Saturday, April 16, 2022

Hospital community benefit requirements: stronger is better

 (As appeared in CT Mirror 3/15/22)

Patients and their caregivers expect the chains that own Connecticut’s non-profit hospitals to invest in healthier communities. Women’s health, maternity services, housing, childhood immunization programs, lead abatement, transportation, and other needs that are identified by those directly impacted in the facility’s service area should be prioritized.  

How can we get there?  By strengthening S.B. 476 — the Governor’s proposal for improving community benefit laws — by clarifying what hospitals report on and implementing a spending floor.

To maintain their non-profit status and avoid federal and state corporate income taxes as well as local sales and property taxes, hospital owners are required to make discretionary investments in “community benefits.” Today, most of those dollars go back into the chain’s system to cover financial assistance and make up for Medicaid’s payment rates being lower than other insurers’ rates. 

At least 29 states have passed laws strengthening community benefit programs with additional state requirements. Requiring more specificity in reporting has led to increased community benefit spending. Considering the community benefit spending increases in other states, this could result in an additional $100-160 million in community benefit dollars in Connecticut. 

Improved reporting also promises to protect vulnerable communities from the loss of vital services at the hands of health chain executives uninterested in meeting patients’ needs. 

Currently, Hartford HealthCare (HHC) is attempting to permanently end labor and delivery care at Windham Community Memorial Hospital (WCMH). Nearly two years ago, our union’s members joined with the Windham United to Save Our Healthcare in calling out the chain’s executives for manufacturing a decrease in births. We demanded accountability for HHC initiating the move to justify the cuts and before seeking regulatory approval from the state’s Office of Health Strategy (OHS).

Since then we’ve called attention to HHC’s most recent Community Health Needs Assessment (CHNA). There is a significant disconnect between the reported findings and the actual Community Benefits Program administered by the chain at WCMH.

The 2021 assessment identified OB/GYN services and transportation as significant needs of the community. Yet HHC’s executives are barreling ahead with their scheme to keep the hospital’s maternity ward closed.

OHS has fined HHC’s executives for violating state statute, but the maternity remains shuttered.

It’s bad enough that the chain failed to address the very OB/GYN and transportation needs identified in their own CHNA. Their executives have made matters worse by forcing pregnant mothers and babies to drive 30 minutes or more on winding two-lane roads to seek maternity care elsewhere.

Chains like HHC have lamented the fiscal challenges of the pandemic to justify such cruel cuts. Yet a majority of Connecticut hospitals saw operating gains in 2020. Acute care facilities received provider relief funds of $1.1 billion, $320 million from investments, and $40 million from patient care, and increased their net assets to over $7.6 billion. 

Still the Connecticut Hospital Association vehemently came out against stronger community benefit requirements proposed last year.

SB 476 is a good start, but it does not address hospital financial assistance policies and should go further in clarifying reporting requirements. All stakeholders, including unions, advocates and providers, must be able to hold health chains accountable for contributing to the health and health equity of their communities. 

As a union, our responsibility is to advocate on behalf of fairness, transparency, and accountability for our members. In line with these values, our member nurses and health professionals support stronger community benefit requirements. 


Sunday, April 10, 2022

AFT in the (White) House


 I visited the White House this week.

Actually, I was invited to the White House, and attended with Ivonne Hamm, another nurse and soon to retire First VP of UHP, AFT Local 3837 in Connecticut. 

We were invited to be representatives of the AFT, a union of 1.7 million members in public service, education, and healthcare. But we were really invited because the AFT is an activist union. 
As one of our T shirts says, “We care, we fight, we show up, we vote.” 
From LA to Boston, from Texas to Chicago, we are engaged not only in the workplace, but in our communities and in politics, and even with our sisters and brothers in other countries through international affiliations like Public Service International and others.
AFT members care for patients, students, and the public through our daily work and are involved in our communities because we are a part of our communities. 
When my own Senator, Chris Murphy, asked “What are you guys doing here?” I’m sure I made a joke about them letting anyone in, but the truth is, we were there because of the work of AFT members.

The White House was INCREDIBLE!

Everywhere there were staff in full military dress uniforms. In a couple of hallways they were sitting planing music as we strolled in. The main room was filled with white chairs in neat rows, like it was prepared for a wedding. We took a seat in row three, just feet from the Vice President and two Presidents.

When the music began playing and President Biden, VP Harris, and President Obama walked in to thunderous and sustained applause. Each spoke, with President Obama praising VP Harris and President Biden and making jokes about the reported “changes” in the White House since he left like the secret service being required to wear aviator glasses and a cat roaming the hallways. President Biden and VP Harris praised President Obama for his work to pass the ACA, and President Biden joked back to remind President Obama about “live mics.” The three of them truly seem to have a relationship of friendship and respect.

President Biden signed an executive order to close an unintended loophole that makes it difficult for some spouses to obtain affordable healthcare coverage under the ACA, if one spouse has coverage through work. He also spoke of extending Medicaid to all states and giving Medicare the right to negotiate with drug companies for lower costs. All of this is logical and fair, and should have no opposition, but over the years special interest groups like the drug and insurance industries have blocked them. 

Over the years, the AFT has advocated and worked for these changes, and THAT advocacy is why we were invited to the White House.