Rural Development News-Summer 1998

Ohio’s Community Health Systems Development Process

In June 1996, the North Central Regional Center for Rural Development sponsored the Rural Health Community Development Academy held in Duluth, Minnesota. Seven state and community teams attended the training representing Arkansas, Kansas, Minnesota, Missouri, Ohio, Washington and West Virginia. The Academy was an initiative to develop and implement community-based efforts to support the development of community health systems in rural communities. Funding for the effort was provided by Pharmacia and Upjohn, Inc., the National Rural Health Association, the United States Department of Agriculture/CSREES, and the Department of Health and Human Services’ Bureau of Primary Care and Office of Rural Health Policy. The curriculum was developed and presented by Mountain States Group and followed the Community Solutions for Rural Health model, which had been developed a year earlier, involving 17 communities designated by the Empowerment Zone/Enterprise Community program as Champion Communities. Technical assistance to the communities was provided by the Apostle Islands Group and evaluation was conducted by the Northeast Regional Center for Rural Development. Ohio’s team, focusing on Perry County, has enjoyed considerable success and has expanded the program into other Ohio communities. Adriana Pust with the Office of Rural Health, Ohio Department of Health, coordinated the state team’s efforts in Perry County.

Ohio's Primary Care & Rural Health Program is taking a leadership role in improving, sustaining and strengthening the health care systems of Ohio communities through a Community Health Systems Development process involving comprehensive data assessment, prioritizing community needs and developing community-based solutions. The process is unique because while the PC&RHP provides technical assistance to communities, it is community residents themselves who drive and control the process.

The ultimate goal of CHSD is to enable communities to improve their capacity to address their health care needs. This goal is in close alignment with the PC&RHP mission in that both work to address the problem of inadequate health care access to quality health care services among underserved Ohio populations by striving to improve health care infrastructures and coordination among health care providers.

An integral piece of the CHSD process will be the involvement of Americorps*VISTA (Volunteers In Service to America) members who will be assigned to serve as local facilitators for the duration of each community project. The Americorps*VISTA members will work with community residents, organizations and health care providers in identifying health needs and potential approaches to better meeting those needs.

Part of the Americorps National Service Network, Americorps*VISTA is a full-time, year-long volunteer program. Men and women at least 18 years of age are assigned to local sponsors and commit themselves to increasing the capability of low-income people to improve the conditions of their own lives. They share their skill and experience and play a valuable role in the community problem-solving process while focusing on mobilizing community resources and increasing the capacity of the community to solve its own problems.

The Americorps*VISTA members who facilitate the CHSD process will ensure that communities are provided the opportunity to be involved in comprehensive data assessment and community health decision making. The members will encourage diverse and inclusive community involvement so that sustainable community solutions to local health care delivery issues are developed. Using a structured community development process, the members will provide a means of:

• Involving residents in community health assessment.
• Involving community members in data needs assessment.
• Bringing residents and health care providers together to improve health status and the health care system.
• Developing community-based solutions to address the issues within the socioeconomic boundaries of the communities.

The CHSD process originated with the combination of the resources and experience from the State Office of Rural Health and the State Systems Development Initiative, which are both housed within the PC&RHP. The PC&RHP has dedicated a large portion of its resources for the past year to a community health development process in Perry County, Ohio. The current expansion efforts of the upcoming CHSD process will build on the lessons learned from this experience.

The Perry County citizen group is now in the midst of assessing its community health needs and resources. Community meetings are being conducted to obtain comprehensive feedback on the need for health care services. Once this feedback is collected, the community needs will be prioritized. Action plans will then be developed with sustainable goals that build on existing community strengths and resources.

Six communities will be selected to participate in the upcoming CHSD process. All 142 Local Health Departments in Ohio were invited in early March to submit an application to participate. In order to meet eligibility requirements, applicants must have a population base of less than 50,000 residents, have at least two collaborative partners, and demonstrate the ability to partner with community organizations and citizens for the purpose of developing a community health plan.

After communities receive notification of their awards in late April, they will be responsible for recruiting a local community resident to serve as the Americorps*VISTA member who will commit to a year of service after a swearing-in ceremony in June.

In addition to receiving an Americorps*VISTA member, communities will be awarded a $5,000 grant in addition to a possible $5,000 continuation award. Comprehensive training and technical assistance will be provided throughout the project by the PC&RHP staff. The technical assistance offered will include topics such as using data sources, conducting community health assessments, building community coalitions, facilitating groups, developing and evaluating goals and objectives, and writing grants.

This technical assistance will serve to enable Ohio communities with the necessary support and resources to develop a community health plan through community ownership and involvement, with the end result being a community that takes charge of its health care system.

Submitted by Adriana Pust. For further information please contact the Primary Care & Rural Health Program, Ohio Department of Health, (614) 644-8508.

Reprinted from ASTHO Report, Vol. 6 No. 12, March-April 1998.

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