Hospital Community Benefit Plans

Overview

Health and Safety Code Section 127340-127360 requires the Department of Health Care Access and Information (HCAI) to collect and post private not-for-profit (NFP) hospitals’ community benefit plans. Pursuant to Health and Safety Code Section 127350, and in order to maintain tax-exempt status per the Internal Revenue Service’s (IRS) 501(r)(3) standard, not-for-profit hospitals are required to adopt and update a community benefit plan. NFP hospitals are required to meet certain needs of their communities through the provision of essential health care and other services.

Submit Community Benefit Plans

HCAI is currently accepting electronic copies of Community Benefit Plans at communitybenefit@hcai.ca.gov.

Request An Extension

Health and Safety Code Section ­127346 authorizes HCAI to grant a 60-day extension for submitting annual community benefit plans. If you need to request a 60-day extension, please submit your request to communitybenefit@hcai.ca.gov.

Late Submission

Health and Safety Code Section ­127346 authorizes HCAI to impose a fine not to exceed five thousand dollars ($5,000) on hospitals for failure to adopt, update, or submit community benefit plans consistent with Section 127350.

Find Community Benefit Plans

All previously submitted Community Benefit Plans can be found on the Open Data Portal. Prior year’s Community Benefit Plans are available here.

Additional Resources

Laws and Regulations

HCAI’s Hospital Community Benefits Plan (CBP) Reporting Program regulation proposal was submitted to the Office of Administrative Law (OAL), and the public comment period began on Friday April 19, 2024. All comments must be received by 5:00 p.m. on June 4, 2024. The proposed regulations are expected to be implemented on October 1, 2024. Please see the Notice of Proposed Rulemaking. Additional rulemaking documents are linked below. For more information, visit the Hospital Community Benefits Plan (CBP) Reporting Program web page.

HCAI’s Hospital Community Benefits Plan Reporting Program revised text of the proposed regulations was released for 15-day public comment period on August 26, 2024. The revisions are substantially related to the original proposed text and are being made available for public review and comment for a period of at least 15 days prior to adoption. All revisions are shown with a double underline  for new language and a double strikethrough   for deleted language. The last day to submit comments regarding the revised text of the proposed regulations is September 11, 2024. Please see the Notice of Modification to Text of Proposed Regulation. The revised text of the proposed regulations is linked below.

HCAI’s Hospital Community Benefits Plan Reporting Program revised text of the proposed regulations was released for 15-day public comment period on December 23, 2024. The revisions are substantially related to the original proposed text and are being made available for public review and comment for a period of at least 15 days prior to adoption. All revisions are noted in Italics for new language and a single strikethrough for deleted language. The last day to submit comments regarding the revised text of the proposed regulations is January 7, 2025. Please see the Notice of Modification to Text of Proposed Regulation and addition of documents added to the rulemaking file.

History of Community Benefit Plans Legislation

Senate Bill 697 (1994)

Senate Bill 697 (Torres, 1994) requires all private and non-profit hospitals to “assume a social obligation to provide community benefits in the public interest” in exchange for their tax-exempt status.

For tax-exempt status, hospitals are required to:

  • Conduct a community needs assessment every three years
  • Develop a community benefit plan in consultation with the community
  • Annually submit a copy of its plan to the Department of Health Care Access and Information (HCAI)

*This state requirement does not apply to government-owned and rural hospitals and is independent of a similar requirement in the federal Affordable Care Act.

Assembly Bill 204 (2019)

Assembly Bill 204 (Chapter 535, Amendments 2019) requires the Department of Healthcare Access and Information (HCAI) to annually prepare a report on community benefits and post the report, along with the community benefits plans submitted by hospitals on the website. In addition, this bill also includes the following:

  • Authorizes HCAI to impose fines of up to $5,000 on hospitals that fail to adopt, update, or submit community benefits plans.
  • Authorizes HCAI to grant an extension under the provisions listed as specified.
  • Hospitals will be required to assign and report the economic value of community benefits and include how needs are being addressed.
  • Expand the provisions that authorizes hospitals to file a consolidated community benefits report.
  • Require each hospital’s community benefit report to contain explanation and methods used to determine their cost.
  • Hospitals are required to post its community benefit plan on its internet website.

The bill also revises the following definitions:

  • Community benefits will exclude activities or programs used primarily for marketing purposes or more beneficial to the organization than the community.
  • “Hospitals” will include small and rural hospitals that are part of a hospital system, and to exclude certain health care district hospitals and nonprofit corporations affiliated with a healthcare district hospital, as specified.

Assembly Bill 1204 (2021)

Assembly Bill 1204 (Chapter 751, Statutes of 2021) expanded the definition of “vulnerable populations” for community benefits planning purposes and also adopted the same definition for hospital equity reporting. In addition to including populations exposed to medical or financial risk by virtue of being uninsured, underinsured, or eligible for Medi-Cal, Medicare, California Children’s Services Program, or county indigent programs, the new definition adds racial and ethnic groups experiencing disparate health outcomes, and socially disadvantaged groups. Effective January 1, 2022, hospitals will need to apply this newly expanded definition when developing their Community Health Needs Assessments.

Contact

For all inquiries related to the Community Benefit Plan Program, please contact us via email at communitybenefit@hcai.ca.gov or via phone at (916) 326-3830. The Community Benefit Plan inbox is supported Monday – Friday 8:00 a.m. to 5:00 p.m. PST, excluding State of California observed holidays.

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