BILL NUMBER: AB 1046 INTRODUCED
INTRODUCED BY Assembly Member Dababneh
FEBRUARY 26, 2015
An act to amend Sections 127340, 127345, 127350, and 127355 of,
and to add Section 127365 to, the Health and Safety Code, relating to
LEGISLATIVE COUNSEL'S DIGEST
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 1. Section 127340 of the Health and Safety Code is amended
127340. The Legislature finds and declares all of the following:
(a) Private not-for-profit hospitals meet certain health
needs of their communities through the provision of essential
health care and other services. Public recognition of their unique
status has led to favorable tax treatment by the government. In
exchange, nonprofit hospitals assume a social obligation to provide
community benefits in the public interest.
(b) Hospitals and the environment in which they operate have
undergone dramatic changes. The pace of change will accelerate in
response to health care reform. In light of this, significant public
benefit would be derived if private not-for-profit hospitals reviewed
and reaffirmed periodically their commitment to assist in meeting
their communities' health
care needs by
identifying and documenting benefits provided to the communities
which they serve.
(c) California's private not-for-profit hospitals provide a wide
range of benefits to their communities in addition to those reflected
in the financial data reported to the state.
These benefits include, but are not limited to, all of the
(d) Unreported community benefits that are often provided but not
otherwise reported include, but are not limited to, all of the
(1) Community-oriented wellness and health promotion.
(2) Prevention services, including, but not limited to, health
screening, immunizations, school examinations, and disease counseling
(3) Adult day care.
(4) Child care.
(5) Medical research.
(6) Medical education.
(7) Nursing and other professional training.
(8) Home-delivered meals to the homebound.
(9) Sponsorship of free food, shelter, and clothing to the
(10) Outreach clinics in socioeconomically depressed areas.
(e) Direct provision of goods and services, as well as preventive
programs, should be emphasized by hospitals in the development of
community benefit plans.
(1) Community health services that may include community health
education, community-based clinical services, health care support
services, and social or environmental services.
(2) Health professions education.
(3) Subsidized health services, including, but not limited to,
emergency and trauma, neonatal intensive care, burn and special care
units, women and children's services, renal services, hospice, home
care, adult day care, behavioral health care services, and palliative
(4) Research in clinical care, community health, and general
studies, including health care delivery.
(5) Financial and in-kind contributions, including grants or other
funds to not-for-profit health care organizations improving
community health needs.
(6) Administrative and operational costs associated with
conducting community health needs assessments and implementing and
evaluating community benefits plans.
(d) Direct provision of health goods and services or partnerships
to enhance the provision of health goods and services, as well as
preventive programs, should be emphasized by hospitals in the
development of community benefits plans.
SEC. 2. Section 127345 of the Health and Safety Code is amended to
127345. As used in this article, the following terms have the
(a) "Community benefits plan" means the a
written document prepared for annual submission to the
Office of Statewide Health Planning and Development that
shall include, but shall not be limited to, a description of the
activities that the hospital has undertaken in order to address
identified community health needs within its mission and
financial capacity, and the process by which the hospital developed
the plan in consultation with the community.
(b) "Community" means the service areas or patient populations for
which the hospital provides health care services.
(c) Solely for the planning and reporting purposes of this
article, "community benefit" means a hospital's activities that are
intended to address community health needs and priorities
primarily through disease prevention and improvement of health
status, including, but not limited to, any of the following:
(1) Health care services, rendered to vulnerable populations,
including, but not limited to, charity care and the unreimbursed cost
of providing services to the uninsured, underinsured, and those
eligible for Medi-Cal, Medicare, California Childrens
Services Program, or county indigent programs , or
other means-tested government programs .
(2) The unreimbursed cost of services included in subdivision (d)
of Section 127340.
(3) Financial or in-kind support of public health programs.
(4) Donation of funds, property, or other resources that
contribute to a community priority
health improvement .
(5) Health care cost containment.
(6) Enhancement of access to health care or related services that
contribute to a healthier community health
(7) Services offered without regard to financial return because
they meet a community health need in the service area of
the hospital, and other services including health promotion, health
education, research, prevention, and social services.
(8) Food, shelter, clothing, education, transportation, and other
goods or services that help maintain a person's health
community health improvement .
(d) "Community health needs assessment" means the
process by which the hospital identifies, for its primary service
area as determined by the hospital, unmet community health
(e) "Community health needs" means those requisites for
improvement or maintenance of health status in the community.
(f) "Hospital" means a private not-for-profit acute hospital
licensed under subdivision (a), (b), or (f) of Section 1250 and is
owned by a corporation that has been determined to be exempt from
taxation under the United States Internal Revenue Code. "Hospital"
does not mean any of the following: include a
hospital that is dedicated to serving children and that does not
receive direct payment for services to any patient.
(1) Hospitals that are dedicated to serving children and that do
not receive direct payment for services to any patient.
(2) Small and rural hospitals as defined in Section 124840.
(g) "Mission statement" means a hospital's primary objectives for
operation as adopted by its governing body.
(h) "Vulnerable populations" means any population that is exposed
to medical or financial risk by virtue of being uninsured,
underinsured, or eligible for Medi-Cal, Medicare, California
Childrens Services Program, or county indigent programs
, or other means-tested programs .
SEC. 3. Section 127350 of the Health and Safety Code is amended to
127350. Each hospital shall do all of the following:
(a) By July 1, 1995, reaffirm its mission statement that requires
its policies integrate and reflect the public interest in meeting
its responsibilities as a not-for-profit organization.
(b) By January 1, 1996,
(a) Every three years, complete,
either alone, in conjunction with other health care providers, or
through other organizational arrangements, a community health
needs assessment evaluating the health needs of the community
serviced by the hospital, that includes, but is not limited to, a
process for consulting with community groups and local government
officials in the identification and prioritization of community
health needs that the hospital can address directly, in
collaboration with others, or through other organizational
arrangement. The community needs assessment shall be updated
at least once every three years.
(c) By April 1, 1996, and annually thereafter
(b) Following completion of the
community health needs assessment every three years, adopt
and update a community benefits plan for providing
community benefits either alone, in conjunction with other health
care providers, or through other organizational arrangements.
(c) Annually submit its an
update of the activities conducted pursuant to the community
benefits plan, including, but not limited to, the activities that the
hospital has undertaken in order to address community health
needs within its mission and financial capacity , to
the Office of Statewide Health Planning and Development. The
hospital shall, to the extent practicable, assign and report the
economic value of community benefits provided in furtherance of its
plan. Effective with hospital fiscal years, beginning on or
after January 1, 1996, each Each hospital shall
file a copy of the plan update with the
office not later than 150 days after the hospital's fiscal year
ends. The reports
(d) The updates filed by the
hospitals with the office shall be made available to the
public by the office , and, upon request, by the hospital, at no
charge . Hospitals under the common control of a single
corporation or another entity may file a consolidated report
update of its community benefits plan .
SEC. 4. Section 127355 of the Health and Safety Code is amended to
127355. The hospital shall include all of the following elements
in its community benefits plan:
(a) Mechanisms to evaluate the plan's effectiveness including, but
not limited to, a method for soliciting the views of the community
served by the hospital and identification of community groups and
local government officials consulted during the development of the
(b) Measurable objectives to be achieved within specified
(c) Community benefits categorized into the following framework:
(1) Medical care services.
(2) Other benefits for vulnerable populations.
(3) Other benefits for the broader community.
(4) Health research, education, and training programs.
(5) Nonquantifiable benefits.
(1) Charity care at cost.
(2) Unreimbursed cost of Medi-Cal, Medicare, county indigent
programs, or other means-tested government programs.
(3) Community health improvement services.
(4) Health research, health professions education, and training
(5) Subsidized health services, cash, and in-kind contributions
and other benefits.
(6) Nonquantifiable benefits.
SEC. 5. Section 127365 is added to the Health and Safety Code, to
127365. The Office of Statewide Health Planning and Development
shall do all of the following:
(a) Post on its Internet Web site the community benefits plans and
updates that are submitted to the office pursuant to subdivision (b)
or (c) of Section 127350 within 120 days of receipt of those plans
(b) Identify on its Internet Web site any hospital that did not
file an update of its community benefits plan on a timely basis.