You asked for information on Connecticut's “community benefits” law, including a reporting requirement for the Department of Public Health (DPH).

SUMMARY

State law requires each hospital and managed care organization (MCO) to submit a biennial report to DPH on whether it has a community benefits program (CGS § 19a-127k). If the hospital or MCO has such a program, the report must describe the program's status and the extent to which it meets certain guidelines. The original law (PA 00-57) required an annual report; PA 03-80 changed it to a biennial report.

The law defines “community benefits” as a voluntary program to promote preventive care and improve the health status of working families and populations at risk in the communities within the geographic areas of an MCO or hospital. DPH can impose a civil penalty of up to $ 50 a day on hospitals and MCOs for each day the report is not submitted.

The law also requires the DPH commissioner to summarize and analyze the required reports biennially and make summaries available to the public. (Attached is DPH's October 1, 2005 Community Benefits Report. )

COMMUNITY BENEFITS BIENNIAL REPORT

Each MCO and hospital with a community benefits program must report biennially on its status. The report must include:

1. the MCO's or hospital's community benefits policy statement;

2. the mechanism for soliciting and incorporating community participation;

3. the community health needs considered in developing and implementing the program;

4. a narrative description of the community benefits, services, and preventive health education provided or proposed;

5. measures to evaluate the program results and proposed revisions;

6. to the extent feasible, a program budget and a good faith effort to measure program expenditures and administrative costs, including cash and in-kind support; and

7. a summary of the extent to which the MCO or hospital has developed and met certain community benefit guidelines the act establishes.

The hospital or MCO must make a copy of report available to the public upon request.

COMMUNITY BENEFIT GUIDELINES AND PRINCIPLES

Under the law, an MCO or hospital can develop community benefit guidelines designed to promote preventive care and improve the health of working families and populations at risk, whether or not they are hospital patients or MCO members. The guidelines must focus on:

1. adopting and publishing a community benefits policy statement;

2. responsibility for overseeing the development and implementation of the community benefits program, resources to be allocated, and regular program evaluation;

3. assistance and meaningful participation from the communities in an MCO's or hospital's service area in defining the targeted population and specific health needs to be addressed (the hospital or MCO must give priority to the public health needs outlined in DPH's most recent state health plan); and

4. developing the program based on an assessment of the health care needs and resources of the targeted populations, particularly low-and middle income medically underserved populations, and barriers to access to health care such as cultural, language, and physical barriers.

DPH SUMMARY OF REPORTS

The law requires the DPH commissioner to summarize and analyze the community benefits program reports and review them for adherence to the guidelines. The commissioner must make the summary and analysis available to the public biennially.

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