Opinions

Hospitals: Crucial players in health care reform

OPINION: 2014 is an unprecedented year for health care professionals working to implement the Affordable Care Act (ACA).  While much of the attention has been focused on helping expand health care coverage, success also depends upon the ability to deliver medical care.  Hospitals and local community benefit partners are doing everything possible to be ready for millions of additional Californians to be seen and treated.  The good news is that the State Legislature and Governor Jerry Brown share the commitment to making the ACA work.  Unfortunately, however, there are significant threats in the form of special interest bills that conflict with the ACA and will limit access to care and services.  Now, more than ever, it is critical that health care experts collaborate with legislators to prevent political agendas that would undermine historic reform.

Communities benefit through preventive care, community wellness  and education programs that address local health needs and services including trauma centers , emergency services, burn units, neonatal care, cancer research and advanced training for health care professionals.

The importance of health care access to underserved populations is clear.  Today, those local health needs are identified and prioritized in collaboration with local governments, nonprofit hospitals and community members.  These “community benefit plans” provide the framework for local hospitals to direct available resources to target local health care needs in the community.  In Sacramento, for example, Dignity Health, Kaiser Permanente, and Sutter Health jointly fund community benefit programs like Sacramento Covered, which helps low-income families obtain health insurance, and WellSpace Health, which operates a safety-net clinic providing health and primary care services to the region’s underserved population.

In Orange County, St. Joseph Health funds Healthy Smiles, a not-for-profit that operates a stationary dental clinic in Garden Grove as well as a mobile clinic that visits area schools to perform screenings and provide fluoride treatments for those who otherwise would go without.  The Healthy Smiles mission is to provide prevention and education that will help change community behaviors that would not be possible without community benefit dollars.

Bill Emmerson

Bill Emmerson

These are just a couple of examples of how California’s not-for-profit hospitals work with  community leaders to identify specific local needs, then invest hundreds of millions of dollars to meet those needs. Communities benefit through preventive care, community wellness  and education programs that address local health needs and services including trauma centers , emergency services, burn units, neonatal care, cancer research and advanced training for health care professionals.

This bill would tear a hole in our health care safety net, damaging the effective partnerships between community-based organizations and nonprofit hospitals to meet the needs of California’s diverse communities.

California’s community benefit law was the model for the federal Affordable Care Act’s community benefit and charity care guidelines.  But legislation introduced last year in Sacramento to change the law threatens to surface again in 2014 and would have devastating impacts on effective, locally-developed community benefit programs across the state.

AB 975, or any future amendments or legislation would be unacceptable if it seeks to establish a one-size-fits-all community benefit mandate with little to no regard for each community’s diverse and changing needs, and no regard for the resources that would be taken away from other health care services such as trauma, emergency or neonatal care.  In fact, the legislation seeks to hold hospitals responsible for addressing and improving every health challenge a community may face, regardless of the cost, all while expanding access and maintaining quality of care for their patients.  The regulatory burdens alone will divert resources to compliance and put community benefit programs that provide critical health care services at risk.

There are grave concerns about the proposed changes to the community benefit law and the impact on our program and patients. Without this community benefit program, many who receive care through our efforts would end up in hospital emergency rooms seeking far more expensive and complex care.  This bill would tear a hole in our health care safety net, damaging the effective partnerships between community-based organizations and nonprofit hospitals to meet the needs of California’s diverse communities.

Implementing the ACA already presents significant challenges and uncertainties, with new demands for services. Now is not the time to undermine implementation of the law by hamstringing not-for-profit hospitals in their efforts to care for the uninsured, underinsured and provide community benefits.

Let’s let the Legislature know that when it comes to community benefit programs, there’s no point in creating new expensive mandates for not-for-profit hospitals that are already meeting the needs of the local community.  We cannot let politics undermine the ACA and should be focused on making sure historic reform is successful.

Ed’s Note: Bill Emmerson is the senior vice president for state relations and advocacy for the California Hospital Association.

 


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