Under Program Area 3, the Federal Office of Rural Health Policy set forth three areas in which State Flex Programs (SFPs) could aim to build Critical Access Hospital (CAH) capacity to improve community health outcomes: community health needs assessments, community strategic planning, and CAH engagement with stakeholders to address specific health needs. In this project, the Flex Monitoring Team will categorize proposed activities and evaluate their implementation using measures suggested by the SFPs, in addition to identifying a core set of outcome measures to assess the impact of the program activities on community health outcomes.