Amended in Assembly April 7, 2015

California Legislature—2015–16 Regular Session

Assembly BillNo. 1046


Introduced by Assembly Member Dababneh

February 26, 2015


An act to amend Sections 127340, 127345,begin delete 127350, and 127355end deletebegin insert and 127360end insert of,begin delete andend delete to add Section 127365 to,begin insert to repeal Section 127355 of, and to repeal and add Section 127350 of,end insert the Health and Safety Code, relating to hospitals.

LEGISLATIVE COUNSEL’S DIGEST

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 deletebegin insert specifyend insert the elements that are required to be included in a communitybegin delete benefits planend deletebegin insert health needs assessment (CHNA) report, which would replace the community benefits plan,end insert and delete the exemption from these requirements for small and rural hospitals. The bill would instead require a hospital to adoptbegin delete a community benefits planend deletebegin insert the CHNA reportend insert every 3 years, and to submit an update of the activities conducted under thebegin delete planend deletebegin insert reportend insert to the office annually. The bill would require thebegin 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 deletebegin insert CHNA report to be widely available to the public, as prescribed.end insert

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

P2    1

SECTION 1.  

Section 127340 of the Health and Safety Code
2 is amended to read:

3

127340.  

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 obligationbegin insert, inherent in their
9missions,end insert
to provide community benefits in the public interest.

begin delete

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
29palliative care.

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.

end delete
begin insert

13(b) California’s private not-for-profit hospitals provide a wide
14range of benefits to their communities, in addition to those reflected
15in the financial data reported to the state in the form of community
16benefits. These contributions seek to achieve a community benefit
17objective, including improving access to health services, enhancing
18public health, advancing increased general knowledge, and relief
19of a government burden to improve health. This includes, but is
20not limited to, programs or activities that meet the following
21requirements:

end insert
begin insert

22(1) Are available broadly to the public and serve low-income
23consumers.

end insert
begin insert

24(2) Reduce geographic, financial, or cultural barriers to
25accessing health services, which, if they ceased, would result in
26access problems, including, but not limited to, longer wait times
27or increased travel distances.

end insert
begin insert

28(3) Address federal, state, or local public health priorities, such
29as eliminating disparities in access to health care services or
30disparities in health status among different populations.

end insert
begin insert

31(4) Leverage or enhance public health department activities,
32such as childhood immunization efforts.

end insert
begin insert

33(5) Strengthen community health resilience by improving the
34ability of a community to withstand and recover from public health
35emergencies.

end insert
begin insert

36(6) Otherwise would become the responsibility of the government
37or another tax-exempt organization.

end insert
begin insert

38(7) Advance increased general knowledge through education
39or research that benefits the public.

end insert
P4    1

SEC. 2.  

Section 127345 of the Health and Safety Code is
2amended to read:

3

127345.  

As used in this article, the following terms have the
4following meanings:

begin delete

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, and other
36goods or services that help community health improvement.

end delete
begin insert

37(a) “Authorized body of a hospital facility” means either of the
38following:

end insert
begin insert

39(1) The governing body, including the board of directors, board
40of trustees, or equivalent controlling body, of the hospital
P5    1organization that operates the hospital facility, or a committee of,
2or other party authorized by, that governing body, to the extent
3that committee or other party is permitted under state law to act
4on behalf of the governing body.

end insert
begin insert

5(2) The governing body of an entity that is regarded or treated
6as a partnership for federal tax purposes that operates the hospital
7facility or a committee of, or other party authorized by, that
8governing body, to the extent that committee or other party is
9permitted under state law to act on behalf of the governing body.

end insert
begin insert

10(b) “Cash and in-kind contribution” means contributions made
11by the organization to health care organizations and other
12community groups for one or more of the community benefit
13activities.

end insert
begin insert

14(c) “Charity care” means free or discounted health services
15provided to persons who meet the organization’s criteria for
16financial assistance and are unable to pay for all or a portion of
17the services. Charity care shall be recorded at cost. Charity care
18does not include bad debt or uncollectible charges that the
19organization recorded as revenue but wrote off due to a patient’s
20failure to pay.

end insert
begin insert

21(d) “Community benefits” includes, but is not limited to, any
22of the following:

end insert
begin insert

23(1) The unpaid cost of charity care and other financial
24assistance.

end insert
begin insert

25(2) The unpaid cost of government-sponsored health care
26programs, including, but not limited to all of the following:

end insert
begin insert

27(A) Medicare.

end insert
begin insert

28(B) Medicaid, including the Medi-Cal program.

end insert
begin insert

29(C) State Children’s Insurance Program.

end insert
begin insert

30(D) State or local medically indigent programs.

end insert
begin insert

31(E) Other means-tested government programs.

end insert
begin insert

32(3) The cost of community benefit programs and activities,
33including, but not limited to, the following:

end insert
begin insert

34(A) Community health improvement services.

end insert
begin insert

35(B) Health professions education.

end insert
begin insert

36(C) Subsidized health services.

end insert
begin insert

37(D) Research.

end insert
begin insert

38(E) Cash and in-kind contributions.

end insert
begin insert

39(F) Community building activities.

end insert
begin insert

40(G) Community benefit operations.

end insert
begin insert

P6    1(e) “Community benefit operations” means activities associated
2with conducting community health needs assessments, community
3benefit program administration, and the organization’s activities
4associated with fundraising or grant-writing for community benefit
5programs. Activities or programs cannot be reported if they are
6provided primarily for marketing purposes or if they are more
7beneficial to the organization than to the community.

end insert
begin insert

8(f) “Community building activities” includes, but is not limited
9to, all of the following:

end insert
begin insert

10(1) Physical improvements and housing, which may include the
11provision or rehabilitation of housing for vulnerable populations.

end insert
begin insert

12(2) Economic development, which may include assisting small
13business development in neighborhoods with vulnerable
14populations and creating new employment opportunities in areas
15 with high rates of joblessness.

end insert
begin insert

16(3) Community support, which may include child care and
17mentoring programs for vulnerable populations or neighborhoods,
18neighborhood support groups, violence prevention programs, and
19disaster readiness and public health emergency activities.

end insert
begin insert

20(4) Environmental improvements, which may include activities
21to address environmental hazards that affect community health,
22such as alleviation of water or air pollution, safe removal or
23treatment of garbage or other waste products, and other activities
24to protect the community from environmental hazards.

end insert
begin insert

25(5) Leadership development and training for community
26members, which may include training in conflict resolution, civic,
27cultural, or language skills, and medical interpreter skills for
28community residents.

end insert
begin insert

29(6) Coalition building, which may include participation in
30community coalitions and other collaborative efforts with the
31community to address health and safety issues.

end insert
begin insert

32(7) Community health improvement advocacy, which may
33include efforts to support policies and programs to safeguard or
34improve public health, access to health care services, housing, the
35environment, and transportation.

end insert
begin insert

36(8) Workforce development, which may include recruitment of
37physicians and other health professionals to medical shortage
38areas or other areas designated as underserved, and collaboration
39with educational institutions to train and recruit health
40professionals needed in the community.

end insert
begin insert

P7    1(9) Other community building activities that protect or improve
2the community’s health or safety that are not described in the
3categories listed in paragraphs (1) to (8), inclusive.

end insert
begin insert

4(g) “Community health improvement services” means activities
5or programs, subsidized by the hospital, that are carried out or
6supported for the express purpose of improving community health.

end insert
begin delete

29 7(d)

end delete

8begin insert(h)end insert “Community health needs assessment” means the process
9by which the hospitalbegin delete identifies,end deletebegin insert identifies unmet community health
10needsend insert
for its primary service areabegin insert,end insert as determined by thebegin delete hospital,
11unmet community health needsend delete
begin insert hospitalend insert.

begin delete

32 12(e)

end delete

13begin insert(i)end insert “Community health needs” means those requisites for
14improvement or maintenance of health status in the community.

begin insert

15(j) “Community health needs assessment report” means the
16written report adopted for the hospital facility by an authorized
17body of the hospital facility.

end insert
begin insert

18(k) “Health professions education” means educational programs
19that result in a degree, certificate, or training necessary to be
20licensed to practice as a health professional, as required by state
21law, or continuing education necessary to retain state license or
22certification by a board in the individual’s health profession
23specialty.

end insert
begin delete

34 24(f)

end delete

25begin insert(end insertbegin insertlend insertbegin insert)end insertbegin insertend insertbegin insert(1)end insertbegin insertend insert“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.
29begin delete “Hospital”end delete

30begin insert(2)end insertbegin insertend insertbegin insert“Hospital”end insert does not include a hospital that is dedicated to
31serving children and that does not receive direct payment for
32services to any patient.

begin delete

33(g) “Mission statement” means a hospital’s primary objectives
34for operation as adopted by its governing body.

end delete
begin insert

35(m) “Implementation Strategy” means the written document
36prepared for annual submission to the Office of Statewide Health
37Planning and Development that describes the hospital facility’s
38strategy to meet the community health needs identified through
39the hospital facility’s community health needs assessment.

end insert
begin insert

P8    1(n) “Other means-tested government programs” means
2government-sponsored health programs where eligibility for
3benefits or coverage is determined by income or assets, including,
4but not limited to, the State Children’s Health Insurance Program
5(SCHIP) and the California Children’s Services (CCS) Program.

end insert
begin insert

6(o) “Research” may include, but is not limited to, clinical
7research, community health research, and generalizable studies
8on health care delivery.

end insert
begin insert

9(p) “Subsidized health services” means clinical services
10provided despite a financial loss to the organization.

end insert
begin delete

11(h)

end delete

12begin insert(q)end insert “Vulnerablebegin delete populations”end deletebegin insert populationend insertbegin insertend insert meansbegin delete anyend deletebegin insert aend insert
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.

begin delete
16

SEC. 3.  

Section 127350 of the Health and Safety Code is
17amended to read:

18

127350.  

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.

28(b) Following 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
32arrangements.

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.

end delete
begin delete8

SEC. 4.  

Section 127355 of the Health and Safety Code is
9amended to read:

10

127355.  

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
18timeframes.

19(c) Community benefits categorized into the following
20framework:

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
26programs.

27(5) Subsidized health services, cash, and in-kind contributions
28and other benefits.

29(6) Nonquantifiable benefits.

end delete
30begin insert

begin insertSEC. 3.end insert  

end insert

begin insertSection 127350 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
31repealed.end insert

begin delete
32

127350.  

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.

end delete
23begin insert

begin insertSEC. 4.end insert  

end insert

begin insertSection 127350 is added to the end insertbegin insertHealth and Safety Codeend insertbegin insert,
24to read:end insert

begin insert
25

begin insert127350.end insert  

(a) Each hospital shall assess the health needs of its
26community.

27(b) Each hospital shall conduct a community health needs
28assessment (CHNA) every three years, as described in this
29subdivision.

30(1) A hospital facility shall complete all of the following steps:

31(A) Define the community it serves.

32(B) Assess the health needs of that community.

33(C) In assessing the health needs of the community, solicit and
34take into account input received from persons who represent the
35broad interests of that community, including those with special
36knowledge of or expertise in public health.

37(D) Document the CHNA in a written report that is adopted for
38the hospital facility by an authorized body of the hospital facility.

39(E) Make the CHNA report widely available to the public.

P11   1(2) A hospital facility shall be considered to have conducted a
2CHNA on the date it has completed all of the steps described in
3this subdivision.

4(3) In defining the community it serves for purposes of this
5subdivision, a hospital facility may take into account all relevant
6facts and circumstances, including the geographic area served by
7the hospital facility, target population served, and principal
8functions. A hospital facility may not define its community to
9exclude medically underserved, low-income, or minority
10populations who live in the geographic areas from which the
11hospital facility draws its patients, unless those populations are
12not part of the hospital facility’s target patient population or
13affected by its principal functions, or otherwise should be included
14based on the method the hospital facility uses to define its
15community. A hospital facility shall take into account all patients,
16without regard to whether or how much they or their insurers pay
17for the care provided, or whether they are eligible for assistance
18under the hospital facility’s charity care, discount, or other
19financial assistance policies.

20(4) A hospital facility shall identify significant health needs of
21the community, prioritize those health needs, and identify resources
22potentially available to address those health needs, such as
23organizations, facilities, and programs in the community, including
24those of the hospital facility. A hospital facility may determine
25whether a health need is significant based on all of the facts and
26circumstances present in the community it serves. In addition, a
27hospital facility may use any criteria to prioritize the significant
28health needs it identifies, including, but not limited to, the burden,
29scope, severity, or urgency of the health need; the estimated
30feasibility and effectiveness of possible interventions; the health
31disparities associated with the need; or the importance the
32community places on addressing the need.

33(5) A hospital facility shall solicit and take into account input
34received from all of the following sources in identifying and
35prioritizing significant health needs and in identifying resources
36potentially available to address those health needs:

37(A) At least one state, local, tribal, or regional governmental
38public health department or equivalent department or agency, or
39a State Office of Rural Health described in Section 338J of the
40Public Health Service Act (42 U.S.C. Sec. 254r), with knowledge,
P12   1information, or expertise relevant to the health needs of that
2community.

3(B) Members of medically underserved, low-income, and
4minority populations in the community served by the hospital
5facility, or individuals or organizations serving or representing
6the interests of those populations. For purposes of this paragraph,
7medically underserved populations include populations
8experiencing health disparities or at risk of not receiving adequate
9medical care, as a result of being uninsured or underinsured or
10due to geographic, language, financial, or other barriers.

11(C) Written comments received on the hospital facility’s most
12recently conducted CHNA and most recently adopted
13implementation strategy.

14(6) A hospital facility may solicit and take into account input
15received from a broad range of persons located in or serving its
16community, including, but not limited to, health care consumers
17and consumer advocates, nonprofit and community-based
18organizations, academic experts, local government officials, local
19school districts, health care providers and community health
20centers, health insurance and managed care organizations, private
21businesses, and labor and workforce representatives.

22(7) The CHNA report adopted pursuant to subdivision (c) shall
23include all of the following:

24(A) A definition of the community served by the hospital facility
25and a description of how the community was determined.

26(B) A description of the process and methods used to conduct
27the CHNA, that describes the data and other information used in
28the assessment, as well as the methods of collecting and analyzing
29this data and information, and identifies any parties with whom
30the hospital facility collaborated, or with whom it contracted for
31assistance, in conducting the CHNA.

32(C) A description of how the hospital facility solicited and took
33into account input received from persons who represent the broad
34interests of the community it serves. This requirement shall be
35fulfilled if the report summarizes, in general terms, any input
36provided by persons who represent the broad interests of the
37community it serves and how and over what time period that input
38was provided; provides the names of any organizations providing
39input and summarizes the nature and extent of the organization’s
40input; and describes the medically underserved, low-income, or
P13   1minority populations being represented by organizations or
2individuals that provided input. A CHNA report does not need to
3name or otherwise identify specific individual providing input. In
4the event a hospital facility solicits, but cannot obtain, input from
5a source described in this section, the CHNA report shall describe
6the hospital facility’s efforts to solicit input from that source.

7(D) A prioritized description of the significant health needs of
8the community identified through the CHNA, along with a
9description of the process and criteria used in identifying certain
10health needs as significant and prioritizing those significant health
11needs.

12(E) A description of the resources potentially available to
13address the significant health needs identified through the CHNA.

14(F) An evaluation of the impact of any actions that were taken
15since the hospital facility finished conducting its immediately
16preceding CHNA, to address the significant health needs identified
17in the hospital facility’s prior CHNA.

18(8) While a hospital facility may conduct its CHNA in
19collaboration with other organizations and facilities, including,
20but not limited to, related and unrelated hospital organizations
21and facilities, for-profit and government hospitals, governmental
22departments, and nonprofit organizations, every hospital facility
23shall document the information described in this paragraph in a
24separate CHNA report unless it adopts a joint CHNA report as
25described in subdivision (b). If a hospital facility is collaborating
26with other facilities and organizations in conducting its CHNA,
27 or if another organization has conducted a CHNA for all or part
28of the hospital facility’s community, portions of the hospital
29facility’s CHNA report may be substantively identical to portions
30of a CHNA report of a collaborating hospital facility or other
31 organization conducting a CHNA, if appropriate under the facts
32and circumstances.

33(c) An authorized body of the hospital facility shall adopt the
34implementation strategy to meet the community health needs
35identified through the CHNA.

36(d) A hospital facility that collaborates with other hospital
37facilities or other organizations in conducting its CHNA shall
38satisfy this section if an authorized body of the hospital facility
39adopts for the hospital facility a joint CHNA report produced for
P14   1the hospital facility and one or more of the collaborating facilities
2and organizations, provided that the following conditions are met:

3(1) The joint CHNA report meets the requirements of this
4section.

5(2) The joint CHNA report is clearly identified as applying to
6the hospital facility.

7(3) All of the collaborating hospital facilities and organizations
8included in the joint CHNA report define their community to be
9the same.

10(e) A hospital facility’s CHNA report is made widely available
11to the public only if the hospital facility does both of the following:

12(1) Makes the current and prior CHNA reports widely available
13on an Internet Web site.

14(2) Makes a paper copy of the current and prior CHNA report
15available for public inspection upon request and without charge.

16(f) (1) A hospital’s implementation strategy shall do either of
17the following:

18(A) Describe how the hospital facility plans to address the health
19need by describing the actions the hospital facility intends to take
20to address the health need and the anticipated impact of these
21actions; identifying the resources the hospital facility plans to
22commit to address the health need, reported in the categories
23outlined in subdivision (d) of Section 127345; and describing
24planned collaboration between the hospital facility and other
25facilities or organizations in addressing the health need.

26(B) Identify the health need as one the hospital facility does not
27intend to address, and explain why the hospital facility does not
28intend to address the health need. In explaining why it does not
29intend to address a significant health need, a brief explanation of
30the hospital facility’s reason for not addressing the health need is
31sufficient.

32(2) A hospital facility may develop an implementation strategy
33in collaboration with other hospital facilities or other
34organizations, including, but not limited to, related and unrelated
35hospital organizations and facilities, for-profit and government
36hospitals, governmental entities, and nonprofit organizations.
37Unless otherwise authorized by law, a hospital facility that
38collaborates with other facilities or organizations in developing
39its implementation strategy shall still document its implementation
P15   1strategy in a separate written plan that is tailored to the particular
2hospital facility, taking into account its specific resources.

3(3) An authorized body of the hospital facility shall adopt the
4implementation strategy on or before the 15th day of the fifth month
5after the end of the taxable year in which the hospital facility
6completes the final step for the CHNA.

7(4) A hospital facility shall annually submit an update on
8 activities related to the implementation strategy to the office, not
9later than 150 days after the hospital’s fiscal year ends. Hospitals
10under the common control of a single corporation or another entity
11may file a consolidated report.

end insert
12begin insert

begin insertSEC. 5.end insert  

end insert

begin insertSection 127355 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
13repealed.end insert

begin delete
14

127355.  

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
22timeframes.

23(c)  Community benefits categorized into the following
24framework:

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.

end delete
30begin insert

begin insertSEC. 6.end insert  

end insert

begin insertSection 127360 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
31amended to read:end insert

begin delete
32

127360.  

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

end delete
38begin insert

begin insert127360.end insert  

end insert

begin insertThis article shall not end insertbe used to justify the tax-exempt
39status of a hospital under state law. begin deleteNothing in this article shallend delete
P16   1begin insert This article shall notend insert preclude the office from requiring hospitals
2to directly report their charity activities.

3

begin deleteSEC. 5.end delete
4begin insertSEC. 7.end insert  

Section 127365 is added to the Health and Safety Code,
5to read:

6

127365.  

The Office of Statewide Health Planning and
7Development shall do all of the following:

8(a) Post on its Internet Web site thebegin delete community benefits plans
9andend delete
begin insert implementation strategyend insert updates that are submitted to the
10office pursuant to subdivisionbegin delete (b) or (c)end deletebegin insert (f)end insert 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 itsbegin delete community benefits planend deletebegin insert implementation
14strategyend insert
on a timely basis.



O

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