Frequently Asked Questions about Community Health Assessments and Community Service Plans

Collaboration

Community Service Plans (CSP)

Community Service Plans and Community Health Assessments

Data

Collaboration

Who is charged with leading the collaboration process: the hospital or local health department?

Both the hospital and local health departments have been charged with leading the collaboration process, and should engage the appropriate community partners in the community health planning process. There are no set rules for how the collaboration must occur. The State Department of Health would be happy to assist local communities in the collaborative process and can provide tools to make this easier for them.

How do you engage State Education Department’s participation in the process to address issues such as childhood obesity, high school dropout rates, etc?

Local health departments and hospitals are encouraged to work with schools in their community to identify and address the health status of children and youth. The State Department of Health staff will work with the State Education Department at the policy level on issues affecting children and families.


How do you see hospitals and local health departments collaborating?

We hope hospitals and local health departments will invite local partners to meet with them, discuss community needs, and identify the common priorities in the context of the Prevention Agenda. Communities can decide how the collaboration will occur.

Community Service Plans/Community Health Assessments


Where can I find a copy of the letter sent to hospital CEOs in November?

The letter sent to hospital Chief Executive Officers is available at: http://www.health.ny.gov/prevention/prevention_agenda/community_service_plan.htm


What timeline does the Community Service Plan (CSP) cover? Is it for activities until 2008, beyond 2008 or both?

The CSP is due on September 15, 2009, and pertains to the period January 1, 2010 to December 31, 2012. It may include a description of current planned activities or could describe new initiatives to address the Prevention Agenda priorities.


How does a hospital prepare a Community Service Plan (CSP) if the hospital is part of a larger health system, or may be covering an area with more than one hospital?

A health system may submit one report, but this report would have to be broken down by each hospital to ensure that the unique situation of that hospital is addressed and clear to the audience. For each hospital, the CSP should have the information that is specific to their locality or target population, as well as what is generic to all hospitals. If there are differences between hospitals (e.g., mission, priorities), these would need to be described. Also, the financial aid reports may be different for each hospital within the system. Additionally, each hospital may acknowledge the other hospital(s) in the collaborative and/or the system if they have identified similar priorities. Each hospital’s CSP may have sections that are similar to what is submitted by partner hospitals or by the larger hospital system.


Will hospitals be able to file the CSP electronically in 2009?

The State Department of Health expects that hospitals will be able to submit their 2009 CSP electronically to the secure HPN network. In addition, the possibility of using an online form to obtain the required information is being explored.


What kind of evaluation plan is required for the CSP?

The evaluation plan should include time-phased, measurable objectives, along with a description of methods to document the impact of actions taken.


With regard to evaluation information in the CSP, will the Department of Health be looking for process and outcome measures?

We will be looking for both process measures (e.g., how many people participate in the workshop) and outcome measures (e.g., number of people who attended the workshop who increased their knowledge or changed their risky behavior).


Where should hospitals report financial information and when is it due?

The financial statement is due the same time as the H990, in early 2010 for the Year 2009. CSPs will not require a separate financial statement as this information is captured through other reports (e.g., Exhibit 50 of the ICR). Hospitals are encouraged to include pertinent financial data meant for the public in their CSP.


If a hospital is in financial jeopardy, should this type of alert be explained in the Community Service Plan?

This alert should be included and explained in the Community Service Plan.


The CSP guidance states that hospitals should report on all programs. It also says that hospitals should choose 2-3 priority areas. Is the hospital required to write about all programs on which they work?

This time, the intent of the CSP is to focus on identifying the community’s needs and a plan for addressing them. Hospitals are encouraged to describe the programs that address the needs. While hospital CSPs have to focus on only 2 or 3 priorities, some of the needs identified by communities may fall outside the Prevention Agenda priorities. It would be helpful to know about these.


Will the New York City Department of Health and Mental Hygiene have the capacity to collaborate with all hospitals in the city?

The Prevention Agenda priorities are consistent with the ‘Take Care New York’ priorities of the New York City Department of Health and Mental Hygiene, which will be working with the Greater New York Hospital Association to identify ways for the city health department to work with all hospitals on these priorities. More information will be forthcoming.


Is it possible to get a list of hospital community service contacts?

Currently, there is no list of hospital community service contacts. Hospitals were invited to submit contact information (email, phone number) to HANYS. This information will be forwarded to the State Department of Health and posted on the secure Health Provider Network.


The county where my hospital is located has aligned with four other counties. I am concerned that the regional priorities may not reflect the priorities of the hospital in the county.

You should be a part of the local collaborative and, as a group, review the data and agree on the specific Prevention Agenda priorities. If you are concerned that the regional needs do not reflect local needs, these should be discussed with the group. A possible solution may be that your collaborative identifies more than the 2 or 3 Prevention Agenda priorities and, as necessary, each member of the collaborative can implement initiatives to address the needs of the community.


The objectives spelled out in the Prevention Agenda may only be partially met by 2010. Is this going to affect how the Community Service Plan is viewed?

The 2010 objectives are “reach” objectives (e.g., ones to aim for). The State Department of Health is looking for improvement and understands that the objectives may not be fully met by the hospital.


Does the Department of Health expect all hospitals in the county to work collaboratively on the Prevention Agenda?

Hospitals in the county are encouraged to work collaboratively on the Prevention Agenda with all community partners. The State Department of Health recognizes that this may not always be possible. The intent is for local health departments and hospitals to coordinate their efforts on 2 or 3 Prevention Agenda priorities and to achieve progress in addressing them.


Why do the hospital CSPs cover a three-year period and the local health department Community Health Assessment (CHA) cover a four-year period?

These time periods are based on statutory requirements and will not change unless revised by the New York State legislature. In 2009, the hospital CSP will cover a three-year time period from 2010-2012, and the local health department CHA will cover a four-year period from 2010-2013. By initiating this process at the same time, a collaborative planning process is encouraged.


If a county identifies two different areas within a particular priority area such as cardiovascular disease and diabetes under Chronic Disease, would this be considered one or two priorities?

If a county chooses to focus on 2 areas within the Chronic Disease priority, it would be considered as 2 priorities.


We have applied for the HEAL-9 grant. Should we wait until we hear about the outcome of this award before we get started?

HEAL-9 awards will provide funds for community health services planning above and beyond the planning called for in the CHA and CSP. Hospitals, local health departments, and their partners should start community health planning immediately and not wait until the awards have been announced.


Is it appropriate for a hospital or local health department to have two sets of reports: one for the state health department and the other for the local community?

An organization can have separate reports tailored to separate audiences.


Are there any DOH funding opportunties to help achieve some of the Prevention Agenda priorities?

Currently, there are no specific awards available to support implementation of the Prevention Agenda. If and when available, the State Department of Health will post such funding opportunities on its website.


Will local health departments receive CHA guidance and CSP call letters?

The CHA guidance and CSP call letters are posted at http://www.health.ny.gov/statistics/chac/nysguidance.htm.


Data

What is the Health Provider Network and what data does it include?

The Health Provider Network (HPN) is a secure website administered by the State Department of Health that can be accessed by health care providers, hospitals and other pre-approved institutions. The HPN has applications that allow providers to send and receive sensitive health information. It allows providers to access hospitalization data through the Statewide Planning and Research Cooperative System (SPARCS) Data Query System, and quality of care information submitted to the Department by New York’s managed care plans through the Quality Assurance Reporting Requirements (QARR) Query System. The HPN also provides access to county-level public health indicators (also on the State Department of Health public website) via the New York State Community Health Data Set, the County Health Indicator Profiles, and the County Health Assessment Indicator Reports. A similar network, the Health Information Network (HIN), is available to local health departments. Institutions with HPN access usually have a designated staff person who coordinates provider information. All hospitals should have a HPN coordinator who can provide information to you. If you do not know your hospital HPN coordinator, please email prevention@health.state.ny.us and the information will be sent to you.


How does the Department of Health address the access and use of data by rural counties with a population of less than 100,000?

The State Department of Health has posted county-level health indicator data for all counties regardless of population size at http://www.health.ny.gov/statistics/chac/data.htm. Updated socio-demographic data are available from the Census Bureau’s American Community Survey. Three-year estimates are available for geographic areas with more than 20,000 residents and one-year estimates for areas with more than 65,000 residents at http://www.factfinder.census.gov. The 2008-2009 Expanded Behavioral Risk Factor Surveillance System (EBRFSS), which collects population-based data on general health, access to care and risk factor prevalence, will have representative data for each county in New York State.


If the E-BRFSS data to be provided to counties in March, 2009 contains only six months of data, how accurately will this information represent the risk profile of the county’s population?

While the sample will be representative of the adults in each county, the smaller size (n~325 for six months) of the sample means that the confidence intervals around the estimates will be larger (e.g., less precise). Also, estimates for population sub-groups will be unreliable because of limited sample size in these groups. Based on past analyses, we expect that estimates generated from the first six months will be comparable to the final estimates and that seasonality has a limited impact. Once the survey is completed, the preliminary estimates will be revised.


Will small, rural counties be able to get county-specific data from the Youth Risk Behavior Survey (YRBS)?

The Youth Risk Behavior Survey (YRBS) uses a different methodology than the telephone-based Behavioral Risk Factor Surveillance System. The YRBS estimates are only generated at the statewide level. The YRBS is school-based, self-administered, requires active informed consent (e.g., an ‘opt-in’ policy) from parents and thus is much more difficult and costly to implement. You may want to use focus groups as an alternative means of assessing youth risk.


When will counties be able to access BMI data being collected by schools?

Legislation was passed in 2007 requiring public schools outside of New York City to collect and report a summary of students’ weight status. The law requires BMI and weight categories (based on BMI for age percentiles) to be included on each student’s health certificate at school entry (pre-kindergarten and kindergarten) and in grade 2, 4, 7 and 10. Starting with the 2008-2009 school year, schools will be required to report student weight status information to generate estimates of childhood obesity rates for each county and for the state as a whole, exclusive of New York City. The sampling plan was designed to result in half of the school districts within a county reporting one year and the other half of the districts reporting the following year. Within a county, school district poverty, race and enrollment were used to stratify the districts and ensure a representative estimate. Schools participating this school year must report the information by January 29, 2009. It is hoped that these data will be available by Fall 2009.


How can the CHAs and CSPs work with the latest Census adjustments when we know the last Census was completed in Year 2000?

The Census Bureau updates the 2000 Census socio-demographic data via the American Community Survey. Three-year estimates are available for areas with more than 20,000 residents and one-year estimates for areas with more than 60,000 residents. The Census Bureau also generates population estimates by age, sex, race, and Hispanic origin at the county level for July of each year. This information is available at http://www.factfinder.census.gov


What are Prevention Quality Indicators (PQI), and when will the Prevention Quality Indicators (PQI) be available on the DOH website?

The PQI Tool was released in December 2008 and is available at the State Department of Health’s website at: https://apps.health.ny.gov/statistics/prevention/quality_indicators/start.map.

The Prevention Quality Indicator website identifies, on a ZIP code level, the rate of hospitalizations for conditions generally considered preventable with good access to primary care and chronic disease management. It also reveals health disparities by breaking data down according to the race and ethnicity of patients. PQI measures were developed by the federal Agency for Healthcare Research and Quality (AHRQ) and are used to monitor the quality of primary and preventive care on state and national levels.

The website provides PQI hospitalization admission rates for the following four disease groups and 12 conditions:

  • Circulatory conditions: angina, congestive heart failure, hypertension;
  • Diabetes-related conditions: short-term complications, long-term complications, lower extremity amputations, uncontrolled diabetes;
  • Respiratory conditions: asthma, chronic obstructive pulmonary disease (COPD).
  • Acute conditions: Bacterial pneumonia, dehydration, urinary tract infection