BILL NUMBER: AB 2942 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MAY 23, 2008
AMENDED IN ASSEMBLY APRIL 2, 2008
AMENDED IN ASSEMBLY MARCH 13, 2008
INTRODUCED BY Assembly Member Ma
FEBRUARY 22, 2008
An act to repeal and add Article 2 (commencing with Section
127340) of Chapter 2 of Part 2 of Division 107 of the Health and
Safety Code, relating to community benefits.
LEGISLATIVE COUNSEL'S DIGEST
AB 2942, as amended, Ma. Hospitals: community benefits.
Existing law requires certain licensed acute care hospitals to
complete a community needs assessment evaluating the health needs of
the community served by the hospital, to annually adopt a benefits
plan for providing community benefits, as defined, and to submit the
annual community benefit plan to the Office of Statewide Health
Planning and Development. Under existing law, community benefits
include providing health care services to members of vulnerable
populations, as specified.
This bill would revise and recast the above-described provisions
to, among other things, require facilities, as defined ,
to include certain hospitals and certain nonprofit clinics exempt
from licensure, to provide community benefits, as defined, to
the community. The bill would require facilities, by
January 1, 2010, to complete a community needs assessment and
, by April 1, 2010, to develop a community benefits plan,
as specified. The bill would require the office to develop a
standardized format and methodology to be followed by hospitals in
calculating and presenting community benefits information.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Article 2 (commencing with Section 127340) of Chapter 2
of Part 2 of Division 107 of the Health and Safety Code is repealed.
SEC. 2. Article 2 (commencing with Section 127340) is added to
Chapter 2 of Part 2 of Division 107 of the Health and Safety Code, to
read:
Article 2. Hospital Community Benefits
127340. The Legislature finds and declares that:
(a) Access to health care services is of vital concern to the
people of California.
(b) Health care providers play an important role in providing
essential health care services in the communities they serve.
(c) Notwithstanding public and private efforts to increase access
to health care, the people of California continue to have significant
unmet health needs. Studies indicate that as many as 6.5 million
Californians are uninsured during a year.
(d) The licensing privilege conveyed by the state to health care
providers for the right to conduct intrastate business should be
accompanied by a concomitant obligation to address unmet health care
needs.
(e)
(d) The state has a substantial interest in ensuring
that the unmet health needs of its residents are addressed. Health
care providers can help address these needs by providing community
benefits to the uninsured and underinsured members of their
communities.
127342. As used in this article, the following terms have the
following meanings:
(a) "Community" means the service areas or patient populations for
which the facility provides health care services.
(b) "Community benefits" means the unreimbursed goods, services,
and resources provided by a facility that address
community-identified health needs and concerns, particularly for
people who are uninsured, underserved, or a member of a vulnerable
population. Community benefits include, but are not limited to, the
unreimbursed cost of free care and discounted care and services to
individuals enrolled in or covered by means-tested government
programs, the cost of community health improvement services and
community benefit operations, and the cost of health professions
education, subsidized health services for vulnerable populations,
research, contributions to community groups, and community building
activities. The cost of care shall be computed consistent with
Article 3 (commencing with Section 127400). The cost of bad debts and
underpayment for Medicare services shall not be included in the
calculation of community benefits.
(c) "Community benefits plan" means the written document prepared
for annual submission to the office that includes, but is not
be limited to, the information required by Section
127345.
(d) "Community health needs assessment" means the written document
prepared pursuant to Section 127344.
(e) "Facility" means both of the following:
(1) A health facility that is defined in subdivision (a), (b), or
(f) of Section 1250, except for a hospital that is dedicated to
serving children and that does not receive direct payment for
services to any patient.
(2) A clinic that is exempt pursuant to subdivision () of Section
1206 from licensure as a clinic pursuant to Chapter 1 (commencing
with Section 1200) of Division 2.
(f) "Free care" means the unreimbursed cost for medical care for a
patient who cannot afford to pay for that care.
(g) "Office" means the Office of Statewide Health Planning and
Development.
(h) "Vulnerable population" means a population that has
disproportionate unmet health-related needs, such as a high
prevalence of one or more health conditions or concerns, and that has
limited access to timely, quality health care.
127343. (a) Each facility shall provide community benefits to
the community. Notwithstanding any other provision of law, a
health facility described in paragraph (1) of subdivision (e) of
Section 127342 shall provide community benefits to the community it
serves as a condition of licensure. the community.
(b) By January 1, 2010, each facility shall develop, in
collaboration with the community all of the following:
(1) An organizational mission statement that describes the
facility's commitment to developing, adopting, and implementing a
community benefits program.
(2) A description of the process for approval of the mission
statement by the facility's governing board, including a declaration
that the board and administrators of the facility shall be
responsible for oversight and implementation of the community
benefits plan.
(3) A community health needs assessment pursuant to Section 127344
that evaluates the health needs and resources of the community it
serves.
(c) By April 1, 2010, each facility shall develop, in
collaboration with the community, a community benefits plan pursuant
to Section 127345 designed to achieve all of the following outcomes:
(1) Increased access Access
to health care for members of underserved and vulnerable
populations.
(2) The addressing of essential health care needs of members of
underserved and vulnerable populations.
(3) The creation of measurable improvements in health for members
of underserved and vulnerable populations.
127344. (a) Prior to adopting a community benefits plan, each
facility shall complete a community needs assessment that evaluates
the health needs and resources of the community served by the
facility that is designed to achieve the outcomes specified in
paragraph (4) of subdivision (c) of Section 127343.
(b) In conducting its community health needs assessment, the
facility shall solicit comments from and meet with local government
officials, including representatives of local public health
departments. The facility shall also solicit comments from and meet
with health care providers, community groups representing, among
others, patients, labor, seniors, and consumers, and other health
related organizations. Particular attention shall be given to persons
who are themselves underserved and who work with underserved and
vulnerable populations.
Particular attention shall also be given to identifying local
needs to address racial and ethnic disparities in health outcomes. A
facility may create a community benefit advisory committee for the
purpose of soliciting community input.
(c) In preparing its community health needs assessment, a facility
shall use available public health data. Facilities may collaborate
with other facilities and health care institutions in conducting
community health needs assessments and may make use of existing
studies in completing their own needs assessments.
(d) Prior to completing the community health needs assessment,
each facility shall make available to the public a copy of the
assessment for review and comment.
(e) Each community health needs assessment shall be filed with the
office. A facility shall update its community needs assessment at
least every three years.
127345. (a) By April 1, 2010, each facility shall develop a
community benefits plan.
(b) As part of its development of a community benefits plan, each
facility shall solicit comment from and meet with local government
officials, including representatives of local public health
departments. The facility shall also solicit comments from and meet
with health care providers, community groups representing, among
others, patients, labor, seniors, and consumers, and other health
related organizations. Particular attention shall be given to persons
who are themselves underserved, who work with underserved and
vulnerable populations, and who work with populations at risk for
racial and ethnic disparities in health outcomes.
(c) The community benefits plan shall include, at a minimum, all
of the following:
(1) A summary of the needs assessment and a statement of the
community health care needs that will be addressed by the plan.
(2) A list of the services the facility intends to provide in the
following year to address community health needs identified in the
community health needs assessments. The list of services shall be
categorized under the following:
(A) Free care and means-tested government programs, including
services to patients eligible for free care or discounted payment
pursuant to Article 3 (commencing with Section 127400) of Chapter 2
of Part 2 of Division 107, Medi-Cal, Healthy Families, county
indigent programs, and other means-tested government programs.
(B) Other community benefits, including community health
improvement services and community benefit operations, health
professions education, subsidized health services, research and
contributions to community groups.
(C) Community building activities targeting underserved and
vulnerable populations.
(3) A description of the target community or communities that the
plan is intended to benefit.
(4) An estimate of the economic value of the community benefits
that the facility intends to provide.
(5) A summary of the process used to elicit community
participation in the community health needs assessment and community
benefits plan design, and a description of the process for ongoing
participation of community members in plan implementation and
oversight.
(6) A list of individuals, organizations and government officials
consulted during development of the plan.
(7) A description of the intended impact on health outcomes
attributable to the plan, including short- and long-term measurable
goals and objectives.
(8) Mechanisms to evaluate the plan's effectiveness.
(9) The name and title of the individual responsible for
implementing the plan.
(10) The names of individuals on the facility's governing board.
(11) If applicable, a report on the community benefits efforts of
the preceding year, including the amounts and types of community
benefits provided, in a manner to be prescribed by the office; a
statement of the plan's impact on health outcomes, including a
description of the facility's progress toward meeting its short- and
long-term goals and objectives; and an evaluation of the plan's
effectiveness.
(d) The facility may also report on bad debts and Medicare
shortfalls although these shall not be calculated or reported as
community benefits.
(e) The governing board of each facility shall adopt the community
benefits plan. Each facility shall make its draft community benefits
plan available to the public, in hard copy and on its Web site, no
later than 10 days prior to its adoption by the governing board of
the facility. The governing board shall hold a public meeting to
receive input from the community on the plan prior to its adoption.
(f) After April 1, 2010, each facility shall annually revise and
submit its community benefits plan to the office, no later than 120
days after the end of the facility's fiscal year.
(g) Any person or entity may file comments on a facility's
community benefits plan with the office.
(h) Facilities under the common control of a single corporation or
another entity may file a consolidated plan.
127346. Each facility shall make its community health needs
assessment and community benefits plan available to the public on its
Internet Web site. A copy of the assessment and plan shall be given
free of charge to any person upon request.
127347. (a) The office shall develop and adopt regulations to
prescribe a standardized format for community benefits plans pursuant
to this article. The office shall develop a standardized methodology
for estimating the economic value of community benefits provided by
a facility.
(b) The office shall provide technical assistance to help
facilities comply with this article.
(c) The office shall make public each community health needs
assessment and community benefits plan and any comments received
regarding those assessments and plans. The office shall make these
documents available on its Web site.
(d) The office shall annually calculate and make public the total
value of community benefits provided by facilities that report
pursuant to this article.
127348. The office may assess a civil penalty against any
facility that fails to comply with this article in the same manner as
specified in Section 128770.