Deadline: March 21, 2014
Please submit completed form to Mark VanKerkhoff
E-mail: VankerkhoffMark@co.kane.il.us
OR mail to:
Kane County Government Center, Bldg. A
Development & Community Services Dept.
Attn: Mark VanKerkhoff
719 Batavia Ave.
Geneva, IL 60134
page 1
Proposal Form
Health Impact Assessment (HIA) Project
Overview
The Kane County Planning Cooperative (KCPC) is pleased to offer Kane County municipalities the opportunity to partner with the KCPC
and Chicago Metropolitan Agency for Planning (CMAP) to perform a Health Impact Assessment (HIA). The project will be funded through
CMAP's Local Technical Assistance program. KCPC and CMAP staff will undertake the project with the support of staff from the chosen
municipality.
What is a Health Impact Assessment?
HIA is an emerging planning tool that uses evidence-based analysis to evaluate how a plan, program, or policy will affect the
overall health of a population. An HIA is designed to inform policy makers before a plan, program, or policy is adopted.
Recommendations are made based on survey results, literature review, analysis of existing data, and stakeholder input.
Learn more about HIA at: http://healthimpactproject.org/hia
How can HIA be used in my community?
Think about a plan or policy decision that your community will consider in 2014. Would understanding the health impacts of
that plan or policy be helpful in making a decision? For examples on how HIA has been utilized in other communities, please
visit http://healthimpactproject.org/hia/us
2. Project Description
Explain how you wish to utilize HIA in your community. Please answer the following questions in your description:
a. What plan, program, or policy will the HIA address?
b. What health indicators do you anticipate the HIA will explore? (e.g. physical safety, obesity, chronic disease,
environmental quality, etc.)
c. How do you believe an HIA will be beneficial during the decision-making process?
You may attach a separate sheet if additional space is needed; please limit your response to 2 pages or less.
1. Applicant and Main Contact
for Application
Organization, name, position, phone
number, e-mail
