This report describes the ways in which Critical Access Hospitals (CAHs) are engaged with their communities, through analysis of data from a national telephone survey of CAH administrators conducted in 2004. Survey respondents were asked about community involvement activities, including: community needs assessment, outreach and formal health promotion programs, relationships with other community organizations, free or reduced cost health care, and hospital activities in support on special populations.

Key Findings:

• The majority of survey respondents (81%) reported that they have conducted a Community Needs Assessment (CNA).  Forty-nine percent were conducted in the year of or prior to conversion.The decision to convert to a CAH was the most important operational change to result from the CNA in 31 CAHs.
• Almost all CAHs are engaged in health promotion activities, including staffing health information booths, sponsoring health promotion programs, offering health education seminars, or sponsoring or participating in immunization drives.
• Many administrators (35%) obtained external funding for activities such as chronic care management, immunization programs, wellness programs, smoking cessation, prescription drug assistance, and various programs for women and children. Just over one-third of these community outreach and prevention programs involved investment by state governments, and nearly one in five programs were supported by federal funds.
• Free care or medication are particularly important to the low income residents of CAH communities, but only one-fourth of CAHs have free clinics and just under one-third distribute free or reduced cost medications. The most commonly reported free or reduced-cost service was health screenings.