The 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.

  • Engage community members in the health of their rural communities.
  • 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. View a list of Montana's Critical Access Hospitals

MORH has generated implementation plans at minimal/no charge* on behalf of more than 25 facilities who have completed the CHSD assessment process since the passage of the Affordable Care Act in March 2010.

*Based on availability of funding through the Montana Health Research and Education Foundation (MHREF) Rural Hospital Flexibility Grant.

Currently, the CHSD process is being utilized by the 25 hospitals involved in the Frontier Medicine Better Health Partnership (FMBHP) project in Montana. Information about MORH’s work on behalf of the FMBHP project is included below. Please visit the FMBHP website for more information.

  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