Ministry Unites to Better "Tell the Good News" of Community Benefits, The

Health Progress, May/Jun 2006 by Finan, John J Jr

Editor's Note: This new Health Progress column, "Community Benefit: Continuing the Tradition," will focus on the contributions of the Catholic health care ministry to our communities and explore how Catholic health care leaders can work collaboratively to promote sustainable and effective community benefit programs.

Catholic health care providers have a long-standing tradition of providing significant benefits to the communities they serve. We relate to our communities as a ministry of the church by serving as providers, employers, advocates, and citizens. Beyond our walls in the communities we serve, we are committed to identifying needs and creating programs to meet them. We recognized an obligation to report community benefit activities long before recent challenges to the tax exemption of not-for-profit health care services. As Sr. Carol Keehan, DC, said in congressional testimony last year, "Catholic hospitals do not provide these services to justify continued tax exemption. We provide them because serving our communities in this way is integral to our history and our mission-it is what we always have done."

For nearly 20 years, CHA has pioneered ways to plan for, quantify, and standardize the reporting of these benefits to community leaders, lawmakers, the media, and the church.

Now new questions surrounding the taxexempt status of not-for-profit hospitals have prompted CHA to commission a top-level task force to address ministry accounting and communications strategies.

COMMUNITY BENEFIT TASK FORCE

The Community Benefit Task Force comprises system and free-standing hospital CEOs, board members, and sponsors. The group's mission is to develop and sustain an effective, coordinated, ministry-wide approach to community benefit and tax-exempt status challenges. The results of the task force's work will enable ministry members to better communicate the many ways they meet and exceed the legal requirements of tax exemption.

There is no doubt that Catholic providers are fulfilling their mission to provide care to the impoverished and vulnerable. The only question facing the ministry is how best to communicate our community benefit activities and programs in an understandable, transparent, and uniform manner. By effectively and consistently communicating the contributions of Catholic providers, we strengthen the public trust that helps us sustain our healing mission.

Too often observers view charity care as the full measure of a provider's contribution to the community. Yet charity care is just one way in which Catholic providers contribute to the health and welfare of the communities they serve. Unfortunately, observers may overlook community health improvement services, such as health promotion activities and free clinics. Health professional education, medical research, subsidized services, community building activities, and direct financial contributions to the community also often go unnoted. And some observers may fail to count the unpaid costs of Medicaid and other government programs to care for vulnerable populations.

When Congress, community leaders, and even the general public focus solely on charity care as the extent of our service to our communities, great misunderstandings may occur. Contributing to the problem has been a lack of a standardized approach to accounting and reporting community benefit. When others do not understand the full extent of our community benefits, they call into question the tax-exempt status of certain facilities. Only through more consistency and transparency can the ministry accurately describe our effective accountability to our communities.

CLARIFYING OUR OWN UNDERSTANDING

The Community Benefit Task Force's first charge has been to clarify our understanding of the federal legal standard for tax exemption. The task force is also developing consistent and standardized language that members can adopt to explain and discuss the standard. This important first step lays the framework for unifying our message.

Consensus and standardization is also needed in the reporting and documenting of community benefits. A universally accepted reporting method will enable observers to see the tremendous aggregate benefit of Catholic providers to the communities they serve. It will also permit CHA to develop an aggregate picture of our community benefit contribution. The task force has come to consensus on key components that not-forprofit providers may consistently employ when documenting community benefit services. Those components are reiterated in the revised CHA community benefits guide, and the task force will work to gain commitment by all CHA members to use the tool consistently. Indeed, we hope it will be adopted by other not-for-profit organizations.

On the national level, CHA is adopting the task force's recommended strategies for advocacy and communications before multiple audiences, including Congress, the church, legal forums, and the general public.

The task force members have met several times since forming in January of this year. The group is committed to working with the CHA Board of Trustees, all system and facility CEOs, and others to achieve a ministry-wide commitment to implementing consistent methodology, terminology, and transparency. CHA is providing the revised community benefit guidelines to assist us in assessing need and record keeping. In addition, CHA is working closely with financial and accounting organizations to ensure that our guidelines are consistent with the best accounting practices. CHA is also working with policymakers and regulators to keep them informed of our advances in reporting community benefits and to ensure that our activities and methodologies are consistent with their expectations.