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 \n\r      \r \n \r \n \r \r ! Gundersen Tri-County & Clinics. 2022-2025. Introduction and Purpose. The Patient Protection and Affordable Care Act requires non-profit healthcare organizations to perform a Community Health Needs Assessment (CHNA) every three years and adopts an implementation strategy, known as a Health improvement plan to meet the outstanding community health needs and to continue to qualify for federal tax exemption. Th Health Improvement Plan (HIP) will be implemented during the years 2022-2025.. Julie Quinn, CPA. VP, Compliance & Cost Reporting. Health Services Associates. Southeast Regional Office. Health . Services Associates, Inc.. 2 East Main . Street 54 Pheasant Ln. Fremont. , MI . 49412 Ringgold, GA.