1. Bridging Community Benefit and Philanthropy
Leading Forward 2016 – The AHP Leadership Conference
July 1, 2016
Julie Trocchio
Catholic Health Association of the United States

2. Overview What is community benefit?
Why hospitals provide and report community benefit
Recent policies on reporting community benefit
Building bridges between philanthropy and community benefit

3. What is Community Benefit?

4. What is Community Benefit?

5. Children’s Hospital Reduces Asthma Admissions
Community Benefit: Rooted in Catholic Tradition
Children’s Hospital Reduces Asthma Admissions

6. What is Community Benefit?
Rural hospital recruits psychiatrists

7. What is Community Benefit?
Community benefit programs or activities address a community health need and meet at least one of the following community benefit objectives:
Improves access to health care services
Enhances the health of the community
Advances medical or health care knowledge
Relieves or reduces government burden for health

8. What is Community Benefit?
Financial assistance
Government-sponsored indigent health care-unpaid costs of public program
Medicaid
State Children’s Health Insurance Program
Medically indigent programs
Community benefit services

9. What is Community Benefit?
Categories of Community Benefit Services:
Community Health Services
Health Profession Education
Subsidized Health Services
Research
Financial Contributions
Community Building Activities

10. Programs should not be counted if:
An objective, “prudent layperson” would question whether the program truly benefits the community
The program or donation is unrelated to a community health need
The program represents a community benefit provided by another entity or individual, such as
Activities by employees on their own time
In-kind value of volunteer time
The program benefits the organization more than the community
Generates referrals principally to the hospital versus community resources
Marketing-focused

11. Programs should not be counted if:
Access to the program is restricted to employees or medical staff affiliated with the hospital, such as 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 (expected of taxable and tax- exempt entities alike)
Employee benefits, such as in-service trainings
Licensure requirements
Discharge planning
Minimum-standard translation service

13. Steps
1. Commit
2. Budget
3. Staff
4. Partner
5. Assess

14. Steps
6. Plan
7. Implement
8. Account
9. Evaluate
10. Report

15. Why is Community Benefit Important Today?
Mission and tradition
Legal imperative
Philanthropy implications

16. Mission and Tradition
In 1866, to respond to the diphtheria, yellow fever and typhoid epidemics, three French Sisters of the Incarnate Word came to Galveston, TX. When they arrived, they learned that not only were they needed to care for victims of disease, but for the children who had been orphaned by the epidemics.
September 22, 2018

17. The Mission Imperative
“Our organizations were established – not for economic opportunity – but to address need for health services in our communities. Our facilities were born out of community need, a tradition that continues today.”
Sr. Carol Keehan, DC
President and CEO
Catholic Health Association

18. Legal Imperative IRS Revenue Rulings: ‘56, ‘69 IRS Form 990 Schedule H
Affordable Care Act
September 22, 2018

19. IRS Form 990 Schedule H

20. New ACA Requirements for Tax-Exempt Hospitals
Community Health Needs Assessments every three years
Implementation strategies based on identified community needs
Financial assistance policy
Policy related to emergency medical care
Billing, collections

21. Issues in Reporting
Community building
Grants and contributions

22. Community Building
“Some community building activities may also meet the definition of community benefit. Do not report in Part II community building costs that are reported in on Part I...as costs of a community health improvement service…”

23. Grants and Contributions
“Direct offsetting revenue also includes restricted grants or contributions that the organization uses to provide a community benefit, such as a restricted grant to provide financial assistance or fund research. Direct offsetting revenue does not include unrestricted grants or contributions that the organization uses to provide a community benefit.”

24. Philanthropy Implications
Community benefit can impact:
Employee loyalty
Community good will
Partnerships and more
Success in advocacy
Perception of stewardship

25. Building Bridges Between Philanthropy and Community Benefit
What Philanthropy can do:
Team or committee membership exchange
Involvement in community benefit process:
Assessment (including focus groups, interviews)
Planning – recommend priorities
Budgeting – need for grants and contributions
Program implementation – see mission in action
Program evaluation – what do funders want?
Telling the community benefit story
Other?

26. Building Bridges Between Philanthropy and Community Benefit
What Community Benefit can do:
Team or committee membership exchange
Dispel myth of deep pockets
Involvement in philanthropy process
Planning
Materials development
Activities
Demonstrate evidence base, sustainability, ROI (short term, too)
Other?

27. Trends in Community Benefit
From random acts to strategic thinking
Public health orientation
Visible and accountable – inside and out
From solo to collaboration – inside and out
Looking upstream – at determinants of health