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Community Benefit


Provisions of the Patient Protection and Affordable Care Act (ACA) require each non-profit hospital facility in the United States to conduct a community health needs assessment (CHNA) and adopt an implementation strategy to meet identified community health needs. In conducting the CHNA, non-profit hospitals are required to take into account input from persons who represent the broad interests of the community served, including those with special knowledge of or expertise in public health.

NACCHO is committed to helping local health departments (LHDs) strategically align their community health assessment efforts with other assessment initiatives such as those of non-profit hospitals. The resources below provide information to help LHDs and non-profit hospitals conduct collaborative community health assessment and improvement processes.


Summary of the Internal Revenue Service’s April 5, 2013, Notice of Proposed Rulemaking on Community Health Needs Assessments for Charitable Hospital

Summarizes proposed regulations that provided guidance to charitable hospital organizations on the 501(r) community health needs assessment requirements and related excise tax and reporting requirements. More »

eLearning Course: Opportunities for Hospital and Local Health Department Collaboration for Community Health Assessment and Improvement Planning
 The fundamental purpose of public health is defined by three core functions: assessment, policy development and assurance. Community health assessments (CHAs) provide information for problem and asset identification and policy formulation, implementation, and evaluation. This module explores the current drivers of community health assessment and community health improvement plan activity in local communities. More>>
Report on 501(c)(3) Hospitals: Proposed IRS Rules under § 9007 of the Affordable Care Act
The Affordable Care Act (§ 9007) created several additional requirements for organizations that operate one or more hospital facilities seeking to maintain or achieve 501(c)(3) tax-exempt status. Specifically, current and future hospital facilities and organizations will have to (1) regularly perform a community health needs assessment, (2) create and publicize a financial assistance policy, (3) impose limitations on charges, and (4) adopt certain billing and collections policies. This report discusses these new requirements and regulations for hospitals in the context of the current standards for tax-exempt status. More »
Assessing and Addressing Community Health Needs
Assessing and Addressing Community Health Needs is a report developed by the Catholic Health Association to help non-profit health care organizations strengthen their assessment and community benefit planning processes. Using the Catholic Health Association's previous work and the experience of community benefit professionals and public health expertise, this book offers practical advice on how hospitals can work with community and public health partners to assess community health needs and develop effective strategies for improving health in our communities. More»
Community Benefit Workshop PowerPoint Slides
The Assessment and Planning team hosted a pre-conference workshop at NACCHO Annual 2012, "Community Benefit: What Every Local Health Department Needs to Know." Participants learned what LHDs can do to increase collaborations with local hospitals and other partners in community health assessment and improvement planning. Speakers included a LHD health planner, a representative from a non-profit hospital association, leaders from two LHD-non-profit hospital collaborative methods, and a representative from a managed care organization.

Strategies for LHD and Hospital Collaboration Webinar
This 60-minute webinar is from NACCHO''s Performance Improvement and Technical Assistance teleconference series. Julia Joh Elligers, Director of Assessment, Planning, and Workforce at NACCHO, and Julie Trocchio, Senior Director of Community Benefit and Continuing Care at the Catholic Health Association, present on how health departments and hospitals can collaborate on community health assessment and improvement activities.

Statement of Policy: Role of Local Health Departments in Community Health Needs Assessment
This NACCHO policy statement promotes the involvement of LHDS in community health needs assessments and discusses ways in which LHDs can be involved throughout the process. More »
Consensus Recommendations on Community Health Needs Assessments
Earlier this year, NACCHO worked with several other national public health organizations to develop consensus recommendations for implementation of the ACA's new community health needs assessment requirement. These recommendations aim to ensure that the needs assessments draw on the expertise of public health professionals and public health agencies, and build on existing local and state needs assessments. More »
Issue Brief: Collaborating through Community Health Assessment to Improve the Public's Health
This NACCHO issue brief describes the current state of community health assessment activity across the country and encourages continued and expanded collaboration among LHDs, hospitals, and other partners. The report is divided into three sections: assessment, a systems-collaborative approach, and epidemiologic and community considerations. More »
NACCHO's Comments on CHNA Requirements for Tax-Exempt Hospitals, Notice 2011-52
This 5-page document is NACCHO's response to Notice 2011-52 regarding the implementation of Section 501(r)(3) requiring a hospital organization to conduct a community health needs assessment (CHNA) every three years and to adopt an implementation strategy to meet the needs identified through a CHNA. More »
Notice and Request for Comments Regarding the Community Health Needs Assessment Requirements for Tax-Exempt Hospitals
This 28-page notice addresses the CHNA requirements described in section 501(r)(3) of the Internal Revenue Code and related excise tax and reporting obligations applicable to non-profit hospitals. More »
NACCHO's Comments on Community Health Needs Assessment Pursuant to IRS Code Notice 2010-39
This 4-page document provides the comments NACCHO submitted to respond to Notice 2010-39 concerning the implementation of Section 501(r)(3) requiring a hospital organization to conduct a CHNA every three years and to adopt an implementation strategy to meet the needs identified through such assessment. More »
CHNA Webinar PowerPoint Presentation
This 24-slide PowerPoint presentation coincided with the "Best Practices for Community Health Needs Assessment and Implementation Strategy Development" webinar. More »
A National Conversation on Community Health Assessment: Convened by NACCHO on Feb. 10, 2011
This 4-page document summarizes the February 2011 National Conversation on Community Health Assessment. NACCHO invited key leaders from public health and healthcare organizations to share experiences, information, and expectations regarding community health assessments. More »

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