127345.
As used in this article, the following terms have the following meanings:(a) “Charity care” means free health services provided without expectation of payment to persons who meet the organization’s criteria for financial assistance and are unable to pay for all or a portion of the services. Charity care shall be reported at cost, as reported to the Department of Health Care Access and Information. no more than 100 percent of Medicare, consistent with the methodology in Section 127405. Charity care does not include bad debt defined as
uncollectible charges that the organization recorded as revenue but wrote off due to a patient’s failure to pay. A hospital shall not attempt to collect debt in violation of the Hospital Fair Pricing Act pursuant to Article 1 (commencing with Section 127400) of Chapter 2.5.
(b) “Community benefits plan” means the written document prepared for annual submission to the Department of Health Care Access and Information that shall include, but shall not be limited to, a description of the activities that the hospital has undertaken in order to address identified community needs within its mission and financial capacity, consistent with this article, and the process by which the hospital developed the plan in consultation with the community, local public health departments, and other stakeholders.
(c) “Community” shall be defined by the Department of Health Care Access and Information through regulation. “Community” shall include medically underserved areas and health profession shortage areas in the region. “Community” shall also include the service areas or patient populations for which the hospital provides health care services.
(d) (1) Solely for the planning and reporting purposes of this article, “community benefit” means a hospital’s activities that are intended to address community needs and priorities primarily through disease prevention and improvement of health status, including, but not limited to, any of the following:
(A) Health care services, rendered to vulnerable populations, including, but not limited to, charity care and the
unreimbursed cost of providing services to the uninsured, underinsured, and those
eligible for, but not enrolled in, Medi-Cal, Medicare, California Children’s Services Program, or county indigent programs.
(B) The unreimbursed cost of services reported on its Internal Revenue Service Form 990, Schedule H.
(C) Financial or in-kind support of public health programs, as documented by the public health department receiving the support.
(D) Donation of funds, property, or other resources that contribute to a community priority, as determined in consultation with the affected community, stakeholders, and the local public department.
(E) Health profession education and workforce training.
care cost containment.
(F) Enhancement of access to health care or related services that contribute to a healthier community.
(G) Services offered and donation of funds, property, or other resources without financial return because they meet a community need as defined in consultation with the affected community, stakeholders, and the local public health departments, and other services including health promotion, health education, prevention, public health, and social services.
(H) Food, shelter, clothing, education, transportation, and other goods or services that help maintain a person’s health.
(I) Health profession education and workforce training.
(2) “Community benefit” does not mean activities or programs that are provided primarily for marketing purposes or are more beneficial to the organization than to the community.
(3) “Community benefit” does not include any tax, fee, quality
assurance fee, or payment related to the quality assurance fee to the California Hospital Medical Center Foundation. of the following:
(A) Consistent with federal law and rules, Medicare shortfalls.
(B) Medi-Cal shortfalls that are greater than the federal upper payment limit or 100 percent of what the hospital would reasonably expect Medicare to pay for the same service.
(C) Any tax, fee,
quality assurance fee, or payment related to the quality assurance fee to the California Health Foundation and Trust.
(e) “Community needs assessment” means the process by which the hospital identifies unmet community needs for the community. community in conjunction with stakeholders in the community.
(f) “Community needs” means those requisites for improvement or maintenance of health status in the community.
(g) “Hospital” means a private not-for-profit acute hospital licensed under subdivision (a), (b), or (f) of Section 1250 and is owned
by a corporation that has been determined to be exempt from taxation under the United States Internal Revenue Code. “Hospital” does not mean any of the following:
(1) Hospitals that are dedicated to serving children and that do not receive direct payment for services to any patient.
(2) Small and rural hospitals as defined in Section 124840, unless the hospital is part of a hospital system.
(3) A district hospital organized and governed pursuant to the Local Health Care District Law (Division 23 (commencing with Section 32000)) or a nonprofit corporation that is affiliated with the health care district hospital owner by means of the district’s status as the nonprofit corporation’s sole corporate member pursuant to
subparagraph (B) of paragraph (1) of subdivision (h) of Section 14169.31 of the Welfare and Institutions Code.
(h) “Mission statement” means a hospital’s primary objectives for operation as adopted by its governing body.
(i) “Vulnerable populations” means any population that is exposed to medical or financial risk by virtue of being uninsured, underinsured, or eligible for, but not enrolled in, Medi-Cal, Medicare, California Children’s Services Program, or county indigent programs. “Vulnerable populations” also includes both of the following:
(1) Racial and ethnic groups experiencing disparately poor health outcomes, including Black/African American, American Indian, Alaska Native, Asian Indian, Cambodian, Chinese,
Filipino, Hmong, Japanese, Korean, Laotian, Vietnamese, Native Hawaiian, Guamanian or Chamorro, Samoan, or other nonwhite racial groups, as well as individuals of Hispanic/Latino origin, including Mexicans, Mexican Americans, Chicanos, Salvadorans, Guatemalans, Cubans, and Puerto Ricans.
(2) Socially disadvantaged groups, including all of the following:
(A) The unhoused.
(B) Communities with inadequate access to clean air and safe drinking water, as defined by an environmental California Healthy Places Index score of 50 percent or lower.
(C) People with disabilities.
(D) People identifying as lesbian, gay,
bisexual, transgender, or queer.
(E) Individuals with limited English proficiency.
(F) People below median income experiencing economic disparities, such as poverty, unemployment, or underemployment.
(G) People who are incarcerated or formerly incarcerated.
(H) Immigrants or refugees.
(I) At-risk youth.