Does your community have mental health needs?

The Network for Public Health Law outlines a unique opportunity for consumers, families, and advocates to bring attention to local mental health needs. Every nonprofit hospital is required to participate. Chances are there’s a nonprofit hospital—and a chance to be involved—near you!

Identify and Address Mental Health Needs in Your Community


Corey Davis & Andy Baker-White
Network for Public Health Law

networkThe majority of American hospitals are recognized as nonprofit organizations under state and federal law. This permits them to receive a number of financial benefits, including an exemption from the federal income tax. Many states and municipalities also provide nonprofit hospitals with exemptions from property, sales, and other taxes. This favorable tax treatment comes with the responsibility that these hospitals provide certain benefits to the communities they serve.

Community Health Needs Assessment

The Patient Protection and Affordable Care Act (ACA) contains a provision that requires each nonprofit hospital to conduct an assessment of the health needs of its community in order to better understand and help meet those needs. This assessment, known as a Community Health Needs Assessment (CHNA) must be conducted every three years and made widely available to the public. Groups and individuals working in, or advocating for, mental health may take advantage of the CHNA to collaborate with hospitals to help determine whether mental health is a health need for the community.

When conducting the CHNA, the nonprofit hospital is required to collect input from people who “represent the broad interests of the community served” by each hospital facility. Under proposed IRS rules, the hospital must take into account input from the following sources, among others:

  • at least one state, local, tribal, or regional governmental public health department with knowledge, information, or expertise relevant to the health needs of that community;
  • members of medically underserved, low-income, and minority populations in the community, or individuals or organizations serving or representing the interests of such populations; and
  • written comments received on the hospital facility’s most recently conducted CHNA and most recently adopted implementation strategy.

The hospital must also develop an implementation strategy to:

  • meet the needs identified in the CHNA;
  • report how it is addressing those needs; and
  • describe any needs that are not being addressed and the reasons they are not being addressed.

Any hospital facility that violates the requirements faces a penalty of $50,000 per year. These requirements went into effect for tax years after March 23, 2012. More detail about the ACA’s CHNA provisions can be found in the Network for Public Health Law’s CHNA issue brief.

Some nonprofit hospitals have completed their current CHNA and implementation plans. For example, the University of Michigan Health System (UMHS) recently released its CHNA and implementation plan.* The UMHS assessment identifies mental health as a health need of the community UMHS serves and sets out an implementation plan to meet the community’s mental health needs.

This CHNA and implementation strategy requirements present an opportunity for community groups and individuals to provide input on the mental health needs that hospitals can help address. The assessment and implementation strategy may also provide an opportunity for more in-depth collaboration on mental health issues between nonprofit hospitals and community groups where interaction already exists, and can provide an opportunity to develop partnerships where they are currently lacking.

Get Involved

  • Explore the possibility of working with local nonprofit hospitals to determine if collaboration would be feasible and beneficial to the hospital and the people it serves.
  • Contact local nonprofit hospitals and provide feedback during the CHNA process.
  • Become involved in the CHNA process if possible; let your local nonprofit hospital know why you think collaboration will be beneficial to the hospital and those it serves.
  • Provide written commentary to the hospital about its CHNA and implementation strategy.

Many state and local health departments are also conducting assessments similar to those required of nonprofit hospitals either as part of a voluntary accreditation process or because of state legal requirements. These assessments also provide an opportunity for those interested in mental health issues to work with their local and state health departments on addressing the mental health needs of their community. The CHNA requirement is a rare opportunity to be involved—and to reap a meaningful and mutually beneficial return.

*Reference to the UMHS CHNA is not an endorsement by the authors or their organizations. It is for illustrative purposes only.

The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.

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