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Community Benefit and Community Health Needs Assessments National Association of Counties (NACo) February 22, 2015 Julie Trocchio Senior Director, Community Benefit and Continuing Care Catholic Health Association 2015 by the Catholic Health Association of the United States 5
Mother Joseph, born in Montreal, led a group of five missionaries to the Pacific Northwest. She was responsible for the completion of 11 hospitals, 7 academies, 5 Indian schools and 2 orphanages. As architect and artist, she designed and supervised their construction as well as fund raising. 2015 by the Catholic Health Association of the United States March 13, 2015 6
Community Benefit Objectives Programs or activities that provide treatment or promote health as a response to community needs and meets at least one community benefit objective: Improve access to health services Enhance public health Advance knowledge Relieve government burden 2015 by the Catholic Health Association of the United States March 13, 2015 7
Identified by: CHNA Community Health Needs Request by NFP or government or other documentation Partnership with NFP or government 2015 by the Catholic Health Association of the United States 8
What Is Community Benefit?? I. Financial Assistance II. Government-sponsored indigent health care unpaid costs of public programs -- Medicaid -- State Children s Health Insurance Program -- Medically indigent programs III. Community Benefit Services 2015 by the Catholic Health Association of the United States 3/13/2015 9
What is Community Benefit? Categories of Community Benefit Services Community health services -- Community health education -- Community-based clinical services -- Health care support services -- Social and environmental improvement activities Health profession education -- Physicians, medical students -- Nurses, nursing students -- Other health professions 2015 by the Catholic Health Association of the United States 3/13/2015 10
What is Community Benefit? Categories of Community Benefit Services Subsidized health services -- Emergency and trauma services -- Behavioral health Research -- Clinical research -- Community health research -- Health care delivery innovation 2015 by the Catholic Health Association of the United States 3/13/2015 11
What is Community Benefit? Categories of Community Benefit Services Cash and in-kind contributions -- Cash donations -- Grants -- In-kind donations Community building activities -- Physical improvements/housing -- Economic development -- Environmental improvements -- Coalition building -- Advocacy for community health improvement 2015 by the Catholic Health Association of the United States 3/13/2015 12
A Process: What is Community Benefit? Community Benefit is a planned, managed, organized and measured approach to health care organizations participation in meeting identified community health and health-related needs. 2015 by the Catholic Health Association of the United States 3/13/2015 13
The Process Building a Sustainable Infrastructure Assessing Need Planning Evaluating Communicating Determining What Counts Accounting for Costs 2015 by the Catholic Health Association of the United States 3/13/2015 14
Questions Raised By Congress Should the playing field be leveled for not-forprofit and for-profit healthcare? Are hospitals sufficiently charitable? Is the community benefit standard for taxexemption adequate? Should the revenue ruling for hospital taxexemption be changed? 2015 by the Catholic Health Association of the United States 3/13/2015 15
Affordable Care Act Community health need assessment Implementation strategy Financial assistance Charges Billing/collections Reporting 2015 by the Catholic Health Association of the United States 3/13/2015 16
Meeting New Requirements for Tax- Exempt Hospitals Overview of IRC 501(r) New Penalties $50,000 excise tax Potential loss of Section 501(c)(3) status with respect to any noncompliant facility 2015 by the Catholic Health Association of the United States 3/13/2015 17
IRS: How is a Community Health Needs Assessment Conducted? Identify and prioritize significant health needs of the community served by the hospital May be conducted in collaboration or jointly with others Must solicit and take into account input from persons who represent the broad interests of the community served including those with special knowledge of or expertise in public health Written report must adopted by authorized body Must be made publicly available 2015 by the Catholic Health Association of the United States 3/13/2015 18
IRS: How is Community Health Needs Assessment Documented? Description of the community served by the hospital Description of the process used to conduct the assessment Sources and dates of the data and other information used; Methods of collecting and analyzing data Description of how information was solicited and used If the hospital collaborated with others who? If the hospital contracted with a consultant include qualifications 2015 by the Catholic Health Association of the United States 3/13/2015 19
IRS: How is Community Health Needs Assessment Documented? (con t) Describe input from persons who represent the broad interests of the community: Summary of the input of these persons; how and over what time period Names of organizations providing input and nature and extent of input Describe the medically underserved, low-income, or minority population being represented by organizations or individuals providing input 2015 by the Catholic Health Association of the United States 3/13/2015 20
IRS: How is Community Health Needs Assessment Documented? (con t) A prioritized description of all the significant community health needs identified through the CHNA, including a description of the process and criteria used in prioritizing such health needs A description of the potential resources identified through the CHNA to address the significant health needs Evaluation of impact of actions taken since previous CHNA 2015 by the Catholic Health Association of the United States 3/13/2015 21
IRS Form 990 Schedule H 2015 by the Catholic Health Association of the United States 3/13/2015 22
IRS: What Does an Implementation Strategy Include? The actions the hospital facility intends to take to address the significant health need The anticipated impact of these actions The resources the hospital plans to commit to address the health need Any planned collaboration between the hospital facility and other facilities or organizations 2015 by the Catholic Health Association of the United States 3/13/2015 23
IRS: How is an Implementation Strategy Documented? Must be attached to hospital s IRS Form 990 or provide on the Form 990 the URL(s) to access online Not required but recommended: post on website Questions on IRS Form 990 Schedule H 2015 by the Catholic Health Association of the United States 3/13/2015 24
The 2013 Wake County Community Health Needs Assessment Presentation for the Health Steering Committee National Association of Counties Legislative Conference February 22, 2015 www.wakegov.com Denise Foreman, Assistant to the County Manager Regina Y. Petteway, Interim Human Services Director 25
2013 Community Health Needs Assessment (CHNA) This presentation will cover: Planning and Implementation Positive Results A Few Tips from Wake County Plans for the 2016 Assessment Alignment with the Healthiest Capital County Campaign Sent from my iphone www.wakegov.com 26
Planning and Implementation Steps 1. Establish a community health assessment team (or teams) 2. Collect and analyze existing statistics and data as well as information from a community door to door survey process 3. Determine priorities through a community engagement process 4. Create the CHNA document 5. Develop community health action plans 6. Make the CHNA document and action plans available to community partners 27
Positive Results Cost savings for the County - $10,000 plus staff time for 2013 Assessment compared to $75,000 and staff time for 2010 Assessment. Community Ownership 60+ partners using the same priorities and data (Top 3 priorities poverty and unemployment; health care access; mental health and substance abuse). Hospitals met their IRS requirements on time, and used the assessment for strategic planning and their community plans. Wake County met state requirements. Also met a Vision 2020 Goal of being data-driven in planning. www.wakegov.com 28
A Few Tips for Success 1. Appoint a Community Co-Chair and County Commissioner Co-Chair as leadership. 2. Start early with a timeline and be clear about deliverables. 3. Make sure to keep your Board of Commissioners informed and engaged along the way. 4. Start with a small steering team (County staff and representatives from partners who share fiscal resources). Also have a larger group of partners and stakeholders with specific roles, but who meet less frequently. 5. Contract out the scientific hard stuff (data collection and producing final documents). 6. Use the marketing expertise of your partners and connect the final information through their social media and yours. 7. Celebrate! www.wakegov.com 29
.Moving Forward Wake County is now aligning the 2016 CHNA Process with our Healthiest Capital County Collective Impact Campaign County Health Rankings Data and Community Health Needs Assessment Data can be reported together We have a coalition of 40+ partners; a recommended structure and plan to move forward; and are currently seeking fiscal partners www.wakegov.com 30
Moving Forward With The Healthiest Capital County Initiative - Highlights Will address 5 indicators (Obesity, Food Insecurity, Children in Poverty; High School Drop Out Rate; Risky Youth Behaviors) Negotiating with 3 community partners to lead Work Groups (Advocates for Health in Action/YMCA; United Way; Youth Thrive Coalition) Seeking continued county support through the budget process; community stakeholder fiscal support and a community home Expect to start implementation in July, including planning for the 2016 CHNA www.wakegov.com 31
QUESTIONS? www.wakegov.com 32
For More Information For an electronic copy of the 2013 Executive Summary and the Full Report, go to: http://www.wakegov.com/humanservices/data/pages/default.aspx You may also contact: Edie Alfano-Sobsey, Wake County Human Services Epidemiologist at Edie.AlfanoSobsey@wakegov.com Lechelle Wardell, Wake County Program Manager and CHNA Project Manager at lwardell@wakegov.com www.wakegov.com 33