Whole Health

CHI Tompkins

Roadmap to Health

Overview

Tompkins County's Community Health Improvement (CHI-Tompkins) program: Whole Health works with other community organizations to conduct ongoing community health improvement through the county Community Health Assessment (CHA) and Community Health Improvement Plan (CHIP). The process includes regular meetings of a CHI Steering Committee, regular updates from partner organizations, and partner participation in several events, such as the Phase One review and Community Partner Assessment.

MAPP 2.0

This approach (Mobilizing for Action through Planning and Partnerships, MAPP) will provide a new scaffold for the CHA and CHIP, while centering health equity through community power and collective action.

Values

Our core values and objectives act as pillars in the promotion of health equity.

Data-based

Effective data sharing between organizations throughout the process. Focus on evidence-based interventions, accurate assessment, inclusive collection of data, & informed evaluation.

Sustainable

Work towards a CHI process with dedicated funding and coordination. Equitable allocation of resources, to facilitate efficiency & longevity of the process.

Collaborative

Cross-sectoral alliance & power-sharing among diverse stakeholders. Intentional & meaningful community involvement throughout the CHI process.

Process

Our core values and objectives act as pillars in the promotion of health equity.

Community Health Survey

Effective data sharing between organizations throughout the process. Focus on evidence-based interventions, accurate assessment, inclusive collection of data, & informed evaluation.

Community Partner Assessment

Work towards a CHI process with dedicated funding and coordination. Equitable allocation of resources, to facilitate efficiency & longevity of the process.

Community Status Assessment

Cross-sectoral alliance & power-sharing among diverse stakeholders. Intentional & meaningful community involvement throughout the CHI process.

Community Context Assessment

Cross-sectoral alliance & power-sharing among diverse stakeholders. Intentional & meaningful community involvement throughout the CHI process.

Community Vision Statement

Our community visioning process went into the community for input and ideas. Completed in May 2024, the statement drew from almost 500 community responses from 15 different collection locations and events.

Community Vision Statement

“Our community is a diverse and dynamic mosaic of people across the lifespan. Shared spaces and natural beauty are central to our community, fostering care and belonging.

“We envision a community where everyone thrives, regardless of background, income, or abilities. We aspire to focus on prevention and health promotion through accessible healthcare, inclusive spaces, and resources that meet everyone’s basic needs. Our community desires collaboration, trauma-informed care, safety, resilience, environmental stewardship, and elevation of marginalized voices. We seek comprehensive well-being that encompasses physical, mental, and social needs.”

2024 Community Health Improvement Highlights

THE 2022-2024 CHA and CHIP focused on 10 goals, across 24 interventions, in collaboration with 23 organizations. 15 interventions were carried out, 8 are in progress, and 1 is in the planning stage.

Key 2024 progress updates are listed by their NYS Prevention Agenda priority. The Prevention Agenda is New York State's Health Improvement Plan.

Prevent Chronic Disease

500 people used the Senior Nutrition Program through Foodnet and County Office for the Aging. Over 110,000 meals were provided.
26 health screening events were held in which Community partners participated, including for hypertension and prediabetes.

Promote Well-being & Prevent Mental Health and Substance Use Disorders

153 units of Permanent Supportive Housing and 45 units of Transitional Housing made available through Continuum of Care (CoC).
153 individuals exited from the Coordinated Entry list to permanent housing.
4,961 Narcan spray kits distributed and 4,347 individuals trained to administer Narcan in the first 3 quarters of 2024.

Promote Healthy Women, Infants, & Children

567 Moms PLUS+ home visits as of December 2024
115 in-person visits made by Community Health Workers in Healthy Infants Partnership (HiP) Tompkins in 2024.

Complete Updates

The complete, updated CHIP matrices are available as 11" x 17" PDF files, and can be found at the following links. (Refer to Column J, Projected or completed Year 3 Intervention.)

Prevent Chronic Disease
Promote Well-being and Prevent Mental and Substance Use Disorders
Promote Healthy Women, Infants, & Children

Timeline for Activities & Engagement

A look at the timeline, 2024-2026:

’24				’25				’26
Phase 1		Phase 2					Phase 3

Phase One: Build the Community Health Improvement Foundation

January–June 2024:

10 community organizations: made up the membership or the CHI steering committee
2 visioning community events hosted to develop vision statement
65 attendees reviewed Phase One as a participant at one of the community events.

Phase Two: Tell the Community Story

June–December 2024:

Secondary data review organized and well underway
Community health survey built to be launched in January 2025

January 2025–September 2025:

Conduct community engaged activities for data collection
Share findings and prioritize issues

Phase Three: Continuously Improve the Community

October 2025–June 2026:

Develop the Community Health Improvement Plan (CHIP)
Collaborate with partners to build ongoing guidance and monitoring for key interventions.

Prevention Agenda (PA) 2025-2030

What's New

The Social Determinants of Health (SDOH) are integrated into the 2025-2030 PA priorities. This establishes a holistic approach to health by addressing root causes and health inequities. The Priorities (also referred to as “Domains”), now reflecting SDOH, are:

Economic Stability
Social and Community Context
Neighborhood and Built Environment
Health Care Access and Quality
Education Access and Quality

This SDOH Framework Supports:

Holistic Approach
Addressing Root Causes
Health Equity
Intersectional Collaboration
Preventive Approach
Community Empowerment

PA Foundations:

Health Equity
Prevention Across the Lifespan
Health in All Policies
Local Collaboration-Building

Resources