Hospital community benefit obligations: Implications for health centers, public health, and communities

Improving the health of communities is a central aim of public health, and improving community health is a central tenet of the Patient Protection and Affordable Care Act (ACA). Section 9007 of the ACA (P.L. 11-148) calls for strengthening and clarifying the obligations of nonprofit hospitals to invest in addressing their communities' health needs as a condition of their tax exempt status. These hospitals are now required to conduct a community health needs assessment (CHNA) and adopt an implementation strategy to address these needs. The CHNAs must take 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. The CHNA must be made widely available. The hospital must also adopt an implementation plan that describes how the hospital facility plans to meet the prioritized health needs identified in the CHNA, identifies health needs that the hospital facility does not intend to meet, and explains why the facility is not investing in meeting a particular need. The implementation plan must be adopted by an authorized governing body of the hospital organization in the tax year in which it conducts the assessment and must be published as an attachment to the hospital facility's annual reporting to the Internal Revenue Service. This presentation will present an overview of the CHNA requirements, highlighting the ethical dimensions and obligations included in the ACA and will discuss opportunities for public health.