Key points
- Different drivers have led health agencies and organizations to institutionalize community health assessment and community health improvement planning in recent years.
National Voluntary Accreditation Requirements
The Public Health Accreditation Board (PHAB) is the national accrediting body for state, tribal, local, and territorial health departments.
The Version 2022 PHAB Standards and Measures encompass 10 domains of performance and include a collaborative process resulting in a comprehensive community health assessment (Domain 1, Standard 1.1) and developing and implementing community health improvement strategies collaboratively (Domain 5, Standard 5.2).
A documented community health assessment and improvement plan, developed collaboratively and dated within the last five years, are required for accreditation.
CDC Grant and State Specific Requirements
CDC grants often require or encourage completing a community health assessment or improvement plan. In some cases, these plans provide valuable information for identifying priority health issues or needs. Examples include:
A number of states, including those listed here, require or support their local health departments to conduct community health assessments and/or improvement plan:
An Examination of State Laws and Policies Regarding Public Health Agency Accreditation Prerequisites contains summary tables of states' mandates and requirements on community health assessments, health improvement plans, and strategic plans.
IRS Requirements for Tax-Exempt Healthcare Facilities
The Patient Protection and Affordable Care Act of 2010 (ACA) revised the federal tax-exempt status requirements for nonprofit hospitals. To claim tax-exempt status, community benefit work must be transparent, concrete, measurable, and both responsive and accountable to identified community need. Therefore, at least once every three years, hospitals must conduct a community health needs assessment and adopt an implementation strategy—often called community benefit, Schedule H, or Form 990, which refer to the required tax forms.
An implementation strategy for a hospital facility is a written plan that addresses each of the significant community health needs identified through a community health needs assessment. A hospital organization must adopt a separate implementation strategy for each hospital facility it operates.
Collaboration between facilities on community health needs assessment and implementation strategy development is encouraged, and implementation strategies submitted by separate facilities may be substantively similar.
The community health needs assessment and the implementation strategy must take into account input from
- At least one state, local, tribal, or regional governmental public health department
- Members of medically underserved, low-income, and minority populations in the community
- Written comments received on the facility's most recent community health needs assessment and implementation strategy
See the Federal Register, the Federal Register, Volume 78, No. 66 [PDF – 320KB] or this IRS website for more information concerning specific requirements.
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