AB 1046, as introduced, Dababneh. Hospitals: community benefits.
Existing law requires certain private not-for-profit acute hospitals to, every 3 years, complete a community needs assessment, as defined, and to annually adopt and update a community benefits plan, as defined. Existing law exempts certain hospitals from these provisions, including small and rural hospitals. Existing law requires a hospital to file a report on its community benefits plan and the activities undertaken to address community needs with the Statewide Office of Health Planning and Development. Existing law requires the office to make those reports available to the public.
This bill would revise and recast these provisions to, among other things, make changes to the elements that are required to be included in a community benefits plan and delete the exemption from these requirements for small and rural hospitals. The bill would instead require a hospital to adopt a community benefits plan every 3 years, and to submit an update of the activities conducted under the plan to the office annually. The bill would require the office to post on its Internet Web site the updates to community benefits plans received by the office from each hospital. The bill would require a hospital to make updates to its community benefits plan available to the public, upon request, at no charge.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 127340 of the Health and Safety Code
2 is amended to read:
The Legislature finds and declares all of the following:
4(a) Private not-for-profit hospitals meet certain needs of
5their communities through the provision of essential health care
6and other services. Public recognition of their unique status has
7led to favorable tax treatment by the government. In exchange,
8nonprofit hospitals assume a social obligation to provide
9community benefits in the public interest.
10(b) Hospitals and the environment in which they operate have
11undergone dramatic changes. The pace of change will accelerate
12in response to health care reform. In light of this, significant public
13benefit would be derived if private not-for-profit hospitals reviewed
14and reaffirmed periodically their commitment to assist in meeting
15their communities’ health
begin delete careend delete needs by identifying and
16documenting benefits provided to the communities which they
18(c) California’s private not-for-profit hospitals provide a wide
19range of benefits to their communities in addition to those reflected
20in the financial data reported to the state.
22(d) Unreported community benefits that are often provided but
23not otherwise reported include, but are not limited to, all of the
25(1) Community-oriented wellness and health promotion.
26(2) Prevention services, including, but not limited to, health
27screening, immunizations, school examinations, and disease
28counseling and education.
29(3) Adult day care.
30(4) Child care.
31(5) Medical research.
32(6) Medical education.
33(7) Nursing and other professional training.
P3 1(8) Home-delivered meals to the homebound.
2(9) Sponsorship of free food, shelter, and clothing to the
4(10) Outreach clinics in socioeconomically depressed areas.
5(e) Direct provision of goods and services, as well as preventive
6programs, should be emphasized by hospitals in the development
7of community benefit plans.
Section 127345 of the Health and Safety Code is
30amended to read:
As used in this article, the following terms have the
33(a) “Community benefits plan” means
begin delete theend delete written document
begin delete prepared for annual submission to the Office of Statewide Health that shall include, but shall not be
35Planning and Developmentend delete
36limited to, a description of the activities that the hospital has
37undertaken in order to address identified community needs
38within its mission and financial capacity, and the process by which
39the hospital developed the plan in consultation with the community.
P4 1(b) “Community” means the service areas or patient populations
2for which the hospital provides health care services.
3(c) Solely for the planning and reporting purposes of this article,
4“community benefit” means a hospital’s activities that are intended
5to address community needs and priorities primarily through
6disease prevention and improvement of health status, including,
7but not limited to, any of the following:
8(1) Health care services, rendered to vulnerable populations,
9including, but not limited to, charity care and the unreimbursed
10cost of providing services to the uninsured, underinsured, and those
11eligible for Medi-Cal, Medicare,
begin delete California Childrens Services
county indigent programs.
12Program, orend delete
14(2) The unreimbursed cost of services included in subdivision
15(d) of Section 127340.
16(3) Financial or in-kind support of public health programs.
17(4) Donation of funds, property, or other resources that
begin delete aend delete community begin delete priorityend delete.
19(5) Health care cost containment.
20(6) Enhancement of access to health care or related services that
begin delete a healthierend delete community.
22(7) Services offered without regard to financial return because
23they meet a community need in the service area of the
24hospital, and other services including health promotion, health
25education, prevention, and social services.
26(8) Food, shelter, clothing, education, transportation,
27goods or services that help
begin delete maintain a person’s healthend delete.
29(d) “Community needs assessment” means the process
30by which the hospital identifies, for its primary service area as
31determined by the hospital, unmet community needs.
32(e) “Community needs” means those requisites for
33improvement or maintenance of health status in the community.
34(f) “Hospital” means a private not-for-profit acute hospital
35licensed under subdivision (a), (b), or (f) of Section 1250 and is
36owned by a corporation that has been determined to be exempt
37from taxation under the United States Internal Revenue Code.
38“Hospital” does not
begin delete mean any of the following:end delete
P5 1(1) Hospitals that are dedicated to serving children and that do
2not receive direct payment for services to any patient.
3(2) Small and rural hospitals as defined in Section 124840.end delete
4(g) “Mission statement” means a hospital’s primary objectives
5for operation as adopted by its governing body.
6(h) “Vulnerable populations” means any population that is
7exposed to medical or financial risk by virtue of being uninsured,
8underinsured, or eligible for Medi-Cal, Medicare,
begin delete California county indigent programs.
9Childrens Services Program, orend delete
Section 127350 of the Health and Safety Code is
12amended to read:
Each hospital shall do all of the following:
14(a) By July 1, 1995, reaffirm its mission statement that requires
15its policies integrate and reflect the public interest in meeting its
16responsibilities as a not-for-profit organization.
17(b) By January 1, 1996,end delete
18complete, either alone, in
19with other health care providers, or through other organizational
20arrangements, a community needs assessment evaluating
21the health needs of the community serviced by the hospital, that
22includes, but is not limited to, a process for consulting with
23community groups and local government officials in the
24identification and prioritization of community needs that
25the hospital can address directly, in collaboration with others, or
26through other organizational arrangement.
begin delete The community needs
27assessment shall be updated at least once every three years.end delete
28(c) By April 1, 1996, and annually thereafterend delete
begin delete and updateend delete a community
31benefits plan for providing community benefits either alone, in
32conjunction with other health care providers, or through other
35 Annually submit
begin delete itsend delete
community benefits plan, including, but not limited
37to, the activities that the hospital has undertaken in order to address
38community needs within its mission and financial capacity
39 to the Office of Statewide Health Planning and Development. The
40hospital shall, to the extent practicable, assign and report the
P6 1economic value of community benefits provided in furtherance of
begin delete Effective with hospital fiscal years, beginning on or after
hospital shall file a copy of the
3January 1, 1996, eachend delete
begin delete planend delete
4 with the office not later than 150 days after the hospital’s
5fiscal year ends.
begin delete The reportsend delete
6 filed by the hospitals shall be
7made available to the public by the office. Hospitals under the common control
9of a single corporation or another entity may file a consolidated
begin delete reportend delete.
Section 127355 of the Health and Safety Code is
12amended to read:
The hospital shall include all of the following elements
14in its community benefits plan:
15(a) Mechanisms to evaluate the plan’s effectiveness including,
16but not limited to, a method for soliciting the views of the
17community served by the hospital and identification of community
18groups and local government officials consulted during the
19development of the plan.
20(b) Measurable objectives to be achieved within specified
22(c) Community benefits categorized into the following
24(1) Medical care services.end delete
25(2) Other benefits for vulnerable populations.end delete
26(3) Other benefits for the broader community.end delete
27(4) Health research, education, and training programs.end delete
28(5) Nonquantifiable benefits.end delete
Section 127365 is added to the Health and Safety Code,
The Office of Statewide Health Planning and
2Development shall do all of the following:
3(a) Post on its Internet Web site the community benefits plans
4and updates that are submitted to the office pursuant to subdivision
5(b) or (c) of Section 127350 within 120 days of receipt of those
6plans or updates.
7(b) Identify on its Internet Web site any hospital that did not
8file an update of its community benefits plan on a timely basis.