Online Program

280967
Community benefits and schedule h: Needs assessment and what counts


Wednesday, November 6, 2013 : 10:45 a.m. - 11:00 a.m.

Martha Somerville, J.D., M.P.H., Somerville Consulting, Baltimore, MD
“Community benefits” are health-related investments and activities, other than fully reimbursed medical care, that a hospital provides to its community. Community benefit obligations can arise in several legal contexts (e.g. condition of licensure, conversions, or health planning processes) but are most commonly associated with tax-exempt hospitals. Section 9007 of the Affordable Care Act (ACA) established new requirements and reporting standards nonprofit hospitals must satisfy for federal tax exemption. These provisions clarify and promote transparency of tax-exempt hospitals' efforts to meet federal community benefit responsibilities in four areas: community health needs assessment, financial assistance policies, limitations on hospital charges, and billing and debt collection requirements. The Internal Revenue Service has implemented the new requirements with guidance notices, a proposed rule, and through Schedule H (Form 990) and associated instructions. In Parts I and II of Schedule H, hospitals report their activities that benefit their communities. In Parts V and VI, they describe their required community health needs assessment, conducted to ensure that each hospital's community benefit initiatives are responsive to their communities' identified health needs and priorities. This presentation will address federal community health needs assessment requirements, financial assistance and other community benefits reportable in Part I of Schedule H, and activities that may be reported as “community health improvement services.” It will also address Schedule H's policy implications and its potential usefulness to public health decision-makers,practitioners, and policymakers.

Learning Areas:

Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
Discuss the rationale supporting the federal tax exemption for nonprofit hospitals Explain the basics of the federal community benefit reporting framework. Discuss the policy implications of Schedule H transparency.

Keyword(s): Community Benefits, Community Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Trained in law and public health, I've worked in health policy for over 17 years, lately focusing on tax-exempt hospital community benefits. Until October 2013, I directed the Hilltop Institute’s Hospital Community Benefit Program, leading development of issue briefs and newsletters exploring state and federal community benefit law and policy, including Schedule H reporting and IRS's proposed CHNA regulations. Currently, as Somerville Consulting, I provide public health policy/legal analysis to public sector and nonprofit clients.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.