June 2011 Symposium

Responding to Community Health Needs within the Framework of the Affordable Care Act A one-day, invitational symposium convened on Tuesday, June 28, 2011

The Hilltop Institute sponsored its fifth invitational symposium at which national experts discussed how the Affordable Care Act (ACA) creates a new framework to address community health needs as an essential and integral component of the success of overall health reform. The elements of this framework include forging new community collaboratives that focus on the determinants of population health, using evidence and data to drive interventions and evaluations, and integrating medical and non-medical approaches to improve the health of communities. Health reform, as envisioned and enacted under the ACA, extends beyond the traditional framework of medical innovations and medical care delivery systems covered by insurance to preserve, promote, and protect the health and wellbeing of United States residents. It extends to those non-medical determinants of overall health status as well. This symposium identified opportunities and approaches that are expected to support the new imperative to focus on community health needs under the aegis of the ACA.

This symposium was designed to address current broad-based attempts to advance healthy communities and healthy living, which are less recognized contributions of the ACA than activities such as coverage expansion, health insurance regulation and reform, and changes in medical practice and payment.

The day was divided into four sessions and highlighted by a keynote address, a luncheon address, and concluding reflections. More than 120 people with an interest in this issue—Maryland county health officers; Maryland state agency officials; Maryland legislators; and representatives from federal agencies, local and national foundations, national associations and organizations, and universities—from across the nation attended the event.

Georges C. Benjamin, MD, Executive Director of the American Public Health Association, began the day with his keynote address: Community Health Concerns, A New Paradigm. He stressed that the cost of health care is becoming unaffordable not only to the individual, but also to the nation as a whole, and that we, the public, should not tolerate health disparities. Dr. Benjamin also stressed the need to promote wellness and health and not just focus on sickness. As he pointed out, the ACA is a step in the right direction; it will achieve 94 percent health coverage and cover 32 million more non-elderly individuals when fully implemented in 2014.

Michelle A. Larkin, JD, Assistant Vice President of the Health Group at the Robert Wood Johnson Foundation, gave the luncheon presentation: The Role of Medical and Non-Medical Determinants of Health in Developing Community Health Needs and Health Impact Assessments. In her presentation, she stressed the influence of where we “live, learn, work, and play” on our overall health, and how it is “not just what happens in the doctor’s office.” In fact, Ms. Larkin believes that socio-economic factors are the heaviest predictors of health outcome. She discussed the importance of bringing healthier foods to neighborhoods with low income, as well as the importance of human resources—especially when monetary resources are limited or lacking altogether.

Mary Vallier-Kaplan, MHSA, Vice President and Chief Operating Officer of Endowment for Health, a private health foundation in New Hampshire, wrapped up the day with her reflections: The Role of Community Coalitions in Meeting Community Health Needs. In this discussion, she revisited some of the topics that arose throughout the day and shared some lessons learned from her own experience. Like many of the day’s speakers, she encountered data availability and use issues in New Hampshire, and stated that learning how to apply data obtained from a needs assessment is a learning process and also a key to success. Ms. Vallier-Kaplan pointed out that needs assessments can be expensive and time-consuming, and because of this, action needs to be taken; it is senseless to assess community needs but do nothing about them. She also stressed the need for congruency with the terminology, a focus on the community and not the organizations, and the involvement of local philanthropies.

Other speakers discussed the many roles and responsibilities of community health needs assessments; issues with and policies that affect the availability and use of data; and institutional responses to community health needs. Common themes that emerged throughout the day focused on social, familial, economic, and environmental dimensions of individual and community health, such as the importance to consider education, income, diet, and place of residence when assessing health.

Click on the links below to view the various symposium materials.

Symposium Program

Speaker Biographies

Symposium Pictures