Free Webinar – October 31, 2017

A Multi-Sector Approach to Improving Child Mental Health: The DC Collaborative for Mental Health in Pediatric Primary Care

9 am PT/10 am MT/11 am CT/12 Noon ET

Dr. Lee Beers
Associate Professor of Pediatrics
Medical Director for Municipal and Regional Affairs, Children’s National’s Goldberg Center for Community Pediatric Health and Child Health Advocacy Institute

Mental health is a significant health need identified in many of our hospital service areas. In this country, approximately 13% of youth live with a serious mental illness, but only about 20% of those with mental illness get the help they need. While primary care providers are often positioned to assess a child’s behavioral problems early on, many feel ill-equipped to make the right referrals, prescribe medications, or manage a chronic condition. To give pediatricians the resources they need, Children’s National worked with other area intuitions to establish the DC Collaborative for Mental Health in Pediatric Primary Care.

This webinar will describe local efforts by Children’s National to integrate mental health services into pediatric primary care. Dr. Beers will describe several key initiatives of the DC Collaborative for Mental Health in Pediatric Primary Care and discuss how taking a health network approach to this complex issue improves outcomes and provides community benefit.

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The IRS Audits Hospitals for Community Benefit Compliance

You may have heard that a 501(c) (3) hospital operated by a “local county government agency” has lost its tax-exempt status because it was not compliant with community benefit requirements, including conducting a CHNA, developing an Implementation Strategy and making them widely available to the public. The link below has some interesting information about the IRS’ work on auditing hospitals for community benefit compliance.

An excerpt from the article by Meg Bryant:

“The IRS reported 2,482 compliance reviews of charitable hospitals completed between 2014 and 2016 in a June 2016 letter to Sen. Chuck Grassley (R-Iowa). Of those, 163 were slated for further examination. The Affordable Care Act (ACA), which established 501(r), requires the agency to conduct such reviews at least once every three years.

Hospitals need to accept that 501(r) is here to stay and learn to live with it, says Gil Ghatan, a senior associate in the tax and benefits department of Ropes & Gray. While Congress could still take another stab at repealing the ACA, lawmakers have shown strong bipartisan support for these requirements of charitable hospitals.”

Tax-Exempt Hospital Schedule H Reporting, 2009 – 2013 Comparison

Ernst & Young LLP (EY) assisted the American Hospital Association (AHA) in reviewing the AHA’s 1,300 member hospitals’ Form 990 Schedule H’s for tax year 2013. Access the entire report here: The report provides breakouts of the data based on a number of subcategories including: systems and single hospitals. Single hospitals are further examined by size (amount of annual expense); location (urban, suburban, rural); and hospital type (children’s, critical access, teaching, medical/surgical).

Community Benefit Connect summarized four years of Schedule H community benefit contributions in the table below. The community benefit contribution is a percentage of total hospital expenses. This information is helpful to use as a benchmark for your hospital community benefit giving.

Tax-Exempt Hospitals’ Schedule H Community Benefit Reporting, 2009, 2010, 2011, 2013

Average percent of total hospital expense Charity care, Medicaid shortfall, other unreimbursed costs from means-tested government programs Health Professions Education Research Cash and In-kind Contributions Other Benefits (community health improvement, subsidized services, CB operations) Total
Community Building
2009 5.7% 0.8% 0.3% 0.3% 0.8% 7.9% 0.1%
2010 5.7% 0.9% 0.6% 0.3% 1.0% 8.5% 0.1%
2011 6.1% 0.7% 0.3% 0.3% 1.5% 8.9% 0.2%
2013 6.0% 0.7% 0.1% 0.2% 1.4% 8.4% 0.1%

Source: Results from 2011 Tax-Exempt Hospitals’ Schedule H Community Benefit Reporting;  Results from 2013 Tax-Exempt Hospitals’ Schedule H Community Benefit Reporting; Prepared by Ernst & Young LLP for the American Hospital Association;

Cash and In-Kind Donations – Is Your Hospital Compliant?

Is your hospital is giving money to community organizations in the form of grants, sponsorships or donations and counting it as community benefit? If yes, you need to make sure you are compliant with the IRS regulations for how you are handling the donations. Hospital contributions must be restricted in writing to the recipient organization and must support a community benefit activity.

Here are the instructions from the IRS and the link to the source document.
“Cash and in-kind contributions” means contributions made by the organization to health care organizations and other community groups restricted, in writing, to one or more community benefit activities.

“In-kind contributions” include the cost of staff hours donated by the organization to the community while on the organization’s payroll, indirect cost of space donated to tax-exempt community groups (such as for meetings), and the financial value (generally measured at cost) of donated food, equipment, and supplies.

Don’t report as cash or in-kind contributions any payments that the organization makes in exchange for a service, facility, or product, or that the organization makes primarily to obtain an economic or physical benefit; for example, payments made in lieu of taxes that the organization makes to prevent or forestall local or state property tax assessments, and a teaching hospital’s payments to its affiliated medical school for intern or resident supervision services by the school’s faculty members.

Report cash contributions and grants made by the organization to entities and community groups that share the organization’s goals and mission. Don’t report cash or in-kind contributions contributed by employees, or emergency funds provided by the organization to the organization’s employees; loans, advances, or contributions to the capital of another organization that are reportable; or unrestricted grants or gifts to another organization that can, at the discretion of the grantee organization, be used other than to provide community benefit. (Underlining added for emphasis by CB Connect).

From IRS Form 990, Schedule H 2016 Instructions

Save the Date

Community Benefit 101
October 3-4, 2017, St. Louis, MO

ACHI National Conference
March 14-16, 2018, Atlanta, GA

11th National Conference on Health Disparities
May 16-19, 2018, Philadelphia