BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 975
                                                                  Page  1

          Date of Hearing:   May 8, 2013

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

                  AB 975 (Wieckowski) - As Amended:  April 25, 2013 

          Policy Committee:                              HealthVote:12-7

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              No

           SUMMARY  

          This bill revises California's nonprofit community benefits  
          requirements to create a definition of charity care, and  
          requires the Office of Statewide Health Planning and Development  
          (OSHPD) to develop a standardized methodology for calculating  
          community benefits, calculate the value of community benefits  
          for submitting entities, and issue civil penalties for  
          noncompliance with filing requirements.  

           FISCAL EFFECT  

          Costs to OSHPD (California Health Data and Planning Fund) of  
          approximately $2.2 million in FY 2014-15 and FY 2015-16 with  
          ongoing costs of approximately $900,000 annually.  

          Costs include information technology staff for various data  
          functions and accounting and reporting services staff to ensure  
          compliance with reporting, audit complex documents, develop  
          regulations, monitor overall compliance and assess penalties.
           
           COMMENTS  

           1)Rationale  .  This bill is sponsored by the California Nurses  
            Association (CNA) to define charity care for nonprofit  
            hospitals and refine what is considered community benefits to  
            ensure California's nonprofit hospitals are fulfilling their  
            mission statements and providing community benefits in  
            exchange for their tax-exempt status.  CNA states in 2010,  
            more than seven million Californians lacked health insurance,  
            yet California's nonprofit hospitals benefited $1.8 billion  
            from their tax-exempt status.  This bill includes a refined  
            definition of community benefits for nonprofit hospitals,  








                                                                  AB 975
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            which must be a direct provision of care, not promotional  
            activities or cost containment, as currently provided within  
            the guidelines of community benefit.  This bill is intended to  
            improve reporting requirements for greater public transparency  
            in how hospitals meet their charity care obligation, with  
            rigorous financial penalties for hospitals that fail to meet  
            reporting requirements. 

           2)Background  .  According to a 2012 Senate Office of Research  
            (SOR) report, about 247 of California's 387 private hospitals  
            may be eligible for certain tax exemptions due to their  
            nonprofit status in exchange for providing various community  
            benefits, such as charity care.  Community benefits are not  
            uniformly defined or measured.  This ambiguity makes it  
            challenging to hold hospitals accountable for the special tax  
            benefits they receive and determine if they are providing  
            meaningful community benefits.  Furthermore, some studies show  
            many investor-owned hospitals and public hospitals provide  
            charity care and other community benefits similar to or  
            greater than their nonprofit counterparts.  

            There appears to be no uniform definition of charity care nor  
            a requirement in state or federal law for nonprofit hospitals  
            to provide a certain amount of charity care or community  
            benefit in order to maintain their tax exempt status.   
            According to the Legislative Analyst, of the private hospitals  
            in California, about 30% are for-profit and about 70% are  
            nonprofit. The for-profit hospitals pay corporate income taxes  
            to the state. Nonprofit hospitals are exempt from state  
            corporate income taxes, local sales taxes, and property taxes.  
            The tax exemptions are intended to allow nonprofit hospitals  
            to use the funds that would have been paid in taxes to provide  
            patient care, invest in their facilities and equipment, and  
            implement other measures that would be beneficial to their  
            delivery of healthcare services.  Controversy exists in how  
            charity care and community benefits are quantified.  Some  
            hospitals use a cost accounting methodology while others use a  
            ratio that converts a hospital's listed charges to the actual  
            cost of the services provided.  SOR also reports in 2008, the  
            federal Internal Revenue Service revised its nonprofit  
            reporting form in an effort to provide transparency and  
            accountability and keep pace with changes in the law for the  
            tax exempt sector.  The new form requires nonprofit hospitals  
            to report their bad debt expenses and Medicare shortfalls, but  
            excludes counting these as community benefits.








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           3)State audits .  The California State Auditor audited the  
            tax-exempt status of nonprofit hospitals in 2007 and 2012.   
            Recommendations from the 2007 report, for closer monitoring by  
            the Franchise Tax Board, have largely been implemented.  2012  
            recommendations, for a mandatory format and methodology for  
            tax-exempt nonprofit hospitals to follow when presenting  
            community benefits in their plans, and for tax exemptions to  
            be based on a certain level of community care, have not been  
            adopted by the Legislature.   

           4)Health reform  .  The Affordable Care Act (ACA) includes new  
            reporting requirements.  Nonprofit hospitals are required to  
            report to the IRS the results of the community needs  
            assessment and if all identified needs are not addressed, they  
            are required to provide reasons.  Hospitals also must submit  
            audited financial statements to the IRS.  These reporting  
            requirements are in addition to the preexisting requirements  
            of Form 990 and Schedule H.  Failure to comply makes hospitals  
            subject to an excise tax penalty of $50,000 and the loss of  
            federal tax exemption.

           5)Support  .  In addition to CNA, supporters include various  
            consumer and labor organizations
           
           6)Opposition  includes hospitals and clinics, Service Employees  
            International Union (SEIU)-UHW, and the California Chamber of  
            Commerce. 


            
           Analysis Prepared by  :    Debra Roth / APPR. / (916) 319-2081