Community Health Assessments and Improvement Plans

The comprehensive community health improvement process includes two major phases: a CHA and a CHIP. The CHA and CHIP are rooted in the principles of health equity and community engagement. They help identify and address priority health issues in a community.

The CHA refers to a state, tribal, local, or territorial health assessment that identifies critical health needs and other issues through data collection and analysis.

The CHIP uses the results of the CHA to develop, with the help of community partners, a long-term plan to address public health concerns in a community.

Since 1993, Wisconsin State Statutes have required Wisconsin communities to develop and implement local health plans to address health conditions affecting their residents advancing the health and wellbeing of their communities.

Local health departments are required by Wis. Stat. ch. 251.05 to:

• Regularly and systematically collect, assemble, analyze, and make available information on the health of the community; including statistics on health status, community health needs, and epidemiological and other studies of health problems.
• Develop public health policies and procedures for the community.
• Involve key policymakers and the general public in determining and developing a community health improvement plan that includes actions to implement the services and functions specified under Wis Stat. § 250.
• Submit data, as requested, to the local public health data system established by the department.

Additional requirements in CHAs and CHIPs are found in Wis. Admin. Code ch. DHS 140.04.

Under the authority of Wis. Stat. § 251.20(1) and Wis. Admin. Code Ch. DHS 140, the Department of Health Services (DHS), Division of Public Health, must formally review operations of all local health departments. The Division of Public Health conducts reviews of local health departments at least every five years to verify that a minimum level of public health services is provided or arranged for throughout the state. The division also designates health departments serving residents above the minimum as Level II or Level III health departments. More information can be found on the Wisconsin Local Public Health: Requirement Updates page.

The State Health Assessment (SHA) and State Health Improvement Plan (SHIP) can be a helpful resource to support the development of CHAs and CHIPs.

The CHA could be framed around the same kinds of qualitative and quantitative data and indicators as the SHA, including information on local, state, and national social and economic, morbidity, mortality, and health behavior indicators.

Priority areas, strategies, actions, and metrics for the CHIP could be organized similarly as in the SHIP, particularly where natural alignment already exists.

Community data could also be compared to the national Healthy People objectives.

Just like CHAs and CHIPs have requirements of Wis. Admin. Code ch. DHS 140, which specifies the required services for Levels I, II, and III local health departments, these foundational documents are requirements of national public health accreditation and are included in the PHAB standards and measures for both initial accreditation and reaccreditation.

Per best practice and PHAB requirements, the CHA and CHIP processes are completed at least every five years.

The requirements for CHA documents are outlined in Domain 1, Standard 1.1 for both initial accreditation and reaccreditation in the PHAB Standards and Measures Version 2022.

The requirements for CHIP documents are outlined in Domain 5, Standard 2.2 for initial accreditation and Domain 5, Standard 2.1 for reaccreditation in the PHAB Standards and Measures Version 2022.

The National Association of County and City Health Officials (NACCHO) provides the following resource:

NACCHO Mobilizing for Action through Planning and Partnerships

The completion of a CHA and CHIP is an extensive process of community engagement and data collection. Data collection includes both primary and secondary data and both quantitative and qualitative data.

The CHA-CHIP Indicator List (Excel) is a curated collection of state, federal, and other data sources that provides public health practitioners with a guide for finding available secondary data for CHAs-CHIPs and other data needs.

The goal of this list is to make finding and accessing secondary data easier, which preserves staff capacity for focusing on other elements of the CHA-CHIP process (for example, primary data collection and community engagement).

The Indicator List is intended to be comprehensive, which means there are many more indicators included in this list than would be relevant or required for any single CHA-CHIP. Many public health practitioners may find it useful to choose a subset of indicators from this list for their CHA based on community input highlighted in the primary qualitative or quantitative data they have collected.

View the accompanying Frequently Asked Questions (PDF) document for more details on how to use the CHA-CHIP Indicator list.

Division of Public Health resources that may be helpful in CHAs can be found on the City, County and Regional Data page.

Dodge-Jefferson Healthier Community Partnership Community Health Needs Assessment 2022 (PDF)

Manitowoc County Community Health Assessment 2022 (PDF)

North Shore Health Department CHA 2022-2026 (PDF)

Outagamie County Health Department Community Health Assessment 2021

Waukesha County Health Department CHA 2022 (PDF)

Brown County Public Health Community Health Improvement Plan 2022-2024

Eau Claire City-County Health Department Community Health Improvement Plan 2021-2024

Florence County Health Department CHIP 2020-2025 (PDF)

Green County Public Health CHIP 2022-2022

Pierce and St. Croix Healthier Together Community Health Needs Assessment and Community Health Improvement Plan 2023-2025 (PDF)

West Allis Health Department and West Milwaukee CHIP 2023-2027