Potential impact of new IRS changes on community health activities

Hospitals are major contributors to the health of individuals and of communities. Providing “community benefit” is the provision in the tax code that enables non-profit hospitals to keep their tax-exempt status. Activities couched as “community benefit” include screenings, emergency rooms, mobile vans, wellness classes, health professions education, community needs assessments, among a long list of others. Recent changes by the IRS effective in 2009 have changed what and how hospitals must report their community benefit activities. These changes have the potential to affect the programs that hospitals offer for and with community partners by increasing, decreasing, or changing activities. In addition, many public health concepts have been incorporated into the new reports, such as defining community need or measuring changes in the health of a community. It is imperative that those working in public and community health understand the new IRS requirements of hospitals and how these might impact current and future community health programming. This presentation explains the provisions of the new tax reporting requirements, gives examples of programs cuts or additions that hospitals might make to comply, explains opportunities for public health experts to apply their methods to enhance hospital programming, and proposes actions appropriate for public health professionals to be advocates for their communities in working with hospitals to plan and implement future activities. Results will be shared of two recent surveys indicating what those in the field expect to change as a result of the new IRS Form 990 Schedule H reporting mandates for hospitals.