Connecticut 2021 Regular Session

Connecticut House Bill HB06550 Compare Versions

Version 1 (Old)

Version 2 (New)

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7		-	General Assembly Substitute Bill No. 6550
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	7	+	General Assembly Raised Bill No. 6550
8	8		January Session, 2021
	9	+	LCO No. 3931
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	12	+	Referred to Committee on PUBLIC HEALTH
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	14	+
	15	+	Introduced by:
	16	+	(PH)
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14	21		AN ACT CONCERNING TH E OFFICE OF HEALTH STRATEGY'S
15	22		RECOMMENDATIONS REGA RDING VARIOUS REVISIONS TO
16	23		COMMUNITY BENEFITS P ROGRAMS ADMINISTERED BY
17	24		HOSPITALS.
18	25		Be it enacted by the Senate and House of Representatives in General
19	26		Assembly convened:
20	27
21	28		Section 1. Section 19a-127k of the general statutes is repealed and the 1
22	29		following is substituted in lieu thereof (Effective from passage): 2
23	30		(a) As used in this section: 3
24	31		(1) "Community benefits program" means any [voluntary] program 4
25	32		to promote preventive care, to reduce racial ethnic, linguistic and 5
26	33		cultural disparities in health and to improve the health status for 6
27	34		[working families and] all populations [at risk in the communities] 7
28	35		within the geographic service areas of [a managed care organization or] 8
29	36		a hospital in accordance with guidelines established pursuant to 9
30	37		subsection (c) of this section; 10
31	38		[(2) "Managed care organization" has the same meaning as provided 11
32		-	in section 38a-478;] 12
	39	+	in section 38a-478;] 12 Raised Bill No. 6550
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	41	+
	42	+
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33	45		(2) "Community building" means activity that protects or improves a 13
34	46		community's health or safety and is eligible to be reported on the 14
35		-	Internal Revenue Service form 990; 15 Substitute Bill No. 6550
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	47	+	Internal Revenue Service form 990; 15
42	48		(3) "Community health needs assessment" means a written 16
43	49		assessment, as described in 26 CFR 1.501(r)-(3) conducted by a hospital 17
44	50		that defines the community it serves, assesses the health needs of such 18
45	51		community, and solicits and takes into account persons that represent 19
46	52		the broad interests of the community; 20
47		-	[(3)] (4) "Hospital" [has the same meaning as provided in section 19a-21
48		-	490.] means a nonprofit entity licensed as a hospital pursuant to chapter 22
49		-	368v that is required to annually file Internal Revenue Service form 990; 23
50		-	and 24
51		-	(5) "Implementation strategy" means a written plan required by 26 25
52		-	CFR 1.501(r)-(3) that addresses community health needs identified 26
53		-	through a community health needs assessment that (A) describes the 27
54		-	actions a hospital intends to take to address the health need and impact 28
55		-	of these actions, (B) identifies resources that the hospital plans to commit 29
56		-	to address such need, and (C) describes the planned collaboration 30
57		-	between the hospital and other facilities and organizations to address 31
58		-	such health need. 32
59		-	(b) On or before January 1, [2005] 2022, and [biennially] annually 33
60		-	thereafter, [each managed care organization and] each hospital shall 34
61		-	submit to the [Healthcare Advocate, or the Healthcare Advocate's] 35
62		-	Health Systems Planning Unit of the Office of Health Strategy, or to a 36
63		-	designee selected by the executive director of the Office of Health 37
64		-	Strategy, a report on [whether the managed care organization or 38
65		-	hospital has in place a] such hospital's community benefits program. [If 39
66		-	a managed care organization or hospital elects to develop a community 40
67		-	benefits program, the] The report required by this subsection shall 41
68		-	comply with the reporting requirements of subsection (d) of this section. 42
69		-	(c) [A managed care organization or] Each hospital [may] shall 43
70		-	develop community benefit guidelines intended to promote preventive 44
71		-	care, reduce racial, ethnic, linguistic and cultural disparities in health 45
72		-	and [to] improve the health status for [working families and] all 46
73		-	populations [at risk] within the geographic service areas of such 47 Substitute Bill No. 6550
	53	+	[(3)] (4) "Hospital" has the same meaning as provided in section 19a-21
	54	+	490; and [.] 22
	55	+	(5) "Implementation strategy" means a written plan required by 26 23
	56	+	CFR 1.501(r)-(3) that addresses community health needs identified 24
	57	+	through a community health needs assessment that (A) describes the 25
	58	+	actions a hospital intends to take to address the health need and impact 26
	59	+	of these actions, (B) identifies resources that the hospital plans to commit 27
	60	+	to address such need, and (C) describes the planned collaboration 28
	61	+	between the hospital and other facilities and organizations to address 29
	62	+	such health need. 30
	63	+	(b) On or before January 1, [2005] 2022, and [biennially] annually 31
	64	+	thereafter, [each managed care organization and] each hospital shall 32
	65	+	submit to the [Healthcare Advocate, or the Healthcare Advocate's] 33
	66	+	Health Systems Planning Unit of the Office of Health Strategy, or to a 34
	67	+	designee selected by the executive director of the Office of Health 35
	68	+	Strategy, a report on [whether the managed care organization or 36
	69	+	hospital has in place a] such hospital's community benefits program. [If 37
	70	+	a managed care organization or hospital elects to develop a community 38
	71	+	benefits program, the] The report required by this subsection shall 39
	72	+	comply with the reporting requirements of subsection (d) of this section. 40
	73	+	(c) [A managed care organization or] Each hospital [may] shall 41
	74	+	develop community benefit guidelines intended to promote preventive 42
	75	+	care, reduce racial, ethnic, linguistic and cultural disparities in health 43
	76	+	and [to] improve the health status for [working families and] all 44 Raised Bill No. 6550
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80		-	hospital, whether or not those individuals are [enrollees of the managed 48
81		-	care plan or] patients of the hospital. The guidelines shall focus on the 49
82		-	following principles: 50
83		-	(1) Adoption and publication of a community benefits policy 51
84		-	statement setting forth [the organization's or] such hospital's 52
85		-	commitment to a formal community benefits program; 53
86		-	(2) The responsibility for overseeing the development and 54
87		-	implementation of the community benefits program, the resources to be 55
88		-	allocated and the administrative mechanisms for the regular evaluation 56
89		-	of the program; 57
90		-	(3) Seeking assistance and meaningful participation from the 58
91		-	communities within [the organization's or] such hospital's geographic 59
92		-	service areas in developing and implementing the community benefits 60
93		-	program and a plan for meaningful community benefit and community 61
94		-	building investments, and in defining the targeted populations and the 62
95		-	specific health care needs [it] such hospital should address. In doing so, 63
96		-	the governing body or management of [the organization or] such 64
97		-	hospital shall give priority to (A) the public health needs outlined in the 65
98		-	most recent version of the state health plan prepared by the Department 66
99		-	of Public Health pursuant to section 19a-7, and (B) such hospital's 67
100		-	triennial community health needs assessment and implementation 68
101		-	strategy; and 69
102		-	(4) Developing its [program] implementation strategy based upon an 70
103		-	assessment of (A) the health care needs and resources of the targeted 71
104		-	populations, particularly a broad spectrum of age, racial and ethnic 72
105		-	groups, low and middle-income populations, and medically 73
106		-	underserved populations, and (B) barriers to accessing health care, 74
107		-	including, but not limited to, cultural, linguistic and physical barriers to 75
108		-	accessible health care, lack of information on available sources of health 76
109		-	care coverage and services, and the benefits of preventive health care. 77
110		-	[The program shall consider the health care needs of a broad spectrum 78
111		-	of age groups and health conditions] Each hospital shall solicit 79 Substitute Bill No. 6550
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	81	+
	82	+	populations [at risk] within the geographic service areas of such 45
	83	+	hospital, whether or not those individuals are [enrollees of the managed 46
	84	+	care plan or] patients of the hospital. The guidelines shall focus on the 47
	85	+	following principles: 48
	86	+	(1) Adoption and publication of a community benefits policy 49
	87	+	statement setting forth [the organization's or] such hospital's 50
	88	+	commitment to a formal community benefits program; 51
	89	+	(2) The responsibility for overseeing the development and 52
	90	+	implementation of the community benefits program, the resources to be 53
	91	+	allocated and the administrative mechanisms for the regular evaluation 54
	92	+	of the program; 55
	93	+	(3) Seeking assistance and meaningful participation from the 56
	94	+	communities within [the organization's or] such hospital's geographic 57
	95	+	service areas in developing and implementing the community benefits 58
	96	+	program and a plan for meaningful community benefit and community 59
	97	+	building investments, and in defining the targeted populations and the 60
	98	+	specific health care needs [it] such hospital should address. In doing so, 61
	99	+	the governing body or management of [the organization or] such 62
	100	+	hospital shall give priority to (A) the public health needs outlined in the 63
	101	+	most recent version of the state health plan prepared by the Department 64
	102	+	of Public Health pursuant to section 19a-7, and (B) such hospital's 65
	103	+	triennial community health needs assessment and implementation 66
	104	+	strategy; and 67
	105	+	(4) Developing its [program] implementation strategy based upon an 68
	106	+	assessment of (A) the health care needs and resources of the targeted 69
	107	+	populations, particularly a broad spectrum of age, racial and ethnic 70
	108	+	groups, low and middle-income populations, and medically 71
	109	+	underserved populations, and (B) barriers to accessing health care, 72
	110	+	including, but not limited to, cultural, linguistic and physical barriers to 73
	111	+	accessible health care, lack of information on available sources of health 74
	112	+	care coverage and services, and the benefits of preventive health care. 75
	113	+	[The program shall consider the health care needs of a broad spectrum 76 Raised Bill No. 6550
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118		-	commentary on its implementation strategy from the communities 80
119		-	within such hospital's geographic service area and consider revisions to 81
120		-	such strategy based on such commentary. 82
121		-	(d) Each [managed care organization and each] hospital [that chooses 83
122		-	to participate in developing a community benefits program] shall 84
123		-	include in the [biennial] annual report required by subsection (b) of this 85
124		-	section [the status of the program, if any, that the organization or 86
125		-	hospital established. If the managed care organization or hospital has 87
126		-	chosen to participate in a community benefits program, the report shall 88
127		-	include] the following components: (1) The community benefits policy 89
128		-	statement of [the managed care organization or] such hospital; (2) the 90
129		-	[mechanism] process by which community input and participation is 91
130		-	solicited and incorporated in the community benefits program; (3) 92
131		-	identification of community health needs that were [considered] 93
132		-	prioritized in developing [and implementing] the [community benefits 94
133		-	program] implementation strategy; (4) a narrative description of the 95
134		-	community benefits, community services, and preventive health 96
135		-	education provided or proposed, which may include measurements 97
136		-	related to the number of people served and health status outcomes; (5) 98
137		-	outcome measures [taken] used to evaluate the [results] impact of the 99
138		-	community benefits program and proposed revisions to the program; 100
139		-	(6) to the extent feasible, a community benefits budget and a good faith 101
140		-	effort to measure expenditures and administrative costs associated with 102
141		-	the community benefits program, including both cash and in-kind 103
142		-	commitments; [and] (7) a summary of the extent to which [the managed 104
143		-	care organization or] such hospital has developed and met the 105
144		-	guidelines listed in subsection (c) of this section; [. Each managed care 106
145		-	organization and each hospital] (8) for the prior taxable year, the 107
146		-	demographics of the population within the geographic service area of 108
147		-	such hospital; (9) the cost and description of each investment included 109
148		-	in the "Financial Assistance and Certain Other Community Benefits at 110
149		-	Cost", and the "Community Building Activities", sections of such 111
150		-	hospital's Internal Revenue Service form 990; (10) an explanation of how 112
151		-	each investment described in subdivision (9) of this subsection 113 Substitute Bill No. 6550
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	118	+
	119	+	of age groups and health conditions] Each hospital shall solicit 77
	120	+	commentary on its implementation strategy from the communities 78
	121	+	within such hospital's geographic service area and consider revisions to 79
	122	+	such strategy based on such commentary. 80
	123	+	(d) Each [managed care organization and each] hospital [that chooses 81
	124	+	to participate in developing a community benefits program] shall 82
	125	+	include in the [biennial] annual report required by subsection (b) of this 83
	126	+	section [the status of the program, if any, that the organization or 84
	127	+	hospital established. If the managed care organization or hospital has 85
	128	+	chosen to participate in a community benefits program, the report shall 86
	129	+	include] the following components: (1) The community benefits policy 87
	130	+	statement of [the managed care organization or] such hospital; (2) the 88
	131	+	[mechanism] process by which community input and participation is 89
	132	+	solicited and incorporated in the community benefits program; (3) 90
	133	+	identification of community health needs that were [considered] 91
	134	+	prioritized in developing [and implementing] the [community benefits 92
	135	+	program] implementation strategy; (4) a narrative description of the 93
	136	+	community benefits, community services, and preventive health 94
	137	+	education provided or proposed, which may include measurements 95
	138	+	related to the number of people served and health status outcomes; (5) 96
	139	+	outcome measures [taken] used to evaluate the [results] impact of the 97
	140	+	community benefits program and proposed revisions to the program; 98
	141	+	(6) to the extent feasible, a community benefits budget and a good faith 99
	142	+	effort to measure expenditures and administrative costs associated with 100
	143	+	the community benefits program, including both cash and in-kind 101
	144	+	commitments; [and] (7) a summary of the extent to which [the managed 102
	145	+	care organization or] such hospital has developed and met the 103
	146	+	guidelines listed in subsection (c) of this section; [. Each managed care 104
	147	+	organization and each hospital] (8) for the prior taxable year, the 105
	148	+	demographics of the population within the geographic service area of 106
	149	+	such hospital; (9) the cost and description of each investment included 107
	150	+	in the "Financial Assistance and Certain Other Community Benefits at 108
	151	+	Cost", and the "Community Building Activities", sections of such 109
	152	+	hospital's Internal Revenue Service form 990; (10) an explanation of how 110 Raised Bill No. 6550
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158		-	addresses the needs identified in the hospital's triennial community 114
159		-	health needs assessment and implementation strategy; and (11) a 115
160		-	description of available evidence that shows how each investment 116
161		-	described in subdivision (9) of this subsection improves community 117
162		-	health outcomes. The Office of Health Strategy shall [make a copy of] 118
163		-	post the annual report [available, upon request, to any member of the 119
164		-	public] required by subsection (b) of this section on its Internet web site. 120
165		-	(e) (1) Not later than January 1, 2023, and biennially thereafter, the 121
166		-	Office of Health Strategy, or a designee selected by the executive 122
167		-	director of the Office of Health Strategy, shall establish a minimum 123
168		-	community benefit and community building spending threshold that 124
169		-	hospitals shall meet or exceed during the biennium. Such threshold shall 125
170		-	be based on objective data and criteria, including, but not limited to, the 126
171		-	following: (A) Historical and current expenditures on community 127
172		-	benefits by the hospital; (B) the community needs identified in the 128
173		-	hospital's triennial community health needs assessment; (C) the overall 129
174		-	financial position of the hospital based on audited financial statements 130
175		-	and other objective data; and (D) taxes and payments in lieu of taxes 131
176		-	paid by the hospital. 132
177		-	(2) The Office of Health Strategy shall consult with hospital 133
178		-	representatives, solicit and consider comments from the public and 134
179		-	consult with one or more individuals with expertise in health care 135
180		-	economics when establishing a community benefit and community 136
181		-	building spending threshold. 137
182		-	(3) The community benefit and community building spending 138
183		-	threshold established pursuant to this subsection shall include the 139
184		-	minimum proportion of community benefit spending that shall be 140
185		-	directed to addressing health disparities and social determinants of 141
186		-	health identified in the community health needs assessment during the 142
187		-	next biennium. 143
188		-	[(e)] (f) The [Healthcare Advocate, or the Healthcare Advocate's] 144
189		-	Office of Health Strategy, or a designee selected by the executive 145 Substitute Bill No. 6550
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	157	+
	158	+	each investment described in subdivision (9) of this subsection 111
	159	+	addresses the needs identified in the hospital's triennial community 112
	160	+	health needs assessment and implementation strategy; and (11) a 113
	161	+	description of available evidence that shows how each investment 114
	162	+	described in subdivision (9) of this subsection improves community 115
	163	+	health outcomes. The Office of Health Strategy shall [make a copy of] 116
	164	+	post the annual report [available, upon request, to any member of the 117
	165	+	public] required by subsection (b) of this section on its Internet web site. 118
	166	+	(e) (1) Not later than January 1, 2023, and biennially thereafter, the 119
	167	+	Office of Health Strategy, or a designee selected by the executive 120
	168	+	director of the Office of Health Strategy, shall establish a minimum 121
	169	+	community benefit and community building spending threshold that 122
	170	+	hospitals shall meet or exceed during the biennium. Such threshold shall 123
	171	+	be based on objective data and criteria, including, but not limited to, the 124
	172	+	following: (A) Historical and current expenditures on community 125
	173	+	benefits by the hospital; (B) the community needs identified in the 126
	174	+	hospital's triennial community health needs assessment; (C) the overall 127
	175	+	financial position of the hospital based on audited financial statements 128
	176	+	and other objective data; and (D) taxes and payments in lieu of taxes 129
	177	+	paid by the hospital. 130
	178	+	(2) The Office of Health Strategy shall consult with hospital 131
	179	+	representatives, solicit and consider comments from the public and 132
	180	+	consult with one or more individuals with expertise in health care 133
	181	+	economics when establishing a community benefit and community 134
	182	+	building spending threshold. 135
	183	+	(3) The community benefit and community building spending 136
	184	+	threshold established pursuant to this subsection shall include the 137
	185	+	minimum proportion of community benefit spending that shall be 138
	186	+	directed to addressing health disparities and social determinants of 139
	187	+	health identified in the community health needs assessment during the 140
	188	+	next biennium. 141
	189	+	[(e)] (f) The [Healthcare Advocate, or the Healthcare Advocate's] 142 Raised Bill No. 6550
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196		-	director of the Office of Health Strategy, shall, within available 146
197		-	appropriations, develop a summary and analysis of the community 147
198		-	benefits program reports submitted by [managed care organizations 148
199		-	and] hospitals under this section and shall review such reports for 149
200		-	adherence to the guidelines set forth in subsection (c) of this section. Not 150
201		-	later than October 1, [2005] 2022, and [biennially] annually thereafter, 151
202		-	the [Healthcare Advocate, or the Healthcare Advocate's] Office of 152
203		-	Health Strategy, or a designee selected by the executive director of the 153
204		-	Office of Health Strategy, shall [make such summary and analysis 154
205		-	available to the public upon request] post such summary and analysis 155
206		-	on its Internet web site. 156
207		-	[(f)] (g) The [Healthcare Advocate] executive director of the Office of 157
208		-	Health Strategy, or the executive director's designee, may, after notice 158
209		-	and opportunity for a hearing, in accordance with chapter 54, impose a 159
210		-	civil penalty on any [managed care organization or] hospital that fails to 160
211		-	submit the report required pursuant to this section by the date specified 161
212		-	in subsection (b) of this section. Such penalty shall be not more than fifty 162
213		-	dollars a day for each day after the required submittal date that such 163
214		-	report is not submitted.164
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	194	+
	195	+	Office of Health Strategy, or a designee selected by the executive 143
	196	+	director of the Office of Health Strategy, shall, within available 144
	197	+	appropriations, develop a summary and analysis of the community 145
	198	+	benefits program reports submitted by [managed care organizations 146
	199	+	and] hospitals under this section and shall review such reports for 147
	200	+	adherence to the guidelines set forth in subsection (c) of this section. Not 148
	201	+	later than October 1, [2005] 2022, and [biennially] annually thereafter, 149
	202	+	the [Healthcare Advocate, or the Healthcare Advocate's] Office of 150
	203	+	Health Strategy, or a designee selected by the executive director of the 151
	204	+	Office of Health Strategy, shall [make such summary and analysis 152
	205	+	available to the public upon request] post such summary and analysis 153
	206	+	on its Internet web site. 154
	207	+	[(f)] (g) The [Healthcare Advocate] executive director of the Office of 155
	208	+	Health Strategy, or the executive director's designee, may, after notice 156
	209	+	and opportunity for a hearing, in accordance with chapter 54, impose a 157
	210	+	civil penalty on any [managed care organization or] hospital that fails to 158
	211	+	submit the report required pursuant to this section by the date specified 159
	212	+	in subsection (b) of this section. Such penalty shall be not more than fifty 160
	213	+	dollars a day for each day after the required submittal date that such 161
	214	+	report is not submitted. 162
215	215		This act shall take effect as follows and shall amend the following
216	216		sections:
217	217
218	218		Section 1 from passage 19a-127k
219	219
220		-	PH Joint Favorable Subst.
	220	+	Statement of Purpose:
	221	+	To make various revisions to community benefits programs
	222	+	administered by hospitals.
	223	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	224	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	225	+	underlined.]
221	226