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What does the future hold for community health assessment?A look at how one community in Portland, Oregon is collaborating with four local health departments and 14 non-profit hospitals to conduct a regional community health needs assessmentHealthy People 2020-National Association of County and City Health Officials Partnership

NumericNoExplosionAnswer NowUse PowerPoint Color SchemeHorizontalCheckmarkNo10TicToc.wavBoxNoAnswered255,255,050%Keypad #Response Devices# of Responses50NoOval# of Votes ReceivedRedYesUse PowerPoint Color SchemeNoneVoting pads only15All Slides00187,224,22751,51,1530,153,153153,204,0128,128,1280,0,00,102,204204,204,255255,0,0255,255,0187,224,22751,51,1530,153,153153,204,0128,128,1280,0,00,102,204204,204,255255,0,0255,255,0YesYesYesYesExpandedTrueYellowChristine Sorvari and Beth Sanders of Multnomah County Health Department in Portland, Oregon are facilitating a four county community health needs assessment involving four county health departments and 14 non-profit hospitals within the Portland metropolitan area.Whats happening in Portland?Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)

Meet the assessors!Christine Sorvari, Research AnalystMultnomah County Health Department

Beth Sanders, Research AnalystMultnomah County Health DepartmentPriscilla Lewis, Executive Director for Community Services & DevelopmentProvidence Health & Services

Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)(Click on one of the speaker icons to hear from Christine, Beth, or Priscilla)

Assessment, Accreditation, and the Affordable Care ActThe launch of national public health department accreditation in September 2011 increased the visibility of community health assessment, requiring local health departments to submit a community health assessment and a community health improvement plan as prerequisites to applying. Provisions of the Patient Protection and Affordable Care Act of 2010 require each non-profit hospital facility in the United States to conduct a community health needs assessment and adopt an implementation strategy to meet identified community health needs.Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)

Public health leaders and hospital leaders in the Portland area began convening two years ago in anticipation of the accreditation requirements and the Affordable Care Act requirements. Everyone knew it would be a great effort to join all these forces together.- Beth Sanders, Multnomah County Health DepartmentComing TogetherHealthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)

It was the Affordable Care Act that changed this from a polite conversation with our hospital colleagues to a more urgent and committed conversation.- Priscilla Lewis, Providence Health & ServicesPolite ConversationsHealthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)

Sorvari and her team are using their past experience with Mobilizing for Action through Planning and Partnerships (MAPP) to help inform this assessment. MAPP is a community-driven strategic planning process for improving community health and is a framework that many communities use to conduct a community health assessment.Building on MAPPHealthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)

We made a lot of mistakes [the first time we conducted MAPP]. Its been great to have that experience. Portland is a place where everyone and every organization, non-profit and government, really values community input and community engagement.- Christine Sorvari, Multnomah County Health DepartmentMAPP and Community EngagementHealthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)

Using Healthy People 2020Healthy People 2020 provides science-based, 10-year national objectives for improving the health of all Americans.

We have an epidemiology workgroup that is conducting the Community Health Status Assessment of the MAPP process, and they created their own methodology on how to prioritize a lot of different health information. One of the criteria includes comparing regional data to Healthy People 2020 objectives.- Beth Sanders, Multnomah County Health DepartmentHealthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)

The four county community health needs assessment includes Multnomah County, Washington County, and Clackamas County of Oregon, and Clark County in Washington State.Working across Four CountiesHealthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)

The four counties are very different and they cross over two states. When I made the proposal to be a convener of this assessment, I asked myself whether I could be neutral when I work for Multnomah County. We by far have the most people and the most resources. My response is that we cant be completely neutral, but I am very conscientious to try.- Christine Sorvari, Multnomah County Health DepartmentActing as a ConvenerHealthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)

It makes sense to include Clark County in this community health needs assessment since Vancouver, Washington and Clark County are all part of the same metropolitan region around Portland. The system may be structured a little differently in Washington but it hasnt been a major challenge.- Beth Sanders, Multnomah County Health DepartmentWorking across State LinesHealthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)

Patients living in Washington State are right across the jurisdictional boundary but they get a lot of their services here in Oregon. Clark County is the natural service area of these hospitals and where patients live.- Priscilla Lewis, Providence Health & ServicesDefining CommunityHealthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)

We just live in a very different world. Public health is a very deep expertise. In those areas [the hospitals] are really scrambling to catch up. There have been some really fun conversations where I can see the hospital people getting brain cramps from listening to the epidemiologists. On the public health side, its really fascinating for me to realize how insulated they are from the amount of care, the patient volume, and the dollar volume of care that goes on within the four walls of our hospitals. That sounds sort of nave, but its obvious that we just operate in two very different worlds.- Priscilla Lewis, Providence Health & ServicesSpeaking Two Different LanguagesHealthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)

As the convener, I found it challenging to negotiate between unknowns of what hospitals may think public health is about and what public health thinks hospitals are about. Another challenge is I dont think the partners fully understood the amount of work the epidemiologists would need to do. I just don't think anyone could have known since it is a new type of project. That has been another limitation in this first year.- Christine Sorvari, Multnomah County Health DepartmentChallenges to CollaborationHealthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)

Ive been really pleased with peoples level of commitment. All meetings are very well attended. People are putting in a lot of time outside the meetings. Often times this is additional work to their regular day jobs, so I think the level of commitment and enthusiasm has been somewhat surprising to me and really refreshing.- Priscilla Lewis, Providence Health & ServicesCommitment to the AssessmentHealthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)

Were learning as we go. Everyone is really pleased and there is lots of enthusiasm on both sides. You never know what youre going to learn, or what your successes or challenges might be. But just come to the table and develop a relationship; thats always the first step.- Beth Sanders, Multnomah County Health DepartmentLearning as We GoHealthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)

Beth Sanders, Research AnalystChristine Sorvari, Research AnalystMultnomah County Health DepartmentMultnomah County Health Department

Priscilla Lewis, Executive Director for Community Services & DevelopmentProvidence Health & ServicesMany thanks!Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2013)

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