AB 1046, as amended, 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,
begin delete make changes toend delete
the elements that are required to be included in a community begin delete benefits planend delete and delete the exemption from these requirements for small and rural hospitals. The bill would instead require a hospital to adopt begin delete a community benefits planend delete every 3 years, and to submit an update of the activities conducted under the begin delete planend delete to the office annually. The bill would require the begin delete 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.end delete
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 health 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 community 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 needs by identifying and documenting
16benefits provided to the communities which they serve.
17(c) California’s private not-for-profit hospitals provide a wide
18range of benefits to their communities in addition to those reflected
19in the financial data reported to the state.
20These benefits include, but are not limited to, all of the following:
21(1) Community health services that may include community
22health education, community-based clinical services, health care
23support services, and social or environmental services.
24(2) Health professions education.
25(3) Subsidized health services, including, but not limited to,
26emergency and trauma, neonatal intensive care, burn and special
27care units, women and children’s services, renal services, hospice,
28home care, adult day care, behavioral health care services, and
P3 1(4) Research in clinical care, community health, and general
2studies, including health care delivery.
3(5) Financial and in-kind contributions, including grants or other
4funds to not-for-profit health care organizations improving
5community health needs.
6(6) Administrative and operational costs associated with
7conducting community health needs assessments and implementing
8and evaluating community benefits plans.
9(d) Direct provision of health goods and services or partnerships
10to enhance the provision of health goods and services, as well as
11preventive programs, should be emphasized by hospitals in the
12development of community benefits plans.
Section 127345 of the Health and Safety Code is
2amended to read:
As used in this article, the following terms have the
5(a) “Community benefits plan” means a written document that
6shall include, but shall not be limited to, a description of the
7activities that the hospital has undertaken in order to address
8identified community health needs within its mission and financial
9capacity, and the process by which the hospital developed the plan
10in consultation with the community.
11(b) “Community” means the service areas or patient populations
12for which the hospital provides health care services.
13(c) Solely for the planning and reporting purposes of this article,
14“community benefit” means a hospital’s activities that are intended
15to address community health needs and priorities primarily through
16disease prevention and improvement of health status, including,
17but not limited to, any of the following:
18(1) Health care services, rendered to vulnerable populations,
19including, but not limited to, charity care and the unreimbursed
20cost of providing services to the uninsured, underinsured, and those
21eligible for Medi-Cal, Medicare, county indigent programs, or
22other means-tested government programs.
23(2) The unreimbursed cost of services included in subdivision
24(d) of Section 127340.
25(3) Financial or in-kind support of public health programs.
26(4) Donation of funds, property, or other resources that
27contribute to community health improvement.
28(5) Health care cost containment.
29(6) Enhancement of access to health care or related services that
30contribute to community health improvement.
31(7) Services offered without regard to financial return because
32they meet a community health need in the service area of the
33hospital, and other services including health promotion, health
34education, research, prevention, and social services.
35(8) Food, shelter, clothing, education, transportation,
36goods or services that help community health improvement.
29 7(d)end delete
8 “Community health needs assessment” means the process
9by which the hospital
begin delete identifies,end delete for its primary service area as determined by the begin delete hospital, .
11unmet community health needsend delete
32 12(e)end delete
13 “Community health needs” means those requisites for
14improvement or maintenance of health status in the community.
34 24(f)end delete
25“Hospital” means a private not-for-profit acute hospital
26licensed under subdivision (a), (b), or (f) of Section 1250 and is
27owned by a corporation that has been determined to be exempt
28from taxation under the United States Internal Revenue Code.
begin delete “Hospital”end delete
30 does not include a hospital that is dedicated to
31serving children and that does not receive direct payment for
32services to any patient.
33(g) “Mission statement” means a hospital’s primary objectives
34for operation as adopted by its governing body.
begin delete populations”end delete
means begin delete anyend delete
13 population that is exposed to medical or financial risk by virtue of
14being uninsured, underinsured, or eligible for Medi-Cal, Medicare,
15county indigent programs, or other means-tested programs.
Section 127350 of the Health and Safety Code is
17amended to read:
Each hospital shall do all of the following:
19(a) Every three years, complete, either alone, in conjunction
20with other health care providers, or through other organizational
21arrangements, a community health needs assessment evaluating
22the health needs of the community serviced by the hospital, that
23includes, but is not limited to, a process for consulting with
24community groups and local government officials in the
25identification and prioritization of community health needs that
26the hospital can address directly, in collaboration with others, or
27through other organizational arrangement.
completion of the community health needs
29assessment every three years, adopt a community benefits plan for
30providing community benefits either alone, in conjunction with
31other health care providers, or through other organizational
33(c) Annually submit an update of the activities conducted
34pursuant to the community benefits plan, including, but not limited
35to, the activities that the hospital has undertaken in order to address
36community health needs within its mission and financial capacity,
37to the Office of Statewide Health Planning and Development. The
38hospital shall, to the extent practicable, assign and report the
39economic value of community benefits provided in furtherance of
P9 1its plan. Each hospital shall file a copy of the update with the office
2not later than 150 days after the hospital’s fiscal year ends.
3(d) The updates filed by the hospitals with the office shall be
4made available to the public by the office, and, upon request, by
5the hospital, at no charge. Hospitals under the common control of
6a single corporation or another entity may file a consolidated update
7of its community benefits plan.
Section 127355 of the Health and Safety Code is
9amended to read:
The hospital shall include all of the following elements
11in its community benefits plan:
12(a) Mechanisms to evaluate the plan’s effectiveness including,
13but not limited to, a method for soliciting the views of the
14community served by the hospital and identification of community
15groups and local government officials consulted during the
16development of the plan.
17(b) Measurable objectives to be achieved within specified
19(c) Community benefits categorized into the following
21(1) Charity care at cost.
22(2) Unreimbursed cost of Medi-Cal, Medicare, county indigent
23programs, or other means-tested government programs.
24(3) Community health improvement services.
25(4) Health research, health professions education, and training
27(5) Subsidized health services, cash, and in-kind contributions
28and other benefits.
29(6) Nonquantifiable benefits.
Each hospital shall do all of the following:
33(a) By July 1, 1995, reaffirm its mission statement that requires
34its policies integrate and reflect the public interest in meeting its
35responsibilities as a not-for-profit organization.
36(b) By January 1, 1996, complete, either alone, in conjunction
37with other health care providers, or through other organizational
38arrangements, a community needs assessment evaluating the health
39needs of the community serviced by the hospital, that includes,
40but is not limited to, a process for consulting with community
P10 1groups and local government officials in the identification and
2prioritization of community needs that the hospital can address
3directly, in collaboration with others, or through other
4organizational arrangement. The community needs assessment
5shall be updated at least once every three years.
6(c) By April 1, 1996, and annually thereafter adopt and update
7a community benefits plan for providing community benefits either
8alone, in conjunction with other health care providers, or through
9other organizational arrangements.
10(d) Annually submit its community benefits plan, including,
11but not limited to, the activities that the hospital has undertaken
12in order to address community needs within its mission and
13financial capacity to the Office of Statewide Health Planning and
14Development. The hospital shall, to the extent practicable, assign
15and report the economic value of community benefits provided in
16furtherance of its plan. Effective with hospital fiscal years,
17beginning on or after January 1, 1996, each hospital shall file a
18copy of the plan with the office not later than 150 days after the
19hospital’s fiscal year ends. The reports filed by the hospitals shall
20be made available to the public by the office. Hospitals under the
21common control of a single corporation or another entity may file
22a consolidated report.
The hospital shall include all of the following elements
15in its community benefits plan:
16(a) Mechanisms to evaluate the plan’s effectiveness including,
17but not limited to, a method for soliciting the views of the
18community served by the hospital and identification of community
19groups and local government officials consulted during the
20development of the plan.
21(b) Measurable objectives to be achieved within specified
23(c) Community benefits categorized into the following
25(1) Medical care services.
26(2) Other benefits for vulnerable populations.
27(3) Other benefits for the broader community.
28(4) Health research, education, and training programs.
29(5) Nonquantifiable benefits.
Nothing in this article shall be construed to authorize
33or require specific formats for hospital needs assessments,
34community benefit plans, or reports until recommendations
35pursuant to former Section 127365, as added by Chapter 1023 of
36the Statutes of 1996, are considered and enacted by the Legislature.
37Nothing in this article shall
be used to justify the tax-exempt
39status of a hospital under state law.
begin deleteNothing in this article shallend delete
P16 1 preclude the office from requiring hospitals
2to directly report their charity activities.
Section 127365 is added to the Health and Safety Code,
The Office of Statewide Health Planning and
7Development shall do all of the following:
8(a) Post on its Internet Web site the
begin delete community benefits plans updates that are submitted to the
10office pursuant to subdivision
begin delete (b) or (c)end delete of Section 127350
11within 120 days of receipt of those plans or updates.
12(b) Identify on its Internet Web site any hospital that did not
13file an update of its
begin delete community benefits planend delete on a timely basis.