The tax-exempt status of health care organizations carries certain restrictions on political activities. However, there are many effective advocacy activities in which tax-exempt, nonprofit hospitals may engage without jeopardizing their tax-exempt status.

A 501 (c)(3) organization has limits on the amount of legislative activities in which it may engage and is prohibited from participating in political campaigns. A tax-exempt hospital that engages in political campaigns or substantial legislative activities at the local, state or federal levels will jeopardize its tax-exempt status.

Your organization may well be incorporated as a classic 501(c)(3) corporation, a tax-exempt charity. If so, the following guidelines will be very useful.

Federal law limits the amount of lobbying activities by a tax-exempt organization. Generally, activities that total more than five percent of the organization's total expenditures is considered suspect and could trigger a review by the Internal Revenue Service. The IRS would look at "time and effort" in determining the expenditures allocated to lobbying activities. The IRS scrutinizes all political activity by tax-exempt organizations and will investigate when it believes an organization has crossed the line.

The following guidelines are intended to provide market-based organizations and facilities with an overview of which advocacy-related actions are permissible and which are not.

Permissible actions include:

• Calling and/or writing letters to elected officials, legislators and government agencies to express the organization's view on a particular issue.
• Arranging personal visits to political leaders to provide the organization's perspective on present and proposed legislation.
  Providing community opportunities (for example, public forums, lectures, debates) to raise awareness of important issues and inform voters of the potential impact of issues on the organization and community.
• Sponsoring non-partisan voter registration drives, including registration conducted within the organization's facilities, and encouraging/assisting employees and community members to get out and vote.
• Hosting an individual candidate or groups of candidates within an organization's facilities, as long as all candidates for a particular office are given similar opportunities to express their views and meet employees and others.
• Personally supporting or opposing candidates as long as the individuals involved do not imply that they are representing the organization.
• Contributing personal funds to a campaign or political action committee (PAC) as long as there is no pressure from the organization to contribute and the contribution is not linked to the organization in any way, but only to the individuals who contribute.

Prohibited actions include:

• The non-profit/tax exempt organization supporting or opposing a particular candidate for public office.
• Sponsoring a fundraiser or another event that endorses a candidate on the property of the tax-exempt organization.
• Contributing 501 (c)(3) non-profit/tax exempt organizational funds or time to support a candidate, PAC or political party.
• Asking employees or staff members within the organization to support or oppose (financially or otherwise) a candidate, or to contribute to a campaign or PAC. The IRS has interpreted a simple request to an employee from a supervisor to support a candidate or contribute to a PAC as a violation of the law.
• Using non-profit/tax exempt organization resources (for example, e-mail, letters on organization letterhead) to seek support for or opposition to a candidate or contributions to a PAC. Do not use e-mail to seek any form of support for a candidate at any level of government.