Welcome! 2013 Healthcare Leadership & Education Summit June 13, 2013 Greensboro, GA

Welcome!2013 Healthcare

Leadership & Education Summit

June 13, 2013Greensboro, GA

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Speaker:Trina S. HackensmithVice President, Lyon Software

Introduction

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Community BenefitWhy are we talking about Community Benefit?

IRS 990H requirements

Ensuring fulfillment of mission

Heightened tax-exempt scrutiny

PR/marketing efforts

Lyon Software 2013

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Community BenefitIRS 990H Requirements

Lyon Software 2013

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Community BenefitHeightened Tax-Exempt Scrutiny

Lyon Software 2013

…accountability and transparency…

distrust of hospitals inconsistency in reporting

how much is enough

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Community BenefitEnsuring Fulfillment of Mission

Lyon Software 2013

“Mission-driven organizations do not provide community benefit because of external pressures…They do it because it is right…”

Source: A Guide for Planning & Reporting Community Benefit, CHA 2012 Edition, page 16

“Our organizations were established not for economicopportunity but to address the need for health services in our communities. Our facilities were born out ofcommunity need, a tradition that continues today.”

Sr. Carol Keehan, DCPresident and CEO

Catholic Health Association

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Community BenefitPR/Marketing Efforts: Telling Your Story

Lyon Software 2013

“The responsibility rests with hospital and health system marketers to put all the pieces of community benefit together to create a consistent, ongoing message that demonstrates the organization’s commitment to improving the community’s health status.”

Patsy MathenyA Marketer’s Guide to Community Benefit Reporting and IRS Form 990H, HCPro, Inc. 2009

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What is Community Benefit and What

Counts?

The information provided in this presentation does not constitute legal or tax advice. The material is provided for informational/educational purposes only.

What is Community Benefit?

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

10Source: A Guide for Planning & Reporting Community Benefit 2012 Edition


1. It must address a documented community need

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• 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: IRS 990H Instructions, 2012



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



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



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



d) Relieve/reduce the burden of gov’t/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 tax-

exempt organization would increase

• The program receives philanthropic support through

community volunteers or contributions

What is NOT Community Benefit


A program does not count as community benefit, if:

The program is primarily for marketing purposes

The program benefits the organization more than the community

An objective “prudent layperson” would question whether the program

truly benefits the community

The program or donation is unrelated to health or the hospital’s mission

The program represents a community benefit provided by another entity

or individual

Access to the program is restricted to employees or physicians affiliated

with the hospital

The activity represents a normal “cost of doing business” or is associated

with the current standard of care

What Qualifies (Counts) as a Community Benefit?

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Financial Assistance

Medicaid

Other Means-tested

Government Programs

Community Benefit ServicesCategories A-G

A. Community Health Improvement

B. Health Professions Education

C. Subsidized Health Services

D. Research

E. Financial & In-kind Contributions

F. Community Building Activities

G. Community Benefit Operations

Categories of Community Benefit

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Community Health Improvement Services (category A)

Source: A Guide for Planning & Reporting Community Benefit 2012 Edition

Health Fairs

Screenings

Ask a Nurse

Lead Removal

“Community health improvement services” means activities or programs, subsidized by the health care organization, carried out or supported for the express purpose of improving community health. Such services do not generate inpatient or outpatient bills, although there may be a nominal patient fee or sliding scale fee for these services.

A1: Community Health EducationA2: Community-Based Clinical ServicesA3: Health Care Support ServicesA4: Social and Environmental Improvement Activities

Source: 2012 IRS 990H Instructions


Health Professions Education (category B)

Educational programs that result in a degree, certificate, or training necessary to be licensed to practice as a health professional, as required by state law, or continuing education necessary to retain state license or certification by a board in the individual's health profession specialty.



B1: Physicians/Medical StudentsB2: Nurses/Nursing StudentsB3: Other Health Professions EducationB4: Scholarships/Funding for Health Professions Education


Subsidized Health Services (category C)



C1: Emergency and Trauma Services C2: Neonatal Intensive CareC3: Hospital Outpatient ServicesC4: Burn UnitsC5: Women’s and Children’s ServicesC6: Renal Dialysis ServicesC7: Subsidized Continuing CareC8: Behavioral Health ServicesC9: Palliative Care

“Subsidized health services” means clinical services provided despite a financial loss to the organization. The financial loss is measured after removing losses associated with bad debt, financial assistance, Medicaid, and other means-tested government programs.

Examples of Subsidized Services

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Research (category D)

“Research” means any study or investigation the goal of which is to generate increased generalizable knowledge made available to the public



D1: Clinical ResearchD2: Community Health ResearchSource: A Guide for Planning & Reporting Community Benefit 2012 Edition

Where is the money coming from to fund the research? Self? Not for profit? Government?

NOT a for profit

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Financial and In-Kind Contributions (category E)


Where is the money going?

“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 described in the table in Part I, line 7

E1: Cash DonationsDon’t count employee-donated fundsSend a “restricted use” letter

E2: GrantsWhat constitutes a grant?

E3: In-Kind DonationsMeeting room spaceEmployee timeActual not opportunity cost



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Community Building Activities(category F)


Report in this part the costs of the organization's activities that it engaged in during the tax year to protect or improve the community's health or safety, and that are not reportable in Part I of this schedule.


F1: Physical Improvements and HousingF2: Economic DevelopmentF3: Community SupportF4: Environmental ImprovementsF5: Leadership Development/Training for Community MembersF6: Coalition BuildingF7: Advocacy for Community Health Improvements and SafetyF8: Workforce DevelopmentSource: A Guide for Planning & Reporting Community Benefit 2012 Edition

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Community Building Activities(category F continued)



Some community building activities may also meet the definition of community benefit… An organization that reports information in this Part II must describe in Part VI how its community building activities promote the health of the communities it serves.

Direct link to health = Category A

Indirect (or less direct) link to health = Category F

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Community Benefit Operations (category G)


“Community benefit operations” means:

• activities associated with community health needs assessments,

• community benefit program administration, and

• the organization's activities associated with fundraising or grant-writing for community benefit programs.


Consider including costs of training, program evaluation, and CBISA™!

IRS Form 990 Schedule H

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IRS 990H Part I: FAP, Medicaid, Means-tested, Categories A, B, C, D, E, & G

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IRS 990H Part II: Community Building Activities (F)

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IRS 9990H Part III: A (Bad Debt), B (Medicare), and C (Collection Practices)

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IRS 9990H Part VI: Supplemental Information

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www.irs.gov/form990

Telling Your Story: A Marketer’s Responsibility

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The information provided in this presentation does not constitute legal or tax advice. The material is provided for informational/educational purposes only.

Telling Your Story

32Source: Listening Post Communiqué No. 22 December 2012

Communicating the core values of nonprofits

Telling Your Story

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How is the hospital demonstrating it’s commitment to improving the health of the community?

Are you helping to tell the story of good stewardship of resources?

Source: Patsy Matheny, A Marketer’s Guide to Community Benefit Reporting and IRS Form 990H, HCPro, Inc. 2009

“Tell your story – Tell your story – Tell your story!”Con Kelly

Social Accountability Task Force

Creating a consistent, ongoing message

Telling Your Story

34Source: Patsy Matheny, A Marketer’s Guide to Community Benefit Reporting and IRS Form 990H, HCPro, Inc. 2009

Helping to prepare the IRS 990 Schedule H

Two fundamental tasks for the marketer…

1. Contribute to the open-ended questions in Part VI (the “essay questions”)

2. Prepare yourself and others on how to respond to media and other inquiries on the information submitted on the Schedule.

Telling Your Story

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Identifying key internal and external audiences

Board MembersVolunteers

ManagementMedical Staff


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Resources

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Resources

Written by: Patsy Matheny, LLC

Available at Amazon.com and HealthLeaders Media

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Resources

www.chausa.org

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Resources

http://www.chausa.org/communitybenefit/printed-resources



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Resources

www.thecommunityguide.org

www.healthypeople.gov

www.countyhealthrankings.org

http://www.thecommunityguide.org/

http://www.healthypeople.gov/

http://www.countyhealthrankings.org/

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Resources

419-885-4593

9:00 am – 5:00 pm (EST)

support@ lyonsoftware.com

www.lyonsoftware.com

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Lyon Software…striving to make social accountability reporting a streamlined process…

Welcome! 2013 Healthcare Leadership & Education Summit June 13, 2013 Greensboro, GA

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