More than a few of Orange County’s prominent hospital operators deliver something in addition to their standard healthcare: “community benefits.”
Names such as Newport Beach-based Hoag Memorial Hospital Presbyterian, St. Joseph Health in Irvine, and Fountain Valley-based MemorialCare Health System are among a group of hospitals required by state law to provide such benefits in order to qualify for tax-exempt status.
Eleven of OC’s 30 largest hospitals file community benefits plans every three years with the state Office of Statewide Health Planning and Development.
The requirement grew out of Senate Bill 697, which passed in 1994. It compels all private, nonprofit hospitals to “assume a social obligation to provide community benefits in the public interest” in exchange for the facilities’ tax-exempt status.
Community Needs
The law requires those hospitals to conduct a community-needs assessment every three years; develop community benefit plans in consultation with the community; and annually submit a copy of their plans to the office.
“For us, the work we do reflects the commitment [made by] the Sisters of St. Joseph,” said Gabriela Robles, vice president, community partnerships for St. Joseph Health. The roots of the owner of St. Joseph Hospital-Orange, St. Jude Medical Center and Mission Hospital reach back to the 1920s when the Sisters of St. Joseph arrived in Orange County.
St. Joseph Health looks “at the health and quality of life” in the communities it operates in as a way to set up its community benefits plans, Robles said.
“Once an issue is identified, we use focus groups to look at all of the community’s needs and how to best provide the service.”
Robles said St. Joseph Health is working on promoting behavioral and mental health and that conversations about that goal include Hoag, which St. Joseph teams up with under the St. Joseph Hoag Health banner.
The state’s figures show that Mission Hospital contributed $41.4 million in community benefits investments in the 12 months that ended Sept. 30, 2013, the most current figure available. That number was down 14% from the $47.2 million in the year-ago period and includes Mission’s campuses in Mission Viejo and Laguna Beach.
Mission said it received more money from the state’s hospital fee program during the 12-month period, a change that led to the 14% reduction in community benefits spending. The program uses fees assessed on hospitals by the state to draw down federal matching funds, which are then issued as supplemental payments to hospitals. The increased supplemental payment resulted in the hospital spending less of its own money on community benefits.
“[The additional hospital fee] funds were primarily used to support the patient safety net,” Mission said in a statement.
“As is consistent with our mission, Mission Hospital is committed to providing assistance to community services for those who have the least financial resources,” it said. “In [fiscal year 2013], we provided close to $4 million to support community services for the poor and $2 million for community services to the broader community. This is in addition to the funds used to provide ongoing charity care and the unreimbursed costs of providing services to our community’s most vulnerable.”
At sister hospital St. Jude in Fullerton, community benefit spending was flat in the same 12-month period. It spent $46.8 million on community benefits, compared to $46.7 million in the previous period. St. Joseph Hospital-Orange spent $45.5 million on community benefits.
“A lot of our focus is on the economically poor and vulnerable” in the hospitals’ service areas, Robles said.
St. Joseph Health’s facilities fund their community benefits spending through operations. The system has a requirement that 10% of each of its hospitals’ net income goes into a fund that includes community benefit plans.
“That is non-negotiable,” Robles said.
Community benefits investment at Hoag, which has campuses in Newport Beach and Irvine, came in at more than $49 million in the 12-month period. That number didn’t include care that Medicare didn’t cover.
Hoag said in its community benefit report that its program, which was established the year after Senate Bill 697 passed, has two main purposes: providing necessary healthcare-related services that are “unduplicated in the community” and providing financial support to existing community-based nonprofit organizations “which already provide effective healthcare and related social services to meet community health needs.”
Project Wipeout
Hoag’s community benefits programs include a mental health clinic, its Health Ministries, which it describes as a “spiritually centered wellness program;” Project Wipeout, a program to promote safety at the beach, with emphases on drowning and spinal cord injury prevention; and Share Our Selves, a program that provides health and social services to more than 120,000 OC residents annually.
Children’s Hospital of Orange County provided $41.6 million in community benefits in the 12 months that ended in June 2013 between its main campus in Orange and its satellite campus in Mission Viejo.
CHOC “operates the only two tertiary, pediatric safety-net hospitals in the county that are vital members of the Orange County community,” the hospital said in its report filed with regulators.
“Both hospitals continue their steadfast organizational commitment to excellence in children’s healthcare and community benefits.”
The pediatric hospital gave examples of how it’s committed to community benefits.
It mentioned “negative margin services,” or those that are provided at a net loss to CHOC, including several pediatric clinics, recreational therapy services, community education and the Breathmobile, which provides mobile asthma care.
Community benefits, under CHOC’s definition, also encompass doctor, administrator and staff involvement in ongoing community-based organizations that serve children.
Those include CalOptima, the Orange-based health system that serves Medi-Cal beneficiaries; the Children & Families Commission of Orange County; the Coalition of Orange County Community Health Centers; Latino Health Access; and programs provided by OC school districts.
Orange Coast Memorial Medical Center provided $19.5 million in community benefits, while sister hospital Saddleback Medical Center, which has locations in Laguna Hills and San Clemente, provided $35.4 million in the 12 months that ended in June 2013.
Orange Coast and Saddleback’s totals include unpaid Medicare costs for senior citizen care.
Some of Orange Coast’s activities include health education, Vietnamese community outreach, and obesity prevention.
At Saddleback, where the population is older than the overall OC average, community benefits include health fairs and screenings geared toward senior citizens.
