Community Benefit: Planning

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Community Benefit Planning Evaluation
1000 am session
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Basic Steps in Community Benefit Planning and
Implementation
Building a Sustainable Infrastructure
Communicating
Interrelated Interdependent Simultaneous
Determining What Counts
Planning
Accounting For Costs
Evaluating
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Planning
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Assess Needs and Assets

• Guidelines
• Form an assessment and planning work group
• Define community and scope of assessment
• Review and analyze available information
• Collect new information
• Assess community strengths

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Form Assessment Planning Workgroup

• External

• Internal
• Community benefit lead
• Quality assurance
• Clinical staff
• Strategic planning
• Communications
• Board member
• Finance
• Others

• Consumers
• Community organizations
• Parishes/congregations
• Public health
• Universities
• Business
• Foundations
• Others

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Define Community

• Geographic area
• Population subgroups
• Underserved areas
• Hospital targeted areas

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Collect Data from Communitywith focus on poor
and underserved

• Secondary Data
• Past Assessments
• Health Department
• United Way
• Healthy People 2010
• Small area variation data
• Other

• Primary Data
• Surveys
• Questionnaires
• Interviews
• Forums
• Focus groups
• Other

• Other Sources
• State community benefit law
• Coalitions
• Politicians interest
• Business initiatives
• Other?

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Collect Data from Organizationwith focus on poor
and underserved

• How can a community benefit program link with
  organizational needs? Assess needs in the

• Emergency department
• Violence
• Domestic violence
• Primary care visits
• Ambulatory services
• Ambulatory sensitive conditions

• Quality Assurance
• Risk Management
• Medical Residency Program
• Clinical priority areas
• Board strategy
• Capital plans

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Assess Community Strengths
What resources are available? skills,
partnerships, money

• Other healthcare providers
• Colleges and universities
• Government organizations
• Grassroots organizations
• Seniors
• Your own organization

• Businesses
• Schools
• Churches/congregations
• Block clubs
• Libraries
• Cultural groups

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Added Value from Community Assessment

• According to St. Vincent Health, a community
  assessment
• Promotes long-term collaboration and programming
  around quality of life concerns.
• Unifies community around shared vision.
• Helps align community resources in problem areas.
• Attracts attention (and ultimately external
  funding).

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Set Priorities

• Guidelines
• Review findings for problems, gaps, and potential
  indicators
• Identify priorities among problems

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Analyze and Prioritize

• Basic Questions
• Importance of problem to community
• Scope of the problem
• Seriousness of the problem
• Effect on community if service offered
• Limiting factors
• Resources available
• Community-wide initiative or
• Organization sponsored initiative

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Analyze and Prioritize

• Popular Methodologies
• Nominal Group Technique
• Brainstorming
• Storyboarding
• Force Field Analysis
• Fishbone (cause and effect) analysis
• 2 X 2 Matrix
• Process Mapping
• Multi Voting
• Value Analysis

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Mercy Circle of Care, Philadelphia

• Activities must
• be aligned with the Mission of the Health System.
• be aligned with the Strategic Initiatives of the
  Health System or must directly reduce
  uncompensated care.
• fall under the definition of Community Health
  Services.
• be aligned with Community Health needs.
• produce a measurable outcome.

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Memorial Hermann, Houston

• Community benefit plan revolves around the citys
  major challenges
• Escalating uninsured
• Lack of community capacity for the uninsured
• Continuing utilization of emergency departments
  for primary care
• Lack of engagement of key stakeholders

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Develop Plans

• Guidelines
• Participate in community-wide plans
• Develop a facility community benefit plan
• Develop an action plan for each program
• Make responsiveness to community needs part of
  the organizations plan

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Community Benefit Plan

• A community benefit plan is a document usually
  produced in conjunction with the health care
  organizations annual strategic plan that
  explicitly details how an organization intends to
  fulfill both its mission of community service and
  its charitable, tax-exempt purpose.
• It includes a description of community benefit
  priorities, programs, staffing and resources.

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Community Benefit Plan Template

• Mission Statement
• Geographic area and target population
• Assessment of community health needs and goals
• Problems organization will address directly and
  those addressed in collaboration with others
• Program goals and objectives
• Evaluation methodology
• Committed resources
• Invite community input

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Community Benefit StructureHoly Cross Hospital
Silver Spring, MD
Community benefit plan receives same
organizational attention
1 including physician development 2 including
information systems 3 including nursing
excellence Committee oversees overall strategic
planning and community benefit
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Basic Steps in Community Benefit Planning and
Implementation
Building a Sustainable Infrastructure
Communicating
Interrelated Interdependent Simultaneous
Determining What Counts
Planning
Accounting For Costs
Evaluating
21
Evaluating

• Guidelines
• Evaluate the overall structure of the community
  benefit program
• Evaluate how each program is carried out
• Evaluate the effectiveness of individual
  community benefit programs
• Evaluate the effectiveness of the overall
  community benefit program

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Overall Program Evaluation
Organizational commitment?
Accountability of leaders staff?
Is the community benefit program working toward
its overall goals? Are the right problems being
addressed? Is the organization doing enough? Do
others view the organization as a community
benefit?
Internal policies?
Successful community partnerships?
Updated community needs assessment?
Adequate human and financial resources?
Short and long term goals in place?
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Individual Program Evaluation
Does the program Target a specific need? Continue
to be needed? Accomplish its purpose? Address
root causes of problems?
Outputs Number of classes Number of
volunteers Number of encounters Number of people
served
Outcomes/Impact Improved conditions Changed
behavior Increased skill Health improvement
Outcome Timelines Initial Intermediate Long-term
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Tools

• New resource
• Results-Based Accountability
• How to Make a Real Difference In Your Community
• Mark Friedman, Fiscal Policy Studies Institute

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CHA Evaluation Efforts

• Evaluation is the focus of system community
  benefit leaders
• CHA is collaborating with
• The Disease Management Association of
  America
• and
• St. Louis University

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Addressing Unmet Health NeedsThe Community
Need Index
Eileen Barsi Director, Community Benefit

April 24, 2007
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Catholic Healthcare West A Leading Not For
Profit Health System

• Hospitals 42
• Assets 8.6 billion
• Acute Care Beds 6,782
• Active Physicians 7,617
• Full-time Equivalent Employees
  37,284
• General Acute Patient Care Days 1.7 million
• Community Benefits Care of the Poor 802
  million

Including unpaid costs of Medicare
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Hospitals Exist For More than Acute Care Services
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Community Programs Should Demonstrably Improve
Health
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Linking People to Policy

• Peoples social and economic circumstances affect
  their health throughout life, so health policy
  must be linked to the social and economic
  determinants of health.
• World Health Organization Findings

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Combining Indicators Leads To Stronger
Correlations
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Northridge Hospital Medical Center
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Admission Rates Nearly Double in High Need Areas

Annual Admission Rate per 1000 Population by CNI
Score All Service Lines


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Preventable Admissions Indicate The Human Impact
of This Work


Annual Admission Rate per 1000 Population by CNI
Score Ambulatory vs. Marker Conditions

Note Ambulatory Sensitive Conditions if treated
properly in an OP setting, do not generally
require an acute care admission

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A National View of Community Health Needs
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Working With Communities Leads to Early Success

• Working with the local district, established a
  free primary care clinic at an elementary school
  in the Sacramento area (North Highlands)
• Identified a high need area in Stockton
  (previously thought to be affluent) and provided
  the community with on-site medical services
  (immunizations, screenings, on-call nurse, etc)
• Determined neediest areas in Arizona for 2 M
  investment to help fund supportive living for
  women/children suffering from domestic abuse and,
  in a separate project, established a substance
  abuse rehabilitation facility for Latino men.

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A Willingness to Work Together
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Contact Information

• Rich Roth
• Senior Director, Strategy Business Development
• Catholic Healthcare West
• 415-438-5593
• richard.roth_at_chw.edu
• Eileen Barsi
• Director, Community Benefit
• Catholic Healthcare West
• 415-438-5593
• eileen.barsi_at_chw.edu