The Nuts and Bolts of Community Benefits Part I

1
The Nuts and Bolts ofCommunity Benefits (Part I)

• Patsy Matheny
• 740-746-0286 phone
• matheny_at_direcway.com

2
Community Benefit-A Process
A planned, managed, and measured approach to
meeting identified community health needs. It
implies collaboration with a community to
benefit its residents---particularly the poor,
minorities, and underserved groups---by improving
health status and quality of life.
3
Basic Steps in Community Benefit Planning and
Implementation
Determining What Counts
Laying the Groundwork
Interrelated Interdependent Simultaneous
Planning
Accounting For Costs
Communicating
Evaluating
4
Basic Steps in Community Benefit Planning and
Implementation
Laying the Groundwork
Determining What Counts
Planning
Accounting For Costs
Communicating
Evaluating
5
Basic Steps in Community Benefit Planning and
Implementation
Laying the Groundwork
Organizational Commitment
Sustainable Infrastructure
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Organizational Commitment
Community Benefit is

• Validated by a community survey
• Highlighted at new employee orientation
• The culture-the expectation-as reported by staff
  and physicians
• Defined by adopted standards

• Part of the vision and mission statements
• Integrated into operational, financial and
  communication plans
• A standing agenda item or separate Board
  committee
• Included in senior leadership performance
  evaluations

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Catholic Health Association
1 Assess unmet health care needs, especially
for the poor and indigent 2 Assume a
leadership role in advocating community wide
responses 3 Partnership approach 4 Community
accountability 5 Organizational commitment
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VHA Inc.
1 Demonstrate leadership as a charitable
institution 2 Provide essential health care
services 3 Be accountable to the
community 4 Evidence commitment to community
benefit 5 Operate free from private profit
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Sustainable Infrastructure

• Sufficient staff with appropriate qualifications
  and written position descriptions
• Reporting lines to the top
• Internal work group
• External work group
• Adequate budget
• Policies that support Community Benefits
  (financial assistance, employee and physician
  involvement, advocacy, environmental
  responsibility)

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Basic Steps in Community Benefit Planning and
Implementation
Determining What Counts
Laying the Groundwork
Planning
Accounting For Costs
Communicating
Evaluating
11
Basic Steps in Community Benefit Planning and
Implementation
Identify Community Needs Assets
Planning
Community Benefit Plan
Link with Organization Strategic Direction
Develop Collaborative Partners
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Planning
Form Workgroup (be inclusive)
Define Community

• External
• Public health
• Universities
• Consumers
• Community
• Organizations
• Business
• Politicians
• Foundations
• Others

• Internal
• Quality
• improvement
• Management
• Information
• Clinical staff
• Strategic planning
• Communications
• Board member
• Others

• Geographic area
• Population subgroups
• Underserved areas
• Hospital targeted areas

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Collect Data (examples)

• Secondary Data
• Past Assessments
• Health Department
• United Way
• Healthy People 2010
• Small area variation data

• Resource Availability
• Community Assets Map
• Internal Assets Map
• Community Partners
• Money

• Primary Data
• Surveys
• Questionnaires
• Interviews
• Forums
• Focus groups

Regulatory JCAHO NCQA/HEDIS Medicare QIO Medicaid
Contracting Section 330 Requirements

• Organization Focus
• Medical Residency
• Programs
• Board focus
• Capital plans

• Political/Legal
• State laws
• Statewide/local coalitions
• Politicians interest
• Business roundtables

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Analyze and Prioritize
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Link with Organization Strategic Direction
Clinical
Community Benefit Programs
Human Resources
Meet Community Needs
Finance
Linked to Hospital Operational Units
Public Relations/ Marketing
Ancillary Services
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Basic Steps in Community Benefit Planning and
Implementation
Laying the Groundwork
Determining What Counts
Planning
Accounting For Costs
Communicating
Evaluating
17
Making It Real
Building the Infrastructure Dan Hodgkins The
Community Health Network
Conducting A Community Assessment Eileen
Barsi Catholic Healthcare West
Integrating Community Benefits with Organization
Strategic Direction Debora Murray St. Josephs
Healthcare
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The Nuts and Bolts ofCommunity Benefits (Part II)

• Patsy Matheny
• 740-746-0286 phone
• matheny_at_direcway.com

19
Community Benefit-A Process
A planned, managed, and measured approach to
meeting identified community health needs. It
implies collaboration with a community to
benefit its residents---particularly the poor,
minorities, and underserved groups---by improving
health status and quality of life.
20
Basic Steps in Community Benefit Planning and
Implementation
Determining What Counts
Laying the Groundwork
Interrelated Interdependent Non linear
Planning
Accounting For Costs
Communicating
Evaluating
21
Basic Steps in Community Benefit Planning and
Implementation
Identify Community Needs Assets
Planning
Develop Community Benefit Plan
Link with Organization Strategic Direction
Develop Collaborative Partners
22
Community Benefit Plan

• A community benefit plan is a document usually
  produced in conjunction with the health care
  organizations annual strategic plan that
  explicitly details how an organization intends to
  fulfill both its mission of community service and
  its charitable, tax-exempt purpose.
• It includes a description of community benefit
  priorities, programs, staffing and resources.

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Community Benefit Plan Template

• Introduction and Background
• Assessment of Community Health Needs and Goals
• Assessment of Organization Strategic Direction
• Programs to Address Identified Community Needs
• Evaluation Methodology
• Committed Resources
• Affirm Commitment

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Collaborative Partners

• In Unity There is Strength

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Basic Steps in Community Benefit Planning and
Implementation
Determining What Counts
Laying the Groundwork
Planning
Accounting For Costs
Communicating
Evaluating
26
Basic Steps in Community Benefit Planning and
Implementation
Community Benefit Reports
Communicating
Telling Your Story
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Challenges to Community Benefits

• Questions raised in the 80s and 90s
• Nonprofit hospitals
• How do we demonstrate community benefits?
• How do we fulfill commitment with financial
• constraints?
• For profit hospitals
• How can you claim to be different?
• Hasnt the time of nonprofit hospitals
  passed?
• Policy Makers
• Do you deserve tax exemption?
• Should there be a level of effort test?

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Challenges to Community Benefits

• Current Questions
• Rationale for charges
• Billing policies
• Charity care policies
• Bad debt policies
• Executive compensation
• What counts and what doesnt count

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Community Benefit Report Template

• Introduction and Background
• Assessment of Community Health Needs and Goals
• The Community Benefit Plan
• Community Benefit Programs
• Outcomes and Impact
• Reaffirm Commitment

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Telling Your Story

• Incorporate messages throughout
• your entire organizational
• communication system

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Telling Your Story

• External Audiences
• Public/community-at-large
• Businesses
• Physicians
• Community agencies
• Other providers
• Consumer groups
• Elected officials
• Policy makers
• Donors
• Health plans
• Media

• Internal Audiences
• Board of directors/trustees
• Senior Leadership
• Staff members
• Volunteers
• Patients
• Visitors
• Physicians

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Telling Your Story

• Ads
• Annual report
• Answer line
• Calendar of Events
• Web site
• Newsletters
• Economic impact studies
• Face-to-face meetings
• Direct mail
• Videotapes

• Public Forums
• Donor events
• Patient handbooks
• Community education programs
• Patient registration opportunities
• Closed-circuit TV
• Community television
• IRS Form 990 attachment

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Reporting Community Benefits on IRS 990

• IRS Form 990 regulations adopted in 1999 require
  tax exempt organizations to make IRS Form 990
  available to anyone
• Guidestar.org provides instant access to IRS Form
  990 of nonprofit health care organizations
  including most health care organizations
• Attach your full community benefits report to
  your IRS Form 990

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Basic Steps in Community Benefit Planning and
Implementation
Determining What Counts
Laying the Groundwork
Planning
Accounting For Costs
Communicating
Evaluating
35
Developing Community Benefit Plans Brad
Mathias St. Marys Health Care
Collaborating with the Community Bart
Rodrigues St. Vincent Healthcare
Making It Real
Community Benefit Reports Woody Thorne Southern
Illinois Healthcare
Sampling Community Benefit Programs Marisue
Garganta St. Josephs Hospital
Telling Your Story Donna Meyer CHRISTUS Health