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General Assembly Raised Bill No. 6550
January Session, 2021
LCO No. 3931
Referred to Committee on PUBLIC HEALTH
Introduced by:
(PH)
AN ACT CONCERNING TH E OFFICE OF HEALTH STRATEGY'S
RECOMMENDATIONS REGA RDING VARIOUS REVISIONS TO
COMMUNITY BENEFITS P ROGRAMS ADMINISTERED BY
HOSPITALS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 19a-127k of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective from passage): 2
(a) As used in this section: 3
(1) "Community benefits program" means any [voluntary] program 4
to promote preventive care, to reduce racial ethnic, linguistic and 5
cultural disparities in health and to improve the health status for 6
[working families and] all populations [at risk in the communities] 7
within the geographic service areas of [a managed care organization or] 8
a hospital in accordance with guidelines established pursuant to 9
subsection (c) of this section; 10
[(2) "Managed care organization" has the same meaning as provided 11
in section 38a-478;] 12 Raised Bill No. 6550
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(2) "Community building" means activity that protects or improves a 13
community's health or safety and is eligible to be reported on the 14
Internal Revenue Service form 990; 15
(3) "Community health needs assessment" means a written 16
assessment, as described in 26 CFR 1.501(r)-(3) conducted by a hospital 17
that defines the community it serves, assesses the health needs of such 18
community, and solicits and takes into account persons that represent 19
the broad interests of the community; 20
[(3)] (4) "Hospital" has the same meaning as provided in section 19a-21
490; and [.] 22
(5) "Implementation strategy" means a written plan required by 26 23
CFR 1.501(r)-(3) that addresses community health needs identified 24
through a community health needs assessment that (A) describes the 25
actions a hospital intends to take to address the health need and impact 26
of these actions, (B) identifies resources that the hospital plans to commit 27
to address such need, and (C) describes the planned collaboration 28
between the hospital and other facilities and organizations to address 29
such health need. 30
(b) On or before January 1, [2005] 2022, and [biennially] annually 31
thereafter, [each managed care organization and] each hospital shall 32
submit to the [Healthcare Advocate, or the Healthcare Advocate's] 33
Health Systems Planning Unit of the Office of Health Strategy, or to a 34
designee selected by the executive director of the Office of Health 35
Strategy, a report on [whether the managed care organization or 36
hospital has in place a] such hospital's community benefits program. [If 37
a managed care organization or hospital elects to develop a community 38
benefits program, the] The report required by this subsection shall 39
comply with the reporting requirements of subsection (d) of this section. 40
(c) [A managed care organization or] Each hospital [may] shall 41
develop community benefit guidelines intended to promote preventive 42
care, reduce racial, ethnic, linguistic and cultural disparities in health 43
and [to] improve the health status for [working families and] all 44 Raised Bill No. 6550
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populations [at risk] within the geographic service areas of such 45
hospital, whether or not those individuals are [enrollees of the managed 46
care plan or] patients of the hospital. The guidelines shall focus on the 47
following principles: 48
(1) Adoption and publication of a community benefits policy 49
statement setting forth [the organization's or] such hospital's 50
commitment to a formal community benefits program; 51
(2) The responsibility for overseeing the development and 52
implementation of the community benefits program, the resources to be 53
allocated and the administrative mechanisms for the regular evaluation 54
of the program; 55
(3) Seeking assistance and meaningful participation from the 56
communities within [the organization's or] such hospital's geographic 57
service areas in developing and implementing the community benefits 58
program and a plan for meaningful community benefit and community 59
building investments, and in defining the targeted populations and the 60
specific health care needs [it] such hospital should address. In doing so, 61
the governing body or management of [the organization or] such 62
hospital shall give priority to (A) the public health needs outlined in the 63
most recent version of the state health plan prepared by the Department 64
of Public Health pursuant to section 19a-7, and (B) such hospital's 65
triennial community health needs assessment and implementation 66
strategy; and 67
(4) Developing its [program] implementation strategy based upon an 68
assessment of (A) the health care needs and resources of the targeted 69
populations, particularly a broad spectrum of age, racial and ethnic 70
groups, low and middle-income populations, and medically 71
underserved populations, and (B) barriers to accessing health care, 72
including, but not limited to, cultural, linguistic and physical barriers to 73
accessible health care, lack of information on available sources of health 74
care coverage and services, and the benefits of preventive health care. 75
[The program shall consider the health care needs of a broad spectrum 76 Raised Bill No. 6550
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of age groups and health conditions] Each hospital shall solicit 77
commentary on its implementation strategy from the communities 78
within such hospital's geographic service area and consider revisions to 79
such strategy based on such commentary. 80
(d) Each [managed care organization and each] hospital [that chooses 81
to participate in developing a community benefits program] shall 82
include in the [biennial] annual report required by subsection (b) of this 83
section [the status of the program, if any, that the organization or 84
hospital established. If the managed care organization or hospital has 85
chosen to participate in a community benefits program, the report shall 86
include] the following components: (1) The community benefits policy 87
statement of [the managed care organization or] such hospital; (2) the 88
[mechanism] process by which community input and participation is 89
solicited and incorporated in the community benefits program; (3) 90
identification of community health needs that were [considered] 91
prioritized in developing [and implementing] the [community benefits 92
program] implementation strategy; (4) a narrative description of the 93
community benefits, community services, and preventive health 94
education provided or proposed, which may include measurements 95
related to the number of people served and health status outcomes; (5) 96
outcome measures [taken] used to evaluate the [results] impact of the 97
community benefits program and proposed revisions to the program; 98
(6) to the extent feasible, a community benefits budget and a good faith 99
effort to measure expenditures and administrative costs associated with 100
the community benefits program, including both cash and in-kind 101
commitments; [and] (7) a summary of the extent to which [the managed 102
care organization or] such hospital has developed and met the 103
guidelines listed in subsection (c) of this section; [. Each managed care 104
organization and each hospital] (8) for the prior taxable year, the 105
demographics of the population within the geographic service area of 106
such hospital; (9) the cost and description of each investment included 107
in the "Financial Assistance and Certain Other Community Benefits at 108
Cost", and the "Community Building Activities", sections of such 109
hospital's Internal Revenue Service form 990; (10) an explanation of how 110 Raised Bill No. 6550
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each investment described in subdivision (9) of this subsection 111
addresses the needs identified in the hospital's triennial community 112
health needs assessment and implementation strategy; and (11) a 113
description of available evidence that shows how each investment 114
described in subdivision (9) of this subsection improves community 115
health outcomes. The Office of Health Strategy shall [make a copy of] 116
post the annual report [available, upon request, to any member of the 117
public] required by subsection (b) of this section on its Internet web site. 118
(e) (1) Not later than January 1, 2023, and biennially thereafter, the 119
Office of Health Strategy, or a designee selected by the executive 120
director of the Office of Health Strategy, shall establish a minimum 121
community benefit and community building spending threshold that 122
hospitals shall meet or exceed during the biennium. Such threshold shall 123
be based on objective data and criteria, including, but not limited to, the 124
following: (A) Historical and current expenditures on community 125
benefits by the hospital; (B) the community needs identified in the 126
hospital's triennial community health needs assessment; (C) the overall 127
financial position of the hospital based on audited financial statements 128
and other objective data; and (D) taxes and payments in lieu of taxes 129
paid by the hospital. 130
(2) The Office of Health Strategy shall consult with hospital 131
representatives, solicit and consider comments from the public and 132
consult with one or more individuals with expertise in health care 133
economics when establishing a community benefit and community 134
building spending threshold. 135
(3) The community benefit and community building spending 136
threshold established pursuant to this subsection shall include the 137
minimum proportion of community benefit spending that shall be 138
directed to addressing health disparities and social determinants of 139
health identified in the community health needs assessment during the 140
next biennium. 141
[(e)] (f) The [Healthcare Advocate, or the Healthcare Advocate's] 142 Raised Bill No. 6550
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Office of Health Strategy, or a designee selected by the executive 143
director of the Office of Health Strategy, shall, within available 144
appropriations, develop a summary and analysis of the community 145
benefits program reports submitted by [managed care organizations 146
and] hospitals under this section and shall review such reports for 147
adherence to the guidelines set forth in subsection (c) of this section. Not 148
later than October 1, [2005] 2022, and [biennially] annually thereafter, 149
the [Healthcare Advocate, or the Healthcare Advocate's] Office of 150
Health Strategy, or a designee selected by the executive director of the 151
Office of Health Strategy, shall [make such summary and analysis 152
available to the public upon request] post such summary and analysis 153
on its Internet web site. 154
[(f)] (g) The [Healthcare Advocate] executive director of the Office of 155
Health Strategy, or the executive director's designee, may, after notice 156
and opportunity for a hearing, in accordance with chapter 54, impose a 157
civil penalty on any [managed care organization or] hospital that fails to 158
submit the report required pursuant to this section by the date specified 159
in subsection (b) of this section. Such penalty shall be not more than fifty 160
dollars a day for each day after the required submittal date that such 161
report is not submitted. 162
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage 19a-127k
Statement of Purpose:
To make various revisions to community benefits programs
administered by hospitals.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]