Community Health Assessments:

Requirements and Models

April 25, 2013

Community Health Assessments:

Requirements and Models

April 25, 2013

Gianfranco Pezzino

Senior Fellow

Kansas Health Institute

Intro to Community Health Assessments

Intro to Community Health Assessments

Why are we here? PHAB pre-requisites for accreditation:

CHA, CHIP and strategic plan IRS reporting standards call for a CHNA

every 3 years Both call for collaboration

PHAB requirements PHAB requirements

PHAB MeasuresStandard 1.1: Participate in or conduct a collaborative process resulting in a comprehensive community health assessment

“A community health assessment is a collaborative process of collecting and analyzing data and information for use in educating and mobilizing communities, developing priorities, garnering resources, and planning actions to improve the population’s health.”

IRS RegulationsIRS Regulations

Notice 2011-52 (July 2011) Reg 106499 (April 5, 2013)

“Section 501(r)(3) requires a hospital organization to conduct a CHNA at least once every three years and adopt an implementation strategy to meet the community health needs identified through the CHNA. The CHNA must take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health.”

Collaboration: Opportunities and Challenges

Collaboration: Opportunities and Challenges

Introduce Crosswalk Document

Models: Why Bother?Models: Why Bother?

PHAB Measure 1.1.1:

The health department must provide documentation of the collaborative process [….]. The process used may be an accepted state or national model; a model from the public, private, or business sector; or other participatory process model.

Models: Why Bother?Models: Why Bother?

PHAB Measure 1.1.1:

The health department must provide documentation of the collaborative process [….]. The process used may be an accepted state or national model; a model from the public, private, or business sector; or other participatory process model.

CHNA GuidelinesCHNA Guidelines

(1) A description of the community served by the hospital facility

(2) A description of the process and methods used to conduct the assessment

(3) A description of how the hospital organization took into account input from persons who represent the broad interests of the community served by the hospital facility

(4) A prioritized description of all of the community health needs identified through the CHNA, as well as a description of the process and criteria used in prioritizing such health needs.

(5) A description of the existing health care facilities and other resources within the community available to meet the community health needs identified through the CHNA.

What is a “model”?What is a “model”?

An accepted state or national model from the public, private, or business sector.

A locally developed model A model made up of parts of multiple

models is also acceptable

Common Community Health Improvement Process ModelsCommon Community Health

Improvement Process Models PRECEDE-PROCEED (1970s) Assessment Protocol for Excellence in Public Health (APEX

PH) (1991) Protocol for Assessing Community Excellence in

Environmental Health (PACE EH) (2000) Mobilizing for Action through Planning and Partnerships

(MAPP) (2001) Healthy People 2020 Association for Community Health Improvement (ACHI)

Toolkit (more hospital-focused) Assessing and Addressing Community Health Needs

(ACHA) State-specific models/frameworks See Page 8 of the handbook

Adapted from: NACCHO, June 2012

MAPP Framework: 6 stepsMAPP Framework: 6 steps Organize for Success Visioning The Assessments

Community Themes and Strengths Local Public Health System Community Health Status Forces of Change

Strategic Issues Goals and Strategies Action Cycle

• Planning• Implementation• Evaluation

HP 2020 – MAP-ITHP 2020 – MAP-IT

Mobilize partners. Assess the needs of your community. Create and implement a plan to reach

Healthy People 2020 objectives. Track your community’s progress.

Catholic Health AssociationCatholic Health Association

1. Plan and prepare for the assessment.

2. Determine the purpose and scope of the CHA.

3. Identify data that describes the health and needs of the community.

4. Understand and interpret the data.

5. Define and validate priorities.

6. Document and communicate results

Similarities Similarities

Many! Overall process

• Planning => Data => Priorities => Communication

Emphasis on community engagement Often more emphasis on assessment

than on improvement plan and strategic plan

DifferencesDifferences

Focus, e.g.: CHANGE = chronic disease NPHPSP = PH system PACE-EH = environmental health

Focus and audience may affect some steps E.g., CHA “community” = focus on

service area

Information for policy makers. Health for Kansans.Information for policy makers. Health for Kansans.

Kansas Health InstituteKansas Health Institute