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Marshall's Community Health Needs Assessment: a Plan of Care and Action

April 7, 2017 — State law requires California’s not-for-profit hospitals to produce official comparisons between their community’s health needs and available resources to meet them. After conducting extensive community surveys and focus groups, Marshall today released its latest Community Health Needs Assessment (CHNA).

Available at, the 2016 CHNA defines “community” as Marshall’s service area. This includes 17 El Dorado County ZIP codes, from which Marshall Hospital receives its top 80 percent of patients. The CHNA helps guide the hospital’s local health improvement programs and benefit activities. Since Fiscal Year 2013 (when the previous CHNA was completed), Marshall has provided over $251 million to such programs.

For Marshall CEO James Whipple, the CHNA’s scope reflects Marshall’s mission: to improve our community’s health by offering quality, patient-centered health services of superior value.

“I really appreciated the passion of all the community, the providers and other health care services that came together,” he said. “They all not only identified the issues, but also the community-wide commitment to addressing those health problems.”

To that end, the latest CHNA specified:

  • Geographic areas experiencing social inequalities. • Locations of health disparities, alongside the community’s overall health status.
  • Health-influencing factors (such as disease rates, risk behaviors and living conditions).
  • The area’s most significant health needs and the local resources equipped to meet them.

Access to behavioral services was identified as our most significant health need. (No. 2 was safe, crime/violence free communities, followed by active living and healthy eating). As a result, Marshall will expand its base of behavioral health specialists in the coming years.

These efforts will include, but not be limited to, the recruitment of Licensed Clinical Social Workers and Clinical Psychiatrists. We plan to provide more substance abuse prevention and treatment services. Marshall is currently in discussion with the El Dorado Community Health Centers to potentially share such resources between facilities.

The 2013 CHNA also identified limited access to mental health services as a health disparity. In response, the Marshall Foundation for Community Health contributed heavily to preventive mental health services, including Big Brothers Big Sisters of El Dorado County’s “Start Early” program. The Foundation funded Bipolar Insights, a Placerville-based non-profit that supports bipolar disorder patients and their families. The grant went to outreach efforts and scholarships for low-income individuals to attend classes there.

A necessity to conduct a Community Health Needs Assessment dates back to the 1994 passage of Senate Bill 697. That California law’s framework served as a national model for similar provisions in the Affordable Care Act. A 2014 study showed California’s not-for-profit hospitals invest $12 billion annually in their communities.

Marshall is an independent, non-profit community healthcare provider located in the heart of the Sierra Foothills. Marshall includes Marshall Hospital, a fully accredited acute care facility with 125 beds in Placerville; several outpatient facilities in Cameron Park, El Dorado Hills and Georgetown; and many community health and education programs. Marshall has more than 200 physicians and 1,500 employees providing quality healthcare services to more than 180,000 residents of El Dorado County.