COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) BACKGROUND
When the Patient Protection and Affordable Care Act (ACA or “Obamacare”) was enacted by Congress on March 23, 2010, Section 501(r) was added to the Internal Revenue Code. Final regulations governing Section 501(r) were released on December 29, 2014
Section 501(r) stipulates that hospital organizations under 501(c)3 status must adhere to new regulations, one of which is conducting a CHNA on a triennial basis. With regard to the CHNA, all nonprofit hospitals are required to:
1) Conduct a community health needs assessment at least once every three years;
2) Solicit and take into account input from the following groups for both the identification and prioritization of significant community health needs:
3) Identify resources potentially available to address the significant health needs;
4) Include an evaluation of the impact of any actions that were taken to address the significant health needs since the previous assessment;
5) Document a separate CHNA for each individually licensed hospital facility that is adopted by an authorized body of the hospital organization, and make the CHNA report widely available to the public; and
6) Adopt an implementation strategy to address identified health needs and attach a copy of the implementation strategy with the hospital organization’s annual Form 990, or post the implementation strategy on the hospital organization’s website and provide the URL on the Form 990.
HAH’S APPROACH TO CHNA
HAH and its member hospitals are committed to engaging in deep and transformative relationships with local communities to address the social determinants of health and to increase access to high quality care. Taking a cue from Hawaii’s collaborative culture, HAH member hospitals chose to work collectively to conduct the CHNAs in 2013 and 2016. CHNAs were prepared with the aim of offering a meaningful understanding of the health needs in the community. This information, in turn, helped guide HAH hospital members in their community benefit planning efforts and development of an implementation strategy to address prioritized needs. Special attention was given to identify health disparities, the needs of vulnerable populations, and unmet health needs or gaps in services.
Past submissions can be found online at www.hah.org/reports.
To truly address the root causes of health in Hawaiʻi, we need to understand that we are a unique people with a unique history living in a unique place.
When Hawaiʻi people are asked to describe a healthy life, few think that the absence of illness and the extension of life years are the only aspects of health.
Diet, exercise, and doctors are essential—though insufficient—to improve health, but they alone are far from capable of providing the sense of meaning, security, loving relationships, sense of home, happiness, quality time, and other aspects of health that people want and deserve.
This Community Health Needs Assessment (CHNA), as required by the Internal Revenue Service for tax-exempt hospital facilities to complete at least once every three years, culminates a yearlong effort involving 19 hospital facilities; numerous community health centers and organizations; and hundreds of providers, experts, and community members to identify and prioritize significant health issues facing Hawaiʻi’s communities. This reports shares the dominant themes that emerged in conversations across the islands, analyzes data sets that impact all aspects of people’s lives, and provides statewide and island specific priorities to address the most significant health issues.
This CHNA report was developed through a collaborative process and provides an overview of the health needs in Hawaii. The goal of this report is to offer a meaningful understanding of the health needs in the community, as well as help guide the hospitals in their community benefit planning efforts and development of an implementation strategy to address prioritized needs. Special attention has been given to identify health disparities, the needs of vulnerable populations, and unmet health needs or gaps in services. Although this report focuses on needs within the community, there are innumerable community assets and a true aloha spirit that provide ample foundation for community health improvement activities.
Links to individualized hospital reports for local hospitals:
Other Community Health Needs Assessments
In Fall 2012, the Healthcare Association of Hawaii partnered with Healthy Communities Institute to conduct a CHNA for Hawaii. Our approach followed the public health model of assessing and understanding community health holistically. A framework for analysis was constructed based on determinants of health; the framework included a broad definition of community health that considers extensive secondary data on the social, economic, and physical environments, as well as health risks and outcomes. The influence of mauka (“toward the mountains”), or upstream factors, and the resulting makai (“toward the ocean”), or downstream impacts, on health is a transcending theme. Key informant interviews with those having special knowledge of health needs, health disparities, and vulnerable populations provided vital information that increased the understanding of the health needs in Hawaii. A small set of community residents provided additional insights on the health needs in Hawaii. It is hoped that this report will provide a foundation for community health improvement efforts and that community health partners will build on this report.
These reports, along with individual hospitals’ community benefit plans, were publically released in July 2013.