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The Center for Children's Health

Community Health Needs Assessment (CHNA)


The data collection and analysis for our 2021 Community Health Needs Assessment is currently underway.

Cook Children's 2021 Community Health Needs Assessment applies academic research standards for both primary and secondary data collection.

Our 2021 Community Health Needs Assessment utilizes the following methodologies:

  • Parent Survey (CCHAPS). Administered to primary caregivers by a combination of mail, phone, or the Internet to a stratified random sample of 25,000 households representative of families with children ages 0 –17 in the primary service area. Surveys are available in English & Spanish.
  • Face-to-Face Survey Interviews. Parent survey available to a purposive sample of homeless caregivers and/or caregivers in families with at least one undocumented member. The target for responses is a minimum of 150 homeless caregivers and 50 undocumented participants.
  • Focus groups or Case Studies. Provide an opportunity for caregivers to provide information not covered in the survey. Priority topics include: Abuse, Asthma, Dental Health, Mental Health, Obesity, Safety / Injury Prevention, COVID-19, and Access to Care.
  • Community Leader Survey. A purposive sample of city, county, government, public agency/health, not-for-profit, school district, and business community leaders working in the eight-county region receives an invitation to complete an online survey focused on the community impact of health issues.
  • Youth Art Contest. Collects information directly from children ages 5 –17 with the "My Feelings are a Work of Art" theme.
  • Secondary data. Using from four to eight sources for each of the eight priority geography areas to determine national, state, and if available, local trends.

Our 2021 CHNA partners include

  • CHNA Administrator, Linda Fulmer
  • ETC Institute, Chris Tatham, CEO
  • MHMR of Tarrant County, Camille Patterson, PhD
  • University of North Texas Health Science Center - School of Public Health, Emily Spence, PhD

Information about our 2021 CHNA

Frequently Asked Questions about the CHNA

CHNA is the acronym for Community Health Needs Assessment. Cook Children's conducts an assessment every three years to collect comprehensive data about children's health (ages 0-17) in our now eight-county service region (Tarrant, Johnson, Hood, Parker, Wise, Denton, Grayson, and Collin Counties).

Everything we do at Cook Children's focuses on the Promise we've made to our community to improve the health of every child in our region through the prevention and treatment of illness, disease and injury. The CHNA helps us fulfill this Promise by providing credible data that guides our strategies for preventing illness and injury to children. The CHNA also meets federal requirements for non-profit hospitals to focus community benefit strategies on the most critical health care needs in the communities we serve.

Cook Children's conducts a stratified random sample survey of parents to ask questions about how various health issues impact their children and how easy or difficult it is to obtain care. We also conduct focus groups to provide an opportunity for parents to tell us about issues not included in the survey. The CHNA also includes health data from government and other reliable sources as well as a survey of community leaders. A children's art contest helps us better understand how children feel about their health.

There are multiple obstacles to maintaining good health for many families such as poverty, discrimination, lack of access to good jobs with fair pay, quality education, housing and safe environments. Addressing these obstacles requires a collaborative, community approach. One organization cannot act alone and be successful. Effective partnerships create a shared vision and increase the community's capacity to shape outcomes.

With accurate information representative of the needs of a community, partners can increase understanding about children's health and the factors that influence it, identify priority needs for community action, develop solutions to address priorities, and evaluate the results of their efforts.

Tax Year

The 2018 Community Health Needs Assessment was approved by the Board of Trustees and is now posted for public comment.

This report is provided in fulfillment of the Internal Revenue Service Section 501(r)(3)(A) requirements for Charitable Hospitals to conduct a Community Health Needs Assessment (CHNA).

View and download the 2018 Community Health Needs Assessment Report

Public comment on this report is encouraged and should be sent via email to:

View and download the 2018 CHNA Implementation Strategies

CHNA Implementation Strategies is a companion piece to the 2018 Community Health Needs Assessment Report by Cook Children's Medical Center (CCMC). It describes the implementation strategies being undertaken by Cook Children's, as approved by the Board of Trustees, in order to address the needs identified in the assessment.

Cook Children's Health Care System

Cook Children's Health Care System is the country's leading vertically integrated pediatric healthcare organization. Cook Children's represents an award-winning, not-for-profit system of seamless healthcare across the continuum of medical care and service, designed to fulfill our promise for children: Knowing that every child's life is sacred, it is the promise of Cook Children's to improve the health of every child in our region through the prevention and treatment of illness, disease and injury.

The system has eleven separate corporate entities focused on this promise, two of which are charitable hospitals as defined by the relevant regulations: Cook Children's Medical Center (CCMC) and Cook Children's Northeast Hospital (CCNH).

Based in Fort Worth, Texas, CCMC and CCNH share a contiguous six-county primary service area (PSA) in North Central Texas: Denton, Hood, Johnson, Parker, Tarrant and Wise counties. This PSA provides 80.2% of the inpatient admissions to these two hospitals. The remaining 19.8% comes from 122-counties outside of the Dallas-Fort Worth Metroplex comprising a geographic referral area of approximately one-half of the state.

Cook Children's Medical Center

Cook Children's Medical Center has a nationally recognized, award winning facility. Magnet designated, licensed by the State of Texas it is accredited by The Joint Commission. Cook Children's is known nation-wide for its excellence in quality and safety and has a distinguished reputation for providing extraordinary care and achieving positive outcomes in its neurology, neurosurgery, cardiology, cardiothoracic surgery, hematology and oncology, neonatology, and pulmonology programs.

The medical center is licensed for 443 beds, making it one of the largest children's hospitals in the country. CCMC offers advanced technological equipment, leading surgical techniques, rehabilitation facilities and ancillary services designed to meet the special needs of children including a Level IV NICU staffed with a team of neonatologists and specialists combining expertise with the latest technology to provide the highest level of neonatal care available.

Additionally, the campus boasts a professional and highly skilled staff of nurses, technologists, therapists and other clinicians, as well as more than 600 physicians and dentists who provide primary, secondary, tertiary and quaternary levels of pediatric care. Child Life specialists, Chaplains, teachers, social services coordinators and translators help patients and families cope with the stressors that accompany a child's hospitalization. Cook Children's designated level II Trauma Center is staffed and equipped to provide comprehensive emergency medical services to patients suffering traumatic injuries 24 hours a day, 7 days a week.

Questions or comments

If you have any questions or would like more information about our program, please email Becki Hale.