Community Benefit: What Counts

1. Community Benefit: What Counts

2. 2

3. Community Benefit Programs Community benefits are programs or activities that provide treatment and/or promote health and healing as a response to identified community needs 3

4. Why is �What Counts� Uncertain? The IRS �community benefit standard� Revenue Ruling 69-545 is �vague.� Two hospitals could provide the same service and count as community benefit at one but not the other, because: the primary rationale for establishing the service can vary (community need versus financial return to the hospital), community needs differ across the United States, or the programs serve different types of consumers. 4

5. Community Benefit Objectives Address Community Need and Improve Access to Health Services and/or Enhance Population Health and/or Advance Knowledge and/or Demonstrate Charitable Purpose 5

6. Objective 1: Address Community Need The program was developed (or continues to be provided) in response to a documented health status need or problem, or The Board or Management considered community needs as a primary rationale for the program, or Community stakeholders (rather than only management or medical staff) were involved in the program�s origins and its design, or Measurable improvement in the targeted health status need or problem can be demonstrated 6

7. Objective 2:  Improve Access to Health Services The program is available broadly to the public, and If the program ceased to exist, the community would lose access to needed services, or The activity is designed and funded to benefit vulnerable people with demonstrated challenges in obtaining access to care (geographic, financial, cultural), or The program has a number of vulnerable people in the census, or Access barriers are reduced or eliminated 7

8. Objective 3:  Enhance Population Health The program is designed around public health goals and principles eliminating health disparities achieving Healthy People 2010 goals, or The program yields measurable improvements in health status, or If the program ceased to exist, the community�s health status would decline, or The program is operated in collaboration with public health partners 8

9. Objective 4:  Advance Knowledge The program involves education or research, with benefits available broadly to the public, or Papers are published based on research support by the healthcare organization, or Education programs are open to community, or Students advance towards health professions degrees or licenses 9

10. Objective 5: Demonstrate Charitable Purpose The program relieves (or leverages) a government financial or programmatic burden, or Government actually provides the same or a similar service (e.g., immunizations), or Government provides explicit support of the activity (e.g. The National Institute of Health), or If the program were closed, cost to government (or another tax-exempt organization) would increase, or 10

11. Objective 5: Demonstrate Charitable Purpose (continued) The program receives philanthropic support, or The service is unlikely to be performed by a taxable organization, or The primary purpose is not related to public relations or marketing (referrals), or The program involves an investment of the hospital�s margin, or The program is highly conducive to collaboration, e.g. with competitors 11

12. Characteristics of Programs that Should Not be Counted An objective, �prudent layperson� would question whether the program should count The program is counted as a community benefit by another organization or person Example: activities by employees on their own time Example: foundation whose restricted revenue should be an offset The program primarily benefits the organization Generates referrals principally to the hospital versus community-wide resources Marketing-focused 12

13. Characteristics of Programs that Should Not be Counted The program is not broadly available to the public Example: Continuing Medical Education program only for your medical staff The activity represents a normal �cost of doing business� or is associated with the current standard of care Example: employee benefits such as in-service trainings 13

14. 14

15. 15

16. 16

17. 17

18. 18

19. Community Benefit Categories E. Financial Contributions Cash donations and grants In-kind donations Cost of fund raising for community programs 19

20. 20

21. 21

22. Community Benefit Objectives Address Community Need and Improve Access to Health Services and/or Enhance Population Health and/or Advance Knowledge and/or Demonstrate Charitable Purpose 22