ODH alignment recommendations for 2019 CHNA process



Ohio Department of Health (ODH) alignment recommendations apply to each tax-exempt hospital, defined as a nonprofit or government-owned hospital, that is exempt from income tax under section 501(c)(3) of the Internal Revenue Code and that under federal law is a hospital organization required to meet Community Health Needs Assessment (CHNA) requirements. No later than October 1, 2020, each tax-exempt hospital must submit a CHNA and related implementation strategy covering years 2020 through 2022 to the ODH. This means that all tax-exempt hospitals must complete a CHNA in 2019 and adopt an implementation strategy covering 2020 through 2022.                                    


Local health departments and tax-exempt hospitals are strongly encouraged to collaborate with a broad range of community partners to identify local health priorities and implement strategies that will contribute to improving the health status of the community. Collaboration should occur at the county level, at a minimum, to conduct a community health assessment to be shared among all partners. Local health departments and tax-exempt hospitals should be the lead partners in the process with suggested participation from the following:

  • Federally qualified health centers (FQHC)

  • Rural health clinics

  • Healthcare providers

  • Alcohol Drug and Mental Health Boards (ADAMH)

  • Health plans

  • Schools

  • Employers

  • Governmental and nongovernmental agencies

  • Businesses


The Ohio 2016 State Health Assessment (SHA) and Ohio 2017-2019 State Health Improvement Plan (SHIP) provide information on Ohio’s population health status, health need priorities and strategies to address health needs. The SHA can be used as a data source in assessing a local community’s health needs. The SHIP provides evidence-based strategies and outcome indicators that can be used as a foundation for implementation strategies.

Local health departments and tax-exempt hospitals are encouraged to select at least two priority topic areas from the SHIP to address in the community health improvement plan (CHIP) and hospital implementation strategy. The priority topics identified in the Ohio 2017-2019 SHIP are:

  • Mental health and addiction

  • Chronic disease

  • Maternal and infant health 

For each priority topic selected, hospitals are encouraged to choose at least one priority outcome indicator, at least one strategy to implement and one related indicator to measure impact.

For a stronger plan, hospitals should consider selecting at least one strategy to implement and one related indicator to measure impact from each of the following cross-cutting factors:

  • Social determinants of health – conditions in the social, economic and physical environment that affect health and quality of life

  • Public health system, prevention and  health behaviors – organizations working to promote health and prevent disease and injury and actions that people take to stay healthy

  • Healthcare system and access – systems that pay for and deliver services and timely use of services for best health outcomes

Some SHIP strategies can be used to address all priority outcomes. Examples of these strategies include school-based health centers, healthy food initiatives, and screening and treatment services.

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