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This is how Georgia State University College of Law Professor Charity Scott introduced the concept of mindfulness to numerous law students and lawyers. Aware that her skeptical, mind-driven audience needed a clear definition for a practice that seemed curious, at best, and esoteric, at worst, she immediately gave us the very lawyerly task of "pars[ing] each of these phrases to understand their importance and relevance to the legal profession" 2 and applying them to our own experience of studying or practicing law. Using scientific evidence, she described the benefits of mindfulness and then invited us to try it and decide for ourselves. Charity was a superb teacher, who knew how to impart knowledge skillfully, and a brilliant lawyer, who could present and defend her case exceptionally well. In fact, "Charity Scott owned the subject matter so deeply that she was able to engage lawyers who otherwise would never have given the concept of mindfulness any credence in a million years. In a way that's hard to describe, she didn't brook any resistance on the topic and, as a result, was able to move the needle on well-being for lawyers at a time when, as far as I can tell, she was the only one doing the lifting," reflects Lynn Garson, health care attorney and mental health advocate. But I believe Charity Scott's true mastery and impact came from her embodiment of mindfulness itself. In her presence, mindfulness ceased to be a mere concept, but instead became her way of being that illuminated her words and actions, nourished her relationships, and changed lives.

There is a growing body of evidence that supports the view that research participants and the public are concerned about commercial access to health data. Evidence also suggests that attitudes are ameliorated when charity organisations are involved and where research promises to deliver 'public benefit'. To a significant extent, therefore, mechanisms that ensure the public benefit are key to sustaining public and participant support for research access to health data. As a regime founded on the concept of public benefit, charity law provides regulatory and governance mechanisms through which the public benefit of a charity is protected and promoted. This article examines the merits of charity law mechanisms and analyses their significance for governance of commercial access to health data for public benefit, using UK Biobank Ltd, a charitable company limited by guarantee, as an example. The article critically analyses three charity law mechanisms that operate to ensure that an organization providing access to data meets its public benefit requirements: charitable purposes; members' and directors' powers and duties; and accountability via the oversight powers of the Charity Commission and charity proceedings in court. The article concludes that there is potential for the charity model to be the benchmark for governing commercial access to health data for public benefit research, but notes the limitations of the model and recommends the appointment of independent data governance committees to further bolster the charity law framework., (© The Author(s) 2019. Published by Oxford University Press; All rights reserved. For permissions, please email: journals.permissions@oup.com.)

This article investigates how the santas casas de misericórdia charitable associations in the state of São Paulo were subsidized by the municipal, provincial, and state governments at the turn of the twentieth century. Budget appropriations from 1838 to 1915 were examined to evaluate these charitable grants as well as the growth in funding during this period. While a care network created with strong state backing, it was put into action by philanthropic assistance. This network of hospital care retained the same format until at least the first third of the twentieth century, and included misericórdia establishments created within the interior of the state of São Paulo.

The cost of technology is high in ophthalmology but given the increasingly competitive environment and the social demand, there is a pressure to progressively lower the costs to the consumer. To keep costs down there is a tendency to do as many surgeries as possible in an assembly line fashion both in hospitals as well as in the charitable camps. This article provides ophthalmologists an insight into the legal pitfalls in practice of ophthalmology in India and the dangers of the constant lowering of costs of surgery as well as of free service. This lowering of costs would have been ideal in a Utopian world, but times have now changed and there is cost to be paid even for providing free service. In India the prevalent tradition of providing free service, has also resulted in a lowering of guard by the eye surgeons. These mass eye surgery assembly popularly called "free eye camps" has seen millions of people benefited. But recently there is an increase in number of cases where exorbitant penalty has been imposed by the courts, on these philanthropic surgeons for any deficiency in service, and this has destroyed the careers of many ophthalmologists. Time has now come to introspect and to factor the cost of litigation and compensations into the cost of surgeries so that we not only benefit the patients but also safeguard the ophthalmologists and help them fulfill their responsibilities towards their own dependents., Competing Interests: There are no conflicts of interest.

Importance: Although independent charity patient assistance programs improve patient access to costly prescription drugs, recent federal investigations have raised questions about their potential to increase pharmaceutical spending and to violate the federal Anti-Kickback Statute. Little is known about the design of the programs, patient eligibility, or drug coverage., Objective: To examine the eligibility criteria of the independent charity patient assistance programs and the drugs covered by them., Design, Setting, and Participants: Descriptive cross-sectional study of the 6 largest independent charities offering patient assistance programs for patients including, but not limited to, Medicare beneficiaries in 2018. These charities offered 274 different disease-specific patient assistance programs. Drugs were identified for subgroup analysis that had any use reported on the Medicare Part D spending dashboard and any off-patent brand-name drugs that incurred more than $10 000 in Medicare spending per beneficiary in 2016., Exposures: Support by independent charity patient assistance programs., Main Outcomes and Measures: The primary outcomes were the characteristics of patient assistance programs, including assistance type, insurance coverage (vs uninsured), and income eligibility. The secondary outcomes were the cost of the drugs covered by the patient assistance programs and the coverage of expensive off-patent brand-name drugs vs substitutable generic drugs., Results: Among the 6 independent charity foundations included in the analysis, their total revenue in 2017 ranged from $24 million to $532 million, and expenditures on patient assistance programs ranged from $24 million to $353 million, representing on average, 86% of their revenue. Of the 274 patient assistance programs offered by these organizations, 168 (61%) provided only co-payment assistance, and the most common therapeutic area covered was cancer or cancer treatment-related symptoms (113 patient assistance programs; 41%). A total of 267 programs (97%) required insurance coverage as an eligibility criterion (ie, excluded uninsured patients). The most common income eligibility limit was 500% of the federal poverty level. The median annual cost of the drugs per beneficiary covered by the programs was $1157 (interquartile range, $247-$5609) compared with $367 (interquartile range, $100-$1500) for the noncovered drugs. Off-patent brand-name drugs (cost: >$10 000) were covered by a mean of 3.1 (SD, 2.0) patient assistance programs, whereas their generic equivalents were covered by a mean of 1.2 (SD, 1.0) patient assistance programs., Conclusions and Relevance: In 2018, among 274 patient assistance programs operated by the 6 independent charity foundations, the majority did not provide coverage for uninsured patients. Medications that were covered by the patient assistance programs were generally more expensive than those that were not covered.

Objectives: We present a national evaluation of the impact of independent verification visits (IVVs) performed by National Health Service (NHS) England as part of quality assuring medical revalidation. Organisational visits are central to NHS quality assurance. They are costly, yet little empirical research evidence exists concerning their impact, and what does exist is conflicting., Setting: The focus was on healthcare providers in the NHS (in secondary care) and private sector across England, who were designated bodies (DBs). DBs are healthcare organisations that have a statutory responsibility, via the lead clinician, the responsible officer (RO), to implement medical revalidation., Participants: All ROs who had undergone an IVV in England in 2014 and 2015 were invited to participate. 46 ROs were interviewed. Ethnographic data were gathered at 18 observations of the IVVs and 20 IVV post visit reports underwent documentary analysis., Primary and Secondary Outcome Measures: Primary outcomes were the findings pertaining to the effectiveness of the IVV system in supporting the revalidation processes at the DBs. Secondary outcomes were methodological, relating to the Model for Understanding Success in Quality (MUSIQ) and how its application to the IVV reveals the relevance of contextual factors described in the model., Results: The impact of the IVVs varied by DB according to three major themes: the personal context of the RO; the organisational context of the DB; and the visit and its impact. ROs were largely satisfied with visits which raised the status of appraisal within their organisations. Inadequate or untimely feedback was associated with dissatisfaction., Conclusions: Influencing teams whose prime responsibility is establishing processes and evaluating progress was crucial for internal quality improvement. Visits acted as a nudge, generating internal quality review, which was reinforced by visit teams with relevant expertise. Diverse team membership, knowledge transfer and timely feedback made visits more impactful., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

This document contains final regulations that provide guidance regarding the requirements for charitable hospital organizations added by the Patient Protection and Affordable Care Act of 2010. The regulations will affect charitable hospital organizations

The relationship between government and the not-for-profit (NFP) sector has important implications for society, especially in relation to the delivery of public health measures and the protection of the environment. In key health-related areas such as provision of medical services, welfare, foreign aid and education, governments have traditionally preferred for the NFP sector to act as service partners, with the relationship mediated through grants or funding agreements. This service delivery arrangement is intended to provide a diversity of voices, and encourage volunteerism and altruism, in conjunction with the purposes and objectives of the relevant NGO. Under the pretence of "accountability", however, governments increasingly are seeking to impose intrusive conditions on grantees, which limit their ability to fulfil their mission and advocate on behalf of their constituents. This column examines the United States Supreme Court decision, Agency for International Development v Alliance for Open Society International Inc 570 US_(2013), and compares it to the removal of gag clauses in Australian federal funding rules. Recent national changes to the health-related NFP sector in Australia are then discussed, such as those found in the Charities Act 2013 (Cth) and the Not-for-Profit Sector Freedom to Advocate Act 2013 (Cth). These respectively include the establishment of the Australian Charities and Not-For-Profit Commission, the modernising of the definition of "charity" and statutory blocks on "gag" clauses. This analysis concludes with a survey of recent moves by Australian States to impose new restrictions on the ability of health-related NFPs to lobby against harmful government policy Among the responses considered is the protection afforded by s 51l(xxiiiA) of the Australian Constitution. This constitutional guarantee appears to have been focused historically on preventing medical and dental practitioners and related small businesses being practically coerced into government or large-scale private corporate operations. As such, it may prohibit civil conscription arising not only from "gag clauses" in managed care contracts, but also from "gag clauses" in governmental ideological controls over taxpayer-funded, health-related NFPs.

Using a permanent income hypothesis approach and an income-giving status interaction effect, a double hurdle model provides evidence of significant differences from the impact of household income and various household characteristics on both a household's likelihood of giving and its level of giving to religion, charity, education, others outside the household, and politics. An analysis of resulting income elasticity estimates revealed that households consider religious giving a necessity good at all levels of income, while other categories of giving are generally found to be luxury goods. Further, those who gave to religion were found to give more to education and charity then those not giving to religion, and higher education households were more likely to give to religion than households with less education. This analysis suggests that there may be more to religious giving behavior than has been assumed in prior studies and underscores the need for further research into the motivation for religious giving. Specifically, these findings point to an enduring, internal motivation for giving rather than an external, “What do I get for what I give,” motive.

During late 1951 and early 1952, married couple, social biologist Elaine Cumming and psychiatrist John Cumming, led a mental health education experiment in Indian Head, Saskatchewan. The study, which was intended to inform strategies toward deinstitutionalization, sought to determine if attitudes regarding mental illness could be changed through commonly used educational practices. It was shaped by the shared interests of powerful philanthropic, charitable, psychiatric, academic and governmental bodies to create healthier citizens and a stronger democratic nation through expert knowledge. However, in addition to the disappointing findings indicating that attitudes remained unchanged, the town appeared to close ranks against the research team. Nonetheless, the Cummings' later association with sociologists at Harvard University enabled them to interpret the results in a way that lent the study credibility and themselves legitimacy, thus opening the door to their careers as very successful researchers and policy-makers.

In Latin American countries with historically strong social policy regimes (such as those in the Southern Cone), neoliberal policies are usually blamed for the increased burden of female unpaid work. However, studying the Nicaraguan care regime in two clearly defined periods — the Sandinista and the neoliberal eras — suggests that this argument may not hold in the case of countries with highly familialist social policy regimes. Despite major economic, political and policy shifts, the role of female unpaid work, both within the family and in the community, remains persistent and pivotal, and was significant long before the onset of neoliberal policies. Nicaragua's care regime has been highly dependent on the ‘community’ or ‘voluntary’ work of mostly women. This has also been, and continues to be, vital for the viability of many public social programmes.

Volunteers and charitable organizations contribute significantly to community welfare through their prosocial behavior: that is, discretionary behavior such as assisting, comforting, sharing, and cooperating intended to help worthy beneficiaries. This essay focuses on prosocial behavior on the Internet. It describes how offline charitable organizations are using the Net to become more efficient and effective. It also considers entirely new models of Net-based volunteer behavior directed at creating socially beneficial information goods and services. After exploring the scope and diversity of online prosocial behavior, the essay focuses on ways to encourage this kind of behavior through appropriate task and social structures, motivational signals, and trust indicators. It concludes by asking how local offline communities ultimately could be diminished or strengthened as prosocial behavior increases online.

IRS Form 990 Schedule H requires hospitals to estimate the amount of bad debt expense attributable to patients eligible for charity under the hospital's charity care policy. Responses to Schedule H, Part III.A.3 open up the entire patient collection process to examination by the IRS, state officials, and the public. Using predictive analytics can help hospitals efficiently identify charity-eligible patients when answering Part III.A.3.

Few charitable organizations have achieved the status of global recognition enjoyed by UNICEF, the United Nations Children's Fund, which embodies the international effort to provide for needy children the world over. Created because of its synchronicity with the United Nations' stated purpose—to maintain peace in the world—UNICEF launched its operations in 1946. Its founding, early operations and eventual restructuring reveal a great deal about concurrent political and economic events, but also provide keen insight into international ideas about who qualified for full citizenship in the post-war world. The consequences of UNICEF's policies, procedures and practices posed challenges to notions of citizenship for both women and children. It challenged citizenship not by questioning sex-specific gender roles, but by judiciously adhering to the United Nations' promise to create equality for men and women alike. UNICEF found itself in the unique position to be able to globalize definitions of what constituted full citizenship in any nation, due to its rapid expansion throughout the world. Through its programs, especially those related to health care, it not only challenged these roles in the West, but began over several decades to complicate the definition of citizenship as it became a forceful presence in Asia and Africa throughout the 1970s.

We examine how and why donors divide gifts between people in the present (across distance) and between the present and future (across time). US donors tend to give less to charities that benefit the poor and more to charities that benefit the non-poor (such as museums, universities, and arts organizations). Many of these wealthier charities have created endowments that benefit not only present persons, but also future persons. We develop a shorthand framework for linking time to distance in charitable allocations that incorporates a "proximity preference," i.e., charity that prefers those who are nearer to us whether by reason of physical distance, psychic-identity, or temporal distance. Even though ethical considerations suggest that recipients' level of need should be the dominant factor in allocating gifts, donors also express preferences, ceteris paribus, for benefits arriving sooner rather than later, and for recipients who are ''closer'' rather than farther away.

In the wake of GAO reports that uniformly measuring community benefits is all but impossible, Sen. Chuck Grassley says he'll draft legislation setting up strict rules for measuring charity care and other benefits. While hospitals are leery, others see merit. "You need to have a standard methodology.... Everyone has a self-interest in reporting numbers that make themselves look terrific", says John Colombo, left.

For a long time healthy and socially disabled people have been helped by caritative institutions, primarily religious ones, with only occasional involvement of the state. The problem was raised by the economic revolution in the XIXth century, with particular emphasis on the highly industrialized countries, such as Alsace and Lorraine. The development of public healthcare, as well as the help to socially disabled people in these two areas (particularly in the spinning factories of Mulhouse, the iron works and the coal-mines of Moselle) have undoubtedly come before and lead to the social laws that were promulgated between 1883 and 1889 by Bismark and then in France after 1919.

By mid-month, the IRS expects to unveil extensive changes to its Form 990 reporting rules for not-for-profits, which could further affect current disclosure or nondisclosure of tax-exempt hospitals' community benefits and charity care. Most hospitals welcome the revisions, but the legislative process to implement those reforms could be lengthy, says healthcare attorney Bernadette Broccolo, left.

The Northampton General Lunatic Asylum opened in 1836 and was funded through local subscriptions. Unlike many other subscription asylums, it did not become a county asylum after the 1845 Lunacy Acts, but was registered as a charitable hospital. This article explores the dynamics that resulted in the Northamptonshire authorities' successfully evading their responsibility to build a county asylum. The loopholes in the supposedly mandatory legislation are examined, with the implications this had for the relationship between the Commissioners in Lunacy and the NGLA governors, as well as the conflict between the local magistrates and the NGLA governors that eventually forced Northamptonshire to conform and build its own specific county asylum in 1876.