Community Health Improvement Plan Review Checklist: [CHB Name]
For more information about this checklist, including references for each item, see www.health.state.mn.us/lphap.
Review Characteristics 1
Dated within past five years
On Which Page(s)
is this Found?
Not Found
(X)
Notes
Date:
Includes full name of CHB or LHD on cover
Describes jurisdiction for which the plan is created
Describes health inequities in the jurisdiction for which the plan is
created
Names (e.g. MAPP2) and/or describes process used to complete
planning
Process Used:
Lists community stakeholders who participated in planning process 3
Documents that CHA information was shared with participants
Lists issues and themes identified by stakeholders
Describes how community was engaged throughout the planning
process
Describes the prioritization process used to identify the primary issues
(from the CHA) that will be included in the CHIP
Lists the top community health needs or priorities
Includes justification for why each issue is a priority
Includes at least one priority aimed at addressing a social determinant
of health that arose based on health inequities that were identified in
the jurisdiction
1
References for the review characteristics include PHAB Standard 5.2 [http://www.phaboard.org/wp-content/uploads/PHAB-Standards-and-Measures-Version-1.0.pdf ],
NACCHO Recommended CHA/CHIP Characteristics Checklist [http://www.naccho.org/topics/infrastructure/chaip/chachip-online-resource-center.cfm] and MDH Local
Assessment and Planning Guidance [http://www.health.state.mn.us/lphap].
2
Models suggested in PHAB include: MAPP [http://www.naccho.org/topics/infrastructure/Mapp/index.cfm] and Healthy Cities/Communities
[http://ctb.dept.ku.edu/en/assessing-community-needs-and-resources]. Other tools that could be adapted include Community Asset Mapping, MDH Model, NPHPSP,
Healthy People 2020, or PACE-EH. CHBs may use a blend of these or a process of their own design.
3
At least three sectors, in addition to public health, should be identified. Collaboration with hospitals that are now required to conduct a community health needs
assessment (CHNA) and adopt an implementation strategy is strongly encouraged [http://www.naccho.org/topics/infrastructure/Mapp/chahealthreform.cfm].
Review Characteristics
1
On Which Page(s)
is this Found?
Not Found
(X)
Notes
Includes evidence-based or promising practices in the selected
strategies4
References state-of-the-art guidance in the strategy descriptions 5
Includes policy changes needed to accomplish health objectives
Identifies individuals or organizations, beside public health,
responsible for strategy implementation
Identifies measureable health outcomes or indicators of progress 6
Notes existing community assets and resources
Describes alignment with state and national priorities
4
NACCHO Resource Center for Evidence-Based Prevention and Cross-Sector Approaches [http://www.ebprevention.org] and Community Guide
[http://www.naccho.org/topics/HPDP/commguide/index.cfm].
5
National state-of-the-art guidance noted in PHAB includes the National Prevention Strategy [http://www.surgeongeneral.gov/initiatives/prevention/strategy/] or Healthy
People 2020 [http://www.healthypeople.gov/2020/default.aspx].
6
For example, “More students from every population group graduate from high school within four years.” Documented by Minnesota Compass
(http://www.mncompass.org/education) based on high school on-time graduation rates from the Minnesota Department of Education.