Instructions
This slide deck contains two presentations:
• An Orientation to Community Benefit for
Organizational Leaders (starts slide 2)
• An Orientation to Community Benefit: What
Frontline Staff Need to Know (starts slide 27)
• The content in these slides may be copied into
existing presentations or used on their own.
1
An Orientation To
Community Benefit For
Organizational Leaders
Our Tradition
• Catholic health care has a rich tradition of
serving our communities
• Founding sisters came to this country to care for
the sick and start hospitals, nursing homes,
schools and orphanages
• We follow the tradition of Jesus who had special
affection for poor and vulnerable persons
• Providing community benefit is an essential part
of our mission
3
(Organization’s Name) Tradition
• (the story of this organization)
4
Our Tradition

Our Gospel values commit us to:
– Promote and defend human dignity – treat every
person with respect
– Care for poor and vulnerable persons – reach out to
underserved persons
– Promote the common good – always look for what is
in the best interest of the community
– Steward resources – use our financial and human
resources wisely
– (add values of this organization)
5
We Need To Be Accountable
Affordable Care Act (ACA)
The ACA added requirements for taxexempt hospitals related to:





Community health need assessment
Implementation strategy
Financial assistance
Charges
Billing/collections
6
Affordable Care Act
ACA requirements for community health
needs assessment (CHNA):
 At least once every three years
 Include input from persons who represent the
broad interests of the community
 Include input from persons having public health
knowledge or expertise
7
Affordable Care Act
ACA requirements for implementation
strategy:
 A written plan that addresses each of the community
health needs identified through a CHNA for the hospital
 Describes either:
• How the hospital plans to meet the health need, or
• Why the hospital does not intend to meet the health
need
 Adopted by governing body
8
We Need To Be Accountable
Mandated Reporting
 The Internal Revenue Service and 20
states require annual reporting of
community benefit information.
9
We Need To Be Accountable
IRS Reporting
 Hospitals must report on the IRS Form 990, Schedule H:
• Financial assistance and other community benefit
information
• Information about:
-- Financial assistance policies
-- Collection policies
-- Community need assessment
-- Other information about how the
organization benefits the community
10
We Need To Be Accountable

We are being asked if we are still
charitable, community oriented
organizations:
•
•
•
•
By the sisters (or others) who sponsor our
organizations
Our board, donors, and others to whom we are
responsible
Our communities
Those who grant us exemption from taxes
11
We Need to Be Accountable

To be accountable, we:
•
•
•
•
Plan community benefit programs in an
organized way
Design community benefit programs to respond
to community needs
Work closely with people and organizations in
our communities
Keep track and report what we do for our
communities
12
Principles of Our Community
Benefit Programs






The economically poor have a moral priority for services
We have a responsibility to work to improve health in
communities by focusing on prevention as well as treatment
Community members and organizations are invited to be
actively involved in all phases of our community benefit
program
It is important to demonstrate the value of community
service
Commitment to community health improvement should be
reflected throughout our organizations
Leadership commitment is needed for successful
community benefit programs (active support of senior
management and governing board)
13
To Be Sustainable, Our Program
Needs Organizational Support





A culture that sets the tone
Commitment of leaders
Sufficient staff
Adequate budget
Collaborative relationships with community
members and groups
14
To Be Sustainable, Our Program
Needs a Strong Infrastructure

Clear and visible policies, including:
•
•
•
Financial assistance for uninsured and
underinsured
Involvement of physicians in serving low-income
persons and participating in community benefit
programs
Encouraging employees to always act charitably
and respectfully and to participate in community
benefit programs
15
To be Sustainable, Our Program
Needs a Strong Infrastructure
 Integration with other critical functions:
• Planning
• Operations
• Clinical Services
• Communications
16
Steps in Our Community Benefit
Program

Assessing needs and resources in
the community:
•
•
•
•
Use existing and new information
Focus on service gaps, risk factors and health
problems
Work with others in our community
(Present greatest needs in this community)
17
Steps in Our Community Benefit
Program

Setting priorities for what services to
engage in:
•
•
•
Look at seriousness and scope of problem,
determine whether this is a problem to the
community
Consider our organization's strengths and what
we can contribute
Put priority on services related to access to care
and other services for the economically poor
18
Steps in Community Benefit
Program
Planning
•
•
•
•
Our strategic plan includes information on health
problems in the community and our role in
addressing them
We are part of community-wide programs to
improve health and health services in our
community (insert examples)
We have our own implementation strategy
describing our specific community benefit efforts
(insert examples)
Each program has a specific objective so we can
track whether it is making a difference
19
Steps in Our Community Benefit
Program
Tracking community benefits
•
We have an organized way of keeping track of
community benefits that is used throughout
Catholic health care and by many other
organizations
20
Tracking Community Benefits
 Community benefits include:
– Financial assistance and discounted services to
uninsured and low-income persons
– Participation in Medicaid programs
– Losses from programs we subsidize because they are
needed in the community (i.e. mental health services)
– Community health services (clinics, health education)
– Training for physicians, nurses and others
– Research
– Contribution: cash and in-kind
– Community building activities (advocacy for early
childhood development programs, housing for lowincome seniors)
21
Steps in Our Community Benefit
Program

Evaluation – we look at:
•
•
•
•
Are we giving resources to the right places?
Are our programs effective in making a
difference?
Are we a good partner in the community?
Is our program well run and of high quality ?
22
Steps in Our Community Benefit
Program
Telling the story
•
•
•
Shows staff, physicians, board and
community members we are a mission-driven
organization
Invites community members and groups to
support our programs – as program partners,
as volunteers, as donors
Demonstrates that our tax exempt purpose is
still being fulfilled
23
Steps in Our Community Benefit
Program
Telling the story
•
We tell our community benefit story in all
communications:
•
•
•
•
•
•
Reports to the community and others
Orientation and education of staff
Board meetings
Talks to community groups
Media contacts
Advocacy visits to policymakers
24
What Community Benefit Programs
Need from Organizational Leadership




Visible and vocal commitment that
community health improvement and
community benefit is an important part of
this organization
Inclusion of community needs and
community benefit programs in strategic and
operational plans
Appointment of staff, committees, other
needed resources
Incentives for all managers, staff, and
physicians to participate
25
Summary





We provide community benefits because this is an
important part of our mission
Our communities need us to provide services to
uninsured and low-income persons and to help
improve health in our communities
We provide community benefits in an organized way
We need the support of executive and trustee
leaders
Community benefits demonstrate that we continue
the faith-inspired tradition of our founders
26
An Orientation To
Community Benefit: What
Frontline Staff Need To Know
Our Tradition
 Catholic health care has a rich tradition of
serving our communities
 Founding sisters came to this country, to care for
the sick and start hospitals, nursing homes,
schools and orphanages
 We follow the tradition of Jesus who had special
affection for poor and vulnerable persons
 Providing community benefits is an essential
part of our mission
28
(Organization’s Name) Tradition
• (the story of this organization)
29
Our Tradition
Our values commit us to:
•
•
•
•
•
Promote and defend human dignity – treat
every person with respect
Care for poor and vulnerable persons – reach
out to underserved persons
Promote the common good - always look for
what is in the best interest of the community
Steward resources - use our financial and
human resources wisely
(add values of this organization)
30
As a Catholic Health Care
Organization
We believe:
•
•
•
•
The economically poor have a moral priority for
services
The "stranger" – persons who were not born in
this country and who do not speak our language
– deserve special consideration
We have a responsibility to work to improve
health in communities by focusing on prevention
as well as treatment
Serving uninsured and poor persons and
providing community benefits is an essential part
of our mission
31
Facts About Poverty
Statistics
•
•
•
In 2010, more than 46 million people lived in
poverty. This number of people living in poverty
is the largest number seen in 52 years.
In over 31% of single family homes (no father),
the children are poor
In 2010, 22% of all children lived in poverty –
that’s over 1 in every 5 children.
www.povertyusa.org
32
Facts About Poverty
Federal definition of poverty:
•
•
For a family of four, income of less than about
$22,314/year
For a family of three, income of less than about
$17,374/year
U.S. Census Bureau
33
Facts About Poverty
What it means to be poor
•
•
•
•
Families meeting federal definition do not have enough
funds to meet basic needs of minimal housing, utilities,
food, transportation, health care, and child care
They have no extra income for things such as school
supplies, clothes, birthday gifts, entertainment, household
supplies
In 2010, one in seven American households were food
insecure.
There are fewer opportunities than before for people to
work their way out of poverty
www.povertyusa.org
34
Facts About the Uninsured

The effect of being uninsured has an
impact on health:
•
•
•
•
Problems getting medical care
Less use of preventative services
Unable to follow-up, fill prescriptions
More likely to be hospitalized with preventable
problems
35
U.S. Census Bureau
Who Benefits From Our
Community Benefit Program?



The whole community
People living in poverty
The uninsured and underinsured
36
How We Help to Make
Communities Healthy
 We do this by:
• Assessing needs and resources in our community
• Setting priorities among service gaps and problems
we find
• Working with other community groups
• Developing an organized plan
• Keeping track of the services we provide
• Evaluating whether our programs are working
• Telling others about our work and inviting them to
help
37
Services We Provide in
Response to Community Need
Some of these services include:
•
•
•
•
•
•
•
Financial assistance and discounted services to
uninsured and low-income
Participation in the Medicaid programs
Losses from programs we subsidize because they are
needed in the community (i.e. mental health services)
Community health services (clinics, health education)
Training for physicians, nurses and others
Contribution: cash and in-kind
Community building activities (advocacy for better
health programs, environment improvement)
38
Information About Our Financial
Assistance Program (Charity Care)




We provide free care and can discount the cost of
care to persons who meet certain financial criteria
We have written financial assistance policies that
are posted in prominent areas
Our policies describe who is eligible and what
services are covered
We try to determine eligibility for financial
assistance before care is given, but sometimes
people do not know or are afraid to tell us they
need financial help
39
Information About Our Financial
Assistance Program (Charity Care)
 Determination for needing financial assistance
can made any time throughout the
admission/treatment/discharge/billing process
 We make an effort to identify all persons who
might be eligible for financial assistance and
discounts
 We treat uninsured and low-income persons
the same way we treat all patients
– High quality care
– With respect
40
(Organization’s name) Financial
Assistance Policies
41
What Emergency Departments
Should Know

Every person who needs emergency
services should be treated:
• With respect
• With the highest quality of care to
all patients
• Without any regard to ability to
pay
42
What Emergency Departments
Should Know

If a patient is uninsured or underinsured:
•
•
•
•
Inform them about financial assistance and discount
policies and how to apply
Find out if they are eligible for Medicaid, state
indigent care or children's health insurance program
and help them to apply
Find out if they can get needed follow-up care (such
as filling prescriptions) and refer to community
resources if needed
Inform them about community resources for getting
affordable primary care which might prevent future
need for emergency care (free clinics, mobile health
units)
43
What Billing Departments
Should Do
 All bills should state:
• That financial assistance, with all or part of
the bill, may be available for uninsured and
low-income persons
• How persons can apply for assistance
 Establish a process for resolving unpaid
bills
* Be sure to check latest IRS rules for specifics
44
What Billing Departments
Should Do

For persons who cannot afford to pay their
bills:
•
•
•
•
Find out if person could be eligible for public
program assistance (Medicaid, state indigent
care, children's health insurance)
Assist them to apply for facility financial
assistance
When appropriate, convert bill to financial
assistance and inform the patient of this
Treat every person respectfully
*Be sure to check latest IRS rules for specifics
45
All Staff Can Participate in
Community Benefit Programs






Tell patients you come in contact with about
programs we provide that may be of benefit to them
Let community benefit staff know about community
health issues you have encountered in your work
Let the community benefit staff know about all
community activities that your department or
program is providing
Volunteer to help with our programs
Tell others about our community benefit programs
and invite them to be involved
Let us know if you would like time off for a personal
volunteer program
46
(Organization’s Name) Community
Benefit Activities
Our community benefit activities include:
For more information about our community
benefit activities, contact (add contact info)
47
Summary



We provide community benefits because
this is an important part of our mission
Our communities need us to provide
services to uninsured and low income
persons and to help improve health in our
communities
When we provide these services, we
demonstrate that:
–
–
We continue the faith-inspired tradition of our founders
We are who we say we are
48
"For I was hungry and you gave me
food, I was thirsty and you gave me
drink, a stranger and you welcomed
me, naked and you clothed me, ill and
you cared for me, in prison and your
visited me. ..what you did not do for
one of these least ones, you did not do
for me….“
- Matthew 25
49