BILL ANALYSIS                                                                                                                                                                                                    �






                             SENATE COMMITTEE ON HEALTH
                          Senator Ed Hernandez, O.D., Chair

          BILL NO:       AB 503
          AUTHOR:        Wieckowski and Bonta
          AMENDED:       June 17, 2014
          HEARING DATE:  June 25, 2014
          CONSULTANT:    Marchand

           SUBJECT  :  Health facilities: community benefits.
           
          SUMMARY  :  Repeals the existing hospital community benefit law,  
          and establishes a new hospital community law to require private  
          non-profit hospitals to complete a community needs assessment,  
          followed by a community benefits plan. Defines "community  
          benefit" and other terms for purposes of this bill, and requires  
          90 percent of a private non-profit hospital's community benefit  
          moneys to be allocated to charity care and projects that improve  
          community health for underserved and vulnerable populations, as  
          defined.

          Existing law:
          1.Establishes the hospital community benefit law (existing CBL),  
            which establishes requirements on private not-for-profit  
            hospitals to complete a community needs assessment and adopt a  
            community benefits plan, to annually submit this community  
            benefit plan to the Office of Statewide Health Planning and  
            Development (OSHPD), along with a report of the economic value  
            of community benefits provided in furtherance of the plan. 
             
          2.Defines "community benefit plan," for purposes of the existing  
            CBL, as a written document prepared for annual submission to  
            OSHPD, that includes a description of the activities that the  
            hospital has undertaken in order to address identified  
            community needs within its mission and financial capacity, and  
            the process by which the hospital developed the plan in  
            consultation with the community.

          3.Defines "community benefit," for the purposes of the existing  
            CBL, as a hospital's activities that are intended to address  
            community needs and priorities primarily through disease  
            prevention and improvement of health status, including, but  
            not limited to, any of the following:

                  a.        Health care services rendered to vulnerable  
                    populations, including charity care and the  
                                                         Continued---



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                    unreimbursed cost of providing services to the  
                    uninsured, underinsured, and those eligible for  
                    Medi-Cal, Medicare, California Childrens Services  
                    Program, or county indigent programs;
                  b.        The unreimbursed cost of services provided  
                    related to community-oriented wellness and health  
                    promotion, prevention services such as health  
                    screenings and immunizations, adult day care, child  
                    care, medical research, medical education, nursing and  
                    other professional training, home-delivered meals to  
                    the homebound, sponsorship of free food and shelter to  
                    the homeless, and outreach clinics in  
                    socioeconomically depressed areas;
                  c.        Financial or in-kind support of public health  
                    programs;

                  d.        Donation of funds, property, or other  
                    resources that contribute to a community priority;
                  e.        Health care cost containment;
                  f.        Enhancement of access to health care or  
                    related services that contribute to a healthier  
                    community;
                  g.        Services offered without regard to financial  
                    return because they meet a need in the service area of  
                    the hospital; and,
                  h.        Food, shelter, clothing, education,  
                    transportation, and other goods or services that help  
                    maintain a person's health.

          4.Requires private, non-profit hospitals, under the existing  
            CBL, to complete, either alone or in conjunction with other  
            health care providers, a community needs assessment evaluating  
            the health needs of the community serviced by the hospital,  
            that includes a process for consulting with community groups  
            and local government officials, and to update the community  
            needs assessment at least once every three years.

          5.Requires private, non-profit hospitals, under the existing  
            CBL, to annually adopt and update a community benefits plan  
            for providing community benefits either alone, or in  
            conjunction with other health care providers, or through other  
            organizational arrangements. Requires the community benefits  
            plan to include the following elements:

                  a.        Mechanisms to evaluate the plan's  
                    effectiveness, including a method for soliciting the  




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                    views of the community served by the hospital;
                  b.        Measurable objectives to be achieved within  
                    specified timeframes;
                  c.        Community benefits categorized into the  
                    following categories: medical care services, other  
                    benefits for vulnerable populations, other benefits  
                    for the broader community, health research and  
                    training programs, and nonquantifiable benefits.

          6.Requires private, non-profit hospitals, under the existing  
            CBL, to annually submit its community benefit plan, including  
            activities the hospital has undertaken in order to address  
            community needs, to OSHPD, and to the extent practicable,  
            assign and report the economic value of community benefits  
            provided in furtherance of its plan.

          This bill:
          1.Repeals the existing CBL law, and establishes a new CBL for  
            private non-profit hospitals and non-profit multispecialty  
            clinics (collectively, non-profit facilities), as these  
            facilities are defined.

          2.Requires, by January 1, 2017, each private non-profit facility  
            to develop, in collaboration with the community benefits  
            planning committee, a community benefits statement that  
            describes the facility's commitment to developing, adopting,  
            and implementing a community benefits program, and a community  
            health needs assessment that evaluates the health needs and  
            resources of the community it serves.

          3.Requires the community benefits planning committee, as  
            defined, to be composed of the following:

                  a.        One of either the governing board of the  
                    hospital organization that operates the facility or  
                    other party authorized by that governing body, or the  
                    governing body of the hospital facility if the  
                    facility has its own governing body;
                  b.        At least one individual from the local,  
                    tribal, or regional governmental public health  
                    department, or an equivalent department, with  
                    knowledge, information, or expertise relevant to the  
                    health needs of that community;
                  c.        At least one individual from an underserved  
                    and vulnerable population, as defined;




          AB 503 | Page 4





          4.Requires a private non-profit facility, in conducting its  
            community health needs assessment, to solicit comments from,  
            and meet with, local government officials, health care  
            providers, registered nurses, and community groups  
            representing specified constituencies.

          5.Requires a private non-profit facility, in preparing its  
            community health needs assessment, to use available public  
            health data, and permits the facility to collaborate with  
            other facilities and health care institutions in conducting  
            community health needs assessments and to make use of exiting  
            studies.

          6.Requires private non-profit facilities, not later than 30 days  
            prior to completing a community health needs assessment, to  
            make a copy of the assessment available to the public for  
            review and comment.

          7.Requires private non-profit facilities to file the community  
            health needs assessment with OSHPD, and to update its  
            community needs assessment at least every three years.

          8.Requires private non-profit facilities, by April 1, 2017, to  
            develop a community benefits plan that conforms to the  
            provisions of this bill. Requires private non-profit  
            facilities, in developing a community benefits plan, to  
            solicit comments from, and meet with, local government  
            officials, including representatives of local public health  
            departments, and to also solicit comments from, and meet with,  
            health care providers, registered nurses, and community groups  
            representing specified constituencies.

          9.Requires a community benefits plan to include, at a minimum,  
            all of the following:

                  a.        A summary of the needs assessment and a  
                    statement of the community health care needs that will  
                    be addressed by the plan;
                  b.        A list of the services the private non-profit  
                    hospital or non-profit multispecialty clinic intends  
                    to provide in the following year to address community  
                    health needs identified in the community health needs  
                    assessments, categorized under the following: charity  
                    care, as defined; other community benefits, as  
                    specified; and, community building activities;




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                  c.        A description of the target community or  
                    communities that the plan is intended to benefit;
                  d.        An estimate of the economic value of the  
                    community benefits that the private non-profit  
                    facility intends to provide;
                  e.        A summary of the process used to elicit  
                    community participation in the community health needs  
                    assessment and community benefits plan design, and a  
                    description of the process for ongoing participation  
                    of community members in plan implementation and  
                    oversight;
                  f.        A list of individuals, organizations, and  
                    government official consulted during the development  
                    of the plan;
                  g.        A description of the intended impact on health  
                    outcomes attributable to the plan, including short-  
                    and long-term measurable goals and objectives;
                  h.        Mechanisms to evaluate the plan's  
                    effectiveness;
                  i.        The name and title of the individual  
                    responsible for implementing the plan; and,
                  j.        The names of individuals on the private  
                    non-profit facility's governing board;

          10.Permits a private non-profit facility to also report on bad  
            debts, Medicare shortfalls, Medi-Cal shortfalls, and  
            shortfalls from any other public program, but prohibits these  
            reports from being reported as community benefits and to be  
            calculated based on hospital costs, not charges.

          11.Requires the governing board of a private non-profit facility  
            to adopt the community benefits plan at a meeting that is open  
            to the public. Requires the governing board, no later than 30  
            days prior to the plan's adoption, to make a draft of the plan  
            available to the public, including on its Internet Web site,  
            as well as a notice of the date, time, and location of the  
            meeting at which the community benefits plan is to be voted on  
            for adoption.

          12.Requires a private non-profit facility, beginning after April  
            1, 2017, to submit to OSHPD a community benefits plan that  
            conforms to this bill every two years, no later than 120 days  
            after the end of the facility's fiscal year. Requires the plan  
            to include, if applicable, a report on the community benefits  
            efforts of the preceding year, including the amounts and types  




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            of benefits provided, a description of the facility's progress  
            toward meeting its goals and objectives, and an evaluation of  
            the plan's effectiveness.

          13.Permits a person or entity to file comments on a facility's  
            community benefits plan with OSHPD.

          14.Defines "community" as the service area or patient population  
            for which a non-profit facility provides health care services.  
            Prohibits a non-profit facility from defining its service area  
            to exclude medically underserved, low-income, or minority  
            populations who are part of its patient populations, live in  
            geographic areas in which its patient populations reside, or  
            otherwise should be included based on the method the hospital  
            facility uses to define its community.

          15.Defines "community benefits" as the unreimbursed goods,  
            services, activities, programs, and other resources provided  
            by a non-profit facility that addresses community-identified  
            health needs and concerns, particularly for people who are  
            uninsured, underserved, or members of a vulnerable population,  
            including, but not limited to, the following: charity care;  
            the cost of community building activities; the cost of  
            community health improvement services and community benefit  
            operations; the cost of school health centers, as defined; the  
            cost of health professions education provided without charge;  
            subsidized health services for vulnerable populations,  
            research; contributions to community groups, and, community  
            building activities.

          16.Permits "community benefits" to include the following,  
            provided that the provision, funding or financial support of  
            these benefits is demonstrated to reduce community health  
            costs: vaccination programs and services for low-income  
            families, school health centers, chronic illness prevention  
            programs and services, nursing and caregiver training provided  
            without assessment of fees or payment of tuition, home-based  
            health care programs for low-income families, or  
            community-based mental health and outreach and assessment  
            programs for low-income families (family with income less than  
            or equal to 350 percent of the federal poverty level).

          17.Excludes from the definition of "community benefits" the  
            unreimbursed cost of providing services to those enrolled in  
            Medi-Cal, Medicare, California Childrens Services Program, or  
            county indigent programs or any goods, services, activities,  




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            programs, or other resources program or activity for which  
            there is direct offsetting revenue, as defined.

          18.Defines "community building activities," for purposes of the  
            community benefit definition, as the cost of various kinds of  
            community building activities, including physical improvements  
            and housing, economic development, community support,  
            environmental improvements, community health improvement  
            advocacy, coalition building, workforce development, and  
            leadership development and training for community members.  
            Provides definitions for each of these terms that are  
            consistent with federal IRS definitions of these terms.

          19.Defines "charity care," for purposes of the community benefit  
            definition, as the unreimbursed cost to a non-profit facility  
            of providing services to the uninsured or underinsured, as  
            well as providing funding or otherwise financially supporting  
            health care services or items on an inpatient or outpatient  
            basis to a financially qualified patient with no expectation  
            of payment, and health care services or items provided to a  
            financially qualified patient through other non-profit or  
            public outpatient clinics, hospitals, or health care  
            organizations with no expectation of payment.

          20.Excludes from the definition of "charity care" any of the  
            following:

                  a.        Uncollected fees or accounts written off as  
                    bad debt;
                  b.        Care provided to patients for which a public  
                    program or public or private grant funds pay for any  
                    of the charges for the care;
                  c.        Contractual adjustments in the provision of  
                    health care services below the amount identified as  
                    gross charges or "chargemaster" rates by the health  
                    care provider;
                  d.        Any amount over 125 percent of the Medicare  
                    rate for the health care services or items provided on  
                    an inpatient or outpatient basis; and,
                  e.        Any amount over 125 percent of the Medicare  
                    rate for providing, funding, or otherwise financially  
                    supporting health care services or items with no  
                    expectation of payment provided to financially  
                    qualified patients through other non-profit or public  
                    outpatient clinics, hospitals, or health care  




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                    organizations.

          21.Requires private non-profit facilities to allocate a minimum  
            of 90 percent of the available community benefit moneys to  
            charity care and projects that improve community health for  
            underserved and vulnerable populations, and to allocate a  
            minimum of 25 percent of the available community benefit  
            moneys to community building activities geographically located  
            within underserved and vulnerable populations. Permits moneys  
            to be used for projects that simultaneously meet both of these  
            criteria.

          22.Defines "underserved and vulnerable population" as any of the  
            following:

                  a.        A population that is exposed to medical or  
                    financial risk by virtue of being uninsured or  
                    underinsured, as defined, or eligible for Medi-Cal or  
                    county indigent programs; or,
                  b.        A population including, but not limited to:  
                    individuals with low educational attainment, as  
                    measured by the percentage of the population with less  
                    than a high school diploma; individuals who suffer  
                    from linguistic isolation, as measured by the  
                    percentage of households in which no one who is 14  
                    years of age or older speaks English very well;  
                    individuals who are 10 years of age or younger, or who  
                    are over 65 years of age, and underserved minority  
                    populations as long as the low educational attainment  
                    and linguistic isolation factors are met. 

          23.Defines "non-profit multispecialty clinic" as a clinic,  
            defined in existing law, that is operated by a non-profit  
            corporation exempt from federal income taxation, as specified,  
            that conducts medical research and health education and  
            provides health care to its patients through a group of 40 or  
            more physicians, who are independent contracts representing  
            not less than 10 board-certified specialties, and not less  
            than two-thirds of whom practice on a full-time basis at the  
            clinic.

          24.Defines "private non-profit hospital" as a private non-profit  
            acute care hospital that has been determined to be exempt from  
            taxation under the Internal Revenue Code, and exempts the  
            following from this definition:





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                  a.        A district hospital organized and governed  
                    pursuant to the Local Health Care District Law, as  
                    specified;
                  b.        A rural general acute care hospital, as  
                    defined;
                  c.        A children's hospital, as defined; and,
                  d.        A multispecialty clinic operated by a  
                    for-profit hospital, regardless of its net revenue.

          25.Requires a private non-profit facility that reports community  
            benefits to the community to report on those community  
            benefits in a consistent and comparable manner to all other  
            private non-profit facilities.

          26.Requires a private non-profit facility to make its community  
            health needs assessment and community benefits plan available  
            to the public on its Internet Web site, and requires a copy of  
            the assessment and plan to be given free of charge to any  
            person upon request.

          27.Permits a private non-profit facility, under the common  
            control of a single corporation or another entity, to file a  
            consolidated plan if the plan addresses services in all the  
            categories specified in this bill to be provided by each  
            hospital or clinic under common control of the corporation or  
            entity.

          28.Requires OSHPD to develop and adopt regulations to prescribe  
            a standardized format for community benefits plans required  
            under this bill, and to develop a standardized methodology for  
            estimating the economic value of community benefits.

          29.Requires OSHPD, in developing standards of reporting on  
            community benefits, to conform, to the maximum extent  
            possible, to Internal Revenue Service (IRS) reporting  
            standards for those data elements reported to the IRS, but to  
            also include those data elements required under this bill or  
            other state laws, including charity care.

          30.Requires a private non-profit facility to annually file with  
            OSHPD its IRS Form 990, or its successor form, and requires  
            OSHPD to post the form on its Internet Web site.

          31.Requires OSHPD to make public, including on their Internet  
            Web site, a community health needs assessment and community  




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            benefits plan and any comments received regarding those  
            assessments and plans.

          32.Requires OSHPD to maintain a public calendar of community  
            benefit adoption meetings held by the governing board of each  
            private non-profit facility, and requires of these meetings to  
            be posted no later than 14 days prior to the meeting date.

          33.Requires OSHPD to calculate and make public, for every other  
            year that a community benefits plan is submitted, the total  
            value of community benefits provided by each facility.

          34.Provides OSHPD the same ability to assess civil penalties for  
            failure to comply with the reporting provisions of this bill  
            as it already has for a facility's failure to file other  
            required reports.

           FISCAL EFFECT  :  This bill has not been analyzed by a fiscal  
          committee.

           PRIOR VOTES  :  Not Applicable
           
          COMMENTS :  
           1.Author's statement.  According to the author, in exchange for  
            providing various community benefits, such as charity care and  
            improving community health, California's private non-profit  
            hospitals are eligible for certain tax exemptions due to their  
            non-profit status. However, charity care and community  
            benefits are not uniformly defined or measure. This ambiguity  
            prevents California communities from determining if these  
            hospitals sufficiently benefit the community, a duty  
            non-profit hospitals are required to fulfill under state and  
                                                              federal law.

          2.Background on non-profit hospitals and community benefit  
            requirements.  Non-profit hospitals have traditionally been  
            exempt from federal income taxes based on the IRS' definition  
            of charity, with the IRS stating that, "the promotion of  
            health is considered to be a charitable purpose. A non-profit  
            organization whose purpose and activity are providing hospital  
            care is promoting health and may, therefore, qualify as  
            organized and operated in furtherance of a charitable  
            purpose." For purposes of California taxes, property owned by  
            a non-profit organization that is used exclusively for  
            religious, hospital, charitable, or scientific purposes is  
            exempt from propriety taxes under what is known as the Welfare  




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            Exemption. State law also allows non-profit hospitals to be  
            exempt from state income tax. 

            When the Legislature enacted the existing CBL in 1996, the  
            Legislature found and declared that private non-profit  
            hospitals meet certain needs of their communities through the  
            provision of essential health care and other services, and  
            that public recognition of their unique status has led to  
            favorable tax treatment by the government. In exchange, the  
            Legislature declared, non-profit hospitals assume a social  
            obligation to provide community benefits in the public  
            interest. The CBL enacted in 1996 requires non-profit  
            hospitals to annually submit a "community benefits plan" to  
            OSHPD, based on a "community needs assessment" that is  
            required to be updated every three years. This CBL includes a  
            definition of "community benefit," which included charity care  
            and the unreimbursed cost of providing services, but does not  
            specifically exclude anything from the definition of community  
            benefit, nor does it define "charity care" itself. While the  
            law requires the plan to be submitted to OSHPD, it does  
            require OSHPD to review the plans to ensure that hospitals are  
            reporting data consistently, and OSHPD does not attempt to  
            standardize these reports.

          3.Senate Office of Research Report. In a report prepared by the  
            Senate Office of Research (SOR) for an August 15, 2012 hearing  
            of the Senate Select Committee on Charity Care and Non-profit  
            Hospitals, about 247 of California's 387 private hospitals may  
            be eligible for certain tax exemptions due to their non-profit  
            status in exchange for providing various community benefits,  
            such as charity care. However, these 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 non-profit counter parts.  The SOR points  
            out that the California Legislative Analyst's Office (LAO), in  
            an analysis of the Charity Care Act of 2012, indicates that  
            there is currently no uniform definition of charity care nor a  
            requirement in State or federal law for non-profit hospitals  
            to provide a certain amount of charity care or community  
            benefit in order to maintain their tax exempt status.   
            According to the LAO, of the private hospitals in California,  




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            about 30 percent are for-profits and about 70 percent are  
            non-profits. The for-profit hospitals pay corporate income  
            taxes to the state. Non-profit hospitals are exempt from State  
            corporate income taxes, local sales taxes, and property taxes.  
            The tax exemptions are intended to allow non-profit 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. The SOR report indicates that  
            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 that in 2008 the IRS revised Form  
            990 in an effort to provide transparency and accountability  
            and keep pace with changes in the law with regard to the tax  
            exempt sector.  The new form requires non-profit hospitals to  
            report their bad debt expenses and Medicare shortfalls, but  
            separates these from community benefits. 

          4.ACA imposed new federal requirements on non-profit hospitals.  
            With the passage of the Affordable Care Act (ACA), a new  
            provision was added to Section 501 of the Internal Revenue  
            Code specific to hospitals. This new provision (subsection r),  
            imposed new requirements that hospitals must meet in order to  
            maintain their tax exempt status. Among the new requirements,  
            which began with the 2012 tax year, are a requirement for  
            hospitals to complete a community health needs assessment, and  
            a requirement to establish a financial assistance policy. The  
            community health needs assessment, along with an  
            implementation strategy for meeting the health needs  
            identified in the assessment, must be completed once every  
            three years, and hospitals face a $50,000 federal excise tax  
            for failure to comply with this requirement. 

          5.State Auditor Reports.  In December of 2007, and then again in  
            August of 2012, the Bureau of State Audits (BSA) published  
            reports concerning whether non-profit hospitals were providing  
            a public benefit that justifies their tax-exempt status. In  
            the 2007 report, BSA concluded that when taken as a percentage  
            of net patient revenues, the uncompensated care provided by  
            non-profit and for-profit hospitals were not significantly  
            different, both including and excluding Medi-Cal costs. BSA  
            noted that benefits provided to the community, which only  
            non-profit hospitals are required to report, differentiate  
            non-profit hospitals from for-profit hospitals, but the  




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            categories of services and the associated economic value are  
            not consistently reported among non-profit hospitals. BSA  
            stated that although state law requires non-profit hospitals  
            to submit a community benefit plan that describes the  
            activities undertaken to address community needs and assign  
            and report economic values to those benefits, state law does  
            not mandate a uniform reporting standard, and as a result,  
            hospitals are reporting their community benefits using  
            different categories and methods for calculating their  
            economic value. In its 2007 recommendations, BSA stated that,  
            "If the Legislature expects plans to contain comparable and  
            consistent data, it should consider enacting statutory  
            requirements that prescribe a mandatory format and methodology  
            for tax-exempt non-profit hospitals to follow when presenting  
            community benefits in their plans."

          In its 2012 report, BSA reiterated its conclusions regarding the  
            lack of statutory standard or methodology for hospitals to  
            follow when calculating community benefits.

          6.Charity Care Act of 2012. This initiative would have required  
            certain non-profit hospitals to provide a minimum amount of  
            charity care equal to at least five percent of net patient  
            revenue, impose new data reporting requirements on certain  
            non-profit hospitals, impose new administrative  
            responsibilities on the Attorney General (AG) and give the AG  
            authority to oversee and enforce the provisions of the  
            measure. This measure would have gone into effect January 1,  
            2013, and been repealed on December 31, 2017. The initiative  
            would have exempted non-profit hospitals that are part of an  
            integrated non-profit health system or part of a safety-net  
            non-profit health system as defined by the measure (Dignity  
            Health and Kaiser Permanente) and it did not include  
            multispecialty clinics. According to the LAO, about 36 percent  
            of the State's non-profit hospitals would have been exempted  
            from the requirements of the initiative. On May 2, 2012, the  
            Los Angeles Times reported that the Service Employees  
            International Union dropped the initiative along with another  
            health care initiative as part of an agreement with California  
            Hospital Association.
             
             In its analysis of the Charity Care Act of 2012, the LAO  
            indicated the measure could have resulted in both costs and  
            savings to State and local governments, depending on how the  
            hospitals subject to the measure responded to it. Their  




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            analysis finds that most of the non-profit hospitals subject  
            to the measure would have to increase the amount of charity  
            care they provide in order to meet its requirements. To offset  
            the additional costs of providing greater amounts of charity  
            care, hospitals subject to the measure could employ a mix of  
            different strategies.
            
          7.Related legislation. SB 1276 (Hernandez), revises the hospital  
            fair billing program by making individuals who meet the income  
            requirements eligible, even if they have received a discounted  
            rate from the hospital as a result of third-party coverage.  
            Defines "reasonable payment plan," for purposes of both the  
            hospital and emergency physician fair billing policies, as  
            monthly payments that do not exceed 10 percent of a patient's  
            family income. SB 1276 is pending in the Assembly Health  
            Committee.
               
            AB 1952 (Pan), requires non-profit hospitals to annually  
            provide charity care amounting to five percent of the  
            hospital's net patient revenue.  AB 1952 was placed on the  
            Assembly Appropriations Committee suspense file.
            
          8.Prior legislation. AB 975 (Wieckowski), of 2013, would have  
            revised California's non-profit community benefits  
            requirements to include multispecialty clinics, narrowed the  
            activities that constitute community benefits, created a  
            definition of charity care, and required OSHPD to develop a  
            standardized methodology for calculating community benefits  
            and to issue civil penalties for noncompliance with filing  
            requirements.  AB 975 failed passage on the Assembly Floor.

          AB 1503 (Lieu), Chapter 445, Statutes of 2010, required  
            emergency physicians who provide emergency medical services in  
            a hospital to provide discounts to uninsured patients,  
            established limits on the expected payment for emergency  
            medical services as specified, limited debt-collection  
            activities, and required hospitals to include a written  
            description of the hospital discount policy.

          AB 2942 (Ma), of 2008, would have implemented the State  
            Auditor's 2007 recommendation for a standardized format and  
            methodology to be used when presenting community benefit  
            information, among other requirements. AB 2942 was held on the  
            Senate Appropriations Committee suspense file.
             
            SB 350 (Runner), Chapter 347, Statutes of 2007, required the  




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            submission of hospital charity care and discount-payment  
            policies to OSHPD.

            AB 774 (Chan), Chapter 755, Statutes of 2006, established  
            Hospital Fair Pricing Policies, which required every hospital  
            to offer reduced rates to uninsured and underinsured patients  
            who may have low or moderate income, and to provide policies  
            that clearly state the qualifications for free care and  
            discounted payments.

            AB 1045 (Frommer), Chapter 532, Statutes of 2005, revised the  
            Payers' Bill of Rights to require hospitals to provide  
            information about their financial assistance and charity care  
            policies, as well as contact information for a hospital  
            employee or office to obtain additional information.

            SB 610 (Machado), of 2005, would have clarified existing law  
            regarding hospitals entitled to claim the welfare exemption  
            for property tax purposes by indicating a hospital  
            organization is deemed to be organized or operated for-profit  
            if operating revenues exceed operating expenses by more than  
            10 percent. SB 610 was vetoed by the Governor. 

            SB 24 (Ortiz), of 2005, would have established charity care  
            and reduced payment policies and requirements as a condition  
            for hospitals to maintain their tax-exempt status. SB 24 was  
            held on the Senate Appropriations Committee suspense file.

            SB 379 (Ortiz), of 2004, would have required every hospital to  
            have a charity care policy and to provide that policy to  
            patients and would have required OSHPD to develop a uniform  
            charity care application to be used by all hospitals. SB 610  
            was vetoed by the Governor. 

            AB 1627 (Frommer), Chapter 582, Statutes of 2003, established  
            the Payers' Bill of Rights, which generally requires certain  
            hospitals to provide written or electronic copies of their  
            chargemaster, as specified.

            SB 697 (Torres), Chapter 812, Statutes of 1994, required  
            non-profit hospitals to conduct community needs assessments  
            and develop community benefit plans and submit those plans to  
            OSHPD.

          9.Support.  This bill is co-sponsored by the California Nurses  




          AB 503 | Page 16




            Association (CNA) and the Greenling Institute. According to  
            CNA, this bill is an important first step in holding  
            non-profit hospital accountable for the tremendous tax  
            benefits they receive through their non-profit status.  
            According to CNA, private non-profit hospitals in California  
            reaped $1.8 billion more in government subsidies and benefits  
            from their tax exempt status than the estimated value of the  
            community benefit and charity care provided. Without a clear  
            definition of community benefit and charity care, and a  
            consistent methodology for determining its value along with  
            uniform reporting requirements, CNA states that abuse of the  
            privilege of tax exemption will continue. According to CNA, in  
            2010, California non-profit hospitals provided a mere 2.46  
            percent or less of their operating expenses on community  
            benefit, well below the one time federal standard of five  
            percent needed to maintain tax exempt status. Furthermore, CNA  
            states that non-profit hospitals accumulated $4.5 billion in  
            profits that same year, nearly half of it by two of  
            California's largest chains: Sutter Health and Kaiser  
            Permanente. CNA quotes a Time Magazine article from February  
            2013 that stated "the 2,900 non-profit hospitals across the  
            country, which are exempt from income taxes, actually end up  
            averaging higher operating profit margins than the 1,000  
            for-profit hospitals after the for-profits' income tax  
            obligations are deducted. In health care, being non-profit  
            produces more profit." The Greenlining Institute states in  
            support that as the ACA continues to roll out, and more people  
            become insured, it believes that hospitals will be able to,  
            and should establish themselves, as anchor institutions in  
            their community by increasing their investments in community  
            benefit. The Greenlining Institute argues that this bill will  
            increase accountability through the standardization of many  
            community benefit definitions and by improving community  
            representation on the decision making bodies that decide where  
            and how community dollars flow, ensuring that they meet the  
            community's health needs.

          10.Support with amendments. The Western Center on Law and  
            Poverty (WCLP) supports the intent of this bill to standardize  
            charity care and community benefit reporting by non-profit  
            hospitals, but has concerns with the bill as currently  
            written. Specifically, WCLP is concerned that the changes this  
            bill is making to the definition of "charity care" will make  
            charity care reporting less transparent as it differs from  
            existing financial reporting requirements. WCLP also is  
            concerned with language that excludes the unreimbursed cost of  




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            providing health care services through government programs,  
            such as Medi-Cal, Medicare, and county indigent programs, from  
            the definition of community benefit. WCLP states that any loss  
            a hospital suffers in providing these services should be  
            considered a community benefit so as to encourage  
            participation in the Medi-Cal program.
               
          11.Opposition. This bill is opposed by the California Hospital  
            Association (CHA), which argues that this bill imposes new  
            burdensome mandates and unnecessary regulations. CHA states  
            that California's existing CBL, which has been in place and  
            working since 1994, serves as a model for the ACA, and that  
            unnecessary and confusing changes in this bill threaten  
            implementation of the ACA at a time when non-profit hospitals  
            can least afford it. CHA states that this bill's mandated  
            charity care spending requirements would potentially eliminate  
            programs, including cancer and other research, physician and  
            health professional training, neonatal intensive care, mobile  
            medical and dental clinics, senior support services, diabetes  
            screening, children's health care and specialized burn units.  
            CHA states that the impact would be especially devastating in  
            communities that collaborate with hospitals to develop  
            programs tailored to meet local needs. Kaiser Permanente  
            states in opposition that this bill continues to define  
            "community benefit" in ways that were relevant before the ACA,  
            but may not be now, and that the traditional view that  
            "community benefit" should be comprised of free health care  
            services to the uninsured is being reconsidered in light of  
            the large number of people who will have health coverage.  
            Kaiser also states that this bill does nothing to increase  
            transparency, and that it disregards current state and federal  
            laws that require hospitals to report detailed planning and  
            charitable spending. Dignity Health states in opposition that  
            in 2013, its hospitals provided $690 million in community  
            benefit, $83 million in charity care, absorbed $503 million in  
            shortfall from cost from Medi-Cal and other means-tested  
            programs (even after the hospital provider fee), and absorbed  
            a $406 million Medicare shortfall. Dignity points out that the  
            IRS tax form for reporting community benefits recognizes and  
            counts Medicaid shortfalls, whereas this bill excludes from  
            the definition of community benefit the unreimbursed cost of  
            providing services to Medi-Cal enrollees or those in other  
            public programs. Dignity states that this bill makes disappear  
            half a billion dollars that Dignity Health dedicates to  
            serving the Medi-Cal population. In addition to numerous  




          AB 503 | Page 18




            hospitals and hospital systems, this bill is also opposed by  
            WEAVE, which states that it receives funding from its  
            non-profit hospital partners, which provides significant  
            funding to support their crisis stabilization programs for  
            victims of domestic violence and sexual assault in the  
            community. WEAVE states that this bill threatens community  
            benefit partnerships like theirs and could lead to a reduction  
            of support to serve some of the most vulnerable families in  
            our communities.

          12.Is the definition of vulnerable and underserved too narrow?  
            On Page 15, lines 26-28, this bill requires 90 percent of  
            community benefit moneys to be allocated to charity care and  
            projects that "improve community health for underserved and  
            vulnerable populations. This bill defines "underserved and  
            vulnerable populations" (Page 14, beginning on line 7) as any  
            of the following:
            
                     i.          A population that is exposed to medical  
                      or financial risk by virtue of being uninsured or  
                      underinsured, as defined, or eligible for Medi-Cal  
                      or county indigent programs; or,
                     ii.         A population including, but not limited  
                      to: individuals with low educational attainment, as  
                      measured by the percentage of the population with  
                      less than a high school diploma; individuals who  
                      suffer from linguistic isolation, as measured by the  
                      percentage of households in which no one who is 14  
                      years of age or older speaks English very well;  
                      individuals who are 10 years of age or younger, or  
                      who are over 65 years of age, and, underserved  
                      minority populations as long as the low educational  
                      attainment and linguistic isolation factors are met.  


            While this definition does contain the caveat "including, but  
            not limited to," given that this definition controls where 90  
            percent of the community benefit is to be allocated, this  
            definition may prove too narrow, and may exclude other  
            underserved or vulnerable populations that the community needs  
            assessment identifies as warranting support.

          13.Drafting concerns.  
               a.     Financially qualified not defined. On Page 11, lines  
                 13-40, this bill defines "charity care," and includes  
                 several references to "financially qualified patient."  




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                 However, there is no definition of financially qualified  
                 patient. However, in there is a definition of financially  
                 qualified patient in a related provision of existing law  
                 (Health and Safety Code 127400, pertaining to Hospital  
                 Fair Pricing Policies) that the author may wish to  
                 cross-reference here.

               b.     Unclear how often OSHPD calculates total value of  
                 community benefits. This bill requires facilities to  
                 submit a community benefits plan every two years (Page  
                 19, lines 27-31), and then goes on to specify that "for  
                 every other year that a community benefits plan is  
                 submitted" OSHPD is required to "annually calculate and  
                 make public the total value of community benefits" (Page  
                 20, lines 32-37). It is unclear how OSHPD can "annually  
                 calculate" something every other year. Additionally, if  
                 OSHPD is to perform this function every other year that a  
                                                                                          plan is submitted, and a plan is submitted every two  
                 years, is the intent of this provision to only require  
                 OSHPD to perform this calculation every four years?

               c.     Definitions are confusing. Beginning on Page 9, line  
                 4, this bill defines "community benefits." After the  
                 initial paragraph of definition, there is a second  
                 paragraph that uses the term "community benefits may  
                 include any of the following, provided that the  
                 provision, funding, or financial support of these  
                 benefits is demonstrated to reduce community health care  
                 costs." Because the initial paragraph of definition did  
                 not include this limiting phrase, and because both  
                 paragraphs include some overlap (school health centers,  
                 for example, are included in both paragraphs), it is  
                 unclear how this limiting phrase applies.

               Also, generally speaking, this bill includes many  
                 definitions of terms, and many of these definitions use  
                 the phrase "including, but not limited to," so that  
                 rather than a limiting definition, it is more of a list  
                 of examples. While some of the definitions, such as the  
                 definitions of community benefit and charity care, are  
                 central to the bill, the author and sponsors may wish to  
                 consider whether all of the many definitions in this bill  
                 are necessary, and whether the bill could be simplified  
                 and still achieve the objectives of the author.





          AB 503 | Page 20




           SUPPORT AND OPPOSITION  :
          Support:  California Nurses Association (co-sponsor)
          Greenlining Institute (co-sponsor)
                    Alameda Labor Council
                    Allen Temple Baptist Church
                    American Federation of Musicians, Local 6
                    American Federation of State, County and Municipal  
                              Employees
                    American Federation of Teachers, Local 2121
                    BAC, Local 3
                    Berkeley Federation of Teachers
                    California Alliance for Retired Americans
                    California Federation of Teachers
                    California Immigrant Policy Center
                    California National Organization for Women
                    California Professional Firefighters
                    California Rural Legal Assistance Foundation
                    California School Employees Association 
                    California School Employees Association, AFL-CIO
                    Communication Workers of America, Retired Member Club  
                              Local 9423
                    Communications Workers of America, AFL-CIO, District 9
                    Consumer Attorneys of California
                    Consumer Federation of California
                    Courage Campaign
                    Democracy for America
                    Gray Panthers, San Francisco Chapter
                    IFEPT, Local 21
                    International Brotherhood of Electrical Workers, Local  
                              332
                    International Longshore workers and Warehouse Union  
                              Pensioners, San Francisco/Bay Area
                    Ironworkers Local 377
                    Jobs with Justice, San Francisco
                    Korean Community Center of the East Bay
                    Labor United for Universal Healthcare
                    Laborers Local 261
                    Latino Coalition for a Health California
                    Los Rios College Federation of Teachers
                    Napa/Solano CLC
                    National Nurses United
                    National Union of Healthcare Workers
                    Nevada Chapter, Health Care for All
                    Office and Professional Employees International Union  
                              Local 3
                    Olallieberry Inn Bed and Breakfast, Cambria,  




                                                             AB 503 | Page  
          21


          

                              California
                    Older Women's League
                    Potrero Hill Democratic Club
                    Progressive Caucus of the California Democratic Party
                    Progressive Democrats of America
                    Progressive Voices
                    Public Citizen
                    Sacramento Central Labor Council
                    San Francisco Building and Construction Trades
                    San Francisco Central Labor Council
                    San Mateo Building and Construction Trades
                    San Mateo Community College Federation of Teachers,  
                              AFT Local 1493
                    San Mateo County Central Labor Council
                    Santa Clara Chapter, Health Care for All
                    Service Employees International Union 1021
                    Service Employees International Union 521 Retirees
                    Sheet Metal Workers' International Association, Local  
                              104
                    South Bay Labor Council
                    UA Local 393
                    UAW Local 5810
                    UC/AFT
                    UNITE/HERE, Local 2
                    United Educators, San Francisco
                    UPTE/CWA
                    USW, Local 675
                    Young Invincibles
                                        
          Oppose:   Adventist Health
                    Adventist Medical Center - Hanford
                    Adventist Medical Center - Reedley
                    Adventist Medical Center - Selma
                    Alliance of Catholic Health Care
                    Arroyo Grande Community Hospital
                    Beverly Hospital 
                    California Chamber of Commerce
                    California Hospital Association
                    Catalina Island Medical Center
                    Central Valley General Hospital
                    Community Medical Centers
                    Dignity Health
                    Dominican Hospital
                    El Camino Hospital
                    French Hospital Medical Center




          AB 503 | Page 22




                    Henry Mayo Newhall Hospital
                    Hoag Health in Newport Beach and Hoag Irvine
                    Kaiser Permanente
                    Lodi Health
                    Loma Linda University Medical Center
                    Long Beach Memorial, Millers Children's and Women's  
                         Hospital Long Beach, and Community Hospital Long  
                         Beach
                    Los Angeles Area Chamber of Commerce
                    Mad River Community Hospital
                    MemorialCare Health System
                    Methodist Hospital of Southern California
                    Mission Hospital in Mission Viejo
                    Mission Hospital Laguna Beach
                    NorthBay Healthcare
                    Petaluma Valley Hospital
                    Pomona Valley Hospital Medical Center
                    Providence Health and Services, Southern California
                    Queen of the Valley Medical Center
                    Redlands Community Hospital
                    Ridgecrest Regional Hospital
                    Saddleback Memorial Medical Center
                    San Gorgonio Memorial Hospital
                    Santa Rosa Memorial Hospital
                    Scripps
                    Sharp HealthCare
                    Sierra View District Hospital
                    Simi Valley Hospital
                    Sole Community Hospital in Amador County
                    Southern Mono Healthcare District dba Mammoth Hospital
                    St. Helena Hospital
                    St. Joseph Health
                    St. Joseph Hospital in Orange
                    St. Jude Medical Center in Fullerton
                    St. Mary Medical Center in Apple Valley
                    Stanford Hospital and Clinics
                    Stanford Hospital and Clinics
                    Sutter Health
                    Ukiah Valley Medical Center
                    WEAVE, Inc.
                    White Memorial Medical Center


                                      -- END --
          





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