What Counts as Community Benefit Trina Hackensmith, Lyon Software 9:30 a.m. session December 7, 2011 Community benefit programs or activities provide treatment and/or promote health and healing as a response to identified community needs. For a program to count : 1.It must address a documented community need, and 2.It must have at least one of these community benefit objectives a) Improve access to health care services b) Enhance health of the community c) Advance medical or health care knowledge d) Relieve/reduce the burden of government/other community efforts 2
1. It must address a documented community need (from the IRS instructions) A community health needs assessment developed or accessed by the organization Documentation that demonstrated community need or a request from a public agency or community group was the basis for initiating or continuing the activity or program The involvement of unrelated, collaborative tax-exempt or government organizations as partners in the activity or program. Source: 2010 IRS 990H Instructions 3 2. It must have at least one of these community benefit objectives a) Improve access to health care services The program is available broadly to the public The program participants include vulnerable or underserved persons A barrier to access is reduced or eliminated If the program ceased to exist, the community would lose access to a needed service Source: A Guide for Planning & Reporting Community Benefit 2008 Edition 4
2. It must have at least one of these community benefit objectives b) Enhance health of the community The program is designed around public health goals and principles The program yields measurable improvements to health status The community s health status would decline if the program ceased to exist A public health agency provides comparable services The program is operated in collaboration with public health partners Source: A Guide for Planning & Reporting Community Benefit 2008 Edition 5 2. It must have at least one of these community benefit objectives c) Advance medical or health care knowledge The program trains health professionals/students as they advance toward health profession degrees or other credentials The organization does not require trainees to join the staff Health professional continuing education programs are open to professionals in the community The program involves research, with findings available broadly to the public within a reasonable period of time Source: A Guide for Planning & Reporting Community Benefit 2008 Edition 6
2. It must have at least one of these community benefit objectives d) Relieve/reduce the burden of government/other community efforts The program relieves a government financial or programmatic burden Government provides the same or a similar service Government provides support of the activity If the program were closed, cost to government or another taxexempt organization would increase The program receives philanthropic support through community volunteers or contributions Source: A Guide for Planning & Reporting Community Benefit 2008 Edition 7 A program does not count as community benefit, if: The program is primarily for marketing purposes The program or donation is unrelated to health or the hospital s mission An objective prudent layperson would question whether the program truly benefits the community The program benefits the organization more than the community The program represents a community benefit provided by another entity or individual Access to the program is restricted to employees and physicians affiliated with the hospital The activity represents a normal cost of doing business or is associated with the current standard of care Source: A Guide for Planning & Reporting Community Benefit 2008 Edition 8
Community Health Improvement Services (category A) Do not generate inpatient or outpatient bills, although they may involve a nominal fee Health Professions Education (category B) Educational programs that result in a degree, certificate, or training that is necessary to be licensed Subsidized Health Services (category C) Clinical services provided despite a financial loss, [even] after removing the effects of charity care and Medicaid shortfalls and bad debt. Make sure to account for double counting within Charity Care, Medicaid, Other Means- Tested programs. Source: A Guide for Planning & Reporting Community Benefit 2008 Edition 9 Research (category D) Any study or investigation of which the goal is to generate generalizable knowledge. Where is the money to fund the research coming from? Financial and In-Kind Contributions (category E) Cash and In-kind contributions means contributions made by the organization to health care organizations and other community groups, restricted to one or more of the community benefit activities in Part I, line 7. Where is the money going? Source: A Guide for Planning & Reporting Community Benefit 2008 Edition and 2010 IRS 990H Instructions 10
Community Building Activities(category F) Include programs that address underlying causes of health problems in order to improve health status and quality of life. cannot include expenditures made to reduce the environmental hazards caused by, or the environmental impact of, its own activities Community Benefit Operations (category G) Include costs associated with planning and operating community benefit programs. Source: A Guide for Planning & Reporting Community Benefit 2008 Edition and 2010 IRS 990H Instructions 11 CBISA Online Program/General screen. Includes all of the information to successfully report this program to the IRS (990H) and your community 12
CBISA Online Occurrence screen. Collects detailed statistics for the Program including: Persons served; Expenses; and Offsetting Revenue 13 CBISA Survey Program screen. Includes all of the information to successfully report this program your association (HAT) 14
CBISA Survey Occurrence screen. Collects statistics for the Program including: Persons served; Total Expenses; and Total Offsetting Revenue 15