Community health improvement plan

A community health improvement plan is a long-term, systematic effort to address public health problems in a community. It is based on the results of community health assessment activities, and is one step in a process to improve community health. The community health improvement plan is developed collaboratively, and defines a vision for the community’s health; the community health improvement plan is the community’s plan, not the community health board’s plan for the community.

Background
MDH assistance
1. Organize
2. Prioritize issues with partners
3. Formulate goals, strategies, and roles with partners
Review checklist
4. Implement, monitor, and revise with partners
Related national public health accreditation standards
Examples
Further resources

A community health improvement plan guides a community health board, its partners, and its stakeholders on work to improve the health of the population within its jurisdiction. It is critical in developing policies and actions to target health promotion. Government agencies, including those related to health, human services, and education, use the community health improvement plan collaboratively with community partners to set priorities, coordinate, and target resources.

The same broad, community-level partnership established for the community health assessment can guide the community health improvement plan. The community health board or a community partner can lead planning.

All community health boards are encouraged to develop a community health improvement plan that meets national public health standards.

Minnesota community health boards have been required to engage in a community health improvement process since the Local Public Health Act was passed in 1976. In Minnesota, community health boards perform community health assessments for the jurisdictions they serve.

National public health accreditation standards note that the community health improvement plan and the strategic plan are related to and should connect with each other.

MDH has designed all assessment and planning guidance to help community health boards meet national public health standards developed by the Public Health Accreditation Board (PHAB).

Staff from the MDH Center for Public Health Practice can help with parts of the community health improvement plan, including working with coalitions, engaging the broader community and moving from planning to action.. MDH has designed guidance and technical assistance to help community health boards meet national public health standards. To contact MDH, visit: Help and technical assistance.

1a. Revisit planning team and community partnership team

The same community-level partnership that guided the community health assessment can lead the community health improvement planning process, or you may change members to better share workload or highlight different perspectives. Your assessment may have indicated the need for new or different members on your planning team. Discuss membership with your team, to hear their input on expanding the partnership.

Some community health boards use a single team with external partners to guide the plan; others use multiple internal and external groups to guide and enact different parts of the process. Think about how your teams work together or complement each other. Be clear on who drives and coordinates overall project management, and each member’s roles and responsibilities.

Your partnership should have a clear charge or charter document to guide its work. Be sure the process meets partners’ needs, and that they remain engaged. This is a good time to reiterate that the community health improvement plan is the community’s plan for public health, not public health’s plan for the community.

Your team might include:

• CHS administrator/director
• CHS department directors
• CHS supervisors
• Key public health staff
• Hospital or primary care partners
• Community-based organizations
• Schools
• Other county agencies (e.g., social services, public safety, etc.)
• Community members
• Businesses
• Foundations
• Distinct populations (e.g., specific racial/ethnic groups or age groups, persons with disabilities, etc.)

You might also consider:

• Who is missing from our planning table?
• Who will lead the group?
• Do members feel burnt out?
• Does our partnership team include members of the community we are trying to impact?
• What is the decision making power of our partnership related to the CHIP?
• How does our partnership team relate to other groups working on other parts of the community health assessment and planning process?
• How does our group coordinate/work with other community collaboratives?

Download ► Identifying interested parties (DOC)

Resources: Revisit planning team and community partnership team

• Matrix of organized participation and roles within each phase of MAPP (PDF), National Association of County and City Health Officials (NACCHO)
• Organize for success and partnership development, MAPP/NACCHO
• Work together, CDC Community Health Improvement Navigator
• Circles of involvement exercise (PDF), NACCHO
• Resource center for community health assessments and community health improvement plans: Engaging partners, stakeholders, and community members, NACCHO (archived)
• Work together: Key activities: Recruit diverse stakeholders from multiple sectors, County Health Rankings & Roadmaps
• Team blueprint: A tool for building a strong partnership foundation, Center for Creative Leadership (hosted by County Health Rankings & Roadmaps)

1b. Set meetings

A meeting schedule should respect partners’ time commitments. You may need to hold some meetings in the evening or on weekends if community members are involved.

1c. Develop communications

Your communication plan should include the community health improvement plan.

Download ►Communications plan (DOC)

Keeping the partnership’s vision in mind, review your community health assessment to determine the issues to include in your plan.

Previously, the assessment resulted in up to 10 priority health issues; these issues may naturally serve as the base of your plan, but your plan does not need to address all 10, or be limited to these 10 issues. The partnership determines the depth of the plan’s focus on health issues. You may decide to write a plan addressing your top five issues, or one encompassing 15 or 20 issues.

Consider community capacity to implement strategies addressing each priority. Think about team members or community members with roles in each priority area, work they already do in that area, and whether they could contribute additional resources.

Resources: Review priority issues with partners

• Focus on what’s important, County Health Rankings & Roadmaps
• Identify strategic issues, MAPP/NACCHO
• Chapters 17-19: Analyzing community problems and designing and adapting community interventions, University of Kansas Community Tool Box

Determine what you hope to accomplish for each priority issue, how you will measure progress, and how everyone in the community can contribute to community health improvement—through independent action or coordination and collaboration. (These steps are sometimes called an action plan.)

Develop a print report, or one that resides online. Use the review checklist (below) to ensure your community health improvement plan is thorough and follows national standards. This report is the community health improvement plan deliverable your community health board will submit to MDH in spring 2020.

Refer to your communications plan to disseminate your report.

Use the MDH CHIP review checklist, based on national public health accreditation standards and other national resources, to ensure your community health improvement plan is complete.

MDH recommends that community health boards consult Public Health Accreditation Board (PHAB) national standards as a point of reference when engaging in assessment and planning, whether or not they are seeking accreditation. The national standards serve as a guide to demonstrate accountability to stakeholders, improve quality of work, enhance credibility, and increase staff morale. You should note, however, that fulfilling MDH Assessment and Planning requirements does not guarantee meeting PHAB national standards for the purposes of accreditation.

Download ►CHIP review checklist (DOC)

After you complete the community health improvement plan, begin to implement it. Continue to monitor progress, and report progress to the community.

As you monitor and revise the community health improvement plan, adjust it to meet your goals. Be sure to share lessons learned, and celebrate success.

5.2.1(L). A process to develop a community health improvement plan.

Related documentation:

• Community health improvement planning process that included:
  • Broad participation of community partners
  • Information from community health assessments
  • Issues and themes identified by stakeholders in the community
  • Identification of community assets and resources
  • A process to set health priorities

5.2.2(L). Community health improvement plan adopted as a result of the community health improvement planning process.

Related documentation:

• Community health improvement plan that includes:
  • Desired measurable outcomes or indicators of health improvement and priorities for action
  • Policy changes needed to accomplish health objectives
  • Individuals and organizations that have accepted responsibility for implementing strategies
  • Consideration of state and national priorities  

5.2.3. Elements and strategies of the health improvement plan implemented in partnership with others.

Related documentation:

• A process to track actions taken to implement strategies in the community health improvement plan
• Implementation of the plan

5.2.4. Monitor and revise as needed, the strategies in the community health improvement plan in collaboration with broad participation from stakeholders and partners.

Related documentation:

• Report on progress made in implementing strategies in the community health improvement plan
• Review and revision, as necessary, of the health improvement plan strategies based on results of the assessment

Minnesota community health improvement plans

To view a jurisdiction's community health improvement plan, please contact that jurisdiction directly: Find a local health department or community health board.

National community health improvement plans

Through 2016, NACCHO maintained an online Resource Center for Community Health Assessments and Community Health Improvement Plans (now archived). Contained within that site are examples of high quality CHAs and CHIPs created by local public health department demonstration sites from across the country. These sites engaged in a robust community health improvement process that yielded two of the three accreditation prerequisites: a CHA and CHIP.

MDH has highlighted specific national plans at: Community health improvement plan examples.

• Mobilizing for Action through Planning and Partnerships (MAPP), National Association for County and City Health Officials (NACCHO)
• Action center, County Health Rankings and Roadmaps
• Healthy Minnesota 2020: Statewide health improvement framework, MDH
• CHA/CHIP Community of Practice: Join the MDH CHA-CHIP Community of Practice to build capacity around conducting, developing, and implementing a community health assessment (CHA) and community health improvement plan (CHIP).