Though their child wasn't receiving medical treatment at the time, that one day at Nationwide Children's Hospital changed the family's lives forever.
The parents hadn't filed income tax returns for three years, but they followed a referral from a Nationwide Children's social worker to a free tax-preparation clinic presented by the hospital. An hour later, the family walked away with $35,000 in tax credits—an amount equal to their entire annual household income.
"They were obviously through-the-roof excited," says Nick Jones, vice president of community wellness at Nationwide Children's in Columbus, Ohio. "It's those types of stories that convince us this is the right thing to do."
Enhancing medical outcomes by lowering poverty levels
Nationwide Children's began offering tax-preparation assistance as an effort to help its patient families and some staff members access the Earned Income Tax Credit (EITC). The EITC is available to families below certain annual income thresholds and is a powerful anti-poverty tool—in 2018, it lifted more than 10 million people above the poverty line, including 5.5 million children.
Yet, it's estimated that 20% of eligible workers don't claim the credit. And those missed opportunities can have detrimental impacts on children's health. The Centers for Disease Control and Prevention (CDC) has identified EITCs as one of 14 key evidence-based interventions that can improve health. "Strong evidence consistently links low income to adverse childhood experience (ACE) exposures and children's long-term health, educational and social outcomes," the agency reports.
"We see this program as an immediate opportunity to address the health disparities that result from living in generational poverty," Jones says. "By lifting these families out of poverty, we can start seeing some positive effects on some of those health outcomes."
The hospital's pilot program launched about five years ago and consisted of a few self-service laptops set up in an old gift shop space where about two dozen families accessed the free tax-preparation software. Today, the initiative has expanded to six fully staffed locations across the Columbus area. In 2022 alone, Nationwide Children's volunteers helped roughly 520 families claim more than $1.5 million in tax refunds, including about $400,000 in EITC reimbursements.
One part of larger health equity efforts
The hospital's tax-preparation program has grown exponentially due in large part to three partnerships:
- Celebrate One, a Columbus-area infant mortality collaborative.
- Tax Time, the regional United Way's Volunteer Income Tax Assistance (VITA) collaborative.
- Office of Minority Health (OMH) at the U.S. Department of Health and Human Services (HHS), which provided a grant.
Teaming up with community organizations enables Nationwide Children's to reach a broader population, and the hospital is cross-training staffers to ensure they convey a common, consistent message across the groups. Celebrate One staff and agencies are being trained in referral, outreach and the value of EITC and related tax credits, while Tax Time staff are being trained in ACES, risk and protective factors and community resources for referral.
As such, the tax-preparation service delivers more than tax refunds to families—it's part of a larger effort: Healthy Neighborhoods Healthy Families (HNHF). Launched in 2008, HNHF is a collaboration among Nationwide Children's and a variety of community organizations, nonprofit programs and public schools to improve health equity by addressing social determinants of health in the area. Families seeking assistance through HNHF can access a number of opportunities related to affordable housing, education, health and wellness, community enrichment and economic development. Jones says the tax-preparation program is a great way to introduce families to other support programs available in their community.
"We're trying to make an easy-to-access system for families to get into the pipeline of services we have to offer," Jones says. "We don't want the tax-preparation experience to be transactional—we certainly want it to help us develop deeper, trusting and long-term relationships that help those families accomplish all of their hopes, dreams and aspirations."