Resolution: 25-04

Supporting Recommendations Contained In the Fiscal Year 2003 Charity Care Report Summary

WHEREAS, in San Francisco, an estimated 90,000 people under the age of 65, or 13.8 percent of the non-elderly population, are uninsured; and,

WHEREAS, many of the uninsured rely on charity care services provided by hospitals to access needed primary and acute care services; and,

WHEREAS, charity care is defined as the provision of health care services to those who cannot afford to pay and without expectation of reimbursement; and,

WHEREAS, under California law, counties have an obligation to care for their most vulnerable residents; and,

WHEREAS, in 2001, the Board of Supervisors passed Ordinance Number 163-01, the Charity Care Policy Reporting and Notice Requirement, (the Charity Care Ordinance), to enable the City to evaluate the need for charity care in the community and to plan for the continued fulfillment of its responsibility to provide care to indigents; and,

WHEREAS, nonprofit hospitals provide charity care as part of their broader social obligation to provide community benefits in the public interest; and,

WHEREAS, the Charity Care Ordinance requires hospitals to report to the Department of Public Health specific information related to the amount of charity care they provide and to notify patients of the hospital’s charity care policies; and,

WHEREAS, the charity care information provided by hospitals helps the San Francisco Health Commission evaluate the utilization of charity care services and provides an indication of the health care needs of our City’s low-income, uninsured and underinsured populations; and,

WHEREAS, the San Francisco Health Commission appreciates the efforts of San Francisco’s hospitals to comply with the Charity Care Ordinance; and,

WHEREAS, the Charity Care Report Working Group, comprising San Francisco hospitals, the Hospital Council, the Service Employees International Union Local 250, and Consumers’ Union, came together for the first time to discuss the provision of charity care in San Francisco and work collaboratively on the preparation of the Fiscal Year 2003 Charity Care Report Summary; and,

WHEREAS, in addition to reporting the charity care data provided by hospitals, the Fiscal Year 2003 Charity Care Report Summary also incorporates contextual data from a variety of sources, including the Office of Statewide Health Planning and Development, the 2000 Census, the Building a Healthier San Francisco 2004 Community Health Assessment, and the Public Health Institute’s Advancing the State of the Art in Community Benefit Demonstration Project; and,

WHEREAS, based upon data from these sources, the Fiscal Year 2003 Charity Care Report Summary makes the following findings:

• An increase in targeted outpatient charity care would benefit San Francisco;
• The Public Health Institute’s Advancing the State of the Art in Community Benefit Demonstration Project will bring planning and accountability to community benefits programming;
• Charity care eligibility for individuals on public assistance is good policy; and
• Charity Care Report Working Group is an effective planning tool; and,

WHEREAS, in accordance with these findings, the Fiscal Year 2003 Charity Care Report Summary makes the following recommendations:

• Hospitals should pursue innovative approaches to increase the provision of outpatient charity care to residents of the following high-risk neighborhoods:
• Bayview/Hunters’ Point, Potrero Hill; Tenderloin, Civic Center; and Bernal Heights, Mission;
• The Department and the San Francisco hospital community should work closely with the Public Health Institute and review the feasibility of implementing the institutional reforms recommended in the Advancing the State of the Art in Community Benefit Demonstration Project;
• The Department should continue to work with San Francisco’s nonprofit hospitals and the Department of Human Services to provide hospitals with the information they need to deem as eligible for charity care patients on public assistance;
• The Charity Care Project should continue its discussions in an effort to improve and increase the provision of charity care to low-income and uninsured San Franciscans; now, therefore be it,

RESOLVED, that the San Francisco Health Commission commends the Charity Care Report Working Group not only for working together on the Fiscal Year 2003 Charity Care Report, which creates a more complete picture of charity care in San Francisco, but also for engaging in the broader topic of improving access to needed health services for the City’s underserved communities; and be it

FURTHER RESOLVED, that the San Francisco Health Commission fully supports the recommendations put forth in the Fiscal Year 2003 Charity Care Report Summary and directs the Director of Health to work with San Francisco hospitals to implement these recommendations.

Michele M. Olson, Executive Secretary to the Health Commission