Unprecedented Times Call for Unprecedented CHNA Processes
Every three years, non-profit hospitals, and many for-profit hospitals, take part in a months-long process called a Community Health Needs Assessment (CHNA). A CHNA is designed to identify the community’s greatest health needs before they develop an action plan to address them. Because of the COVID-19 pandemic, many hospital officials have been forced to alter their approach this year, attempting the intimidating prospect of a virtual CHNA. They’ve switched to virtual sessions or telephone interactions to gather and share information. Granted, it‘s not ideal to complete an entire CHNA remotely, but it is possible. Stratasan has had the opportunity to perform three fully remote CHNAs in 2020. In this post, we’ll discuss how to conduct a successful virtual CHNA.
The Challenge of CHNAs In a COVID-19 World
One of the purposes of conducting a CHNA is to bring parts of the community together to focus on one common goal: assessing and improving the health of the community. By definition, this is almost impossible to do remotely. Almost. We at Stratasan have conducted over 70 CHNAs and all have included focus groups of 20 plus people, one-on-one in-person interviews, and very large community health summits where as many as 150 people have gathered in a hotel ballroom. These are exactly the types of activities the CDC says we’re not supposed to be doing in the wake of COVID-19. As conscientious healthcare providers and partners, we would never go against this guidance. So, what’s a hospital to do? Our vote is to give the virtual experience a try.
How We Do It
The fully remote CHNAs we’ve conducted were originally scheduled to have in-person focus groups, one-on-one interviews, and very large community health summits. The focus groups were changed to one-on-one telephone conversations where the community members received the discussion questions ahead of time. 30 to 45 minutes were spent with each person discussing the health needs of different segments of the community, barriers, assets, and what they think should be prioritized for improvement. This method is more time consuming than gathering 20 people together for a 90-minute discussion, but the information is just as good as if the group was together.
The community health summit was also virtual. While this isn’t the ideal setup, we still managed to meet the IRS criteria of soliciting and taking into account input from persons who represent the broad interests of the community served by the hospital and identifying and prioritizing significant health needs. We gathered approximately 40 people via Go-to-Meeting for one summit, and Zoom for the other. The community health primary and secondary data was presented and then every participant submitted their three top community health needs based on the data and their experiences. We did this two ways. For the first summit, a SurveyMonkey survey was completed by everyone, the break was used to organize health needs by topic, and then the prioritized list was presented to the group via PowerPoint. For the second summit, the participants sent an email listing their top needs. That information was then organized using Padlet, an online tool that simulates a virtual post-it note exercise usually performed at summits. The priorities were then added to the post-it notes on the screen and then organized into categories on-screen while everyone took a break. The outcome was very similar to what would have occurred in an in-person summit.
One of the benefits of having a summit in person is the discussion that occurs during the Q&A time and during the segment where the group brainstorms solutions to the top health issues. This interaction cannot occur virtually. Post-COVID, there will likely be pressure to gather groups together again to remind everyone of what was decided upon during the virtual CHNA, and reiterate what needs to be done to improve health in the community.
A Little Help from the IRS
The IRS provided some deadline relief to hospitals required to complete a CHNA under section 501(r)(3) of the tax code. Notice 2020-523 postponed until July 15, 2020 the deadline for performing any CHNA that was originally due to be completed on or after April 1, 2020, and before July 15, 2020. Notice 2020-56 further postponed that deadline until December 31, 2020. If a hospital’s current tax year ends December 31, 2020, then the CHNA will be due by the end of the year unless another postponement is issued.
A few CHNA reminders: your CHNA implementation plan must be adopted on or before the 15th day of the 5th month after the end of the taxable year in which the hospital conducts a CHNA. It is also required to have two cycles of a CHNA on the hospital website.
Stratasan has been energized by the experience of working with our hospital partners and seeing that the CHNA process truly can be executed virtually. Given today’s health concerns, it’s critical that we’re all nimble and willing to shift to virtual engagements whenever possible. It’s been inspiring to see these hospitals band together to execute their CHNA, fully embracing the new virtual experience. The results have been as insightful and impactful as anything we’ve done in the past, during our normal face-to-face process.
For more information on how your hospital can execute a virtual CHNA, contact our team and schedule a discovery call today.
Article by Lee Ann Lambdin, SVP of Healthcare Strategy for Stratasan