BridgeThe Community Health Services Development (CHSD) project is a community health needs assessment process that helps Montana Critical Access Hospitals (CAHs) engage members of their rural community, identify and measure the community’s health needs, recognize potential gaps in healthcare services, and develop specific strategies to prioritize and address the health needs that were identified during the CHSD process.

CHSD involves a steering committee to actively engage community members, a random sample mailed survey, local focus groups and key informant interviews, and an implementation planning process with the hospital’s leadership team. In recent years, the CHSD process has been modified to comply with the IRS 990 Schedule H requirements for CAHs to provide community benefit to their service area. To date, over 40 communities in Montana have used the CHSD process to conduct a community health needs assessment to inform their hospitals’ community benefit plan and improve the overall health of their community.

CHSD Philosophy:

  • Healthcare is a local affair.
  • Healthcare delivered in rural communities is affordable, high quality, and necessary to the good health of the entire community.
  • Citizens of rural communities/counties should take responsibility for the health of the community.
  • Effective problem-solving by communities is the most important factor in the survival of rural health services.  

A community health needs assessment (CHNA) is a systematic process that involves the community to identify and analyze community health needs and assets. The process also involves prioritizing needs and laying the groundwork for action to address unmet community health needs. 

The CHSD process assists rural hospitals in conducting a meaningful CHNA, helping the facility to achieve various objectives, such as: 

  • Accountability
  • Community Input/Engagement
  • Assessing Social Determinants of Health
  • Health service and delivery planning
  • Gather real-time information about rural health in Montana.
  • Identify specific priorities of health needs and access to services for rural communities in Montana.
  • Help Critical Access Hospitals (CAHs) fulfill IRS 990 Schedule H reporting requirements to develop a community benefit plan and maintain nonprofit, tax-exempt status.

MORH has partnered with 45 of the 48 Critical Access Hospitals in Montana in conducting their CHNA and implementation plans.  Many facilities having completed the CHSD process multiple times. 

View the most current aggregate report on CHNAs and implementation plans here. 

View infographic here. 


  CHSD Data Hub:

  1. An interactive map displaying the top needs found in each community by hospital and public health department, in addition to health and wellness resources across the state.
  2. Archived  CHSD data: view Community Health Needs Assessments, Implementation Plans, secondary data sets by county, and our Montana Aggregate Report. 
  3.  Opportunities for Collaboration: View our resource map and resource table to learn about potential stakeholders in your community with similar health improvement goals.


CHSD Data Hub

CHSD Data Hub