Community health needs assessments (CHNAs) and community health improvement plans (often known as CHIPs or implementation strategies — same thing!) represent major investments, not just in time and resources, but in the potential for meaningful change. While the names vary, these plans follow the CHNA and are required as part of a process to collect data from and about the community's health and then make a plan with partners to improve the health of area residents.
Communities spend months collecting survey data, conducting interviews and focus groups, building consensus and selecting health priorities. Hospitals and health departments dedicate staff and other resources to not only meet Internal Revenue Service and Public Health Accreditation Board requirements (requiring that this process happens every three years), but also to connect with community partners and create community health improvement.
But here's the hard truth: Too often, these plans end up shelved, with goals unmet and momentum lost. If this sounds familiar, you're not alone. Across the country, health leaders are wrestling with the same frustrating question: What's the point of all this planning if it doesn't lead to real impact?
WHY CHIPs FAIL AND WHAT'S AT STAKE
The gap between planning and implementation is common. Leadership changes can derail momentum. New directors may shift focus, while staff turnover creates knowledge gaps that stall coordination.
Then there's the resource reality check. Many plans look great on paper but crumble under real-world constraints. Without dedicated staff and accountability, even the best intentions get sidelined by daily demands.
Perhaps most critically, stalled implementation erodes trust. Community members who contribute to CHNAs invest their time in the hope of change. When they see no change, rebuilding that trust becomes an uphill battle.
Unrealized CHIPs don't just jeopardize compliance; they represent missed opportunities to prevent disease, reduce disparities and improve lives. When plans sit idle, improvement work doesn't get done well or doesn't happen at all. Resources scatter, partnerships weaken and faith in collaborative efforts fades.
LEARNING FROM THE FIELD
To explore how communities can move from planning to impact, we, at Moxley Public Health, hosted a national networking call with CHA titled "What's the Point of Doing a Community Health Needs Assessment and Improvement Plan if It Doesn't Lead to Real Change?" That conversation, which followed another session we conducted this past summer at National Association of County and City Health Officials' NACCHO360 annual conference, highlighted strategies communities across the nation are using to make CHIPs successful.
Dedicated Leadership
The most successful implementations have one thing in common: someone whose job it is to make the CHIP happen! Whether it's a project manager, public health planner or team lead, this coordinator keeps the process on track. It's important to remember that this person is not doing all the work; rather, they ensure the plan stays on track.
These leaders facilitate communication, maintain accountability and help partners stay aligned. Partners collaborating on a CHIP serve residents in various ways; they may be local governments, area schools or other organizations working toward community health improvement. Some communities pair internal staff with external "champions" for specific strategies. Others boost engagement by allowing staff to lead work that aligns with their passions. When people care deeply about the issues they're addressing, implementation energy sustains itself more naturally.
Successful communities prioritize what's realistic while staying ambitious. They set realistic goals while still pushing for meaningful change, finding that sweet spot between ambition and achievability.
Planning With Purpose
Gone are the days of large, unfocused meetings where little gets done. Effective communities rely on smaller, goal-oriented work groups that meet regularly and report to a larger steering committee or the dedicated leadership of the CHIP.
These groups function best with clear roles, consistent schedules and concrete deliverables. We have seen success when these groups meet regularly with clear agendas and then report quarterly to the broader collaborative. Pilot testing work group configurations helps identify the right mix of people willing to roll up their sleeves, not just attend meetings.
Leveraging Resources, Integrating Partners
Too often, CHIPs aim to create new programs rather than optimize existing ones. Effective implementation starts with comprehensive resource mapping — understanding not just what's available but also how it connects and where gaps exist.
Some communities hold "Did You Know?" webinars to increase partner awareness of available resources, leading to better collaboration and less duplication. In many communities where the CHIP is most successful, health partners create integrated approaches in which all plans reinforce the same priorities instead of having initiatives pulling in different directions.
Many CHIPs falter when the hospital or health department is expected to do all the work itself instead of building genuine community ownership. Aside from aligning community resources, successful implementation also involves sharing leadership with community partners.
This means involving community partners not just during implementation but also in the assessment and planning process. It means creating opportunities for residents to participate meaningfully. Some communities even have pathways for community members who want to join work groups.
Most importantly, community partnership means listening to subject matter experts in the community rather than having just a few leaders dictate community health priorities. One NACCHO360 conference participant offered wise advice: "Listen to your local organizations. Don't let leaders alone dictate CHIP priorities."
Technology and Transparency
Simple tools can have a big impact. Communities using shared documents for work plan updates report better engagement between meetings. Live dashboards track goal progress and create visibility, creating both accountability and celebration opportunities.
Some communities use program management systems to help track CHIP activities, but the technology isn't what matters. Instead, it's consistent documentation and regular progress monitoring embedded into organizational routines that can make a difference.
Acknowledging 'Less Is More,' and Sustaining Commitment
Perhaps one of the most important lessons from communities is to resist the urge to fix everything at once. As one leader put it, "Less is more. It's a hard lesson to learn because we want to fix it all."
Successful communities prioritize what's realistic while staying ambitious. They set realistic goals while still pushing for meaningful change, finding that sweet spot between ambition and achievability.
Aside from setting realistic expectations, the communities sustaining their CHIP work over multiple years share certain practices. They celebrate progress through annual reports that highlight accomplishments while maintaining accountability for ongoing work. They adapt their approaches based on what they learn, viewing implementation as an ongoing process rather than a one-time event.
Most importantly, they've embraced the collective impact model: recognizing that lasting change requires sustained commitment from multiple community organizations working toward shared goals with coordinated effort and support.
THE PATH FORWARD
CHIPs can drive real change and improve the health of communities, but only with intentional, ongoing implementation. This means investing in coordination, aligning resources, building authentic partnerships and staying focused.
The question isn't whether your CHIP can transform community health. It's whether you're ready to move from planning to action, from good intentions to measurable results. For communities ready to make that commitment, the tools are there — and so is the opportunity to create lasting impact.
At Moxley Public Health, STEPHANIE MOXLEY is CEO and lead consultant. CAROLINE GAGNE and MADISON THOMPSON are public health consultants.