Opinion: Hospital Community Benefit Requirements: Louder, Better

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Patients and their caregivers expect the proprietary chains of Connecticut’s nonprofit hospitals to invest in healthier communities. Women’s health, maternity services, housing, childhood immunization programs, lead reduction, transportation, and other needs identified by those directly involved in the facility’s service area should be prioritized.

How can we get there? By strengthening SB 476 — Governor’s proposal to improve community benefit laws — clarifying hospital reporting and implementing a spending floor.

To maintain their non-profit status and avoiding 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 system to cover financial assistance and compensate for lower Medicaid payment rates than other insurers.

At least 29 States to have passed laws strengthening community benefit programs with additional state requirements. Need more precision in the reports has led to increased spending on behalf of the community. Given increased community benefits spending in other states, this could result in a $100 million to $160 million increase in community benefits in Connecticut.

Improved reporting also promises to protect vulnerable communities from the loss of vital services at the hands of health chain executives unwilling to meet patient needs.

Currently, Hartford HealthCare (HHC) is trying to permanently end labor and delivery care at Windham Community Memorial Hospital (WCMH). Almost two years ago, members of our union joined Windham United to save our health care by calling on chain leaders to manufacture a decrease in births. We demanded accounts for HHC initiating the movement to justify the cuts and before seeking regulatory approval from the state’s Office of Health Strategy (OHS).

Since then, we have drawn attention to Most recent HHC Community Health Needs Assessment (CHNA). There is a significant discrepancy 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 important community needs. Still, HHC leaders are pushing ahead with their plan to keep the hospital’s maternity ward closed.

OHS fined HHC executives for breaking state law, but the maternity ward remains closed.

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

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

Always the Connecticut Hospital Association spoke out vehemently against stricter requirements for community benefits offered 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 their contribution to the health and health equity of their communities.

As a union, our responsibility is to defend fairness, transparency and accountability for our members. In keeping with these values, our member nurses and health care professionals support stronger requirements for community benefits.

John Brady, RN is Vice President of AFT Connecticut

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