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.