Public Health Intersection

The State of California requires that nonprofit hospitals do an assessment of the benefit they provide the communities they serve.

This assessment is required to occur every three years.

In the interest of full disclosure, and to provide a framework for this blog, PHFE sponsors the Orange County Health Needs Assessment, (OCHNA), which publishes a community benefit report every three years on behalf of the nonprofit hospitals serving Orange County, California.

OCHNA also provides many other reports and services on an annual, as well as, project basis.

With the passage of the first steps of health system reform, it may make sense to revisit the current approach to determining what constitutes community benefit.

For instance, oftentimes the amount of uncompensated care a hospital provides is used as a measure of community benefit.

If everyone has insurance to pay for care, uncompensated care should disappear as a need and a measure.

So what do we measure to document and verify community benefit?

At the risk of fanning the flames and shrieks of “government takeover”, I would propose that now is the time for governmental public health to assert itself in this arena.

State and local health departments are responsible for protecting and improving the health of the public.

As honest brokers, focused on the health of the entire community, shouldn’t they step up and take responsibility for identifying what ails the public and shouldn’t they also be expected to identify the barriers to better health?

I think they should and, to be fair, in most cases they do.

What seems to be missing is connecting the hospital requirement for providing community benefit to governmental public health’s responsibility for identifying the health challenges facing the community.

While some work has been done on developing more of a community focus on what should “count” as community benefit, the connection to the public health mission isn’t as strong as it could or should be.

This week OCHNA begins what could be the start of reshaping what community benefit looks like in Orange County, California.

Stay tuned.