At a time when crucial health care reform is underway in California, it serves no one’s purpose-especially hospital patients and the health care professionals who treat them-to engage in rhetorical mud wrestling at the Capitol over an unnecessary and flawed so-called charity care bill.
Yet that’s exactly what is happening with Assembly Bill (AB) 503, a recycled version of a failed measure from last year that would slap chains on the ability of California’s not-for-profit hospitals to meet the specific health care needs of their communities.
In the Sacramento Bee this week, columnist Bruce Maiman exposed what are distortions of fact from the California nurses union that is at the wheel of this misdirected jalopy of a campaign. Maiman found that, in direct conflict with recent comments from the California Nurses Association’s Deborah Burger, the non-partisan Legislative Analyst’s Office never said in a 2012 report that there was a problem with how charity care responsibilities are carried. Also counter to Burger’s claims, Maiman said the State Auditor never issued a recommendation in 2012 for the Legislature to reform regulations on not-for-profit hospitals, but did find these hospitals were following all applicable state and federal laws. Instead, the Auditor’s report noted that it was the Legislature’s prerogative to decide if changes are necessary.
Last year, the Legislature answered that question, killing AB 975 in the Assembly by a decisive 28-38 vote. And now this year, a new version is back. AB 503 would impose a costly scheme to redefine community benefit standards at California’s not-for-profit hospitals, limiting consumer access to neighborhood-level health care and community benefit programs. It would impose a one-size-fits-all Sacramento mandate on the types of community benefit programs that hospitals can provide.
AB 503 would require that 90 percent of a not-for-profit hospital’s community benefit spending be re-directed to charity and prescribed community health programs. This would result in dramatic cuts or outright elimination of current community benefit investments that don’t fit into the pre-determined, narrow formula. Casualties could include mobile medical clinics that screen for diabetes, high cholesterol, and other dangerous conditions, as well as neonatal care, dental screening, and adult day care programs. Grants to community programs would be jeopardized.
It makes far more sense to tailor these community outreach programs, in consultation with local groups, to meet specific local needs. And contrary to critics who are pushing AB 503, a robust level of transparency already exists. Current state law requires not-for-profit hospitals to conduct community health needs assessments and develop community benefit plans based on those assessments. These plans are submitted each year to the California Office of State Health Planning and Development (OSHPD) and are posted online for public review.
One other point of clarification arose from Maiman’s Sacramento Bee column. The nurses union behind AB 503 cites its own report that not-for-profit hospitals provide only $1.4 billion a year in public benefits. But as Maiman noted, that excludes an important fact, based on a report prepared for the California Hospital Association by former State Finance Director Tom Campbell. If both uncompensated and undercompensated care – e.g. care that is provided by hospitals for which no payment is received – is included, the actual value of those benefits climbs to $5 billion a year.
It does not serve the public good to dish up distortions or phony claims, especially when it comes to something as important as health care is to our communities. It’s clear that the sponsor of AB 503 is on another manufactured witch hunt. At the end of the day, AB 503 remains a solution in search of a problem.