Conducting a Community Health Needs Assessment

Community Health Needs Assessment (CHNA) is a systematic process involving the community to prioritize, plan and act on community health needs. This process results in a written report.

The IRC Section 501(r)(3) state that the written report must be adopted by the governing board of each hospital facility, made widely available to the public, and include:

• Definition of community served,
• Description of the process and methods used to assess the health needs of the community,
• How the hospital solicited and took into account input from the community, including a public health agency, on identifying and prioritizing significant community health needs,
• Description of significant community health needs and prioritization,
• Description of resources potentially available to address the identified needs, and
• Evaluation of impact of any actions taken since prior CHNA.

CHNA Resources

CHA Resources

• Community Benefit Framework Videos: Community Health Needs Assessment
• A Summary of CHNA and IS Requirements and Recommended Practices
• A Guide for Planning & Reporting Community Benefit, Chapter 5: Planning and Implementing Community Benefit Programs
  • Appendix E: Suggested Information to be Included in a Community Health Needs Assessment
• Assessing & Addressing Community Health Needs
  • Appendix B: Factors Influencing the Success of Collaboration
  • Appendix C: Overview of Terms and Concepts Used in Health Research and Epidemiologic Studies
  • Indicator Selection Tool
• Community Health Needs Assessment Report Template

Other Resources

• Planning Models
  
  
  • The Community Tool Box | Center for Community Health and Development, University of Kansas
  • MAPP Framework, National Association of County and City Health Officials
  • Community Health Assessment Toolkit, American Hospital Association Community Health Improvement
  • Community Planning for Health Assessment: Index | Centers for Disease Control and Prevention
    
    
• Data and Indicators
  
  
  • Population Demographics
    
    
    • QuickFacts | U.S. Census Bureau
    • American Community Survey | U.S. Census Bureau
    • U.S. Bureau of Labor Statistics
      
      
  • Public Health and Health Care Statistics
    
    
    • Behavioral Risk Factor Surveillance Survey (BRFSS) | Centers for Disease Control and Prevention
    • CDC Wonder | Centers for Disease Control and Prevention
    • City Health Dashboard | NYU Langone Health
    • Community Commons
    • County Health Rankings | University of Wisconsin Population Health Institute
    • Healthy People 2030 | U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion
    • Health Professional Shortage Area | U.S. Department of Health and Human Services, Health Resources and Services Administration
    • Medically Underserved Areas/Populations | U.S. Department of Health and Human Services, Health Resources and Services Administration
    • National Environmental Public Health Tracking Data explorer | Centers for Disease Control and Prevention
    • National Neighborhood Indicators Partnership
    • Kids Count: Indicators of Child Well-Being | Annie E. Casey Foundation
    • Mapping Medicare Disparities Tool | Centers for Medicare & Medicaid Services
    • PLACES: Local Data for Better Health | Centers for Disease Control and Prevention
    • Prevention Quality Indicators (PQIs) | Agency for Healthcare Research and Quality
    • State Health Facts | Henry J. Kaiser Family Foundation
    • Youth Risk Behavior Surveillance System (YRBSS) | Centers for Disease Control and Prevention
      
      
  • Indexes
    
    
    • National Risk Index | FEMA
    • Neighborhood Atlas's Area Deprivation Index | Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health
    • Social Vulnerability Index | Centers for Disease Control and Prevention and Agency for Toxic Substances and Disease Registry
      
      
• Collecting Community Input
  
  
  • Community Health Assessment Guidebook | North Carolina Department of Health and Human Services, Division of Public Health
  • The Community Tool Box | Center for Community Health and Development, University of Kansas
  • Community Engagement Toolkits | AAMC Center for Health Justice
    
    
• Priority-Setting
  

  The IRC 501(r)(3) states the following,
  "A hospital facility may determine whether a health need is significant based on all the facts and circumstances present in the community it serves. Additionally, a hospital facility may use any criteria to prioritize the significant health needs it identifies, including, but not limited to the:

  • Burden, scope, severity, or urgency of the health need,
  • Estimated feasibility and effectiveness of possible interventions,
  • Health disparities associated with the need, or
  • Importance the community places on addressing the need."
    
    
• Reporting/Communication
  
  
  • CHNA Report Template | CHA

Developing an Implementation Strategy

Implementation Strategy (IS) is the hospital's written plan for addressing community health needs, including the priority health needs identified in the community health needs assessment. While the term "implementation strategy" was introduced by the Affordable Care Act provisions, other terms that are commonly used are community health improvement plan (CHIP) and action plan.

The IRC Section 501(r)(3) states that the IS written report must be adopted by the governing body of the hospital facility and either attached to Form 990, Schedule H or posted online. The written IS describes,

• What actions the hospital plans to take to meet significant health needs identified in its CHNA,
• The anticipated impact of these actions,
• The programs and resources the hospital plans to commit to address those health needs, and
• Any planned collaboration between the hospital facility and other facilities or organizations.
• For each significant health need identified in its CHNA report that the hospital does not intend to meet, the IS needs to explain why the hospital does not intend to meet that heath need.

Implementation Strategy Resources

CHA Resources

• Community Benefit Framework Videos: Planning for Community Health Improvement and : Building Blocks of Planning and Evaluation
• A Summary of CHNA and IS Requirements and Recommended Practices
• A Guide for Planning & Reporting Community Benefit, Chapter 5: Planning and Implementing Community Benefit Programs
• Assessing & Addressing Community Health Needs
  • Appendix B: Factors Influencing the Success of Collaboration
  • Appendix C: Overview of Terms and Concepts Used in Health Research and Epidemiologic Studies 
• Implementation Strategy Report Template

Other Resources

• Healthy People 2030 | U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion
• Logic Model Development Guide | W.K. Kellogg Foundation
• Change Lab Solutions
• Evidence-Based Practice Resource Center | SAMSHA
• Social Determinants of Health (SDOH) website | Centers for Disease Control and Prevention
• Developing a State Health Improvement Plan: Guidance and Resources | ASTHO

Program Planning and Implementation

Once you have developed your implementation strategy, it may be necessary to develop and implement programs for the strategies identified. Program plans describe what you plan to do and the intended results. Many organizations use logic models and SMART goals when developing and monitoring programs. It is important when planning programs to include how you will monitor and evaluate the program implementation outputs, outcomes, and impact.

Program Planning and Implementation Resources

CHA Resources

• Community Benefit Framework Videos: Building Blocks of Planning and Evaluation
• A Guide for Planning & Reporting Community Benefit, Chapter 5: Planning and Implementing Community Benefit Programs
• Assessing & Addressing Community Health Needs
  • Appendix B: Factors Influencing the Success of Collaboration
  • Appendix C: Overview of Terms and Concepts Used in Health Research and Epidemiologic Studies 
• Program Planning Worksheet

Other Resources

• Healthy People 2030 | U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion
• Logic Model Development Guide | W.K. Kellogg Foundation
• Blueprints for Healthy Youth Development
• Health in All Policies | American Public Health Association
• The Guide to Community Preventive Services | Centers for Disease Control and Prevention
• Preventing Chronic Disease | Centers for Disease Control and Prevention