Editor’s note: This is the first in a series that examines community health assessments, why they are conducted, and what they tell the community.

UP Health Systems (UPHS) announced the release of its 2022 Community Health Needs Assessments (UPCHNA) on Dec. 8. The stated purpose for the 74-page document is to define priorities for health improvement, creates a collaborative community environment to engage stakeholders, and an open and transparent process to listen and truly understand the health needs of Marquette and Houghton counties, Michigan.

According to the IRS (https://www.irs.gov/charities-non-profits/community-health-needs-assessment-for-charitable-hospital-organizations-section-501r3), Section 501(r)(3)(A) requires a hospital organization to conduct a community health needs assessment (CHNA) every three years and to adopt an implementation strategy to meet the community health needs identified through the CHNA.

In keeping with the IRS law, UPHS conducts its assessment every three years to establish in clear terms “the unique needs of our community, ensures we have the information we need to work towards community health improvement goals, and provides an opportunity to improve coordination between hospital community benefits and other community health initiatives.”

To conduct a CHNA, states the IRS, a hospital facility must complete the following steps:

• Define the community it serves.

• Assess the health needs of that community.

• In assessing the community’s health needs, solicit and take into account input received from persons who represent the broad interests of that community, including those with special knowledge of or expertise in public health.

• Document the CHNA in a written report (CHNA report) that is adopted for the hospital facility by an authorized body of the hospital facility.

• Make the CHNA report widely available to the public.

A hospital facility is considered to have conducted a CHNA on the date it has completed all of these steps, including making the CHNA report widely available to the public.

As stated in the UPHS CHNA, Marquette and Houghton Counties (were) the primary focus of the CHNA due to the service area of UPHS-Marquette. Used as the study area, Marquette and Houghton Counties provided 88% of inpatient discharges from January 1, 2021, through December 31, 2021.

Earlier this year the Western Upper Peninsula Health Department released its own version of the assessment.

The WUPHD stated that the objective of the 2021 Upper Peninsula Community Health Needs Assessment (CHNA) is to gather “accurate, actionable, local information to advance our knowledge of our current health status, our future health needs, and identify our health-related priorities. With the input of community members, this information can be used to generate plans, develop policies, and allocate resources to improve the health of our local communities.”

The Health Department’s CNHA is the result of recommendations of the National Association of County and City Health Officials (NACCHO).

NACCHO encourages local health departments, nonprofit hospitals and community health centers to collaborate on community health needs assessments (CHNA) or community health assessments (CHA), pursuant to the statutory requirement of nonprofit hospitals to conduct a CHNA under the Patient Protection and Affordable Care Act (ACA), as well as accreditation requirements for local health departments under the Public Health Accreditation Board (PHAB). This also fulfills IRS requirements for both hospitals (Section 990 Schedule H, regarding community benefit) and health centers (Section 330).

According to the executive summary of the WUPD’s first CHNA occurred in 2012 and included Baraga, Gogebic, Houghton, Keweenaw, and Ontonagon counties. The process was repeated in 2015, adding Iron County and expanded to include the entire Upper Peninsula in 2018.

Since 2012 the CHNA has expanded to include 42 area local public health departments, health systems, community mental health agencies, and substance abuse services coordinating agencies, which serve Since 2012 the CHNA has expanded to include 42 area local public health departments, health systems, community mental health agencies, and substance abuse services coordinating agencies, which serve the Upper Peninsula of Michigan. The foundation of this CHNA is a resident survey, the Upper Peninsula Community Health Issues and Priorities Survey (UPCHIPS), that was distributed in August 2021. The survey is based on the Behavioral Risk Factor Surveillance System (BRFS) survey conducted annually by the Centers for Disease Control and Prevention (CDC).

While the CHNA published by UPHS consists of 74 pages, the WUPD CHNA contains 458 pages. Among the reasons for the difference is that while UPHS focused on two U.P. counties, the WUPD covers all 15 U.P. counties. At the same time, each organization looked at specific areas of study beneficial to that particular organization, while at the same time, both focused on shared areas of interest.