May 2019 Community Benefit Update

We would like to share the following community benefit news and resources with you. Please visit www.chausa.org/communitybenefit for access to all of CHA's updates and resources on community benefit.

Senator Grassley Renews Probe of Non-Profit, Tax-Exempt Hospitals
In February Senate Finance Committee Chairman Chuck Grassley announced plans to focus on oversight of not-for-profit hospitals and community benefit. The Senator sent a letter on Feb. 19 to the Internal Revenue Service (IRS) asking for information about hospital compliance with the tax-exemption requirements of the Affordable Care Act (ACA).

In a recent meeting with CHA staff, Senate Finance Committee (SFC) oversight and health staff highlighted several issues they are looking into, such as:

  • What is the trend in hospital compliance;
  • Who are the bad actors and what is being done by the IRS;
  • How transparent are hospitals with their communities;
  • Are hospital debt collection practices in compliance;
  • Are not-for-profit hospitals making a difference in their communities; and
  • How have hospitals' decisions changed because of the requirements? 

It is likely the SFC will hold a hearing on the IRS findings and could potentially include "bad actors," hospitals identified by the IRS or press. There did not seem to be a focus on adding new rules or legislative requirements at this time. 

Pre-Assembly Community Benefit Program — The Heart of Community Benefit
If you are planning to attend CHA's annual Assembly in Dallas this year, don't miss the Community Benefit Pre-Assembly program — The Heart of Community Benefit: Relationships, Accountability and Impact. Held in the morning hours on June 9 prior to the opening of Assembly 2019, this session brings together leaders in community benefit as well as sponsors, executives, mission and clinical leaders who are working to improve the health of the communities they serve. This year's program will highlight innovative approaches to addressing the social determinants of health as well as a discussion with ministry colleagues on how to be more transparent and accountable — from both a reporting and health impact perspective.  Visit the CHA website for more information.

New Report on Community Resource Referral Platforms
Health care organizations are increasingly seeking to document patients' social and economic needs and facilitate relevant referrals to social service organizations. To help health care organizations understand what new technologies can support this work, the Social Interventions Research and Evaluation Network (SIREN) of UCSF has developed a guide that explores the landscape of community resource referral platforms and the experiences of early adopters. Drawing upon a review of nine commonly used platforms and interviews with 39 organizations in the process of selecting or implementing a platform, the guide provides a primer on the current features and functionalities of these technologies and distills lessons learned and recommendations on how to implement a community resource referral platform.

NACCHO and the Urban Institute Announce a Webinar — Social Determinants on the Local Level: Housing and Health
On May 14 at 2 p.m. ET, the National Association of County and City Health Officials (NACCHO) and The Urban Institute will host a webinar that explores the relationship between housing and health and ways to assess housing as a social determinant in your community. Housing stability, quality, safety and affordability all affect health outcomes. Poor-quality housing is associated with various negative health outcomes, including infectious disease and psychological distress. This webinar will discuss specific quality affordable housing strategies that can lead to improvements in physical and mental health. For more information and to register, click here.

Webinar — Communities for Change: Preventing Suicide
We lose someone to suicide every 12 minutes in the United States, and the suicide rate has increased almost 30 percent in the last two decades. In addition to the enormous emotional toll of suicide and self-harm, the combined medical and work loss costs amount to over $56.9 billion per year.

Suicide is preventable with treatment and support. The third part in the National Institute for Health Care Management (NIHCM) Foundation's Defying Despair series, this May 8 webinar will delve deeper into the data on suicides and explore a range of initiatives designed to prevent suicide in different communities. Visit the NIHCM's website for a draft agenda and to find Part 1 in their series on the science of well-being and Part 2 on mental health trends.

Nonprofit Hospitals and Health Disparities
The March 2019 edition of the AMA Journal of Ethics features the article, "How Should Nonprofit Hospitals' Community Benefit Be More Responsive to Health Disparities?" The authors of the article suggest changes to federal policy such as requiring community partners' involvement in implementation strategies, requiring CHNAs be completed every five years instead of three years, changing IRS regulations to recognize work on social determinants as community benefit and requiring CHNAs to describe a community's health disparities and clarify how their implementation strategies address them. 

Actively Addressing Social Determinants of Health will Help Us Achieve Health Equity
A new blog post by Cara V. James, Ph.D., director of the CMS Office of Minority Health, discusses CMS' work on addressing social determinants of health, a key step towards achieving health equity.  Dr. James' post includes links for information about ICD-10 codes on socioeconomic and/or psychosocial needs; the Accountable Health Communities (AHC) Health-Related Social Needs Screening Tool; the PRAPARE tool (Protocol for Responding to and Assessing Patients' Assets, Risks and Experiences) and the Health Leads Screening Toolkit.

In Case You Missed It — New Resources from CHA
Visit the CHA website to learn more about the following new resources:

Upcoming CHA Events

  • May 13, 2019, at 2 p.m. ET — What Counts as Community Benefit webinar. Does it count as community benefit? What are the guiding principles for reporting (and not reporting) programs and activities as community benefit? Presenters Trina Hackensmith of Lyon Software and Julie Trocchio of the Catholic Health Association will review the basic guidelines from the IRS Form 990, Schedule H Instructions and from CHA's A Guide for Planning and Reporting Community Benefit that can help answer these questions. They will also review the categories of community benefit and what should and should not be reported in each, go over recent questions submitted to the CHA What Counts Hotline and discuss some of the "gray areas" of community benefit. For more information, visit the CHA website. This webinar is free to CHA and Vizient members.
  • June 9, 2019 from 8 a.m. to Noon — Community Benefit Pre-Assembly Program — The Heart of Community Benefit: Relationships, Accountability and Impact.This year's pre-assembly meeting will focus on the importance of community relationships, addressing the social determinants of health and the accountability and impact of an organization's community benefit efforts.  For more information, visit the CHA website.
  • October 15-16, 2019 — Community Benefit 101: The Nuts and Bolts of Planning and Reporting Community Benefit, St. Louis. Taught by experienced community benefit leaders, this program presents a practical framework for assessing community needs and planning, evaluating and reporting on community benefit programs. For more information, visit the CHA website.

Community Benefit in the News
View recent articles from Catholic Health World and Health Progress featuring community benefit news and programs from the across the ministr