Section Jus 415.04 - Exemption from Community Benefits Plan Requirement(a) Any health care charitable trust for which compliance with the annual community benefits plan reporting requirement would be a financial or administrative burden may request that the director grant an exemption for 3 years by completing and filing Form NHCT-32 "Community Benefits Plan Application for Exemption," effective September 2022, available online at www.doj.nh.gov/charitable-trusts/forms.htm.(b) The director of charitable trusts shall grant an exemption from the annual community benefits plan reporting requirement for 3 years if the health care charitable trust demonstrates that it meets the following criteria:(1) The health care charitable trust serves a specifically defined and very limited segment of the population and provides no health care services to the community at large;(2) The cash assets of the health care charitable trust are valued at less than $100,000.00, and: a. The financial resources of the health care charitable trust would be negatively impacted by the obligation to prepare annual community benefits plans; andb. It is not possible to enter into a collaboration with another health care charitable trust for the purpose of preparing a community benefits plan; or(3) The health care charitable trust does not have sufficient paid staff, volunteers, or other resources available to prepare the community benefits plan, and:a. It does not have sufficient financial resources available to engage the services of an outside entity for the purposes of preparing the community benefits plan; andb. It is not possible to enter into a collaboration with another health care charitable trust for the purpose of preparing a community benefits plan.(c) Any health care charitable trust seeking an exemption under Jus 415.04(a) shall supply with Form NHCT-32 "Community Benefits Plan Application for Exemption" the following: (1) If the health care charitable trust seeks an exemption under Jus 415.04(b)(1), copies of the health care charitable trust's mission statement, articles of agreement, bylaws, and other governing documents;(2) If the health care charitable trust seeks an exemption under Jus 415.04(b)(2): a. Copies of the health care charitable trust's mission statement, articles of agreement, bylaws, and other governing documents; andb. Copy of the health care charitable trust's Internal Revenue Service Form 990, Internal Revenue Service Form 990-EZ, audited financial statement, or other financial report for the most recent accounting period;(3) If the health care charitable trust seeks an exemption under Jus 415.04(b)(3): a. Copies of the health care charitable trust's mission statement, articles of agreement, bylaws, and other governing documents;b. Copy of the health care charitable trust's Internal Revenue Service Form 990, Internal Revenue Service Form 990-EZ, audited financial statement, or other financial report for the most recent accounting period; andc. An organizational chart showing all paid full- and part-time positions.(d) Form NHCT-32 "Community Benefits Plan Application for Exemption" shall be signed by the president or treasurer under penalty of false written statement in accordance with RSA 641:3 and RSA 641:8.N.H. Admin. Code § Jus 415.04
Derived from Volume XLII Number 45, Filed November 10, 2022, Proposed by #13455, Effective 10/7/2022, Expires 10/7/2032