While California not-for-profit hospitals can detail the community benefits they provide, putting a price tag on those claimed benefits isn't easy.
That's among the key findings of the first report on California's landmark community benefits reporting law for not-for-profit hospitals.
The 84-page report, released last week, analyzed the results of the state's 1994 community benefits reporting law.
The law, which went into effect in 1995, requires most not-for-profit hospitals in the state to report how much they provide annually in community benefits, including direct spending on charity care, and to conduct a community health needs assessment every three years.
The key problems with the law, according to the report, is the lack of standard community benefits accounting and reporting guidelines. Despite a lack of more detailed numbers, the state agency that released the report said it's pleased with what the hospitals have accomplished.
"This shows they really, on the whole, are doing a very good job, and this thing, I think, will kind of motivate them to do even more and better," said David Werdegar, M.D., director of California's Office of Statewide Health Planning and Development.
Werdegar's agency is in charge of tracking hospital community benefits under the law.
But to give at least some measure of value, the state estimated the value of hospitals' charity-care costs and government program payment shortfalls to be about $823 million in 1996 for those hospitals that were required to report their community benefits.
Last week's report includes data for 166 hospitals.
According to the findings, 205 of the state's 384 not-for-profit hospitals were required to make reports to the state. Of those required to file, some were not required to file in time to be included in the state's first review.
State, county, district and University of California hospitals are exempt from the law, as are 40 small and rural facilities. But 14 of the exempt hospitals voluntarily filed with the state.
In its report, the state agency said it would work with hospitals to find reliable ways to assign economic values to community benefits.
When California passed its law, it said not-for-profit hospitals had a social obligation to provide community benefits in exchange for the tax breaks they received. According to the report, not-for-profit hospitals covered by the law received about $380 million in federal and state income tax exemptions in 1996.
Besides California, at least seven other states have community benefits reporting laws, according to the Catholic Health Association (Jan. 26, p. 44).
According to the California report, access to care and community health education programs were the most frequently cited community needs. The community benefits most frequently cited by hospitals were health education programs and charity care, as well as counseling and support groups.