Coordinated Community Health Needs Assessment

The Patient Protection and Affordable Care Act (ACA) added new requirements which nonprofit hospital organizations must satisfy to maintain their tax-exempt status under section 501(c)(3) of the Internal Revenue Code. One such requirement added by ACA Section 501(r) of the Code, requires nonprofit hospitals to conduct a Community Health Needs Assessment (CHNA) and adopt implementation strategies to meet the identified needs at least once every three years. As part of the CHNA, each hospital is required to collect input from designated individuals in the community, including:

• public health experts;
• residents;
• representatives or leaders of low-income, minority, and medically underserved populations;
• and individuals with chronic conditions. 

The community health needs assessment process offers an opportunity for the entire community to work together to collectively improve health. As of early 2015, the following facilities, in partnership with in the Maricopa County Coordinated Health Needs Assessment (CCHNA) collaborative, will conduct an assessment of the health needs of residents in the communities they serve:

• Adelante Healthcare
• Banner Health
• Dignity Health
• Mayo Clinic Hospital
• Mountain Park Health Centers
• Native Health
• Phoenix Children’s Hospital

The Shift Toward a Collaborative, Coordinated Health Assessment

ACA community benefits reporting requirements are mirrored in the Public Health Accreditation Board’s (PHAB) standard mandating that health departments participate in or conduct a comprehensive community health assessment (CHA) every three to five years. Other PHAB standards require that health departments conduct a comprehensive planning process resulting in a community health improvement plan (CHIP), and implement strategies to improve access to health care. Maricopa County Department of Public Health completed its first CHA in 2012 with the subsequent 2012-2017 CHIP underway.

 

Additionally, federally funded community health centers must ensure their target communities are of high need. They must also address the shortage of health services that are occurring within these communities. The similar requirements from IRS, PHAB and the United States Department of Health and Human Services provide an opportunity to catalyze stronger collaboration and better shared measurement systems among hospitals, health centers and health departments. Additionally, limited resources for comprehensive health assessments and the move toward new population health models have created the need for an organized, collaborative public-private approach for conducting assessments.

Maricopa County hospitals and health centers play significant roles in the region’s overall economy and health. In addition to providing safe and high-quality medical care, these institutions work to improve regional health through programs that promote health in response to identified community needs. Maricopa County’s hospitals and health centers have joined forces with Maricopa County Department of Public Health to identify the communities’ strengths and greatest needs in  the first  Coordinated Community Health Needs Assessment (CCHNA).  

Hospital assessment processes will run concurrently with the county's community-based health assessment process. The Maricopa County assessment will be completed with information obtained through written questionnaires and focus groups attended by key informants and community leaders representing the various needs and interests of Maricopa County. The assessment also draws from county health status report data, the Arizona Department of Health Services Vital Statistics, Primary Care Area Statistical Profiles, and the U.S. Census Bureau.

Together, these combined assessment tools will help inform the next community health improvement planning cycle set to commence in early 2018. 

 

Mayo Clinic Hospital, Arizona

St. Joseph's Hospital and Medical Center

Chandler Regional Medical Center

Mercy Gilbert Medical Center

Banner Good Samaritan Hospital

Banner Boswell

Phoenix Children's Hospital

 

 Connecting the Dots: A Healthy Community Leader's Guide to Understanding Nonprofit Hospital Community Benefit Requirements (July 2015, SLHI)

 

Catholic Health Association of the United States: Assessing and Addressing Community Health Needs   

Best Practices for Community Health Needs Assessment and Implementation Strategy Development:  A Review of Scientific Methods, Current Practices, and Future Potential                          

National Association of County & City Health Officials (NACCHO) Community Benefit Page                 

Summary of the Internal Revenue Service’s April 5, 2013, Notice of Proposed Rulemaking on Community Health Needs Assessments for Charitable Hospitals                                                               

New Community Benefit Requirements for Non-Profit Hospitals                                                                  

Hospital Community Benefits after the ACA: Partnerships for Community Health Improvement                (Feb. 2012)                         

 

Robert Wood Johnson Foundation: Hospital Community Benefit topics 

How Investments in Community Health Pay Off

Collective Impact: Stanford Social innovation Review (Winter 2011)