Hospital Community Benefit Accountability


In alignment with HB23-1243, the Department of Health Care Policy & Financing (HCPF), in partnership with the Colorado Health Institute (CHI), is seeking feedback on best practices for nonprofit hospitals to ensure diverse input from local community members in determining community priorities and best practices to collaborate and reduce redundant community needs assessments.

HCPF is seeking feedback from nonprofit hospitals and health systems, community-based organizations and advocacy groups, local public health agencies, community health care providers, and others interested in hospital community benefit.

The HB23-1243 guidance memorandum outlines the new annual Hospital Community Benefit Accountability requirements along with current requirements that remain unchanged.

HB23-1243 Hospital Community Benefit Stakeholder Forum

HCPF and CHI held a Stakeholder Forum on November 28, 2023, to receive feedback from stakeholders on best practices for non-hospitals to source input from their local community on community needs, and receive feedback on how HCPF and non-profit hospitals can best reduce redundancies in community benefit assessments.

CHI facilitated these sessions and is accepting written feedback or questions at focusgroups@coloradohealthinstitute.org.

Hospital Community Benefit: Hospital Initiatives Memo
Hospital Community Benefit: Process and Guidelines Report

HB 23-1243 Implementation Timeline

  • Stakeholder Engagement - February-April 2024
  • Public Rule Review Meeting (PRRM) - April 22, 2024
  • Initial Medical Service Board (MSB) Meeting - May 10, 2024
  • Final MSB Hearing - June 14, 2024
  • Effective date of revised rules - July 30, 2024
  • Hospital reports due - September 13, 2024

Rule revisions to Section 8.5000 Concerning Hospital Community Benefit Accountability DRAFT -  Updated May 3, 2024


House Bill (HB)19-1320 requires non-profit tax exempt general hospitals, Denver Health Medical Center, and University of Colorado Hospital, to complete a community health needs assessment every three years and an annual community benefit implementation plan every year. These hospitals are required to report to the Department of Health Care Policy and Financing (HCPF) the following:

  • Certain community benefits
  • Costs
  • Shortfalls in the preceding year

Any hospital not required to report is encouraged to do so.

Each hospital is required to convene a public meeting at least once a year that will be used to seek feedback on the hospital's community benefit activities and the hospital's community benefit implementation plan. Hospitals are required to invite the following entities to participate:

  • Representatives from local public and local government agencies
  • Representatives from certain state agencies
  • The general public

HB19-1320: Hospital Community Benefit Accountability

HB 23-1243, Hospital Community Benefit, expands on the previous legislation of HB 19-1320 by including changes to hospitals' community benefit activity requirements, and imposes certain requirements on public meetings regarding hospitals' community benefit activities and implementation plans.

HB23-1243: Hospital Community Benefit

Requirement changes between HB 19-1320 and HB 23-1243 include the following:

1. Hospital requirements on invite list for public meetings:

  • Posting the invitation on hospital website
  • Social media page(s)
  • Hospitals e-newsletter
  • Email list(s)
  • Posted at least 30 days prior to meeting date

2. Share previous years' community benefit activities:

  • Amount funded for each activity
  • Description of how activities and funding align with community priorities

3. Required to provide evidence showing:

  • How investment improves community health outcomes
  • How the investment directly corresponds to community identified needs

4. Submit the following to HCPF:

  • Details of who attended meeting
  • Topics discussed
  • Decisions made as a result – pertaining to community benefit
  • Community feedback

5. Make each report available to the public

6. HCPF is required to:

  • Conduct stakeholder meetings to determine best practices to ensure diverse input from local community members
    • Meaningfully engaged
    • Best practices for hospitals to collaborate with local health agencies/community organizations to reduce redundant community health needs
  • Include tax exemption information in the annual report (This has already been done by HCPF but is now required. Additionally, analysis will be done by the Department of Revenue going forward.)
  • Take remedial action if hospital fails to comply
    • Require reporting hospital to submit corrective action plan within 120 days for approval by state department
    • If a reporting hospital fails to submit corrective action plan (hospitals non-compliance), there is potential for weekly fines between $5,000 and $20,000 for each violation

HCPF will send updates via email. Please sign-up for Hospital Community Benefits Updates. To complete the sign-up process, enter your contact information and select the Hospital Community Benefit box.


Back to: Hospital Reports Hub

Reporting Hospitals

Please visit the hospital website for their submitted Hospital Community Benefit Accountability Report, or you can email hcpf_hospitalcommunity@state.co.us to request a copy of the submitted report.


Contacts to be invited to public meetings:

Each Reporting Hospital shall invite, at a minimum, representatives from the following entities to participate in the meeting if any such entities operate in the hospital’s community:

  • General Public;
  • A member of the tribal council or their designee for a hospital whose community includes one of Colorado’s land-based tribes;
  • A member from the Urban Indian Organization for a hospital whose community includes a federally designated Urban Indian Health Center or Urban Indian Organizations;
  • A member from an institution of higher learning for a hospital whose community includes such institutions;
  • Local public health agencies;
  • Local chambers of commerce and economic development organizations;
  • Local health care consumer organizations;
  • School districts;
  • County governments;
  • City and town governments;
  • Community Health Center;
  • Certified rural health clinics or primary care clinics located in a county that has been designated as a rural or frontier county;
  • Area agencies on aging;
  • Safety Net Clinics; and
  • Health care consumer advocacy organizations.