Community Health Needs Assessment (CHNA)

Project Overview

The FY2021 Community Health Needs Assessment was led by a core team comprised of leaders from St. Francis Hospital (SFL), Hillsboro Area Hospital (HAH), Carlinville Area Hospital & Clinics (CAH&C), and facilitated by the Southern Illinois University School of Medicine’s Department of Population Science and Policy (PSP). The entities collaborated on the planning, implementation, and completion of the assessment. 
The three hospitals facilitated several methods of data collection including secondary data analysis, a community advisory council, focus groups, and a community survey. Through these data collection methods, the needs of the community were prioritized as follows 1) access to mental and behavioral health treatment, 2) workforce development, and 3) food insecurity. Barriers and solutions to each of these priority areas were discovered through a community survey and a final report of the findings was shared with the three hospitals.


A Community Health Needs Assessment (CHNA) is a strategic plan developed by hospitals and other healthcare organizations to identify communities served and evaluate residents’ health needs. Provisions in the 2010 Patient Protection and Affordable Care Act state that for hospitals to maintain non-profit status, they must (a) conduct a CHNA report every three years, (b) be publicly accessible, and (c) adopt an implementation strategy based on community health needs identified in the assessment. In addition, a CHNA must consider the needs of the community through the input of persons who appropriately represent the community and their interests. This also includes anyone with greater knowledge and/or expertise in public health initiatives. 

To combine resources and reduce duplicative efforts, this year’s CHNA was a collaborative process between St. Francis Hospital, Hillsboro Area Hospital, and Carlinville Area Hospital & Clinics to target the service areas of Macoupin and Montgomery Counties. The CHNA process began by collecting data from preexisting sources on community demographics, housing, poverty, education, labor, and health. This data was compiled into a presentation by PSP, and recommendations were given around initial priority selection. The hospitals selected the remaining top 14 priorities. Then, the hospitals conducted a Community Advisory Council meeting of stakeholders from Montgomery and Macoupin Counties. This diverse group of 20 individuals ranked the 14 health needs into a list of six total needs.  Then, four focus groups were conducted. The 15 focus group participants were asked to rank their top three from the list of the six priorities. The hospitals’ internal advisory council reviewed the final three priorities and the rankings for the other six priorities. Based on the CHNA planning and development process described, the final community health needs were identified. Finally, an online and paper survey was distributed to the community specifically targeted towards the three priority areas.  An evaluation report was completed for the hospitals using this data so that the information could be used to better inform their evaluation plans. 

Project Lead

Nicole Summers-Gabr

PSP Team Members

Corbin Coniglio, Jessica Cantrall 


HSHS St. Francis Hospital, Hillsboro Area Hospital, and Carlinville Area Hospital & Clinics


To complete a combined 2021 Community Health Needs Assessment and recommendations to help guide implementation for the three collaborating hospitals. 


Access to mental and behavioral health treatment is an essential issue in Montgomery and Macoupin Counties. Mental health is specifically a concern, and responses to the Community Survey demonstrated that major depression was likely in 12.5% of the respondents. There has been some work to address mental and behavioral health in Montgomery and Macoupin Counties, however, it appears from the data that more work in behavioral and mental health care is needed. For example, only 44.7% of respondents reported that their doctor had talked to them about mental health during their last appointment. Not only that, 13.0% of respondents reported that they were unable to get mental or behavioral health treatment in the past year. Out of these participants, 8.1% reported that there was too long of a wait for appointments, 4.0% were unable to find a counselor, 3.6% could not afford to pay their co-pay or deductible, and 3.1% said that they were too embarrassed to seek out mental health counseling.
 Workforce development is another key issue in Montgomery and Macoupin Counties, with 3.7% of respondents reporting that they were unemployed but looking for work. A large proportion of people reported that they worked more than one job (21.1%), with the number of jobs worked ranging from 2 to 5 jobs. The cost of transportation to workplaces in Montgomery and Macoupin Counties may be another prevalent issue. The average commute to work one way is 16.1 miles, but one person reported traveling 90 miles one way for work. Looking for jobs or maintaining jobs required to work remotely may also be a challenge for some Montgomery County and Macoupin County residents. While most residents of the counties had reliable access to the Internet (88.4%) or own a personal computer or laptop (86.7%), there were still residents that did not have access to these technologies (11.6% and 13.3%, respectively). 

Nearly 30% of the survey respondents were somewhat food insecure. Within this group of community members, 2.2% were mildly food insecure, while 12.1% were moderately food insecure, and 13.0% were severely food insecure. Several respondents reported using supplemental nutrition programs, with 15.7% of the respondents reporting that they used food stamps over the past 90 days. Despite the prevalence of food insecurity, 66.3% of respondents said their doctor never talked to them about nutrition at their last appointment. 


Summers-Gabr N and Cantrall (Grim) J. (2021) An Assessment of the quality of community health needs assessments nationwide. Presented at the American Public Health Association Annual Conference in Denver, CO. 


The combined CHNA report can be found on each partner hospital’s website.