Hospitals,Collaboration,and Community Health Improvement

National Center for Chronic Disease Prevention and Health Promotion, “Chronic Diseases and Health Promotion,” page last updated May 9, 2014, Centers for Disease Control and Prevention website, available at <http://www.cdc.gov/chronicdisease/overview/index.htm> (last visited February 11, 2015); The Organisation for Economic Co-operation and Development (OECD), “OECD Health Statistics 2014 – Frequently Requested Data,” available at <http://www.oecd.org/health/health-systems/oecd-health-statistics-2014-frequently-requested-data.htm> (last visited February 11, 2015).

Berwick D. M. Nolan T. W. Whittington J. , “The Triple Aim: Care, Health, and Cost,” Health Affairs 27, no. 3 (2008): 759–769, at 760.

University of Wisconsin Population Health Institute, “Our Approach,” County Health Rankings website, available at <http://www.countyhealthrankings.org/our-approach> and sources cited at note 7, infra.

Patient Protection and Affordable Care Act of 2010 (ACA), e.g., Titles I and II (expanding access to care); ACA §§ 3001 and 3025 (Medicare value-based purchasing and ACO shared savings); Davis C. Somers S. , Public Health Provisions of PPACA Title IV: Prevention of Chronic Disease and Improving Public Health (2011), Network for Public Health Law Website, available at <https://www.networkforphl.org/_asset/x4mc6h/ACA-chart-formatted-FINAL.pdf> (last visited February 11, 2015).

A mean of 85% of community benefit expenses was attributed to charity care or other patient care services; only 5% was reported as community health improvement services. Young G. Chou C. Alexander J. Lee S. D. Raver E. , “Provision of Community Benefits by Tax-Exempt U.S. Hospitals,” New England Journal of Medicine 368, no. 16 (2013): 1519–1527. More recent evidence suggests that hospitals are continuing to assign relatively low priority to non-medical community health improvement efforts. See Barnett K. , Supporting Alignment and Accountability in Community Health Improvement (April 2014); National Network of Public Health Institutes website, available at <http://nnphi.org/CMSuploads/SupportingAlignmentAndAccountabilityInCommunityHealthImprovement.pdf> (last visited February 11, 2015).

U.S. Department of the Treasury, Internal Revenue Service, 2014 Instructions for Schedule H (Form 990) (December 22, 2014), at 15–16, available at <http://www.irs.gov/pub/irs-pdf/i990sh.pdf> (last visited February 11, 2015).

Robert Wood Johnson Foundation, How Does Where We Live, Work, Learn and Play Affect Our Health? (September 2011), Commission to Build a Healthier America website, available at <http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2011/rwjf71339> (last visited February 11, 2015); Robert Wood Johnson Foundation, Overcoming Obstacles to Health (February 2008), Commission to Build a Healthier America website, available at <http://www.rwjf.org/content/dam/farm/reports/reports/2008/rwjf22441> (last visited February 11, 2015).

26 C.F.R. § 1.501(r) – 3(b)(4), 79 Federal Register 78954–79016, at 79002 (December 31, 2014).

Mattessich P. W. Rausch E. J. , “Cross-Sector Collaboation to Improve Community Health: A View of the Current Landscape,” Health Affairs 33, no. 11 (2014): 1968–1974.

12 U.S.C. § 2901(2014); 12 C.F.R. parts 25, 228, 345, and 195 (2014).

Federal Financial Institutions Examination Council, Community Reinvestment Act: Background & Purpose, Federal Financial Institutions Examination Council website, available at <http://www.ffiec.gov/cra/history.htm> (last visited February 11, 2015).

12 C.F.R. § 228.12(g) (2014).

Sprong S. Stillman L. , Leveraging Multi-Sector Investments: New Opportunities to Improve the Health and Vitality of Communities (January 2014), Health Resources in Action website, available at <http://www.hria.org/uploads/reports/PPReport_r3_012714_pages.pdf> (last visited February 11, 2015).

79 Federal Register 78954–79016, at 79001–04 (December 31, 2014.

26 C.F.R. § 1.501(r) – 3(b)(3), 79 Federal Register 78954–79016, at 79002 (December 31, 2014).

If a hospital is unable to obtain input from any of these mandatory sources, it must describe its efforts to solicit such input in its CHNA report. 26 C.F.R. §1.501(r) – 3(b)(6)(iii), 79 Federal Register 78954–79016, at 79003 (December 31, 2014).

Local and state health departments seeking voluntary accreditation from the Public Health Accreditation Board (PHAB) must satisfy national standards that include collaborative community assessment. PHAB, Standards and Measures Version 1.5 (December 2013), Standard 1.1., at 13, PHAB website, available at <http://www.phaboard.org/wp-content/uploads/SM-Version-1.5-Board-adopted-FINAL-01-24-2014.docx.pdf> (last visited February 11, 2015). In several states, periodic needs assessment is a component of mandatory health department accreditation. See Office of State, Tribal, Local and Territorial Support, Menu of State Public Health Department Accreditation Laws, Centers for Disease Control and Prevention website, available at <http://www.cdc.gov/phlp/docs/menu-phdeptaccreditation.pdf> (last visited February 11, 2015).

26 U.S.C. § 4959 (2014).

ACA § 9007(e), 26 U.S.C. §501 note, 124 Stat. 858 (2010).

DeLeire T. Joynt K. McDonald R. , ASPE Issue Brief: Impact of Insurance Expansion on Hospital Uncompensated Care Costs in 2014 (September 24, 2014), Department of Health and Human Services website, available at <http://aspe.hhs.gov/health/reports/2014/UncompensatedCare/ib_UncompensatedCare.pdf> (last visited February 23, 2015).