Transcript The Community Needs Assessment & Schedule H Requirements

Creating a Successful Community
Health Improvement Process
Outline:
 What is a CHNA? a CHIP?
 Patient Protection Affordability Care Act
 Key Ingredients and Benefits of a CHNA/CHIP
 Recommended Partners, Tools and Resources
 BRMH’s Health Improvement Process
 More Tools and Resources
Community Health Improvement Processes
 Understanding the new Accountable Care Act (ACA)/IRS
Community Health Needs Assessment (CHNA) Requirements
 Original hospital term: CHNA
 Public health term: CHIP or CHIPP = Community Health
Improvement Plan and Processes
Both processes have similar steps, all with the same goal:
Work strategically and collaboratively at the local
level to improve the health of the community
►
Patient Protection Affordability Care Act
(PPACA) CHNA/CHIP Requirements:
 CHNA/CHIP must be conducted at least every three
years (Public Health currently does one every 5 years)
 Demonstrate collaboration and broad input from the
community served – including those with expertise in
public health
 Findings must be made widely available
 Must adopt an implementation strategy PLAN
“Community Health Improvement Plan & Process”
Failure to meet in any given year = $50,000 excise tax
►
PPACA Requirements - SCHEDULE H
Schedule H is now a Supplement of IRS Tax Form 990
and is required by all non-profit hospitals
The CHNA/CHIP is a component of Schedule H
Overall Guiding Principles of IRS
• Provide complete transparency
• Improve tax compliance
• Attempt to stabilize or decrease burden of
community costs
►
CHNA/CHIP Reporting Requirements
The hospital’s CHNA/CHIP is required to:
 Define our “community” including demographics and
existing resources (we defined this as our county)
 Explain how data is selected and obtained
 Identify needs gathered from broad community input
 Explain how we are helping to meet the needs identified
with a focus on outputs and what we are doing to get closer
to desired outcomes
 Provide description of needs not being addressed and
explanation of why (i.e., needs that may not be tied to our mission,
strengths, abilities, or resources available)
►
Benefits Beyond IRS Reporting…
 Increase effectiveness of efforts through collaboration
 Plan for future and health improvements of community
 Reduce duplication of efforts in our community
 Broaden community engagement and awareness around
health issues
 Create goodwill
 Reduce health care costs
 Assist with and enhance our Community Benefit
reporting (currently a WHA initiative for non-profit hospitals)
►
Key Ingredients of a CHNA
S:
O:
A:
P:
Subjective Information
- Stories / Symptoms
- Obtained via Interview
Objective Information
- Data
Assessment or Diagnosis
- Problem
Plan/Intervention & Evaluation
- Action Steps
Recommended Key Partners
 Public Health
 United Way
 UW Extension
 Schools and Universities
 Community-based organizations
 Chamber of Commerce
 Local Government
 Business Leaders
 Local Citizens
►
Some Recommended Resources:
Wisconsin’s State Health Plans
11 Priorities
23 Focus Areas
►
Wisconsin County Health Rankings
 Published annually by the UW Madison Population Health
Institute
● Ranks health based on the
multiple determinants of
health (28 Health Factors
& Outcomes)
►
2010-2012 Jackson County Health Rankings:
More Specifics
 Data is analyzed on the diverse factors of health in Wisconsin
and now in all states in the U.S.
 Compares how each county fares in various components of
health
 Jackson County, WI
2010:
2011:
2012:
2013:
Health
Outcomes
69
68
68
61
Mortality
71
69
66
38
 Jackson County’s rankings for Health Factors fare better
(particularly for clinical care); however, due to issues with
injury and early/young death, we have historically been ranked
as one of the 5 least healthy counties in Wisconsin.
►
BRMH CHNA Planning Committee:
 Black River Memorial Hospital
 Ho-Chunk Nation Health Care Center
 Jackson County Board Supervisor
 Jackson County Interfaith Caregivers
 Jackson County Public Health
 Together for Jackson County Kids (TFJCK)
 UW Extension
 Western Dairyland Women’s Health Center
 BRF School District
 Population Health Institute / Population Health Fellow
 Wisconsin Hospital Association / CHIPP Pilot Project Mentor
How were top priorities selected?
Planning Committee considered:

Needs identified through most recent assessments
conducted by local agencies: TFJCK, Public Health,
Western Dairyland, UW Extension, Ho-Chunk Nation

Ho-Chunk Health Care Center & BRMH visits from
2010-11

Key informants/local agency contacts

2010 & 2011 Jackson County Health Rankings and
other data from recent local statistics

Healthiest Wisconsin 2020
How were priorities determined?
 Each Planning Committee member
came up with 3-6 priorities
 We noted some duplication and overlap
and combined our categories
accordingly
Top 7 Community Priorities
Selected by CHNA Planning Committee:
 Access to health care services
 Obesity/Nutrition/Diabetes
 Mental Health
 Injury/Safety
 Dental
 Prevention Education
 Alcohol, Tobacco, & Other Drug Abuse
Narrowing down the priorities
 We then organized a Community-wide
Forum in October 2011 to gather a broader
section of community input related to these
categories and narrow the selection of
priorities
Gathering Community Input:
CHNA Forum – October 2011
1) “SPEED DISCUSSIONS”
Participants selected priorities most important to them
and learned more about the issues through table
discussions and by sharing knowledge and experience
2) PRIORITIZE
Report on top 7 issues and vote for top 3 priorities
3) TALLY and PRESENT TOP 3 PRIORITIES
4) “WORLD CAFÉ”
Participants took part in roundtable discussions and
considered strategies and resources that the community
could engage to address the issues and also how the
hospital might impact these strategies
Narrowed Down to Three Priorities
(in no particular order)
Access to Healthcare Services
 Transportation
 Poverty/Finances
 Large Aging Population (lack of providers particularly appropriate cultural care)
Obesity/Nutrition/Diabetes
 Hypertension/Heart Disease/High Cholesterol
 Access to Healthy Food
 Need for increased nutrition education
 Worksite Wellness
►
Narrowed Down to Three Priorities – cont’d
(in no particular order)
Alcohol, Tobacco, & Other Drug
Abuse
 Increased need for Preventive and Rehabilitative
Resources
 Prescription Drug Abuse
 Prenatal Tobacco Use
 Chronic Disease issues, i.e. chronic obstructive
pulmonary disease (COPD), cancer, heart/liver disease
►
CHNA SUMMARY REPORT
 Working draft in progress (45+ pages)
 BRMH Board of Directors’ Strategic Planning process
complete in August 2012
 Action Plan competed February 2013 - priorities that
fall with our strategic plan and can be affected by
BRMH were incorporated into this plan
 Phases yet to complete:
* Implementation & Evaluation
* Planning for the next cycle
 Complete CHNA Summary Report to be finalized in
2013 and be published on-line and made widely
available to the public
►
Recent Grant Awarded
 Wisconsin Community Health Improvement Plans
and Processes (CHIPP) Infrastructure Improvement
Project: $5,000 towards resources
 BRMH is one of ten sites selected
 Through December 2013, all sites are piloting and
evaluating tools/resources created by:
 Wisconsin
Association of Local Health Departments and
Boards (WALHDAB)
 UW School of Medicine and Public Health
 Wisconsin Partnership Program
 Other state-wide representatives, including Wisconsin
Hospital Association
►
Tools & Resources
As a pilot site, we have access to tools and resources, including:
 Wisconsin Guidebook (step by step guidance tool with
associated checklists and templates)
 Templates for Action Planning and guidance on their use
 Indicators/Objectives for Action Planning for the most
commonly selected health priorities in Wisconsin
 Guidance and Technical Assistance on engaging
stakeholders and community members
 Cost Benefit information about CHIPPs to engage
community leaders
►
Questions??
Thank you!
Liz Lund
Business Development Manager
Black River Memorial Hospital
Black River Falls, WI
(715) 284-1386
[email protected]