California Assembly Bill AB1046 Introduced / Bill

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