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The community needs assessment: analyzing the not-for-profit market.

Ohio Presbyterian Retirement Services (OPRS) has been doing its own "market analyses" - i.e., conducting community needs assessments - routinely since 1982. Our first assessment was conducted at our Willoughby, Ohio community under a Robert Wood Johnson Foundation grant. This was the foundation of the network of services we sponsor today.

Founded in 1922, OPRS is Ohio's largest and oldest provider of not-for-profit retirement services, with eight continuing care retirement communities in the state, each with its own home- and community-based services program.

Our reasons for conducting these assessments are two-fold. First, they provide us with market feasibility information that helps us determine whether we can sustain a particular service in the market before we initiate it. Second, the assessment serves as a tool to determine community needs with respect to aging services and our ability to begin to meet them.

Since our initial assessment 15 years ago, we've continually refined our methodology. Today, combining market feasibility studies with a community needs analysis gives us a range of perspectives, from those of community leaders and advocacy organizations to those of the individuals we'll be serving.

OPRS conducts community needs assessments in every community we serve. A technical assistance brief I prepared and which is available from AAHSA, Conducting a Needs Analysis for Home and Community-Based Services, provides a step-by-step outline of the process. The following is an overview of the steps involved:

* Begin at your area Agency on Aging, asking for their take on the needs of the community's elderly and the ways in which your organization might be able to meet them.

* Survey/interview as many potential referral sources as you can think of - attorneys, trust officers, hospital discharge planners, social workers, the Alzheimer's Association, AARP, and so on - asking what they perceive to be the needs of those whom they represent: What services do their clients need? What services are available, and how do they perceive their quality? What services are not available?

While this can be done by mail or phone, I have a strong preference for face-to-face interviews. These are, after all, the people you'll be calling upon once you begin operating your service, and the more relationships you can develop ahead of time, the better.

* Conduct a provider audit. This is a very thorough, very methodical assessment of the services offered by every area agency: the kind and number of services they provide, the types of clients they serve, their geographic boundaries, fee structures, and so on.

If the agency you're auditing is using public funds, which most do, much of this information can be readily found in annual reports or other types of documentation that the agency is required to keep.

You should, however, be prepared for some roadblocks since some agencies have very rudimentary (i.e., not computerized) record-keeping systems.

You'll also find that some types of information (ie, the capacity of an adult daycare center) are more quickly and easily obtained than others (i.e., the number of home health aide hours provided in the previous fiscal year). The key in these cases is patience and persistence. You may not get the material on the same day you request it, but it will usually be forthcoming eventually.

One of the best ways to ensure this is to get the "right person" on the phone, and the best way to do that is to call the top executives and ask them who to talk to - it's simple, and it works.

* Ask would-be clients for their opinions of available services. There are a number of ways to do this, i.e., focus groups, written surveys and face-to-face interviews. Collaboration with a university can be very helpful. Universities are often interested in conducting community assessments themselves and they frequently have students who are willing and able to assist.

Another option is to hire an independent market research firm, something OPRS did to phone survey 2,400 older adults in Ohio. The questions related to their housing preferences, service preferences, perceived affordability of both, and so on. This provided us with a great deal of useful market information.

* Collect utilization data. This final step, digging up as many data about expected and actual utilization of services as possible, helps determine market feasibility, i.e., comparing what you know about the services provided to their anticipated use. For example, we uncovered a utilization statistic indicating that one adult daycare slot is needed for every 1,000 people (of all ages) in a community. Such information could be applied to the situation in your community to determine whether there is a shortage of daycare slots, a surplus or the appropriate number. This, in essence, is the number-crunching phase: looking at and analyzing the demographics, market characteristics, current and potential utilization and information about other providers in the area.

Applications

OPRS has used the information gleaned from these assessments in a variety of ways. We found, for example, that many home health organizations in one of our communities require clients to use a minimum of three or four hours of service. Thus, someone who wanted a personal care aide but only needed an hour of service would have to pay for three to four hours. OPRS decided to provide personal care services by reducing that minimum, increasing the price and clustering services in specific geographic settings to improve efficiency. This has enabled us to serve a large number of low/middle-income people.

Another example relates to our meal services. In talking with seniors in one community, we learned that Meals-On-Wheels was providing frozen meals which, of course, had to be removed from the freezer, thawed and reheated. That translates into a lot of preparation for people who are frail or can't be on their feet for long periods. We decided to provide hot meals, delivered that way from our kitchen to the person's doorstep. This was tremendously well received and, when we visit a senior center, we often hear, "You're the ones with the good meals."

Logistics

Community needs assessment shouldn't be viewed as a "study," with a beginning and an end-point. It is, instead, an ongoing process, something done routinely and enabling the organization's providers to know their communities, their prospective clients and prospective referral sources on an ongoing basis.

Now that OPRS is well established in home- and community-based services, our directors are routinely talking with community members about their needs, participating on community task forces, staying in touch with referral sources and clients, keeping abreast of funding dynamics - it's all part of the job. Just as you would know when a competitor was building down the street, you should also know about the aging services network all around you, and be keeping abreast of general utilization statistics as they appear in the literature.

Because many of our organizations don't have the luxury of being able to bring someone on staff to conduct a needs assessment, they sometimes form task forces and teams within their organizations and frequently bring in task force members from other OPRS organizations. We might have a steering committee that includes someone from the area Agency on Aging, the Alzheimer's Association, a family member, and so on, to incorporate as many viewpoints as possible.

Student interns are another viable alternative to actually hiring staff for this purpose. OPRS has done this many times - in fact, conducting a community needs assessment was part of my own student internship 14 years ago.

For providers needing help in getting started, the technical assistance brief available from AAHSA is an extremely helpful resource (and in lay language). Universities are another valuable resource, and area agencies on aging should be partners to the extent possible.

Funding should be taken on as you would any other "new building" project. But the assessments can be done at very little or even no cost by using in-house staff, volunteers and face-to-face interviews.

You can also spend thousands of dollars out-of-pocket to hire a market research firm, as we did to conduct the telephone survey mentioned earlier. That research was based on a very strong commitment by our organization to be ready for the future.

Formal research and independent audits are usually best handled by the experts; yet, it's important to realize the value of the organization's participation in the process. The organization gains much more by actually participating in information acquisition than by simply receiving and reviewing reports.

Nancy K. King is Vice President of Corporate Support Services, Ohio Presbyterian Retirement Communities, a subsidiary of Ohio Presbyterian Retirement Services, Columbus, OH. Ms. King developed the technical brief, Conducting a Needs Analysis for Home and Community-Based Services, which is available through AAHSA. For more information, call AAHSA at 202-783-2242.
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Title Annotation:Presbyterian Retirement Services
Author:King, Nancy K.
Publication:Nursing Homes
Date:Feb 1, 1997
Words:1446
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