STEP I: Self-Assessing Organizational Capacity

__ Public Health Administrator (PHA) reviews with IPLAN Coordinator (if other than PHA) the Organizational Capacity Self-Assessment to determine the completeness of the previous assessment, the current relevancy of the plan and how the plan can be strengthened.

__ PHA meets with senior staff and Chairperson of Community Health Committee to discuss the Organizational Capacity Self-Assessment review and inform the group that the IPLAN process will be conducted for recertification purposes.

__ When the analysis of the Organizational Capacity Self-Assessment is completed, the PHA should submit report to the local board of health for review. A letter from the local board of health acknowledging the review of the Organizational Capacity Self-Assessment is required for the recertification application.

Tools: Self-Assessing Organizational Capacity

STEP 2: Convening the Community Health Committee

__ PHA or IPLAN Coordinator should bring together the Community Health Committee for the purpose of conducting a community health needs assessment and developing a community health plan. Community participation should include, but not be limited to, involvement by representatives from the following constituencies: ethnic and racial groups, the medical and hospital communities, mental health and social service organizations, the cooperative extension service, schools, law enforcement organizations, voluntary organizations, the faith community, the business community, economic development, unions, and senior citizens, as appropriate.

__ PHA or IPLAN Coordinator should orient Community Health Committee to the IPLAN process, including: history of IPLAN; certification requirements; examination of indicator categories contained in the IPLAN data system; explanation of criteria for determining health priorities; and a brief overview of the previous activities under the first community health needs assessment and community health plan. Provide and explain the function of the APEXPH forms designed to assist in conducting community health needs assessments and planning activities, including: Health Problem Analysis Worksheet, Community Health Plan: Worksheet, and Community Health Plan (Appendix B).

Tools: Convening the Community Health Committee

STEP 3: Analysis of Health Priorities and Health Data

__ Using the IPLAN Data System, version 3.0, run summary reports for jurisdiction through 1995 (1996, if available). Examine each indicator category, including: 1) demographic and socioeconomic characteristics; 2) general health and access to care; 3) maternal and child health; 4) chronic disease, including cancer incidence; 5) infectious disease; 6) environmental, occupational, and injury control; and 7) sentinel events. Gather any other jurisdictional health-related data, including information from the Behavioral Risk Factor Surveillance Survey (county-level, if available), Illinois Hospital and HealthSystems Association's Community Health Information System (CHIS), Illinois State Board of Education's Youth Risk Behavior Survey, maternal and child health reports, voluntary organizations (i.e., American Cancer Society), police reports, etc. to develop community health profile, as appropriate.

__ Analyze the community health profile focusing on issues pertaining to health status and determine if a health problem exists. The APEXPH definition of a health problem is "a situation or condition of people which is considered undesirable, is likely to exist in the future, and is measured as death, disease, or disability."

__ Examine health priorities selected in the first round of IPLAN and any other indicators that appear to reflect undesirable levels. Choose the most reliable mortality and morbidity statistics (e.g., incidences or rates) for making comparisons (see page 48, IPLAN Unit I Manual). Note: The IPLAN Data System does not provide post-1990 age-adjusted rates because of the unreliability of intercensal population estimates. Using the formula for percent change (see page 35, IPLAN Unit I Manual), assess whether there has been a rate increase or decrease in the identified health priority.

__ Present the results of the analysis to the Committee and explain the source and meaning of the data.

__ Solicit input from the Committee on their perceptions of additional community health problems and ascertain if data or anecdotal reports are available to verify the perceived health problems.

Tools: Analysis of Health Priorities and Health Data

STEP 4: Prioritize Community Health Problems

__ Select and utilize a prioritization process which best meets the needs of your Committee (see Appendix A: Narrative of Prioritization Methods, IPLAN Unit I Manual).

__ Determine if there is a need to retain or change the health priorities, and if additional health priorities should be added to community health plan.

Tools: Prioritize Community Health Problems

STEP 5: Conduct Detailed Analysis of Community Health Problems

__ Obtain information on health problem risk factors, including direct and indirect contributing factors and enter on Health Problem Analysis Worksheet.

__ Discuss with the Committee the importance of determining risk factors associated with health problems and the ability to develop outcome and impact objectives and proven intervention strategies that will affect the health priorities.

__ Summarize the analysis of each health problem on the Community Health Plan Worksheet.

__ Prepare the Community Health Needs Assessment document that contains the following:

• A statement of purpose of the community health needs assessment that includes a description of how the assessment will be used to improve health in the community;
• A description of the community participation process, a list of community groups involved in the process, and method for establishing priorities;
• A description of the health status and health problems most meaningful for the community in the data groupings contained in the IPLAN Data System; and
• A description of the process and outcomes of setting priorities.

Tools: Conduct Detailed Analysis of Community Health Problems

STEP 6: Inventory Community Health Resources

__ Inventory current and potential community assets that might be useful in reducing the level of factors that indirectly contribute to the health problems identified by the Committee. Stress the importance of community ownership of problems and its responsibility to change the conditions that contribute to the problem.

__ Identify barriers to reducing direct and indirect contributing factors.

__ Summarize the information on resources and barriers on the Community Health Plan Worksheet.

Tools: Inventory Community Health Resources

STEP 7: Develop a Community Health Plan

__ For each problem selected, identify corrective actions that will reduce the contributing factors identified on the Community Health Plan Worksheet.

__ Prepare the Community Health Plan by including:

• A statement of purpose of the community health plan that includes how the plan will be used to improve the health of the community;
• A description of the process used to develop the Community Health Plan;
• A description of each priority including the importance of the priority health need, summarized data and information on which the priority is based, the relationship of the priority to Healthy People 2000 National Health Objectives and subsequent revisions and factors influencing the level of the problem (e.g., risk factors, direct and indirect contributing factors);
• At least one measurable outcome objective covering a five-year time frame related to each priority health need;
• At least one measurable impact objective with intermediate time frame (i.e., 2 to 3 years) related to each outcome objective; and
• At least one proven intervention strategy to address each impact objective. The description should include a discussion of the community resources that will contribute to implementation, estimated funding needed for implementation, and anticipated sources of funding; and
• An evaluation plan describing how progress in achieving the outcome and impact objectives and the effectiveness of the intervention strategy will be assessed.

Tools: Develop a Community Health Plan

STEP 8: IPLAN submission check list to be submitted to IPLAN Administrator at DPH.IPLAN@Illinois.gov

1. Certification Application via LHD Certification Application
2. Electronic version of IPLAN (Community Health Needs Assessment and Community Health Improvement Plan)
1. IPLAN must include page numbers and table of contents
2. We require a Board of Health (BOH) approval letter signed and dated of:
1. The IPLAN approval (dated and signed by your BOH president or representative) and
2. A letter stating that the BOH has seen the Organizational Self-Assessment Plan
3. Both of these BOH approval documents can be combined in one letter.
3. Please keep your organizational Self-Assessment Plan for your records, we do not require a copy
3. IPLAN substantial compliance evaluation
1. LHD completes
• LHD Name (on first page)
• Health Priorities (on first and as applicable for pages 3-6)
• Page numbers for substantial compliance review (if there is something missing LHD will provide comments to why ie: data not available?)
4. Applicable new Personnel Information Form (PIF) ie change in personnel
5. Any applicable LHD change requests: ie name changes, contact information and or updates to the LHD directory, please send a formal notice on your LHD letter head, signed, dated and addressed to IPLAN Admin re: change request with justification for need submitted to DPH.IPLAN@Illinois.gov

Extension requests:Per 600.210(d) of the Certified Local Health Department Code if you need to utilize an extension please send a formal notice on your LHD letter head, signed, dated and addressed to IPLAN Admin listing qualified justification for need of extension and submit to DPH.IPLAN@Illinois.gov

Within sixty days of receipt by the Department of the LHD's IPLAN Recertification Application, the Division of Health Data and Policy will review and approve (if in compliance) the Community Health Needs Assessment and Community Health Plan and notify the LHD that the requirements under Title 77 Illinois Administrative Code, Section 600.400 or 600.410 have been satisfied. Notification of compliance will also be sent to the Department's Regional Health Officer.

Technical assistance is available for the LHDs by Department staff from the:

• Division of Health Data and Policy (217-785-1064)
• Illinois Center for Health Statistics (217-785-1064)
• Division of Epidemiologic Studies (217-785-1873)
• Division of Chronic Disease Prevention and Control (217-785-2060)
• Division of Health Promotion and Health Education (217-785-2060)
• State/Local Liaison Unit (217-785-4357)

1. Turnock, B.J., Handler, A., Hall, W., Lenihan, D.P., and Vaughn, E. (1995). Capacity-building influences on Illinois local health departments. Journal of Public Health Management Practice, 1(3), 50-58.

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