The Community Health Needs Assessment and
Improvement Plan Process in Yellowstone County
Engagement and Accreditation
Montana Public Health Association Conference
October 1, 2014
Heather Fink and Shawn Hinz
Community Engagement
What is Community Engagement?
The Alliance
Community Health Improvement
Objectives
To introduce a Community Health Needs Assessment
approach including potential strategies for engaging key
collaborators and community members in the process.
To demonstrate alignment with required domains of Public
Health Accreditation.
ACHI Framework for the CHNA and CHIP
Suggested
7th step:
revisit and
refine plan
and process.
http://www.assesstoolkit.org/assesstoolkit/ACHI-CHAT-intro-slides-8-27-10.pdf
COMMUNITY HEALTH NEEDS ASSESSMENT TIMELINE
ACHI steps 1 & 2: Establish
and Assess Infrastructure
Survey Design
CHNA Advisory Group
PRC Contract
Survey tools finalized (HBDL)
Mar-July 13
ACHI step 3: Analyze Data
Results Returned
Alliance & HBDL review
BC, RSH & SVH internal review
CHNA Advisory Group review
HBD Coalition review
Aug-Oct 13
ACHI step 3: Collect Data
Survey Conducted
Focus Groups (PRC)
Telephone (PRC)
Nov-Dec 13
ACHI step 4: Select
Priorities
Prioritization Process
Community process
Institutional processes
Alliance final adoption
Jan-Feb 14
ACHI step 5: Document and
Communicate Results
Results Released Publicly
a) Press Conference (Jan)
b) Internal, key groups, community, &
media – results, priorities & engage
ACHI step 6:
Plan for
Action
Author CHIP
Mar-June 14
ACHI step 6:
Monitor
Progress
CHIP begins
July-Sept 14
ACHI step 6: Plan for
Action
CHIP Adopted (June 30)
BC adopts facility plan
SVH adopts facility plan
step 7:
Revisit and
Refine plan
and process
CHNA= Community Health Needs Assessment
PRC= Professional Research Consultants – vendor
CHIP= Community Health Improvement Plan
HBDL=Healthy By Design Leadership
ACHI=Association of Community Health Improvement (framework for CHNA-steps referenced)
Assess
DOMAIN 1: Conduct and disseminate assessments
focused on population health status and public health
issues facing the community
• Standard 1.1: Participate in or Conduct a Collaborative
Process Resulting in a Comprehensive Community
Health Assessment
• Standard 1.2: Collect and Maintain Reliable, Comparable, and Valid Data
That Provide Information on Conditions of Public Health Importance and
On the Health Status of the Population
• Standard 1.3: Analyze Public Health Data to Identify Trends in Health
Problems, Environmental Public Health Hazards, and Social and Economic
Factors That Affect the Public’s Health
• Standard 1.4: Provide and Use the Results of Health Data Analysis to
Develop Recommendations Regarding Public Health Policy, Processes,
Programs, or Interventions
Community Engagement
DOMAIN 4: Engage with the community to
identify and address health problems
• Standard 4.1: Engage with the Public Health
System and the Community in Identifying and
Addressing Health Problems Through
Collaborative Processes
• Standard 4.2: Promote the Community’s
Understanding of and Support for Policies
and Strategies That will Improve the Public’s
Health
Community Health Needs Assessment
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Completed every 5 years, now every 3
Sponsored by the Alliance
Randomized telephone survey of 404 Yellowstone
County adults
Secondary Data
 Public health data & vital records statistics
Focus Groups
 Physicians & other Health Professionals
 Legislators
 Social Service Providers
 Educators
 Employers
South side neighborhood residents
Action Plan
Measure
Opportunity for
Improvement
History/Current
Status
Action
4.1.2
Example 2
Required
Documentation
Source of
Evidence-based
practices
RiverStone Health may want to
consider how the
work they currently do or
could do provides their many
community coalition partners
with technical assistance, tools
and resources to provide
information about community
engagement principles,
processes, and/or models.
RiverStone Health is using
the Association of
Community Health
Improvement (ACHI) model
for Community
Engagement. This process
was also used in
2010.
Present to community
members who have
selected priority
areas and
stakeholders on how the
ACHI model of
community
engagement is used
in the development of
a CHIP and other
types of community
engagement. The
community members
will
participate in setting
priority activities.
Documentation
Invitation
Responsible
Staff
Date
Shawn Hinz,
On
Director and
5/2/2014
Agendas of
Heather Fink,
meetings
Coordinator for
Community
Meeting Minutes Health
Improvement
PowerPoint
Presentation
ACHI model
Documentati
on of Priority
Planning
Attendance
Sheets
Community
Resources
• The Alliance
• Community Health Improvement Leadership
• CHNA Advisory Group
• Healthy By Design Coalition
• CHIP workgroup
Points of engagement
• Press Conference and Preview Meetings
• CHNA Advisory Group Check-Ins
• Community Forum
• Content Expert Meetings
• CHIP Strategy Discussions
Areas of Opportunity
► Access to Health Services*
► Cancer*
► Chronic Kidney Disease
► Dementias, Including Alzheimer’s Disease
► Heart Disease & Stroke*
► Injury & Violence*
► Infant Health & Family Planning
► Mental Health & Mental Disorders*
► Nutrition, Physical Activity & Weight*
► Respiratory Diseases*
► Substance Abuse*
► Tobacco Use
Bold items were identified as a top concern in
focus groups.
* Denotes issues identified as Areas of Opportunity
in 2010 as well.
Underlined-identified in 2014 Community Forum
Identified Community Priorities
– Access to Health Services
– Mental Health & Mental Disorders,
Substance Abuse
– Nutrition, Physical Activity & Weight
Policies and Plans
DOMAIN 5: Develop public health policies and plans
• Standard 5.1: Serve As a Primary and Expert Resource for
Establishing and Maintaining Public Health Policies,
Practices, and Capacity
• Standard 5.2: Conduct a Comprehensive Planning Process
Resulting in a Tribal/State/Community Health
Improvement Plan
• Standard 5.3: Develop and Implement a Health
Department Organizational Strategic Plan
• Standard 5.4: Maintain an All Hazards Emergency
Operations Plan
Action Plan
Measure
Opportunity for Improvement
5.2.4
The required
documentation includes
monitoring progress in
meeting performance
measures and a description
of the progress made on
health indicators as
defined in the plan.
The primary constraint for
meeting this measure is
related to the newness of the
plan. That said, the plan and
the updates could be
improved if the objectives and
strategies/interventions were
written as SMART, and rather
than simply aiming to
decrease or increase a
particular activity, the plan
could set specific targets; for
example, increase by x% from
x to y, etc.
History/Current Status
RiverStone Health conducted Community
Health Needs Assessments in 2005, 2010,
and 2014 in partnership with the local
hospitals (The Alliance). Following each
needs assessment, a plan to improve the
health of the community was written using
community engagement.
The 2014 CHIP is currently being written and
the strategies will be written as SMART
objectives.
Action
Reports of progress for the 2010
CHIP will be provided.
In December 2013, a
presentation to the Alliance on
the health priorities and
outcomes occurred comparing
the results of the 2005, 2010, and
2014 Community Health Needs
Assessment.
Documentation
7-8-13 Report of CHIP
progress
Meeting Minutes
Attendance
PowerPoint
Work groups were formed
following the development of the
2010 CHIP and developed work
plans which were updated in
March 2014
2014 CHIP update which
includes;
work plans, progress,
updates and revisions March
2014.
Responsible Staff
Shawn Hinz, Director
and
Heather Fink,
Coordinator for
Community Health
Improvement
Accomplish by Date
7-8-13
12-18-13
March 2014
The Alliance
Community Health Improvement
CHNA and Implementation Plan
Healthy Weight
2014-2017
Community
Health
Improvement
Plan Priorities
Healthy By Design
Access to Health Services
Mental Health and Substance Abuse
Healthy Weight Priority
Healthy By Design’s
Current Initiatives
Making the healthy choice the easy choice
Focused on Policy, Systems and
Environmental Change!
Healthy By Design Coalition
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Better Billings Foundation
Big Sky EDA
Big Sky State Games
Billings Clinic
Billings Family YMCA
Cancer Control Coalition
Chamber of Commerce/CVB
City-County Planning Dept.
community health advocates
League of Women Voters
MET Transit
McCall Development
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MSU Billings
MSU Extension Service
Northern Plains Resource Council
Nutrition for the Future
Parks and Rec
Peaks to Plains Design
RiverStone Health
Safe Routes to School
Salvation Army
St.Vincent Healthcare
School Health Advisory Council
United Way
Priority: Healthy Weight
(Brand: Healthy By Design)
Focus Areas
Health
Equity
Wellness
Built
Environment
Workgroups
Children/
Families
(partners: BAFHK, SHAC)
Worksite
Projects: BSED
Recognition
Active
Living
Every Day
Gardeners’
Market
Community Message: 5-2-1-0
Food
Access
Alternative
Transportation
Evidence Based Practice
DOMAIN 10: Contribute to and apply the evidence
base of public health
• Standard 10.1: Identify and Use the Best
Available Evidence for Making Informed Public
Health Practice Decisions
• Standard 10.2: Promote Understanding and Use
of Research Results, Evaluations, and Evidencebased Practices With Appropriate Audiences
Healthy By
Design
Workgroup
Workplan
Example
“Complete Streets” passed unanimously
by City Council. Adopted by Billings
August 22, 2011
Complete streets are
designed and operated to
enable safe access for all
users. Pedestrians,
bicyclists, motorists, and
public transportation
users of all ages and
abilities are able to safely
move along and across a
complete street.*
* Source: National Complete Streets Coalition
www.completestreets.org
Zimmerman Trail near Poly Drive
Gardeners’ Market
Report on 2014…
 Average of 150-200 customers each week
 Average of 12 sellers weekly
 Moved to South Park
 SNAP, Debit, Credit
Active Living Every Day Classes
Address identified
physical activity
barriers and
opportunities.
Action Plan
Measure
Opportunity for
Improvement
10.1.1
Example 2
To seek out and utilize
Required
evidence-based or
Documentation
promising practices
that are aligned with
Source of Evidence- the 10 Essential Public
based practices
Health Services
History/Current Status
The Healthy By Design
Coalition is led by RiverStone
Health, and Alliance partners
Billings Clinic and St. Vincent
Healthcare. There are 5
active workgroups: Healthy
Weight, Worksite Wellness,
Health Equity, Built
Environment, and
Recognition Program that all
embrace 5210 messaging. 5
fruits/vegetables, 2 hours or
less of screen time, 1 hour of
physical activity per day, and
0 sugary beverages. This
5210 messaging is centered
around our work to decrease
obesity and chronic disease
(a priority of our current
CHIP) and evidenced by the
success of the “Let’s Go
Maine” program and
referenced in many CDC
resource lists. See below
Action
To assure consistent
messaging of the 5210
model a train the trainer
program will be
developed and
implemented to include
sanitarians, and
immunization staff.
Documentation
Responsible
Staff
Accomplish by
Date
Invitation
PowerPoints
Attendance
Training Materials
Melissa and
Dasheema
5/15/2014
Emails/minutes
Melissa and
Dasheema
5/15/2014
Identify target audiences
for future 5210 trainings
Let’s Go Maine, Hawaii Initiative for Childhood Obesity Research and Education, Healthy By Design.
Healthy Weight Collaborative Project
Community Message
Healthy By Design
www.healthybydesignyellowstone.org
Alliance and Community Health Improvement Leadership
Community Health Improvement Staff
Community Health Needs Assessment
Community
Community Health Improvement Plan
Priorities
Mental Health/
Substance Abuse
Access to
Care
Healthy
Weight
Priority: Mental Health/ Substance
• Strategy team meeting 8/27/14:
•
Heather Fink, Nathan Stahley, Kristin Lundgren,
TommiLee Harper, Libby Carter
Proposed co-chairs: Libby Carter, DPHHS and Barbara Mettler, Mental Health Center
(to be approached by Kristin)
• Common strategies of focus:
– Increase capacity for trauma informed care
– Support advocacy efforts for co-occurring treatment and family treatment
– Identify mental health and substance abuse related resources (integrate
trauma informed certification)
• Actions:
Outline strategy plan, aligned with DESTRESS grant
Finalize chairs
Hiring for grant coordinator
Identify opportunity to connect/collaborate with Tobacco and Substance Abuse
Coalitions
– Pursue potential interns to support
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Priority: Clinical/Access
• Finalizing Alliance organizations strategy team
representatives
• Determine meeting time and date
• Review CHNA, CHIP, strategies
• Recognize current efforts underway
• Determine priority strategies and potential
opportunities
– Meeting scheduled in October
– Determine where Healthy Weight Plans fit
Alliance and Community Health Improvement Leadership
Community Health Improvement Staff
WHO?
Community Health Needs Assessment
Community
Community Health Improvement Plan
Priorities
Mental Health/
Substance Abuse
Access to
Care
Healthy
Weight
Backbone Structures
Who does the work?
• Collaborative
• Nonprofit organization
• Dedicated staff
Collective Impact
Making a difference
THANK YOU
Shawn Hinz
Vice President, Public Health Services
RiverStone Health
shawn.hin@riverstonehealth.org
406-247-3365
Heather Fink
Community Health Improvement Manager
On behalf of the Alliance: Billings Clinic, RiverStone Health, St. Vincent Healthcare
heather@healthybydesignyellowstone.org
406-247-3272