1. Community Health Assessments: Requirements and Models April 25, 2013 Gianfranco Pezzino Senior Fellow Kansas Health Institute

2. 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

3. PHAB requirements PHAB Measures Standard 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.”

4. IRS 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.”

5. Collaboration: Opportunities and Challenges Introduce Crosswalk Document

6. 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.

7. 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.

8. CHNA Guidelines  A description of the community served by the hospital facility  A description of the process and methods used to conduct the assessment  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  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.  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.

9. 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

10. Common 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

11. MAPP 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

12. MAPP Steps 1-2 Organizing  Organizing planning process and developing planning partnership Visioning  Guiding community through collaborative, creative process leading to shared community vision and common values.

13. MAPP Steps 3-4 Four Assessments  Community Themes and Strengths  Local Public Health System  Community Health Status  Forces of Change Strategic issues  Explore results of four MAPP Assessments and determine how issues affect the achievement of the shared vision.

14. MAPP Steps 5-6 Goals and Strategies  Take strategic issues and formulate goal statements Action Cycle  Three activities— Planning Implementation Evaluation

15. HP 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.

16. Catholic 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

17. Similarities Many!  Overall process Planning => Data => Priorities => Communication  Emphasis on community engagement  Often more emphasis on assessment than on improvement plan and strategic plan

18. Differences 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

19. Information for policy makers. Health for Kansans. Kansas Health Institute