Healthcare
DQ 5.1: Community Benefit Requirement
Locate and review a hospital or health system’s Community Benefit Report. Based on this week’s readings and your own research, briefly define and analyze Community Benefit”, differentiating between federal and state requirements. Based on your assessment, is Community Benefit is valid construct, or does it measure what health services organizations already do?
POST 1
UMMC "submits community benefit information to the federal government annually on its IRS Form 990, Schedule H" for federal requirements (2022). Schedule H has been described as "categories of community benefit activities include the net, unreimbursed costs of charity care (providing free or discounted services to patients who qualify under the hospital's financial assistance policy); participation in means-tested government programs, such as Medicaid; health professions education; health services research; subsidized health services; community health improvement activities; and cash or in-kind contributions to other community groups (such as donating funds to a community health screening event or hosting a blood drive)" (James, 2016). For state requirements, UMMC sends the Maryland government a summary or report on what it does to contribute to the community around the organization.
According to James (2016) in this week's article on non-profit tax exemption, taxes were originally based upon the hospitals actions towards charitable care or allowing for the "chariting" of those who cannot afford care at that specific hospital. Today, it is still loosely based upon charity, but the general charity/goodwill/contribution to the community around an organization. A healthcare organization has to prove that is a pillar of the community, not a detriment to the community. UMMC's report on community contributions is a valid justification of funding through tax exemption by the state of Maryland. The report, at least at UMMC, is solid and informative as any report for any business interaction usually is. The Federal government's schedule H form sounds more ambiguous, leaving a lot a a gray are for funding justification simply by its definition.
PLEASE RESPOND
POST 2
TOPIC
In 2010, the state of Illinois revoked the real estate tax exemption of Provena Health. How would you measure whether your community benefit strategy is working? Be specific.
The impact of a community benefit strategy is accessible in sever ways depending on the identified need in the community needs assessment, the tactics, and set metrics to measure the impact of that strategy. Nonprofit hospitals must conduct community needs assessments once every three years to identify unmet community needs and provide health services free of charge as a charity or offer financial assistance to low-income qualified individuals (Yue & Colias, 2010). If the identified community need is a reduction of chronic disease as diabetes in the community, then the hospital leaders jointly work with the community leaders and government agencies on the best way to address it. For instance, in New Jersey, the reduction in diabetes death baseline was 24.5 percent versus a target of 15.8 (Diabetes , n.d.). The Department of Health Diabetes Prevention and Control Program partnered with community hospitals to improve the quality of diabetes care and access to care (Diabetes, n.d.). The hospital's strategies: offering sugar monitoring supplies and monthly evaluations, sharing education on the importance of a healthy diet and active and healthy living, with access to fitness facilities to low-income individuals partially or free of charge, are a way for the hospitals to contribute to the community benefit. Community partnerships with fitness facilities and weight loss programs such as Weight Watcher are a way to generate measurable outcomes to support metrics such as weight-in check-ups and weight loss support groups. The monthly monitoring of diabetes patients, hospital claims, and weight loss progress are the metrics to assess the impact of the strategy on the community versus the established target.
PLEASE RESPOND
POST 3
In the case of Provena Covenant Medical Center, the Illinois Supreme Court ruled in favor of state officials for denying Provena Covenant Medical Center’s tax-exempt status for lacking evidence of being a charitable institution, as well as using the hospital complex for only charitable purposes (Yue et.al, 2010). This ruling could have implications for other hospitals across the nation, therefore to avoid this from happening, hospitals should continue their commitment of improving the health of the communities they serve and channel its activities in ways that are consistent and make a documentable difference. These activities should be from evidence-based programs and evaluated with specific measures.
For instance, the Logic Model for Hospital Community Benefit Program on Obesity Prevention for Children began by first identifying educational materials, partnering with schools and pediatricians. The second step was to select activities such as health education and counseling for parents, health education programs in schools, health education applications for kids, doctors’ screening and identifying high risk kids. These activities were followed by measurable short-term outputs such as the number of families identified and number of families offered counseling, the number of high-risk kids identified and the number of kids using health education applications. Lastly, the model showed the long-term impact including school districts changes in curriculum to include health education, school clinics adopting weight screening, pediatricians adopting weight screening and health education/counseling, change in social norm in local communities, and decreased childhood obesity in target areas (Evashwich & Jackson, 2020).
Overall, changes in the health status of a community take time and require appropriate evaluations for measuring long-term outcomes.
POST 4
1. What were the strengths of Michell Rhee’s approach to leadership and managing?
Rhee was well-educated and passionate about ensuring every child received a first-rate education regardless of color, race, or ethnic status (2015, Williams). She did a good job defining the problem for the community and garnering initial support for the “need for change.” At the onset, Rhee identified the importance of the church as a central component of the black community. Rhee used this knowledge to seek their support.
2. What were the challenges of Michelle Rhee’s approach to addressing the significant problem?
The inherent challenge of Rhee’s approach was that it lacked partnership and community engagement. She failed to develop a network of individuals within the community, like Former Mayor Marion Barry, to work with her and serve as fellow change agents and supporters (2015, Williams).
Rhee lacked a clear understanding of the core values of the community and the impact of the decisions she was making. Rhee did not act with sensitivity and lacked community individuals as partners to determine the pros and cons of her choices.
Rhee was challenged by the ability to be a strategist, and she allowed her personal bias and feelings about politicians to interfere with operating in a manner that would be received by the community (2015, Williams).
3. In which ways could Michelle Rhee’s approach to addressing the school district's challenges be approved?
Based on the readings, Rhee would have benefited from engaging in true community partnerships to address a complex problem. Rhee would have benefited from understanding the importance of strategy and how to bring diverse groups together to address a problem (2015, Williams). The lack of executive leadership training contributed to her challenges navigating change throughout the community.
Rhee could have benefited from managing the public’s perception of her. She needed to partner with someone from the community to champion and support her decisions so they would not look like they were coming from a stranger.
4. What challenges do you have in your leadership and management style that could adversely impact your success in addressing the challenges that are part of every leader’s career? How will you mitigate the impact of your leadership and management challenges?
Like Rhee, when I am passionate about an issue and believe I am “right,” I often come off like a dictator, alienating staff. In my current role, most of the employees I oversee have been with the organization for over ten years, so they see me as an outsider. Healthcare is changing, and I am tasked with delivering the change as the department leader. Without understanding my personal bias, I can lose sight of the goal.
It is also challenging to merge the needs of clinical leadership and support staff to achieve the overall goal of delivering quality patient care. I am motivated differently from my team, and I must recognize this and address it.
POST 5
Michell Rhee displayed strength in understanding the importance of religion within the community that she was trying to reach. Her decision to speak during services showed her commitment to crossing racial, socioeconomic, religious, and political boundaries (Williams, 2015).
The challenges that she faced were mainly in her approach to tackling the problem of low test scores among students. Michelle Rhee fired administrators and teachers she saw as incompetent, she tried to address the issue from a technical standpoint (Williams, 2015). This resulted in her earning many enemies and being removed from her position before achieving her goals.
She could have improved upon her approach by dedicating more time to building trusting relationships with her staff members. Relationship management allows a leader to influence others to achieve common goals and work towards a shared vision through building and maintaining healthy relationships (Balaji, n.d.). This can be achieved through effective communication skills, such as careful listening and asking questions to gain a better understanding of the other parties’ perspective, and effectively communicating to develop a shared vision based upon common values (Balaji, n.d.).
The challenges that I have are based on my introversion. It has been difficult for me at times to speak up when necessary, and it takes more time for me to build positive rapport with other managers or employees. I don’t believe I will ever be comfortable forcing myself to be an extrovert, even though it is demanded in certain situations. I feel that the best thing to do is recognize the strengths of my introverted nature and try to use them to my advantage. An introverted leader is more open to listening to others and tends to have strong analytical skills, this can be leveraged to assess the viability of suggestions from others and aid in leading teams and implementing process improvement (Farrell, 2017). Recognizing my strengths can help me shore up my weaknesses and display my worth to the senior leadership in my organization as well as my peers and subordinates.