1. A Study on the Sustainability of Public Charity Organizations in States with Highest and Lowest Health Rankings
Presented by:
Angela D. Johnson, PhD(c),MPPA
Jackson State University,
Department of Public Policy and Administration

2. Research question
Are public charities in states with the lowest health rankings less likely to sustain government grants and contributions than public charities in states with the highest health rankings?

3. Definition: State Health Rankings
Four Categories of Determinants of Health
Based on the World Health Organization’s definition of health:
“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”
Z score =
State value – U.S. Value
Standard deviation of all state values
The Z score indicates the number of standard deviations a state value is above or below the U.S. Value. A indicates a state has the same value as the U.S. States with higher values than the U.S. value have positive scores, while states that perform below the U.S. value have a negative score.

4. Definition: Public charities
Churches, hospitals, qualified medical research organizations affiliated with hospitals, schools, colleges and universities,
Have an active program of fundraising and receive contributions from many sources, including the general public, governmental agencies, corporations, private foundations or other public charities,
Receive income from the conduct of activities in furtherance of the organization’s exempt purposes, or
Actively function in a supporting relationship to one or more existing public charities.

5. METHODOLOGY: Frequency Analyses
HYPOTHESES
METHODOLOGY: Frequency Analyses
PRIMARY DATA SOURCES
HO1: To the 501(c)(3) public charities in states with the worst health rankings, the majority revenue source will be government grants, relative to the other funding sources.
Independent Variable: State Health Rankings
Dependent Variable: Revenue Sources
Number of 501(c)(3) public charities in the top 5 ranked states ( )
Number of 501(c)(3) public charities in the bottom 5 ranked states ( )
Number and proportion of 501(c)(3) public charities receiving majority support from government unit (fed, state, local) in top 5 and bottom 5 ranked states ( )
*Other revenue sources: Private Foundations and Corporations
America’s Health Ranking’s Annual Report ( )
IRS Exempt Organizations Business Master File
IRS Subsection Code 03, Classification Code 1
Tax Period
IRS Foundation Code 15
HO2: 501(c)(3) public charities in states with the worst health rankings will be less likely to sustain program services than those in states with best health rankings.
Dependent Variable: Program Sustainability
Number of 501(c)(3) public charities in states with best and worst health rankings automatically revoked by IRS ( )
IRS Exempt Organizations Select Check Database
State
Exempt Type (501(c)(3)
Revocation Posting Date

6. Source: Internal Revenue Service’s Business Master File Extract
State Health Rankings Annual Report ( )

7. Source: Internal Revenue Service’s Business Master File Extract
State Health Rankings Annual Report ( )

8. State Health rankings by all determinants of health, 201750 49 48 47 46 45 44 43 42 41 1 2 3 4 5 6 10 9 50 49 48 47 46 45 44 43 42 41 1 2 3 4 5 6 10 9 50 49 48 47 46 45 44 43 42 41 1 2 3 4 5 6 10 9 50 49 48 47 46 45 44 43 42 41 1 2 3 4 5 6 10 9 50 49 48 47 46 1 2 5 3 4 8
Source: Annual Health Ranking Database

9. Public Charity Statistics Top five states with best Overall Health rankings (2015-2017)
2016
Health Rank
State
# Public Charities
PC with Majority Rev from GG/C
Reported Revenue > $0 1
Hawaii
305
184 (60%)
32% 2
Vermont
193
78 (40%)
22% 3
Massachusetts
1082
613 (57%)
36% 4
Minnesota
808
441 (55%)
30% 5
New Hampshire
261
173 (66%)
34%
Health Rank
State
# Public Charities
PC with Majority Rev from GG/C
Reported Revenue > $0 1
Hawaii
3405
1878 (55%)
54% 2
Massachusetts
16621
8050 (48%)
65% 3
Connecticut
7962
3983 (50%)
55% 4
Minnesota
12825
6676 (52%) 5
Vermont
2484
1454 (59%)
52%
2017 (
Health Rank
State
# Public Charities
PC with Majority Rev from GG/C
Reported Revenue > $0 1
Massachusetts
7736
3893 (50%)
53% 2
Hawaii
1005
497 (49%)
29% 3
Vermont
1439
649 (45%)
45% 4
Utah
1906
643 (34%)
36% 5
Connecticut
4252
2251 (53%)
48%
Source: Internal Revenue Service’s Business Master File Extract
State Health Rankings Annual Report ( )

10. Public Charity Statistics Top five states with worst Overall Health rankings (2015-2017)
2016
Health Rank
State
# Public Charities
PC with Majority Rev from GG/C
Reported Revenue > $0 50
Louisiana
649
393 (61%)
20% 49
Mississippi
314
203 (65%)
17% 48
Arkansas
410
260 (63%) 47
West Virginia
255
142 (56%)
13% 46
Alabama
782
393 (50%)
16%
Health Rank
State
# Public Charities
PC with Majority Rev from GG/C
Revenue > $0 50
Mississippi
5430
3773 (69%)
29% 49
Louisiana
8263
4742 (57%)
43% 48
Arkansas
4954
2918 (59%) 47
Alabama
7895
4836 (61%)
47% 46
Oklahoma
7340
54227 (58%)
2017
Health Rank
State
# Public Charities
PC with Majority Rev from GG/C
Revenue > $0 50
Mississippi
1536
729 (47%)
32% 49
Louisiana
2546
1350( 53%)
35% 48
Arkansas
2213
964 (44%)
40% 47
Alabama
3570
1423 (40%)
34% 46
West Virginia
2064
1418 (69%)
21%
Source: Internal Revenue Service’s Business Master File Extract
State Health Rankings Annual Report ( )

11. IRS policy CHANGE: Form 990N (e-postcard)
The Form 990-N electronic-filing system moved from Urban Institute’s website to IRS.gov in February 2016. 
All filers must register at IRS.gov prior to filing their next Form 990-N. This is a one- time registration
Form 990-N must be completed and filed electronically. There is no paper form.
Exceptions to this requirement include:
Organizations that are included in a group return,
Churches, their integrated auxiliaries, and conventions or associations of churches, and
Organizations required to file a different return
IRS policy CHANGE: Form 990N (e-postcard)
1). POLICY CHANGE: Form 990-N, Electronic Notice (e-Postcard) for Tax-Exempt Organizations Not Required to File Form 990 or Form 990EZ, must be submitted electronically.
The Form 990-N electronic-filing system moved from Urban Institute’s website to IRS.gov in February 2016. All filers must register at IRS.gov prior to filing their next Form 990-N. This is a one-time registration; you won’t be asked to register again when filing next year.
Form 990-N must be completed and filed electronically. There is no paper form.
Exceptions to this requirement include:
Organizations that are included in a group return,
Churches, their integrated auxiliaries, and conventions or associations of churches, and
Organizations required to file a different return
(2). DUPICATED ORGANIZATIONS: Different Spelling of Organization Name – Unique EIN
(3). SAME ORGANIZATION, DIFFERENT LOCATION OR CHAPTERS –Unique EIN

12. Sustainability of Public Charities in states with best health rankings
Source: Internal Revenue Service’s Exempt Organization Select Check Database (2017)

13. Sustainability of Public Charities in states with worst health rankings
Source: Internal Revenue Service’s Exempt Organization Select Check Database (2017)

14. Initial findings
There is no significant association between state health rankings and sustainability of government funding to public charities in states with highest health rankings compared to states with lowest health rankings.
There is no significant difference in the sustainability of programs and services among states with the highest health rankings compared to states with the lowest health rankings.

15. CONCLUSION
The United States continues to document increasing mortality rates even in those states ranked highly for for overall health.
The number of public charities situated in states with lower health rankings is not indicative of increased health outcomes.
Public Charities can serve as agents of governmental entities to address social determinants of health.
Public policies and government funding can significantly increase the number of public charities but does not necessarily increase their capacity to sustain programs and services.