CDC Childhood Lead Poisoning Primary Prevention Collaboration Pilot

In September 2014, the Centers for Disease Control and Prevention (CDC) awarded Solutions an 18-month project to study how federally tax-exempt nonprofit hospitals could leverage the community benefits requirements in the Patient Protection and Affordable Care Act (ACA) and Internal Revenue Service (IRS) requirements to reduce exposure for children at greatest risk for lead poisoning. Solutions piloted the project with Children’s Mercy Kansas City (Kansas City, Missouri) and provided recommendations and templates for CDC’s future use. The templates address how to integrate environmental health and housing considerations into hospitals’ community health needs assessments (CHNAs), build collaborative partnerships, strengthen community outreach, and engage hospital decision-makers in prioritizing services to assess and improve housing conditions.

Poster_The-Role-of-Hospital-Community-Benefit-Requirements-in-Reducing-Environmental-Health-Disparities [full]

Poster from the 2016 National Healthy Homes Conference.

Solutions’ project team identified barriers in the CHNA process that limited incorporation of data on housing conditions or residential environmental health threats or that reduced engagement of housing experts and community development organizations through several data collection efforts. Team members interviewed representatives responsible for CHNA and community benefits planning from eight nonprofit tax-exempt hospitals. Interview topics included how they engaged hospital decision-makers, collected data or used third-party contractors for data analysis, identified relevant secondary source data, gained input from community groups and governmental agencies, and set CHNA and community benefits spending priorities. Since most of the eight children’s hospitals used third-party consultants to collect and analyze their CHNA data, the team also interviewed representatives of those firms to understand the secondary data sources they used most frequently and why data related to housing, environmental health, and health outcomes such as lead poisoning were not included in their analyses.

Next, Solutions conducted literature searches, analyzed more than 40 published CHNAs and their accompanying Schedule H submissions, and reviewed over 30 national datasets to identify validated measures related to housing, environment, or the health conditions associated with environmental risks that could be included in a CHNA. Solutions found more than 20 different measures and made recommendations to CDC on how it could partner with other federal agencies to promote their use. A number of these measures were included in Children’s Mercy’s CHNA. The case study of the hospital’s community priority setting activities illustrated how the inclusion of these measures raised community awareness of neighborhood needs for housing rehabilitation and home assessments.

Finally, Solutions made recommendations about how to engage hospital decision-makers and develop partnerships that could improve community health outcomes, with examples of successful programs. The Children’s Mercy case study and the document templates serve as national models for other organizations. The Association for Community Health Improvement’s Community Health Assessment Toolkit incorporated some of the project’s recommendations, and the team presented its findings at the NEHA 2016 AEC and HUD Healthy Homes Conference.

Learn More

View Solutions’ and Children’s Mercy’s poster from the 2016 conference here. For more information, contact us.