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BACKGROUND: Beginning in the first taxable year after April 2012, the Internal Revenue Service (IRS) requires that non-profit hospitals conduct community health needs assessments at least every three years. Federally Qualified Healthcare Centers (FQHCs) are under similar obligations whereby they are required to submit a needs assessment prior to application for funding and to continually assure that they are addressing the needs of the community where they are located. Additionally, recently established Public Health Accreditation Standards require state or local public health agencies seeking to establish or maintain accreditation to conduct a community health assessment and resulting health improvement plan every three to five years.
METHODS: The Maricopa County Department of Public Health (MCDPH) embarked on a process to consolidate these needs assessment requirements across sectors in the Fall of 2013. This process included a fee structure whereby each of the participating facilities would pay into a pool, administered by MCDPH, and those fees would be used to support staff and contracts to complete one comprehensive needs assessment which would meet all partner needs. Consensus needed was built with organizations that regularly competed. Processes were developed to build collaboration for long-term community benefit for population health; including chronic disease prevention and management, access to healthcare, and the opportunity to integrate strategies with a community health improvement plan.
RESULTS: The process for recruiting participants and receiving their fee payments ended in December 2014. Of the 22 non-profit hospitals in Maricopa County, 16 are participating in the project. Five of the non-participating hospitals represent one hospital group that is in the process of a corporate merger. Out of the 21 FQHCs in Maricopa County, 16 have chosen to participate in the project. The five non-participants represent only two administrative entities. Initial success includes consensus on a list of common health indicators as well as the framework for community-based focus groups. This work is staffed through a newly created position funded through this initiative and housed in the MCDPH Office of Epidemiology.
CONCLUSIONS: There is no rule, legislation, or organization in Arizona or MC requiring partners to collaborate on community health needs assessments. Additionally, there were almost no examples where more than one hospital or clinic facility collaborated on a community-based initiative. The first year of this multi-year process has had great challenges and great successes. For our community, this has been a critical first step in moving towards collective impact in our community health improvement initiatives.