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August 4, 2004/revised August 2, 2005
Community Benefits Reporting in Illinois: Definitions and Standards for ReportingThe Illinois Community Benefits Act (PA 93-0480) was enacted on August 8, 2003 and requires certain non-profit hospitals to file several types of reports with the Attorney General's office, including an annual community benefits report. The legislation outlines ten types of community benefits that must be reported: charity care, language assistant services, government-sponsored indigent health care, donations, volunteers, education, government-sponsored program services, research, subsidized health services and bad debt. Compliance instructions were issued in February 2004 by the Illinois Attorney General's office that provided broad guidance on types of costs to include in the annual report. But, quantifying the many and varied benefits that a hospital provides is a challenging task. Especially so as many organizations are increasingly complex and provide such diverse benefits to their communities based on the individual community needs. It is therefore unwise to attempt comparisons among hospitals as they are responding to their unique communities in the benefits they provide. It is important for hospitals to maintain consistency from year to year in what types of benefits they are including and if there is a significant change in what is counted, to make a note in the report as to the nature of the change. Also, hospitals that are a part of a system, should maintain consistency across the system as to what types of community benefits are reported. Catholic Health Association Guidelines and Other States It is important to note that in all documents pertaining to community benefit reporting there is an understanding that there is no one way of reporting and no one way to determine what specific services should be included or excluded. The CHA document emphasizes that their guidelines are simply that, guidelines, and that it is perfectly acceptable for organizations to develop their own criteria for community benefits. They also emphasize that their guidelines are fluid and will be revised as a result of ongoing discussion and experience. The work group examined community benefit reporting definitions from fifteen other states that required or had voluntary reporting requirements. In general, most of these states have very broad definitions similar to that in the Illinois legislation of areas to include in the community benefit report. The following outlines three specific areas of Illinois community benefit that will differ from the CHA guidelines: language assistance services, volunteers, and bad debt. In addition, Medicare shortfalls are open for debate in the CHA guidelines, while specifically included in the Illinois statute. In conversations with the CHA, it was made clear that their recommendations pertain to a quantitative report by the organization that focuses on intentional services provided as a result of community need. However, they also recommend that hospitals issue a qualitative report that would include other community benefits that better lend themselves to a narrative report, such as the amount of volunteer hours and bad debt. Bad debt reporting is usually associated with a quantitative report and should be included there for Illinois reporting purposes. The CHA report stressed that their guidelines are not intended to preclude a hospital from reporting whatever benefits it determines are justifiable for their community. Community Benefits: Illinois Specifics Language Assistant Services: Volunteers: The hospital is the conduit for such services to be provided to the community. Without the hospital, such volunteer service would likely be lost. Although volunteers provide very valuable services, these services would likely be discontinued if they required employee time. Volunteers provide such appreciated services such as accompanying patients during discharge, locating family members in the facility when there are developments with the patient, conveying test results immediately, delivering flowers and mail, etc. Also, as most of the volunteers are seniors, the volunteer time could also be looked at as a benefit for social interaction. Bad Debt: The provision of health care is different from providing other services, in that hospitals, although they may attempt to obtain financial information before service is provided, focus on providing the patient with needed health care and later try to obtain payment. In other industries, the service provider can check the customer's credit rating, ask for payment in advance, etc and is usually asking this information when the consumer is not in a health crisis and under great stress and worry. At a later time, when the provider attempts to collect payment and finds the patient unwilling to pay, their options are again limited given the nature of the service provided and the inability to repossess the service. Medicare Unreimbursed Cost: Conclusion Hospitals need to keep in mind that these are simply guidelines and hospitals are free to use their own criteria for development of these reports within the outline of Illinois law and the Attorney General's compliance instructions. The Illinois hospital community is varied and complex and their reports will reflect such diversity as they meet the needs of their own local communities. The IHA Work Group on Hospital Community Benefits urges Illinois hospitals follow these recommendations to be more consistent in reporting as a hospital community. Please feel free to contact Sandy Kraiss at (630)276-5522 or any of the members of the Work Group with questions or suggestions. The Work Group will continue to periodically review these recommendations and welcomes any input to the process. IHA Work Group on Hospital Community Benefit Members: Attachments:
Staff Contact: Sandy Kraiss: (630) 276-5522 | |
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