Amanda Freshley and Emma Cho presented the 2024 Addison County Community Health Needs Assessment (CHNA) at the Addison County Regional Planning Commission meeting on Nov. 13, saying the report identifies health care access, housing and mental health/substance-use services as the three priorities the community will target in the next three-year Community Health Improvement Plan (CHIP).

Freshley, a senior community health liaison who works at the Health Network and Porter, said the CHNA used a mixed-methods approach—an online and in-person community survey, secondary datasets and focus groups—and yielded more than 1,000 completed survey responses, up from roughly 700 in the prior cycle. “The community health needs assessment is an IRS requirement under the Affordable Care Act,” Freshley said, explaining the hospital-driven process that feeds the CHIP and local planning efforts.

The assessment identified six high-level priorities; county stakeholders narrowed the upcoming CHIP work plan to three: improving health care access, expanding housing options and addressing mental health and substance use. On health care access, presenters reported community requests for more primary care availability, appointments outside standard business hours, shorter wait times and services that are low- or no-cost to patients. Secondary data in the report showed declines in some preventive services (for example mammography and certain childhood screenings), and residents described transportation and provider turnover as recurring barriers to care.

On housing, presenters said survey results and county housing data show substantial affordability pressure: more than 43 percent of respondents disagreed that they could find affordable housing, and state data show many renters are cost-burdened (about 26 percent paying 50 percent or more of income for housing). The CHNA highlights the need for a range of housing types—apartments to single-family units—and specialized options, including sober living, respite care, housing for older adults and housing designed to serve people with criminal records.

The CHNA also reports behavioral-health access gaps: Freshley said over a fifth of survey respondents disagreed they could get mental health services, and more than a quarter said they could not access substance-use treatment. Focus-group participants described trouble accessing crisis services and long waits for inpatient beds; presenters shared a recent tally of patients waiting in Vermont emergency departments for behavioral-health placement to underscore the point.

Presenters emphasized equity and the social determinants of health as organizing frameworks for the CHNA. Emma Cho of the Vermont Department of Health said the assessment looked for where opportunities to improve equity exist and noted the role of place-based factors—housing, transportation, language access and social connection—in shaping health outcomes.

Freshley and Cho outlined next steps: sharing detailed findings publicly, helping partners use the CHNA for grant applications and program planning, and convening community partners to draft the CHIP. The presenters said additional data and chapters are available in the full report (print copies were offered and the report is available online), and they invited commission members to contact them for more information or to participate in upcoming CHIP planning work.

The commission discussion included methodological questions about the CHNA’s data-collection window (survey fielded in May with focus groups the following month) and whether recent changes to a motel program for housing people experiencing homelessness affected findings; presenters said their outreach strategy included incentives (Charterhouse-distributed $20 gift cards) to broaden participation and said a January point‑in‑time count will offer another comparison point.

The commission took no formal action on the CHNA at the meeting; presenters said they will begin convening partners to translate findings into an action-oriented CHIP.