Health care partnerships improve community benefits programs

Assessments, written plans, networking set stage for quality programs

In 1995, 10 not-for-profit hospitals in the San Gabriel Valley formed a network to meet the requirements of a community benefits bill passed by the California legislature in 1994.

The bill requires that hospitals conduct a formal needs assessment every three years to determine how they will go about meeting the needs of the community. Then they must submit a written implementation plan to the Office of Statewide Health Planning and Development (OSHPD) in Sacramento. While the network helped the San Gabriel Valley hospitals better satisfy the provisions of the legislation, it had a far greater impact. The hospitals shared ideas and information on past mistakes and successes. They identified projects that would be of greater community benefit if done in collaboration among several members of the network. They also designed a method for conducting a formal community needs assessment as a team rather than individually.

The time and resources saved by working together on community outreach education will benefit any patient education manager's budget and schedule, whether similar regulations exist in your state or not.

"In addition to educating ourselves on the legislation, we tried to use our network as an advocacy group. It is difficult for one hospital to get the attention of the department of health services, but as a collective group we have been fairly successful in getting these people to at least meet with us and hear our issues, and to provide some education on how their services work," says Marcia Jackson, MBA, corporate director of planning and marketing at Citrus Valley Health Partners in Covina, and chair of the network group.

The network group organized by Jackson and her partners could be duplicated in any community, she suggests. In addition, health care systems throughout the nation could implement the steps required by the California Senate bill to fine-tune community outreach programs.

"The bill forced hospitals to look at what they were already doing and see how their resources were being spent and how effective they were," explains Elsa Murphy, program manager for OSHPD. "When hospitals develop a community benefits plan, the bill requires that they develop measurable objectives and a time frame."

Although all the nonprofit hospitals had community benefit programs, formal needs assessments revealed that they didn't always completely address the needs of the community. "The formal community needs assessment was eye-opening," says Eileen Diamond, MBA, director of business development at San Gabriel Valley Medical Center in San Gabriel. Using focus groups as part of the assessment process, the health care system uncovered the need for more bilingual education, especially targeting the Chinese community.

As a result, an Asian health education outreach program was developed. The series of classes was offered in two dialects, Mandarin and Cantonese. "The average attendance for health education classes is about 20 to 30 people. We found with this program that 110 to 150 people were enrolling in the classes. We knew we really hit a need," says Diamond.

^{Collaborating to meet community needs}

Written plans help to detail goals and identify partners to ensure that the programs are successful. "Every project we picked for our community benefit plan was a collaboration," says Teri Muse, area director of public affairs for San Gabriel Valley Kaiser Permanente in Baldwin Park. "We knew we couldn't address any of the needs identified in the assessment alone. In order for the needs to be addressed and the programs to be successful, we had to collaborate."

Kaiser looked at the priorities identified in its community needs assessment - health education and prevention, access to primary health care, prenatal care, and coordinating resources - and reviewed its existing partnerships to see whom Kaiser could work with to address these needs.

For example, the health care facility had been giving child immunizations with the school districts, but this functioned as a catch-up effort. When it was time to enroll children in kindergarten, there was a push to complete all immunizations. In the written plan for community benefits based on the findings of the needs assessment now required by law in California, Kaiser identified a course of action to immunize children throughout the year on a scheduled basis and to target preschool children.

To implement the plan, Kaiser provided all the funding to the school district so school staff could track children's immunizations as they participated in the free clinics and send reminder cards to parents when it was time for the next shot. Kaiser also provided nurses on the day the immunization clinic was scheduled and printed flyers promoting the clinics. The county health department donated the vaccine.

The San Gabriel Valley Community Benefits Networking Group provided opportunities for partnerships. By sharing ideas, hospitals were able to work together, says Muse. For example, Citrus Valley Health Partners provided a mobile van for the immunization project. (For more ideas for community partnerships, see story below.)

The network also gave members an opportunity to work together after sharing the information gathered on their needs assessments, which they did individually in 1995. "We presented our needs assessment to each other so we could see where there were areas of duplication and overlap and then figure out where we might work together," says Jackson.

In 1998, the network is conducting its second needs assessment as a group. The group has developed one survey. During the first round each hospital did its own needs assessments through their own mail or telephone surveys. Because service areas overlap, many agencies or organizations received surveys from as many as four health care facilities.

This year, every hospital will submit a list of needs that the network will merge. "The survey will be sent to all the key stakeholders in the San Gabriel Valley, including schools, health and human service agencies, cities, and all people involved in providing services to the community," says Jackson.

A secondary data team is collecting demographic information such as age, sex, income, poverty level, education level, and health statistics such as teen pregnancy and leading causes of hospitalizations. "We will collect the material on the whole San Gabriel Valley and then break the information down by zip code so each health care facility can isolate its service area," says Jackson.