The document outlines a 6 step process for conducting a Community Health Needs Assessment and developing an implementation plan as required by the Affordable Care Act, including establishing parameters, collecting and analyzing data, obtaining community input, documenting results, prioritizing needs, and creating a written implementation strategy. It provides details on each step and notes that the process helps hospitals identify and address the health needs of the communities they serve.

1. Community Health Needs Assessments
and Implementation Plan:
p
Our Approach
December 2011

2. CHC Continuum of Services
2

3. Our Client Locations
3
= Owned hospitals
= Managed hospitals
= Strategic Support Services Hospitals

4. Community Health Needs Assessment
Our E
O Experience
i
4
 We have conducted community health needs
assessments and implementation plans for our
Texas hospital clients for several years
 Not-for-profit hospital requirement
 Texas charity care & community benefit statute
 IRS proposed regulations are very similar to
Texas requirements

5. Community Health Needs Assessment
Background
B k d
5
 Patient Protection & Affordable Care Act
specifies four new requirements for not-for-profit
hospitals
 Conduct Community Health Needs Assessments
(CHNA) once every three years
 Specific regulations h
S ifi l i have not b
been fi li d b
finalized by
the Treasury Department
 IRS recently released Notice 2011-52
tl l d N ti 2011 52
 Describes specific provisions related to CHNA
requirements that the IRS anticipates will be in the
regulations

6. Community Health Needs Assessment
Background
B k d
6
IRS 2010 Form 990
Schedule H provides
additional indication
of the requirements

7. Community Health Needs Assessment
Our P
O Process
Step 1:
• Establish Parameters & Scope
Step 2:
• Collect & Analyze Data
Step 3:
• Obtain Input from Persons with Special Knowledge
Step 4:
• Document & Communicate Results
Step 5:
• Prioritize Community Need
Step 6:
• Develop Implementation Plan

8. The Process Step 1:
Establish Parameters & Scope
8
 Define and map service area of the community
served
 Geographic location ( y, county, metro area)
g p (city, y, )
 For some hospitals, could be a specific target
population or function served
 Our recommendation - Service area based on…
 Hospitals’ patient origin
 Available data sources
 Realistic capabilities of serving community needs
 Confirm methods of data collection and gathering
g g
input from community

9. The Process Step 2:
Collect & Analyze Data
9
 Conduct assessment of study area
 Demographics of study area
 Population
p g
growth by age and ethnicity
y g y
 Economic factors
 Access to healthcare
 Health status of study area
 Disease categories
 Communicable diseases
 Natality and children’s health
 Senior citizens
 Mortality

10. The Process Step 3:
Obtain Input – Specific Persons
10
 Input from persons who represent the broad
interests of the community
 Persons with special knowledge of or expertise in
public health
 Federal, tribal, regional, state or local health
departments or agencies with information relevant to
the health needs of community served
 Leaders, representatives or members of medically
, p y
underserved, low-income and minority populations,
and populations with chronic disease needs in the
community served

11. The Process Step 3:
Obtain Input – Others (optional)
11
 Hospital may consult with other individuals or
organizations if relevant
 Types of Entities/Organizations  Examples we have consulted
 Local/regional government  Hospital district
health agencies  Regional education center
 Public health regions  School Superintendent
 Local insurance companies  School nurse director
 Local school districts and  Heart Association, Mental
universities Health Association, Diabetes
Association, etc.
 Health related entities
 Senior citizen center/Meals
 Community leaders
on Wheels
 Hospital advisory council
 FQHC physicians

12. The Process Step 4:
Document & Communicate Results
12
 Document findings for:
 Methodology including sources/dates of data
 Description of collaboration with other organizations
p g
 Study area demographics
 Health status of study area
 Findings of interviews, including names and
credentials, and consumer focus groups findings
 Description of additional health services available in
the community
 Description of any information g p
p y gaps

13. The Process Step 5:
Prioritize Community Need
13
 Work with hospitals to prioritize health needs
based on results from study
 Determine need priority based on
 Depth and breadth of the health need
 Other resources and organizations in the
community currently serving the need
 Hospitals’ abilities to serve the need
 Hospital service mix and capabilities
 Hospital resources

14. The Process Step 6:
Develop Implementation Plan
14
 Adopt an Implementation Strategy
 A written plan that addresses each of the community
health needs indentified
 Describes how the hospital plans to meet the health need,
or
 Identifies the health need as one the hospital does not
p
intend to meet and explains why
 Must be tailored to a hospital’s specific programs,
resources and priorities
 Collaboration with related organizations is allowed in
developing an implementation strategy and/or
p g p gy
meeting a health need

15. The Process Step 6:
Develop Implementation Plan
15
 Our Process – Develop with the hospitals…
 Measureable objectives
 Rationale for the objectives – including the
j g
prioritization of health needs which the hospital will
meet
 Implementation tactics
 Metrics for reporting progress
 Annual budget for activities
 Action plan outlining responsible parties and
timeframes

16. Adoption of Implementation Strategy Step 6:
16
 How and when an implementation strategy is
adopted
 IRS will consider an implementation strategy as being
adopted on the date the implementation strategy is
approved by an authorized governing body (including
committees) of the hospital organization
 Implementation strategy must be adopted by the end
of the same taxable year in which it conducts that
CHNA

17. Making CHNA Widely Available
g y
17
 Posting the written report of the CHNA on the
hospital facility’s website
 Posting o website o a o e e y, as long as
os g on ebs e of another entity, o g
there is either a link to the hospital’s CHNA or
the hospital facility provides the website address
where the document can be accessed
 The CHNA must remain available until such time
that a subsequent CHNA is made available

18. The Team
18
 Cindy B. Matthews, Executive Vice President
B Matthews
 Mike E. Bowers, Senior Vice President
 Lisette N. Hudson, Marketing Manager
N Hudson
 Laura Schieber, Marketing Consultant
 Others at CHC as needed
Oth t d d

19. For More Information
19
David Domingue, Director of Sales
Community Hospital Consulting
5801 Tennyson Parkway, Suite 550
Plano, TX 75074
972.943.6400
www.communityhospitalcorp.com
y p p
ddomingue@communityhospitalcorp.com