Issues

Community Benefit: Continuing the Tradition - Community Benefit Guidelines Born of Shared Experience

July-August 2006

BY: JULIE TROCCHIO, RN, MS, and NATALIE DEAN
Ms. Trocchio is senior director, continuing care ministries, Catholic Health Association, Washington, DC. Ms. Dean is director, social accountability, Trinity Health, Novi, MI, and chair, CHA Community Benefit Committee.

In June, CHA published A Guide for Planning and Reporting Community Benefit, a revision of its 1989 Social Accountability Budget. The new guide, like its predecessor, was developed from leading practices in Catholic health care systems and facilities.

The Guide represents more than 20 years of experience of community benefit leaders of Catholic health care organizations. Its guidelines present lessons learned from community benefit "laboratories" across the country.

Core Beliefs
The Guide reflects the enduring and contemporary core beliefs on which Catholic health care community benefits were built and that continue to undergird them today. Among them are these:

  • People who live in poverty and at the margins of our society have a moral priority for services.
  • Not-for-profit, mission-driven health care organizations have a responsibility to work to improve health in the communities they serve.
  • Community members and organizations should be actively involved in health care facility community benefit programs.
  • Health care organizations must demonstrate the value of their community services.
  • Community benefit programs must be integrated throughout health care organizations.
  • Leadership commitment is required for successful community benefit programs.

The building blocks of community benefit programs, as described in the Guide, comprise the steps that community benefit leaders have learned are required for successful community benefit programs.

Building a Sustainable Infrastructure
In order for community benefit programs to be sustainable, health care organizations have learned that they must make sure they commit themselves to a clear mission to serve their communities.

They also must put together a solid community benefit program infrastructure that includes building collaborative relationships with community members and organizations, securing adequate staffing and budgeting, having policies that are well understood and consistently practiced, and making leaders accountable for meeting community benefit goals.

Planning for Community Benefit Community
benefit professionals have discovered that preparation for a community benefit program needs to be as conscientious as that for any other initiative. Successful programs must integrate planning for community benefits with other health care organization planning functions — including strategic, communications, and financial planning — and must also be integrated with community-wide efforts to improve health locally.

Determining What Counts as Community Benefit
Community benefit leaders have spent considerable effort in recent years identifying what should and should not be counted as community benefit. CHA's newly revised guidelines define community benefit to be consistent with Internal Revenue Service rules and rulings and include the following categories: charity care, subsidized government indigent care programs, community health services, health professions education, subsidized health services, research, financial contributions, and community-building activities.

These definitions, however, as well as the other guidelines, are works in progress.

Accounting for Community Benefit
Chief financial officers of Catholic organizations have helped develop standardized principles and policies to account and budget for community benefits and to tell the community benefit story. These standardized accounting methods ensure that quantitative reports of community benefit are credible and accurate and can be compared with reports from other organizations.

Evaluating Community Benefit Programs
Since CHA first published its Social Accountability Budget, a major advancement in the field of community benefit has been the development of methods not only to capture the cost of community benefits and the numbers of people served but also to determine whether services and activities are effective in improving health in the community.

By establishing specific objectives and indicators of effectiveness, the Guide builds on experience in the field to help those who use it evaluate the overall community benefit program and individual initiatives.

Communicating the Community Benefit Story
Community benefit leaders have also learned that community benefit programs should be closely connected to all aspects of an organization's communications. Communications and community benefit staff should work together closely in developing, planning, tracking, and evaluating community benefit programs in order to tell the community benefit story.

Let's Share Ideas
In the months and years ahead, the community benefit guidelines will continue to be augmented by experience from the field and will also be refined through dialogue. CHA's website, www.chausa.org, will supplement the guide with examples from the field — policies, job descriptions, sample reports, successful experiences, and much more.

We hope that leaders of community benefit programs at member organizations will send us examples of items to be shared with others. Please send ideas, questions, and suggestions to jtrocchio@chausa.org.

Copyright © 2006 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.