Instructions This slide deck contains two presentations: An Orientation to Community Benefit for Organizational Leaders (starts slide 2) An Orientation to Community Benefit: What Frontline Staff Need to Know (starts slide 27) The content in these slides may be copied into existing presentations or used on their own.

An Orientation To Community Benefit For Organizational Leaders

Our Tradition Catholic health care has a rich tradition of serving our communities Founding sisters came to this country to care for the sick and start hospitals, nursing homes, schools and orphanages We follow the tradition of Jesus who had special affection for poor and vulnerable persons Providing community benefit is an essential part of our mission

(Organization’s Name) Tradition (the story of this organization)

Our Tradition Our Gospel values commit us to: Promote and defend human dignity – treat every person with respect Care for poor and vulnerable persons – reach out to underserved persons Promote the common good – always look for what is in the best interest of the community Steward resources – use our financial and human resources wisely (add values of this organization)

We Need To Be Accountable Affordable Care Act (ACA) The ACA added requirements for tax- exempt hospitals related to: Community health need assessment Implementation strategy Financial assistance Charges Billing/collections

Affordable Care Act ACA requirements for community health needs assessment (CHNA): At least once every three years Include input from persons who represent the broad interests of the community Include input from persons having public health knowledge or expertise

Affordable Care Act ACA requirements for implementation strategy: A written plan that addresses each of the community health needs identified through a CHNA for the hospital Describes either: How the hospital plans to meet the health need, or Why the hospital does not intend to meet the health need Adopted by governing body

We Need To Be Accountable Mandated Reporting The Internal Revenue Service and 20 states require annual reporting of community benefit information.

We Need To Be Accountable IRS Reporting Hospitals must report on the IRS Form 990, Schedule H: Financial assistance and other community benefit information Information about: -- Financial assistance policies -- Collection policies -- Community need assessment -- Other information about how the organization benefits the community

We Need To Be Accountable We are being asked if we are still charitable, community oriented organizations: By the sisters (or others) who sponsor our organizations Our board, donors, and others to whom we are responsible Our communities Those who grant us exemption from taxes

We Need to Be Accountable To be accountable, we: Plan community benefit programs in an organized way Design community benefit programs to respond to community needs Work closely with people and organizations in our communities Keep track and report what we do for our communities

Principles of Our Community Benefit Programs The economically poor have a moral priority for services We have a responsibility to work to improve health in communities by focusing on prevention as well as treatment Community members and organizations are invited to be actively involved in all phases of our community benefit program It is important to demonstrate the value of community service Commitment to community health improvement should be reflected throughout our organizations Leadership commitment is needed for successful community benefit programs (active support of senior management and governing board)

To Be Sustainable, Our Program Needs Organizational Support A culture that sets the tone Commitment of leaders Sufficient staff Adequate budget Collaborative relationships with community members and groups

To Be Sustainable, Our Program Needs a Strong Infrastructure Clear and visible policies, including: Financial assistance for uninsured and underinsured Involvement of physicians in serving low-income persons and participating in community benefit programs Encouraging employees to always act charitably and respectfully and to participate in community benefit programs

To be Sustainable, Our Program Needs a Strong Infrastructure Integration with other critical functions: Planning Operations Clinical Services Communications

Steps in Our Community Benefit Program Assessing needs and resources in the community: Use existing and new information Focus on service gaps, risk factors and health problems Work with others in our community (Present greatest needs in this community)

Steps in Our Community Benefit Program Setting priorities for what services to engage in: Look at seriousness and scope of problem, determine whether this is a problem to the community Consider our organization's strengths and what we can contribute Put priority on services related to access to care and other services for the economically poor

Steps in Community Benefit Program Planning Our strategic plan includes information on health problems in the community and our role in addressing them We are part of community-wide programs to improve health and health services in our community (insert examples) We have our own implementation strategy describing our specific community benefit efforts (insert examples) Each program has a specific objective so we can track whether it is making a difference

Steps in Our Community Benefit Program Tracking community benefits We have an organized way of keeping track of community benefits that is used throughout Catholic health care and by many other organizations

Tracking Community Benefits Community benefits include: Financial assistance and discounted services to uninsured and low-income persons Participation in Medicaid programs Losses from programs we subsidize because they are needed in the community (i.e. mental health services) Community health services (clinics, health education) Training for physicians, nurses and others Research Contribution: cash and in-kind Community building activities (advocacy for early childhood development programs, housing for low-income seniors)

Steps in Our Community Benefit Program Evaluation – we look at: Are we giving resources to the right places? Are our programs effective in making a difference? Are we a good partner in the community? Is our program well run and of high quality ?

Steps in Our Community Benefit Program Telling the story Shows staff, physicians, board and community members we are a mission-driven organization Invites community members and groups to support our programs – as program partners, as volunteers, as donors Demonstrates that our tax exempt purpose is still being fulfilled

Steps in Our Community Benefit Program Telling the story We tell our community benefit story in all communications: Reports to the community and others Orientation and education of staff Board meetings Talks to community groups Media contacts Advocacy visits to policymakers

What Community Benefit Programs Need from Organizational Leadership Visible and vocal commitment that community health improvement and community benefit is an important part of this organization Inclusion of community needs and community benefit programs in strategic and operational plans Appointment of staff, committees, other needed resources Incentives for all managers, staff, and physicians to participate

Summary We provide community benefits because this is an important part of our mission Our communities need us to provide services to uninsured and low-income persons and to help improve health in our communities We provide community benefits in an organized way We need the support of executive and trustee leaders Community benefits demonstrate that we continue the faith-inspired tradition of our founders

An Orientation To Community Benefit: What Frontline Staff Need To Know

Our Tradition Catholic health care has a rich tradition of serving our communities Founding sisters came to this country, to care for the sick and start hospitals, nursing homes, schools and orphanages We follow the tradition of Jesus who had special affection for poor and vulnerable persons Providing community benefits is an essential part of our mission

(Organization’s Name) Tradition (the story of this organization)

Our Tradition Our values commit us to: Promote and defend human dignity – treat every person with respect Care for poor and vulnerable persons – reach out to underserved persons Promote the common good - always look for what is in the best interest of the community Steward resources - use our financial and human resources wisely (add values of this organization)

As a Catholic Health Care Organization We believe: The economically poor have a moral priority for services The "stranger" – persons who were not born in this country and who do not speak our language – deserve special consideration We have a responsibility to work to improve health in communities by focusing on prevention as well as treatment Serving uninsured and poor persons and providing community benefits is an essential part of our mission

Facts About Poverty Statistics In 2010, more than 46 million people lived in poverty. This number of people living in poverty is the largest number seen in 52 years. In over 31% of single family homes (no father), the children are poor In 2010, 22% of all children lived in poverty – that’s over 1 in every 5 children. www.povertyusa.org

Facts About Poverty Federal definition of poverty: For a family of four, income of less than about $22,314/year For a family of three, income of less than about $17,374/year U.S. Census Bureau

Facts About Poverty What it means to be poor Families meeting federal definition do not have enough funds to meet basic needs of minimal housing, utilities, food, transportation, health care, and child care They have no extra income for things such as school supplies, clothes, birthday gifts, entertainment, household supplies In 2010, one in seven American households were food insecure. There are fewer opportunities than before for people to work their way out of poverty www.povertyusa.org

Facts About the Uninsured The effect of being uninsured has an impact on health: Problems getting medical care Less use of preventative services Unable to follow-up, fill prescriptions More likely to be hospitalized with preventable problems U.S. Census Bureau

Who Benefits From Our Community Benefit Program? The whole community People living in poverty The uninsured and underinsured

How We Help to Make Communities Healthy We do this by: Assessing needs and resources in our community Setting priorities among service gaps and problems we find Working with other community groups Developing an organized plan Keeping track of the services we provide Evaluating whether our programs are working Telling others about our work and inviting them to help

Services We Provide in Response to Community Need Some of these services include: Financial assistance and discounted services to uninsured and low-income Participation in the Medicaid programs Losses from programs we subsidize because they are needed in the community (i.e. mental health services) Community health services (clinics, health education) Training for physicians, nurses and others Contribution: cash and in-kind Community building activities (advocacy for better health programs, environment improvement)

Information About Our Financial Assistance Program (Charity Care) We provide free care and can discount the cost of care to persons who meet certain financial criteria We have written financial assistance policies that are posted in prominent areas Our policies describe who is eligible and what services are covered We try to determine eligibility for financial assistance before care is given, but sometimes people do not know or are afraid to tell us they need financial help

Information About Our Financial Assistance Program (Charity Care) Determination for needing financial assistance can made any time throughout the admission/treatment/discharge/billing process We make an effort to identify all persons who might be eligible for financial assistance and discounts We treat uninsured and low-income persons the same way we treat all patients High quality care With respect

(Organization’s name) Financial Assistance Policies

What Emergency Departments Should Know Every person who needs emergency services should be treated: With respect With the highest quality of care to all patients Without any regard to ability to pay

What Emergency Departments Should Know If a patient is uninsured or underinsured: Inform them about financial assistance and discount policies and how to apply Find out if they are eligible for Medicaid, state indigent care or children's health insurance program and help them to apply Find out if they can get needed follow-up care (such as filling prescriptions) and refer to community resources if needed Inform them about community resources for getting affordable primary care which might prevent future need for emergency care (free clinics, mobile health units)

What Billing Departments Should Do All bills should state: That financial assistance, with all or part of the bill, may be available for uninsured and low-income persons How persons can apply for assistance Establish a process for resolving unpaid bills * Be sure to check latest IRS rules for specifics

What Billing Departments Should Do For persons who cannot afford to pay their bills: Find out if person could be eligible for public program assistance (Medicaid, state indigent care, children's health insurance) Assist them to apply for facility financial assistance When appropriate, convert bill to financial assistance and inform the patient of this Treat every person respectfully *Be sure to check latest IRS rules for specifics

All Staff Can Participate in Community Benefit Programs Tell patients you come in contact with about programs we provide that may be of benefit to them Let community benefit staff know about community health issues you have encountered in your work Let the community benefit staff know about all community activities that your department or program is providing Volunteer to help with our programs Tell others about our community benefit programs and invite them to be involved Let us know if you would like time off for a personal volunteer program

(Organization’s Name) Community Benefit Activities Our community benefit activities include: For more information about our community benefit activities, contact (add contact info)

Summary We provide community benefits because this is an important part of our mission Our communities need us to provide services to uninsured and low income persons and to help improve health in our communities When we provide these services, we demonstrate that: We continue the faith-inspired tradition of our founders We are who we say we are

"For I was hungry and you gave me food, I was thirsty and you gave me drink, a stranger and you welcomed me, naked and you clothed me, ill and you cared for me, in prison and your visited me. ..what you did not do for one of these least ones, you did not do for me….“ - Matthew 25