Montana AHEC & Office of Rural Health

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Health Information
P.O. Box 170520
Bozeman, MT 59717-0520

Tel: (406) 994-6002
Fax: (406) 994-5653
Location: 302 Culbertson

Director:
Kristin Juliar
(406) 994-6003
kjuliar@montana.edu

> Health Information > Montana Office of Rural Health

Community Health Services Development

The CHSD Program focuses on providing technical assistance to Critical Access Hospitals (CAHs) as a means of improving, maintaining and stabilizing these small rural facilities.

History
In 1983, the University of Washington School of Medicine initiated the Rural Hospital Project (RHP). This was a regionalized demonstration project designed to restructure the services provided by rural hospitals in the WAMI (Wyoming joined in 1996) states (Washington, Alaska, Montana, Idaho). The purpose of the RHP was to demonstrate ways rural hospitals in the WAMI states could assess and modify their financial structure - and - the types, quantity, and quality of services provided in the community. This demonstration project was funded by the W.K. Kellogg Foundation and involved 6 hospitals in the WAMI states.

The Community Health Services Development (CHSD) project evolved as a follow-up of the W.K. Kellogg Foundation Rural Hospital Project (RHP). The RHP provided a conceptual framework for development of CHSD. CHSD was one of the first community-based outreach programs of the University of Washington School of Medicine (UWSM). The two most visible partners in CHSD were the UWSM Department of Family Medicine and the Regional WAMI Area Health Education Centers (AHECs). The CHSD program was initiated in 1987 at approximately the same time the Montana Office of Rural Health was started at Montana State University.

CHSD Description
The purpose served by the CHSD Program is to provide technical assistance to rural communities; especially assistance with stabilization of health care delivery systems.
In most instances, the assistance given has been in the form of conducting community-based surveys, analyzing survey data, presenting survey data to the community - or a board of trustees - and facilitating strategic planning. The purpose of developing strategic plans for these facilities and in these counties is to provide guidance in addressing previous and current problems and to maintain quality health care delivery systems to serve the continuing and future needs of the community.

The CHSD Program promotes the following: (a) health care is a local affair, (b) health care delivered in rural communities is affordable, high quality, and necessary to the good health of the entire community, (c) citizens of rural communities/counties should take responsibility for the health of the community, and (d) most communities face a larger number and greater array of issues than usually acknowledged, (e) adequate dollars exist to maintain local health care delivery systems and (f) effective problem-solving by communities is the most important factor to the survival of rural health care services. Delivering services offered through the CHSD Program usually includes a multi-step process including: (a) organization, (b) analysis, (c) planning, (d) implementation of plan, (e) governance education and (f) follow-up.
The program is funded through the Montana Healthcare Research and Education Foundation (MHREF) and the Montana Office of Rural Health (MORH).

Communities Participating in CHSD
2011