Community Health Needs Assessments and Implementation Plan: pOur Approach

December 2011December 2011

CHC Continuum of Services2

Our Client Locations3

= Owned hospitals= Owned hospitals

= Managed hospitals

= Strategic Support Services Hospitals

Community Health Needs AssessmentO E iOur Experience

We have conducted community health needs4

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

Community Health Needs AssessmentB k dBackground

Patient Protection & Affordable Care Act5

Patient Protection & Affordable Care Act specifies four new requirements for not-for-profit hospitals Conduct Community Health Needs Assessments

(CHNA) once every three yearsS ifi l i h b fi li d b Specific regulations have not been finalized by the Treasury DepartmentIRS tl l d N ti 2011 52 IRS recently released Notice 2011-52 Describes specific provisions related to CHNA

requirements that the IRS anticipates will be in therequirements that the IRS anticipates will be in the regulations

Community Health Needs AssessmentB k dBackground

6

IRS 2010 Form 990IRS 2010 Form 990 Schedule H provides additional indicationadditional indication of the requirements

Community Health Needs AssessmentO P

• Establish Parameters & Scope

Our 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

• Prioritize Community NeedStep 5: • Prioritize Community Need

Step 6: • Develop Implementation PlanStep 6:

The ProcessEstablish Parameters & Scope

Step 1:Establish Parameters & Scope

Define and map service area of the community8

Define and map service area of the community served Geographic location (city, county, metro area)g p ( y, 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 Available data sources Realistic capabilities of serving community needs

Confirm methods of data collection and gathering g ginput from community

The ProcessCollect & Analyze Data

Step 2:Collect & Analyze Data

Conduct assessment of study area9

Conduct assessment of study area Demographics of study area Population growth by age and ethnicityp g y g y Economic factors Access to healthcare

Health status of study area Disease categories Communicable diseases Communicable diseases Natality and children’s health Senior citizensMortality

The ProcessObtain Input Specific Persons

Step 3:Obtain Input – Specific Persons

Input from persons who represent the broad10

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 todepartments or agencies with information relevant to the health needs of community served

Leaders, representatives or members of medically , p yunderserved, low-income and minority populations, and populations with chronic disease needs in the community servedcommunity served

The ProcessObtain Input Others (optional)

Step 3:Obtain Input – Others (optional)

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Hospital may consult with other individuals or

Examples we have consulted

Hospital may consult with other individuals or organizations if relevant

Types of Entities/Organizations Hospital district Regional education center School Superintendent

Local/regional government health agencies

Public health regions School Superintendent School nurse director Heart Association, Mental

Public health regions Local insurance companies Local school districts and

Health Association, Diabetes Association, etc.

Senior citizen center/Meals

universities Health related entities Community leaders on Wheels

FQHC physicians

Community leaders Hospital advisory council

The ProcessDocument & Communicate Results

Step 4: Document & Communicate Results

Document findings for:12

Document findings for: Methodology including sources/dates of data Description of collaboration with other organizationsp 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 Description of additional health services available in

the community Description of any information gapsp y g p

The ProcessPrioritize Community Need

Step 5: Prioritize Community Need

Work with hospitals to prioritize health needs13

Work with hospitals to prioritize health needs based on results from study

Determine need priority based on Determine need priority based on Depth and breadth of the health need Other resources and organizations in the Other resources and organizations in the

community currently serving the need Hospitals’ abilities to serve the need Hospital service mix and capabilities Hospital resources

The ProcessDevelop Implementation Plan

Step 6:Develop Implementation Plan

Adopt an Implementation Strategy14

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 prioritiesresources and priorities Collaboration with related organizations is allowed in

developing an implementation strategy and/or p g p gymeeting a health need

The ProcessDevelop Implementation Plan

Step 6:Develop Implementation Plan

Our Process – Develop with the hospitals…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 Implementation tactics Metrics for reporting progress Annual budget for activities Annual budget for activities Action plan outlining responsible parties and

timeframes

Adoption of Implementation Strategy Step 6:

How and when an implementation strategy is16

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 organizationcommittees) of the hospital organization

Implementation strategy must be adopted by the end of the same taxable year in which it conducts that CHNA

Making CHNA Widely Availableg y

Posting the written report of the CHNA on the17

Posting the written report of the CHNA on the hospital facility’s website

Posting on website of another entity, as long as os g o ebs e o a o e e y, as o g asthere 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

The Team

Cindy B Matthews Executive Vice President18

Cindy B. Matthews, Executive Vice President Mike E. Bowers, Senior Vice President Lisette N Hudson Marketing Manager Lisette N. Hudson, Marketing Manager Laura Schieber, Marketing Consultant

Oth t CHC d d Others at CHC as needed

For More Information19

David Domingue, Director of Sales

Community Hospital ConsultingCommunity Hospital Consulting5801 Tennyson Parkway, Suite 550

Plano, TX 75074972.943.6400

www.communityhospitalcorp.comy p pddomingue@communityhospitalcorp.com