1 Tier 3 Program Department
Adolescent and family health: Fatherhood Coalition Health

Priority Goal #2: Support active living.

Issues:

Aging: Being active improves the quality of life for Lincoln's senior population, reduces health care costs and keeps seniors safely in their homes as long as possible. In February 2008, 23% of Lancaster County's 60+ population was being served in some capacity by the Lincoln Area Agency on Aging (LAAA).

Physical Activity: National studies indicate that proximity and ease of access to outdoor recreation facilities increase the likelihood that residents will engage in physical activities. Organized recreation and team sport programs provide opportunities for participants to learn and develop proficiency in physical activities, experience teamwork and sportsmanship and engage in social interaction.

Sidewalks: The City has about 1,800 miles of sidewalk that is deteriorating and does not meet the Americans with Disabilities Act (ADA) standards. At least $60 million in sidewalk improvements is needed to bring the entire sidewalk network into compliance with ADA standards. Lincoln must continue to make progress on ADA compliance or the City could face major fines and legal settlements.

Progress Indicators:

  1. Ensure utilization of LAAA services by at least 20% of all people age 60 and older in Lancaster County.
  2. Maintain percent of survey respondents who report engaging in a physical activity during the prior year at a Parks & Recreation facility at 90%; or participating in a Parks & Recreation sports program during the prior year at 20%.
  3. Maintain percentage of people who rate maintenance and operation of Parks & Recreation physical activity facilities and programs as good or excellent:
    1. Sports programs - 80%
    2. Ball fields: 80% (benchmark - 83%)
    3. Trails: 90% (benchmark: 91%)
    4. Golf Courses: 85% (benchmark: 89%)
  4. Ensure projects to repair 100,000 square feet of sidewalk and construct 100 new sidewalk curb ramps (to make 1.5% of the total improvements needed) are under contract by August 31, 2010.
Goal #2 Tier 1 Programs Departments
ActivAge Centers Aging
Operation and maintenance of sports fields Parks & Recreation
Operation and maintenance of commuter/recreation trails Parks & Recreation
Sidewalk program Public Works
Goal #2 Tier 2 Programs Departments
Operation and maintenance of Ager Play Center Parks & Recreation
Pedestrian and bicycle mobility Public Works
Goal #3 Tier 3 Program Department
Volunteer programs Aging
Adult team sports programs Parks & Recreation
Youth team sports programs Parks & Recreation
Operation and maintenance of municipal golf courses Parks & Recreation

Priority Goal #3: Support vulnerable populations.

Issues:

Low-Income Pre-Natal Care: Low-income women experience greater difficulties in obtaining adequate prenatal care. Adequate prenatal care is associated with improved pregnancy and birth outcomes, including fewer health complications for the mother and infants born on time and of healthy birth weight. The American College of Obstetricians and Gynecologists recommends at least 10 prenatal visits in every pregnancy. According to birth statistics for Lancaster County for 2005 and 2006, only 50.2% of all Lancaster County mothers giving birth in those years saw their primary health care provider at least 10 times. However, 90% and 94%, respectively, of the high-risk low-income women in the Health Department's home visitation program saw their provider 10 times.

Children's Dental Care: State statute requires school districts to determine if every child needs dental care. LLCHD's dental program coordinates Lincoln's dental screening with volunteer dentists to assure all children who have not seen a dentist within the past year are appropriately screened. Lincoln Public Schools' elementary student enrollment increased 5.9% over three years compared to LLCHD dental screening data, which identifies a 10.2% increase over the same period of time for students who needed a dental screening.

Therapeutic Recreation: Parks and Recreation provides therapeutic recreation programs serving people with developmental disabilities, mental health challenges, and head injury trauma. The programs encourage participants to develop meaningful social connections and promote personal growth in physical, social, leisure interest and life skills. More than 400 individuals with developmental disabilities ranging from school age through older adults participate in weekly club programs. Parks and Recreation also organizes, coordinates and provides Special Olympics sports programs for all ages. A summer day camp is offered to school age children with developmental disabilities. The adult day service program provides therapeutic recreation to people with mental health challenges and head injury trauma, a unique offering in the community. Through collaboration with CenterPointe and Community Mental Health, writing and arts studio programs are offered at "F" Street Community Center.

Progress Indicators:

  1. Increase the percentage of low-income mothers served by LLCHD who obtain 10 or more prenatal visits with the doctor to 95%.
  2. Reduce to 25% the number of children needing a dental screening because they have not seen a dentist in the past 12 months.
  3. Maintain percent of therapeutic recreation program participants who find activities useful and interesting at 80%.
  4. Maintain percent of parents and care givers who rate therapeutic recreation programs as good or excellent at 90%.
Goal #3 Tier 1 Programs Departments
School-based dental screening Health
Dental program presumptive eligibility Health
Maternal Child Health Program Health
Goal #3 Tier 2 Programs Departments
Therapeutic recreation programs for children, youth and adults with developmental disabilities Parks & Recreation
Social work & mgt services Aging
Healthy Homes minority outreach Health
Goal #3 Tier 3 Program Department
Home delivered meals Aging
Day service for program for adults with behavioral health challenges, and adults with head injury trauma Parks & Recreation

Priority Goal #4: Assure appropriate access to health care.

Issues:

Low-Income Health Care Access: Connecting low-income, uninsured residents to a dental and medical home improves their ability to receive timely, appropriate medical and dental care. Medical and dental homes reduce the inappropriate use of the emergency room and reduce costs to the health care system by providing the appropriate service at the appropriate level of care. U.S. Bureau of the Census population estimates indicate the number of Lancaster County residents 18+ years increased from 206,500 to 210,000 from 2006 to 2007. During the same time, the number of uninsured adults (18+ years) rose from 24,574 (11.9% of the population) to 29,610 (14.1% of the population). During this time, LLCHD connected about 4,400 adults to medical homes and served as a dental home to 5,500 patients (children and adults).

Progress Indicators:

  1. Increase the number of low-income, uninsured, and under-insured individuals connected to a medical home in Lancaster County to 20%.
Goal #4 Tier 1 Programs Departments
Dental clinic Health
Goal #4 Tier 2 Programs Departments
Presumptive eligibility Health
Information and referral call center- Increase the number of low-income, uninsured and under-insured individuals connected to medical homes in Lancaster County Health
Goal #4 Tier 3 Program Department
Adult screening and community outreach services Health

Priority Goal #5: Support community literacy issues.

Issues:

Internet Access: Internet is important to the economic and social well-being of community members. The Internet is a primary source of communication and news and a link between employers and workers. Many low-income families rely on the public libraries for Internet access. In fiscal year 2007-2008, 282,194 Internet sessions were booked at Lincoln City Libraries. The average wait length at Bennett Martin Public Library for Internet access is nearly 15 minutes.

Access to Books: In 2007-2008, the annual per capita circulation rate for circulating library materials was 11.5 (2007-2008 circulation divided by July 1, 2007 Census estimate of Lancaster County population). The national average of circulation per capita is 7.2.

Encourage Youth Reading: Time spent reading outside of school is the best predictor of reading achievement. The libraries' summer reading program is designed to encourage youth reading during summer holiday. The libraries also provide encouragement for children to read outside of school through their partnerships with programs such as Prime Time Family Reading Time, Bilingual Preschool and the Even Start family literacy program. The libraries are instituting practices from a national program, "Every Child Ready to Read," to enhance literacy support in ongoing programming. A national poll conducted for the American Library Association by Harris Interactive in 2007 found that more than 78 percent of surveyed teens who use the libraries borrowed books and other materials for personal use.

Progress Indicators:

  1. Maintain an average wait of less than 15 minutes for those reserving an Internet shift.
  2. Answer 95% of library customers' questions at time of first contact.
  3. Maintain annual rate of library materials checked out per person in Lincoln and Lancaster County from fiscal year 2007-2008 to fiscal year 2008-2009 at 11.5.
  4. Maintain rate of youth ages 0-14 years who participate in the Summer Reading Program at 20% of the total Lincoln/Lancaster County youth population with 50% successfully completing the program.
  5. Maintain community participation in the Prime Time and Every Child Ready to Read programs at 90% of program capacity.
  6. Maintain percentage of teens who borrowed books and other materials for personal use from Lincoln City Libraries at 75% or higher as determined by annual survey of teens who use the public library.
Goal #5 Tier 1 Programs Departments
Maintain evening and weekend hours at quadrant libraries. Library
Make books and other materials available for checkout. Library
Provide free Internet access Library
Goal #5 Tier 2 Programs Departments
Maintain evening and weekend hours at Bennett Martin Library. Library
Provide online access to information (for example, catalog, databases, government data) and other content. Library
Programs to support and encourage children's literacy. Library
Goal #5 Tier 3 Program Department
Maintain evening and weekend hours at neighborhood libraries. Library

Priority Goal #6: Promote self-sufficiency.

Issues:

Keeping Seniors at Home: Lincoln Area Agency on Aging (LAAA) strives to increase the number of Lancaster County residents who safely live outside nursing homes. Lancaster County's total of non-nursing home residents as a percentage of the county population age 65 and older exceeds the State average.

Low Income Senior Citizens: In 2008-2009, 38% of LAAA clients receiving registered services were below the federal poverty level. Low-income elderly are at risk for malnutrition and medical afflictions and are challenged to lead dignified lives. Federal regulations require that LAAA provide services regardless of a client's ability to pay.

Child Care: A lack of quality child care prevents parents from working and taking part in educational advancement. In 2007, the Lincoln-Lancaster Health Department received more than 19,000 phone and on line inquiries to the "Child Care Connection," a child care referral system assisting parents in locating child care to meet their family's needs.

Progress Indicators:

  1. Maintain the percentage of Lancaster County residents age 65 and older who are healthy enough and have the support systems in place to safely live outside nursing homes at greater than 95%.
  2. Ensure utilization of LAAA services by at least 33% of people age 65 and older in Lancaster County who are at or below the poverty level.
Goal #6 Tier 1 Programs Departments
Information and referral services Aging
Insurance and financial counseling Aging
Joint Budget Committee funding of non-profits Human Services Administration
Goal #6 Tier 2 Programs Departments
In-home services for seniors Aging
Legal services Aging
Goal #6 Tier 3 Program Department
Child care referral system - "Child Care Connection" Health

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