610 - Free Tax Preparation Assistance in Pediatric Hospital Setting: A Feasibility and Pilot Study

Publication Number: 3591.610

John Feister, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Emily Miller, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Ndidi Unaka, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, United States; Andrew F. Beck, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States

Background: Poverty, and associated financial strain, negatively affects child health and wellbeing. Refundable tax credits (RTC), such as the earned income tax credit (EITC) and child tax credit (CTC), serve as direct cash infusions. Both have been shown to decrease child poverty and improve their health outcomes. However, many eligible families do not claim their RTC due to lack of filing taxes, or use costly fee-based tax preparation services that reduce the amount of their refund. To our knowledge, no research has focused awareness, utilization, and barriers to claiming RTC among families with hospitalized children.

Objective: To gain insights from families with infants in the design and piloting of a hospital-based, free tax preparation clinic (FTPC).

Design/Methods: Families with infants in the neonatal intensive care unit (NICU) at a large quaternary hospital in Ohio were surveyed regarding eligibility, awareness, and receipt of RTC, as well as potential interest in a hospital-based FTPC. In collaboration with a community partner, a FTPC was established within the hospital. Families with hospitalized children, particularly those in the NICU, were recruited as clients.

Results: A total of 25 families were surveyed (descriptive statistics in table 1); 20% of included families were unaware of RTC (table 2). Over half of all families used a paid tax preparation service in the previous year (median fee: $200), but most (72%) expressed interest in using a hospital-based FTPC in the future. In the first year of a piloted FTPC, we prepared 21 tax returns, saving families roughly $300 in preparation fees and assisting with the claiming of roughly $900 in refunds per return. Although the FTPC was initially developed for NICU families, most family-clients were from the surrounding community. The second year of the clinic will focus on expansion and enhanced marketing to families of hospitalized children and those with complex medical needs (2026 results forthcoming).

Conclusion(s): Knowledge of RTC varies even as many families pay for tax preparation services. Hospital based tax preparation assistance offers the potential to address health related social needs for families of hospitalized children. Although most families expressed interest in hospital-based FTPC, uptake was limited by families of hospitalized infants. That said, several families still used the service, suggesting that offering hospital-based FTPC is feasible. Moreover, the service saved families money related to tax preparation fees and assisted them in claiming refundable tax credits worth hundreds of dollars.

Table 1
Selected sociodemographic characteristics of the sample. ^: missing 1 response; #: does not include infant hospitalized; *:2 missing responses

Table 2
Results of tax preparation survey. *all answers refer to tax season immediately prior to completion of survey. ^one participant declined to answer. CTC: Child Tax Credit; EITC: Earned Income Tax Credit