Date of Graduation

Winter 12-16-2016

Document Access

Project/Capstone - Global access

Degree Name

Master of Public Health (MPH)


School of Nursing and Health Professions


The Patient Protection and Affordable Care Act (ACA) added a requirement for nonprofit hospitals to keep their tax-exempt status under the Internal Revenue System Code 501(c) 3. This code requires all nonprofit hospitals to complete Community Health Needs Assessment (CHNA) reports every three years and must include input from community stakeholders and underserved individuals representing the low-income, minority and chronically ill population.

In addition to the CHNA, implementation strategies are required to be executed in the geographic areas served in order to meet the identified prioritized needs from the CHNA. Oftentimes, CHNAs are difficult to conceptualize and operationalize within the general acute care settings, especially in large health care systems. The current landscape calls on healthcare organizations to play an active role in total health for communities. It is important to integrate the necessary stakeholders within the organization and execute on an overarching strategy to provide services to the community.

Kaiser Permanente (KP) has been committed to community health through its mission, vision and values. Beyond that, there is a structure and dedicated public health resources in place for addressing the health needs of the communities served by KP. The national and regional community benefit departments within KP plays an active role in the organization and are often looked to for providing expertise on addressing community health needs.

In the recent past, KP launched a statewide effort to improve the behavioral health program. Senior leadership identified the need to strengthen processes in screening, treating and following up on behavioral health patients. It consisted of community outreach through television campaigns, improving clinic environments, screening in the emergency room, expanding behavioral health resources by way of hiring, etc. Nonetheless, a critical piece was missing - how the organization will serve the non-member population the same way it serves its members.

Although the treatment is intended to be equal for uninsured non-members, there is a difference in follow-up treatment and disposition of the patient due to benefits. In order to close this gap, community partnership and outreach is not only in the best interest of the individual, but also that of the organization. By investing resources and creating active partnerships in the community, KP can reduce costs, contribute significantly to the overall health of communities, and more effectively deliver on its mission.

To achieve this, the hospital must take on a collaborative and active role in screening, treating and catching patients who fall through the cracks and present in the emergency rooms. Patients who present in the emergency rooms have clear needs for follow-up and treatment, whether it is through KP or community health services. Nonetheless, KP should ensure patients have a follow up plan. This paper illustrates how hospitals can play a more active role in community health initiatives. The example presented is that of behavioral health needs in Richmond, California. Behavioral health encompasses mental health and substance use disorders.