What is a Community Health Needs Assessment?
A Community Health Needs Assessment (CHNA) is a process of systematically collecting and analyzing data in order to comprehensively identify key health needs for the community of interest. The assessment is followed by an implementation plan where specific actions are described that address the identified needs. This whole process, if done well, increases the ability of communities to invest resources in ways that maximize desired population health outcomes. The process also can lead to greater collaboration among the range of stakeholders working to support the health and well-being of their community.
Who performs CHNAs?
Different entities are required or encouraged to perform CHNAs, including:
Organizations applying for grants from the CDC or other grant-making organizations
Accredited Health Departments
The Public Health Accreditation Board (PHAB) started its national accreditation program for public health departments in September 2011. Under the program, local health departments are required to submit three prerequisites as part of the application process:
A Community Health Assessment
A Community Health Improvement Plan
An Agency Strategic Plan
|Health Department||County||Community Health Assessment||Community Health Improvement Plan|
|Dallas County Health and Human Services||Dallas||2016 Dallas County CHA|
|Houston Department of Health and Human Services||Harris||2013 Houston CHIP|
|Tarrant County Public Health||Tarrant||2013 Tarrant County CHA|
|Austin Public Health||Travis||2017 Travis County CHA|
|Williamson County and Cities Health District||Williamson||2016 Williamson County CHA|
Non-Profit Hospitals in Texas
Non-Profit Hospitals, IRS Community Benefit Standard, and CHNAs
Prior to 1965, a hospital qualified as a tax exempt "charitable organization" if it provided medical care to people who could not afford to pay.
With introduction of Medicare in 1965 covering previously uncompensated care, the IRS established the Community Benefit Standard as the basis for tax-exemption. Free and discounted care continued to count toward justifying tax exemption, investments to promote community health also qualified toward meeting nonprofit hospitals' obligations. However, the lion's share of community benefit dollars still go towards uncompensated care.
Following the passage of the Affordable Care Act in 2010, those IRS rules were modified. Nonprofit hospitals are now required to perform a CHNA and an Implementation Plan every three years.
In addition, the IRS expanded the ways hospitals can satisfy community benefit requirement - including leadership development, community coalitions, cash and in-kind contributions to community groups. For more information, visit: https://www.chausa.org/communitybenefit/community-benefit
A non-profit hospital's current CHNA, Implementation Plan, and how it's community benefit dollars are spent are publicly-available documents. To find these documents, click on the location and a pop-up window will provide links. Additionally, you can check the hospital's website.