House Bill (HB) 19-1320 requires non-profit tax-exempt general hospitals, Denver Health Medical Center, and University of Colorado Hospital to convene a public meeting at least once each year to seek feedback regarding the hospital's community benefit activities. Each hospital must report to the Department of Health Care Policy & Financing (HCPF) certain community benefits, costs, and shortfalls. HCPF is required to submit an annual summary report to subject matter committees of the general assembly. 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.
Hospital Requirements
- Complete a community health needs assessment every 3 years
- Complete a community benefit implementation plan every year
- Convene a public meeting at least once a year
- Annual meeting invitation requirement:
- Advertisements placed in any major newspaper in the hospital’s community
- Post the information to the hospital's public website
- Post the information to the Hospital’s social media page(s)
- Post the information to the in the hospital e-newsletter
- Sent to all email lists
- Invite posted/sent at least 30 days prior to meeting date
Hospital Reporting Elements
- Most recent Community Health Needs Assessment
- Community Benefit Implementation Plan for the coming year
- The following information on the public meeting held that satisfies the public meeting requirements:
- A Date, time, location
- Outreach efforts to ensure broad community participation and accessibility
- Individuals and organizations invited to the meeting, including populations served by the organizations
- A list of individual meeting attendees and organizations represented
- Meeting agenda
- A summary of the meeting discussion
- Actions taken as a result of feedback from meeting participants
- Each year, reporting hospitals are required to complete a community benefit implementation plan that:
- Addresses the needs described by the reporting hospital’s community health needs assessment
- Includes an explanation of the community served by the hospital facility
- Describes how the community was determined pursuant
- Copy of most recently submitted form 990
- Description of investments made that were included in Part I, Part II, and Part III of Schedule H of form 990
- Indicate the cost of the investment
- Indicate whether the investment addressed a community-identified health need
- For any investment that addressed a community identified health need identify the following applicable categories:
- Free or discounted health care services
- Programs that address health behaviors or risks
- Programs that address the social determinants of health
- Spending to address individuals needs such as housing, food, transportation, interpersonal violence, education, and job opportunities
- Provider recruitment, education, research and training
- Provide evidence showing how the investment improves community health outcomes and how the investment directly corresponds to community-identified needs
- Description of total expenses included in line 18 of section 1 of submitted form 990
- Revenue less expenses included in line 19 of section 1 of the submitted form 990
Public Meeting Requirements
- Each reporting hospital is required to invite, at a minimum, representatives from the following entities to participate in the meeting:
- Local public health agencies
- Local chamber of commerce and economic development organizations
- Local health-care consumer organizations
- School districts
- County governments
- City and town governments
- Community health centers
- Certified rural health clinics or primary care clinics located in a county that has been designated by the federal office of management and budget as a rural or frontier county
- Area agencies on aging
- Health-care consumer advocacy organizations
- Safety net clinics
- 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
- Each reporting hospital is required to invite, at a minimum, representatives from the following state agencies to participate in the meetings:
- The Department of Health Care Policy and Financing, hcpf_hospitalcommunity@state.co.us
- The Department of Public Health and Environment – Michele Shimomura, michele.shimomura@state.co.us
- The Department of Human Services – Christopher Frenz, christopher.frenz@state.co.us
- The Colorado Commission of Higher Education - Megan McDermott, Megan.McDermott@dhe.state.co.us
- The Office of Saving People Money on Health Care – Isabelle Nathanson, isabelle.nathanson@state.co.us
- Division of Insurance, Department of Regulatory Agencies – Sara Bencic, sara.bencic@state.co.us
- Each reporting hospital’s annual community benefit report submitted must include, at a minimum, the following:
- Making the report available to community members by making the report publicly available on the reporting hospital’s website
- Meeting minutes
- A list of the meeting attendees
- Content of meeting discussion – any community benefit priorities discussed, and the decisions made regarding those discussed CB decision priorities
- Community feedback received and how the hospital plans to incorporate the feedback into the reporting hospital’s community benefit implementation plan
- Any data collected from attendees, such as data concerning race, ethnicity, or income
- During a hospital’s annual public community meeting, the presentation of the community benefit activities for the previous year must include:
- Reporting hospital’s discrete community benefit activities
- The amount funded for each activity
- A description of how the activities and funding amounts align with the community’s identified priorities
- Presenting proposed community benefit implementation plan, reporting hospitals must:
- Present priority areas identified in the reporting hospital's most recent CHNA and any other community benefit investment option recommended by the reporting hospital
- Each priority recommendation presented must clearly identify the source of the recommendation
- Solicit public input for any additional community benefit investment priority
- Review and incorporate the public feedback received before the reporting hospital finalizes its annual community benefit implementation plan
- A reporting hospital may only add community benefit priorities to the implementation plan if the community benefit priorities were presented at the annual meeting and the public was provided an opportunity to provide feedback. The reporting hospital must indicate whether the implemented community benefit priorities are a result of the hospital choosing the recommendations or the recommendations coming from community feedback.
HCPF Requirements
- Submit an annual summary of the hospital reports submitted including:
- Amount each reporting hospital invested in:
- Free or reduced cost health care services that addressed community identified health needs
- Programs that addressed health behaviors or risks
- Programs that addressed social determinants of health
- All services and programs that addressed community identified health needs
- Summary of investments that have been effective in improving community health outcomes
- Legislative recommendations
- Develop a website for reporting hospitals to submit reports
- Post reports on a public web page
- 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
- Amount each reporting hospital invested in:
- 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