Or. Admin. R. 410-141-3730

Current through Register Vol. 63, No. 6, June 1, 2024

Section 410-141-3730 - Community Health Assessment and Community Health Improvement Plans

(1) CCOs shall comply with the requirements in ORS 414.627 and 414.629, as well as any requirements specified in the contract regarding the Community Health Assessment (CHA) and the Community Health Improvement Plan (CHP). To the extent a CCO shares all or part of a Service Area, the CCO must develop a shared CHA and CHP with all of the following organizations and entities: local public health authorities, hospitals, other CCOs, and, if a federally recognized tribe has already developed or will develop their own CHA or CHP, CCOs must invite the tribe to participate in the shared CHA and CHP. These entities will be referred to as the Collaborative CHA/CHP Partners. This collaboration shall be documented in the CHA and CHP documents, inclusive of CHP progress reports.

(2) The CCOs' CACs shall oversee, with the Collaborative CHA/CHP Partners, the development of the shared CHA.

(3) In developing and maintaining a CHA, CCOs shall, with the Collaborative CHA/CHP Partners, meaningfully and systematically engage representatives of local and tribal governments, community partners and stakeholders, and critical populations to assess the Community health needs of Contractor's Service Area. The following must be engaged in the CHA process, without limitation:

(a) County and city government representatives;

(b) Federally recognized tribes (if not already collaborating on a shared CHA);

(c) SDOH-E partners, as defined in OAR 410-141-3735;

(d) Local mental health authorities and community mental health programs;

(e) Physical, behavioral, and oral health care providers;

(f) Federally Qualified Health Centers;

(g) Indian Health Care Providers;

(h) Traditional Health Workers;

(i) School nurses, school mental health providers, and other individuals representing child and adolescent health services;

(j) Culturally specific organizations, including Regional Health Equity Coalitions; and

(k) Representatives from populations who are experiencing health and health care disparities.

(4) The CHA must include or identify and analyze at a minimum, all of the following:

(a) The demographics of all of the Communities within Contractor's Service Area, including race, ethnicity, languages spoken, disabilities, age, sex, gender identity, and sexual orientation. CCOs shall work with community organizations and available data sources to obtain information on gender identity and sexual orientation if it is available;

(b) The health status and issues of all the Communities within Contractor's Service Area;

(c) The health disparities among all of the Communities within Contractor's Service Area;

(d) Findings on health indicators, including the leading causes of chronic disease, injury and death within Contractor's Service Area;

(e) Findings on social determinants of health indicators across the four key domains (economic stability, education, neighborhood and built environment, social and community health);

(f) Assets and resources that can be utilized to improve the health of the all of the Communities served within Contractor's Service Area with an emphasis on determining the current status of:

(A) Access to primary prevention resources;

(B) Disproportionate, unmet, health-related needs;

(C) Description of assets within the Community that can be built on to improve the Community's health;

(D) Systems of seamless continuum of care; and

(E) Systems or programs of collaborative governance of community benefit.

(g) Means to promote the health and early intervention in the treatment of children and adolescents within Contractor's Service Area, and whether they are sufficient and effective;

(h) Areas for improvement; and

(i) The persons, organizations, and entities with whom Contractor collaborated and process for collaboration in creating the CHA as such persons, organizations, and entities are identified in Section (2) of this rule.

(5) CCOs and their CACs must develop baseline data on health disparities identified through the CHA process. CCOs and their CACs may collaborate with the Authority in developing this data, which includes health disparities defined by race, ethnicity, language, health literacy, age, disability, gender identity, sexual orientation, behavioral health status, geography, neighborhood and environment, or other factors. This data will be used to identify and prioritize strategies to reduce health disparities in the development of their CHPs.

(6) CCOs shall develop, review, and update its CHA at least every five years (or more often, if so requested by the Authority).

(7) Using the findings documented in their CHAs, including any health disparities data and other reliable data, CCOs shall draft a CHP, which shall serve as a strategic plan for developing a population health and health care system plan to serve the Communities within the CCOs Service Areas. Any Collaborative CHA/CHP Partners from the shared CHA, must collaborate in the development of a shared CHP. The CCOs' CACs are responsible for adopting CHPs.

(8) In developing a CHP, CCOs shall, with the Collaborative CHA/CHP Partners, meaningfully and systematically engage representatives of local and tribal governments, community partners and stakeholders, and critical populations. The following must be engaged in the CHP process, without limitation:

(a) County and city government representatives;

(b) Federally recognized tribes (if not already collaborating on a shared CHA);

(c) SDOH-E partners, as defined in OAR 410-141-3735;

(d) Local mental health authorities and community mental health programs;

(e) Physical, behavioral, and oral health care providers;

(f) Federally Qualified Health Centers;

(g) Indian Health Care Providers;

(h) Traditional Health Workers;

(i) School nurses, school mental health providers, and other individuals representing child and adolescent health services;

(j) Culturally specific organizations, including Regional Health Equity Coalitions; and

(k) Representatives from populations who are experiencing health and health care disparities.

(9) A CHP adopted by a CAC shall describe the health priority goals and strategies that will govern the activities and services the CCO will implement in order to address the population health needs and resources of the Community.

(a) CHP health priority goals are intended to improve the Community's health, and may include, without limitation, issues related to:

(A) Closing the gap on disproportionate, unmet, health-related needs;

(B) Creating access to primary prevention;

(C) Building a system of seamless continuum of care;

(D) Building on current Community resources and improving Community capacity to improve health or address SDOH-E, or both; and

(E) Engaging the Community in the implementation of the CHP.

(b) The CHP strategies should be based on research and may include, without limitation:

(A) Developing a or supporting Health Policy that supports the CHP goals and objectives;

(B) Implementing or supporting community health or SDOH-E interventions, or both, to support the CHP goals and objectives, with emphasis on evidence-based interventions as available;

(C) Developing public and private resources and capacities;

(D) Designing and building a system of Integrated service delivery;

(E) Developing and implementing best practices of culturally and linguistically appropriate care and service delivery.

(c) The CHP shall include metrics or indicators used to monitor progress toward CHP goals and strategies;

(d) The CHP must also address, with the input of school nurses, school mental health providers, and other individuals representing child and adolescent health services, the needs of adolescents and children in a CCO's Service Area and must address:

(A) Findings based on research, including adverse childhood experiences;

(B) The adequacy of existing school-based health center (SBHC) networks and make recommendations relating to the improvement of, and undertake efforts that will ensure, SBHC networks meet the specific health care needs of children and adolescents in the Community;

(C) The integration of all services provided to meet the needs of children, adolescents, and families; and

(D) Primary care, behavioral and oral health, promotion of health and prevention, and early intervention in the treatment of children and adolescents.

(10) In addition, CACs shall annually publish a CHP progress report that evaluates and describes progress towards advancing CHP goals and strategies, addressing health disparities, and improving health equity. Progress reports will be submitted in the manner and form proscribed by OHA.

Or. Admin. R. 410-141-3730

DMAP 56-2019, adopt filed 12/17/2019, effective 1/1/2020; DMAP 62-2020, amend filed 12/16/2020, effective 1/1/2021; DMAP 80-2022, minor correction filed 09/30/2022, effective 9/30/2022

Statutory/Other Authority: ORS 413.042, 414.615, 414.625, 414.635 & 414.651

Statutes/Other Implemented: ORS 414.610 - 414.685