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2018 - September 2022

Local health improvement coalitions (LHICs) are integral on-the-ground partners for health literacy improvement.

Horowitz Center’s Involvement with LHICs

The Horowitz Center for Health Literacy has been involved in the effort to improve and support Maryland LHICs since 2018. 

  • Phase 1 - Spring 2018 
  • Phase 2 - March - September 2020 
    • Created and disseminated MDH-sponsored health literacy tools to help LHICs with MD Diabetes Action Plan in 2020. 
    • Contract #OPASS-20-18909-G-MOD1
  • Phase 3 - October 2020 - September 2021 
    • Provided technical assistance for LHIC capacity-building, data use, and community engagement
    • Public health fellows collaborated with LHICs to create governance documents and advise on coalition structure, increase data analysis capacity and application, and expand community engagement strategies to diversify LHIC participation.
    • Contract #OPASS-20-18909-G-MOD1
  • Phase 4 - Oct 2021 - Sept 2022
    • Continued providing technical assistance for capacity building and community engagement
    • Assist and monitor LHICs' diabetes strategy implementation and evaluation
    • Contract #OPASS-22-19427-G

LHIC Background Information

Local Health Improvement Coalitions (LHICs) are groups of jurisdictional-level stakeholders that help determine and address public health priorities. There are 20 county-level LHICs across the state of Maryland, 19 represent individual counties and one represents counties on Maryland's Mid-Shore (Caroline, Dorchester, Kent, Queen Anne’s, and Talbot). These coalitions are typically led by local health departments or hospital systems. Many LHICs are informal extensions of the local health department, some are extensions of the local hospital system, and some are registered as 501(c)(3) non-profits. 

The 20 LHICs in Maryland strive to coordinate population health efforts among their members and stakeholders to address priority health topics including but not limited to chronic disease, health disparities, and maternal/infant health. LHIC members can pool their skills, insights, and resources to reduce duplication of efforts and address health topics across their jurisdiction through multi-sectoral approaches. 

LHIC Structure and Activities

Although each Maryland LHIC has a unique governance structure, they typically consist of one or two LHIC leaders/chairs, two to three workgroups with one to two leaders or chairs per workgroup. Workgroups are usually formed to address specific priority areas in public health that have been identified by the LHICs. Other LHIC members include representatives from community organizations, county government departments, local business owners, or community members who are interested in advancing public health in the jurisdiction. Most LHICs do not have budgets and are primarily funded by in-kind services and volunteer staff time. However, some LHICs have dedicated full-time or part-time staff members who are a part of the local health department.  

LHICs typically participate in the following activities:

  • Conduct Community Health Needs Assessments (CHNAs) with health departments and hospital systems to identify and analyze community health needs and strengths through primary and secondary data collection and analyses. 
  • Prioritize health topics based on CHNA data, community member input, and LHIC member expertise. 
  • Address health priorities through programs, policies, and coordinated efforts with programmatic, data, and infrastructure support from the state and county.
  • Plan and coordinate future health efforts for the jurisdiction through Local Health Improvement Plans (LHIPs) 

History of Statewide LHIC Projects

The Department of Health and Mental Hygiene established the State Health Improvement Process (SHIP) in 2012 to emphasize the importance of improving population health outcomes and measure jurisdictions on their performance on 39 population health metrics. CHRC awarded 24 grants (totaling $1.95 million) to support the planning and implementation activities for LHICs to address SHIP priorities. These grants were primarily used to hire community health workers, program administrators, and community health nurses to participate in population health improvement efforts. 

In 2020, the Maryland Department of Health (MDH) and Maryland Community Health Resources Commission (CHRC) partnered to re-engage and support Maryland LHICs. CHRC provided $1M to 20 LHICs to support their growth and development. MDH and CHRC partnered with the Horowitz Center to provide technical assistance to the LHICs in the form of resource sharing, informational webinars, data consultations, community engagement strategy planning, and guidance on the development and implementation of diabetes strategies that align with Maryland’s Diabetes Action Plan.