Community Health Needs Assessments: Guidance & Considerations

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Ally Orwig, MBA, Senior Director at Indiana Rural Health Association, provides information on conducting a Community Health Needs Assessment (CHNA) as required by Section 501(r)(3). The assessment must be completed every 3 years, with reports made publicly available. Steps include defining the community, assessing needs, and incorporating community input. Target populations must not be excluded, and resources should be identified to address identified needs.


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  1. COMMUNITY HEALTH NEEDS ASSESSMENTS GUIDANCE & CONSIDERATIONS Ally Orwig, MBA Ally Orwig, MBA Senior Director Senior Director Indiana Rural Health Association Indiana Rural Health Association

  2. 501(r)(3) for 501(c)(3)s ACA added requirement in 2010 Must be completed on a facility-by-facility basis https://www.irs.gov/charities-non-profits/community- health-needs-assessment-for-charitable-hospital- organizations-section-501r3 2

  3. Timeline Needs Assessment Every 3 years Based on taxable year Implementation Strategy One for every CHNA Accepted by May 15 of following taxable year 3

  4. Publically Available Posted online to your website Physical copies available upon request, without a fee Prior 2 reports must also be available 4

  5. Conducting a CHNA Define the community it serves Assess the health needs of that community Solicit input received from persons who represent the broad interests of that community, including those with special knowledge of or expertise in public health Document the CHNA in a written report that is adopted for the hospital facility by an authorized body of the hospital facility 5

  6. Defining Your Community Geographic area served by the hospital Target populations served Principal functions, such as a focus on a particular specialty area or targeted disease CANNOT exclude medically underserved populations CANNOT exclude patients based on method or amount of payment nor eligibility for hospital assistance 6

  7. Assessing Needs Identify the significant needs Prioritize the needs Identify resources to address needs 7

  8. Community Input At least one state, local, tribal, or regional governmental public health department or a State Office of Rural Health Members of medically underserved, low-income, and minority populations or organizations serving or representing the interests of these populations Written comments received on the hospital facility s most recently conducted CHNA and most recently adopted implementation strategy 8

  9. Additional Input Patients and patient advocates Nonprofit and community-based organizations Local government officials Local school districts Health care providers and community health centers Business owners Faith community 9

  10. Documentation Community served Process and methods Data and other information used Method of collecting and analyzing this data and information Identify any collaborators or third parties used to conduct the CHNA 10

  11. Documentation Continued Solicitation and use of input Significant health needs process and criteria used in identifying and prioritizing Resources available Evaluation of the impact and actions from immediately previous CHNA 11

  12. Collaboration & Joint CHNAs Permitted with special considerations Must be the same service area OR specifically and clearly address the different areas 12

  13. Implementation Strategy Addressing the need Planned actions and anticipated impact Resources committed to planned actions Collaboration with any other organizations or facilities to complete planned actions NOT addressing the need Resource constraints Already addressed by other organizations Lack of expertise Lack of effective interventions 13

  14. Special Circumstances Acquired facilities New hospitals Transferred/terminated hospitals 14

  15. Questions? Ally Orwig aorwig@indianarha.org 812-478-3919 ext. 235 https://www.indianaruralhealth.org/

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