Community Benefit

Learn more about the Community Benefit and how it can support local substance use prevention efforts. 

Community Benefit -- General Information

What is the Community Benefit?  Non-profit hospitals, in order to maintain their tax-exempt status under section 501(c)(3) of Federal Internal Revenue Code, are required to provide a benefit to the health of the community they serve.  This is commonly known as the Community Benefit.  The concept of what constitutes a Community Benefit has changed over time.  Originally the focus was on charity care (i.e., free or discounted health services^v[1] and was subsequently expanded to include activities that promote the overall health of a community.^[2],[3]  The IRS estimates the value of the Community Benefit nationwide to be $62.4 billion.^[4]

What Are Non-Profit Hospitals Required to Do?  With passage of the Affordable Care Act in 2010, new requirements for non-profit hospitals were established.^[5]  Now each 501(c) (3) hospital facility must:

• Conduct a community health needs assessment (CHNA) that takes into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health;
• Conduct the CHNA at least once every three years and make it widely available to the public; and
• Adopt an Implementation Strategy to meet the needs identified in the CHNA.

Community Benefit and Coalition Work

The Community Benefit Can Support Substance Use Prevention Coalition Work.  Community building activities, including coalition building, are permitted activities.  This includes, but is not limited to, non-profit hospitals participating in community coalitions and other collaborative efforts with the community to address health and safety issues.  Community benefit can provide resources to Drug Free Communities coalitions that work with their local hospitals to support prevention efforts in their communities.

What Kinds of Resources are Available?  Support can include, but is not limited to, charity care, direct funding, resources for coalition building, grants to organizations, provision or rehabilitation of housing for vulnerable populations, assisting small business development, and workforce development, in-kind donation such as media, marketing, printing materials, and space for meetings.^[6]

How to Get Started

There is no one single way to get started.  Coalitions who have engaged with their local non-profit hospitals recommend the following:

• How to find your local non-profit hospital. There is not a consolidated list of the Nation’s non-profits hospitals, instead information is available from a number of sources.  Examples of sources used by communities include the following:
  • State Hospital Associations.  Most state associations provide information on their members, including non-profit status.
  •  Health Department Websites.  Some state and local health departments will provide a list of hospitals in their area.
  • Search Engines.  In an on-line search engine, search for your town or county and ‘non-profit’ hospital.
  • Internal Revenue Service.  The IRS provides downloadable data files of tax-exempt organizations, including non-profit hospital (https://www.irs.gov/Charities-&-Non-Profits/Exempt-Organizations-Business-Master-File-Extract-EO-BMF).  Information about the data is available here.
  • Guidestar. Provides online information on non-profit organizations, including hospitals.  Registration is free.
  • Local Library.  For example, the American Hospital Association’s AHA Guide® 2016 Edition is available in book format and includes information about hospitals by state, including non-profit hospitals.
• Build a relationship with your local hospital.  Find the hospital’s Community Benefit office and request a meeting.  Bring information about your coalition and its capabilities, its members, and data on youth substance use in your area.  Ask the hospital about their priorities and challenges.  This is an opportunity to build a relationship and educate the hospital about your coalition’s abilities to make changes in your community.
• Find out where the hospital is in its assessment process.  Get a copy of the current CHNA report (often available online) and study it!  How is the hospital facility planning to solicit community input for the next CHNA (e.g., town hall meetings, meetings with community members, written input, etc.)?   Offer to provide useful information and ask to be part of the process.  If the CHNA has been completed and they are in the implementation phase, identify areas where you can join existing efforts to benefit your community.
• Don’t give up!  Be persistent and patient.  Look for areas where you can work together and support mutual priorities.

Where Can I Learn More?

• National Institutes of Health. Provides a broad range of information including an overview of the Community Benefit, sample Community Health Needs Assessments, data and statistics, and research articles. https://www.nlm.nih.gov/hsrinfo/community_benefit.html
• CDC Community Health Navigator.  Provides tools on how to work collaboratively around community health issues, including tobacco use. http://www.cdc.gov/chinav/
• Internal Revenue Service. Learn how non-profit hospitals provide and report benefits to the community. https://www.irs.gov/Charities-&-Non-Profits/Charitable-Organizations/Hospitals-and-Community-Benefit-Interim-Report and https://www.vha.com/AboutVHA/PublicPolicy/CommunityBenefit/Documents/Report_to_Congress_on_Hospitals_Jan_2015.pdf

Tell us what you are doing around Community Benefit!

Email us at CommunityBenefit@ONDCP.EOP.GOV and let us know how you are working with your local non-profits hospitals around Community Benefit and prevention.