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General Assembly Substitute Bill No. 6550
January Session, 2021
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 Section 19a-127k of the general statutes is repealed and the 1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
(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 Substitute Bill No. 6550
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(3) "Community health needs assessment" mean s 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.] means a nonprofit entity licensed as a hospital pursuant to chapter 22
368v that is required to annually file Internal Revenue Service form 990; 23
and 24
(5) "Implementation strategy" means a written plan required by 26 25
CFR 1.501(r)-(3) that addresses community health needs identified 26
through a community health needs assessment that (A) describes the 27
actions a hospital intends to take to address the health need and impact 28
of these actions, (B) identifies resources that the hospital plans to commit 29
to address such need, and (C) describes the planned collaboration 30
between the hospital and other facilities and organizations to address 31
such health need. 32
(b) On or before January 1, [2005] 2022, and [biennially] annually 33
thereafter, [each managed care organization and] each hospital shall 34
submit to the [Healthcare Advocate, or the Healthcare Advocate's] 35
Health Systems Planning Unit of the Office of Health Strategy, or to a 36
designee selected by the executive director of the Office of Health 37
Strategy, a report on [whether the managed care organization or 38
hospital has in place a] such hospital's community benefits program. [If 39
a managed care organization or hospital elects to develop a community 40
benefits program, the] The report required by this subsection shall 41
comply with the reporting requirements of subsection (d) of this section. 42
(c) [A managed care organization or] Each hospital [may] shall 43
develop community benefit guidelines intended to promote preventive 44
care, reduce racial, ethnic, linguistic and cultural disparities in health 45
and [to] improve the health status for [working families and] all 46
populations [at risk] within the geographic service areas of such 47 Substitute Bill No. 6550
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hospital, whether or not those individuals are [enrollees of the managed 48
care plan or] patients of the hospital. The guidelines shall focus on the 49
following principles: 50
(1) Adoption and publication of a community benefits policy 51
statement setting forth [the organization's or] such hospital's 52
commitment to a formal community benefits program; 53
(2) The responsibility for overseeing the development and 54
implementation of the community benefits program, the resources to be 55
allocated and the administrative mechanisms for the regular evaluation 56
of the program; 57
(3) Seeking assistance and meaningful participation from the 58
communities within [the organization's or] such hospital's geographic 59
service areas in developing and implementing the community benefits 60
program and a plan for meaningful community benefit and community 61
building investments, and in defining the targeted populations and the 62
specific health care needs [it] such hospital should address. In doing so, 63
the governing body or management of [the organization or] such 64
hospital shall give priority to (A) the public health needs outlined in the 65
most recent version of the state health plan prepared by the Department 66
of Public Health pursuant to section 19a-7, and (B) such hospital's 67
triennial community health needs assessment and implementation 68
strategy; and 69
(4) Developing its [program] implementation strategy based upon an 70
assessment of (A) the health care needs and resources of the targeted 71
populations, particularly a broad spectrum of age, racial and ethnic 72
groups, low and middle-income populations, and medically 73
underserved populations, and (B) barriers to accessing health care, 74
including, but not limited to, cultural, linguistic and physical barriers to 75
accessible health care, lack of information on available sources of health 76
care coverage and services, and the benefits of preventive health care. 77
[The program shall consider the health care needs of a broad spectrum 78
of age groups and health conditions] Each hospital shall solicit 79 Substitute Bill No. 6550
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commentary on its implementation strategy from the communities 80
within such hospital's geographic service area and consider revisions to 81
such strategy based on such commentary. 82
(d) Each [managed care organization and each] hospital [that chooses 83
to participate in developing a community benefits program] shall 84
include in the [biennial] annual report required by subsection (b) of this 85
section [the status of the program, if any, that the organization or 86
hospital established. If the managed care organization or hospital has 87
chosen to participate in a community benefits program, the report shall 88
include] the following components: (1) The community benefits policy 89
statement of [the managed care organization or] such hospital; (2) the 90
[mechanism] process by which community input and participation is 91
solicited and incorporated in the community benefits program; (3) 92
identification of community health needs that were [considered] 93
prioritized in developing [and implementing] the [community benefits 94
program] implementation strategy; (4) a narrative description of the 95
community benefits, community services, and preventive health 96
education provided or proposed, which may include measurements 97
related to the number of people served and health status outcomes; (5) 98
outcome measures [taken] used to evaluate the [results] impact of the 99
community benefits program and proposed revisions to the program; 100
(6) to the extent feasible, a community benefits budget and a good faith 101
effort to measure expenditures and administrative costs associated with 102
the community benefits program, including both cash and in-kind 103
commitments; [and] (7) a summary of the extent to which [the managed 104
care organization or] such hospital has developed and met the 105
guidelines listed in subsection (c) of this section; [. Each managed care 106
organization and each hospital] (8) for the prior taxable year, the 107
demographics of the population within the geographic service area of 108
such hospital; (9) the cost and description of each investment included 109
in the "Financial Assistance and Certain Other Community Benefits at 110
Cost", and the "Community Building Activities", sections of such 111
hospital's Internal Revenue Service form 990; (10) an explanation of how 112
each investment described in subdivision (9) of this subsection 113 Substitute Bill No. 6550
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addresses the needs identified in the hospital's triennial community 114
health needs assessment and implementation strategy; and (11) a 115
description of available evidence that shows how each investment 116
described in subdivision (9) of this subsection improves community 117
health outcomes. The Office of Health Strategy shall [make a copy of] 118
post the annual report [available, upon request, to any member of the 119
public] required by subsection (b) of this section on its Internet web site. 120
(e) (1) Not later than January 1, 2023, and biennially thereafter, the 121
Office of Health Strategy, or a designee selected by the executive 122
director of the Office of Health Strategy, shall establish a minimum 123
community benefit and community building spending threshold that 124
hospitals shall meet or exceed during the biennium. Such threshold shall 125
be based on objective data and criteria, including, but not limited to, the 126
following: (A) Historical and current expenditures on community 127
benefits by the hospital; (B) the community needs identified in the 128
hospital's triennial community health needs assessment; (C) the overall 129
financial position of the hospital based on audited financial statements 130
and other objective data; and (D) taxes and payments in lieu of taxes 131
paid by the hospital. 132
(2) The Office of Health Strategy shall consult with hospital 133
representatives, solicit and consider comments from the public and 134
consult with one or more individuals with expertise in health care 135
economics when establishing a community benefit and community 136
building spending threshold. 137
(3) The community benefit and community building spending 138
threshold established pursuant to this subsection shall include the 139
minimum proportion of community benefit spending that shall be 140
directed to addressing health disparities and social determinants of 141
health identified in the community health needs assessment during the 142
next biennium. 143
[(e)] (f) The [Healthcare Advocate, or the Healthcare Advocate's] 144
Office of Health Strategy, or a designee selected by the executive 145 Substitute Bill No. 6550
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director of the Office of Health Strategy, shall, within available 146
appropriations, develop a summary and analysis of the community 147
benefits program reports submitted by [managed care organizations 148
and] hospitals under this section and shall review such reports for 149
adherence to the guidelines set forth in subsection (c) of this section. Not 150
later than October 1, [2005] 2022, and [biennially] annually thereafter, 151
the [Healthcare Advocate, or the Healthcare Advocate's] Office of 152
Health Strategy, or a designee selected by the executive director of the 153
Office of Health Strategy, shall [make such summary and analysis 154
available to the public upon request] post such summary and analysis 155
on its Internet web site. 156
[(f)] (g) The [Healthcare Advocate] executive director of the Office of 157
Health Strategy, or the executive director's designee, may, after notice 158
and opportunity for a hearing, in accordance with chapter 54, impose a 159
civil penalty on any [managed care organization or] hospital that fails to 160
submit the report required pursuant to this section by the date specified 161
in subsection (b) of this section. Such penalty shall be not more than fifty 162
dollars a day for each day after the required submittal date that such 163
report is not submitted.164
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage 19a-127k
PH Joint Favorable Subst.