Resolution: 18-05

Supporting Recommendations Contained in the Fiscal Year 2004 Charity Care Report Summary

WHEREAS, in San Francisco, an estimated 83,000 people under the age of 65, or 12.5 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 health care needs of our City’s low-income, uninsured and underinsured populations; and

WHEREAS, the Charity Care Project, comprising San Francisco hospitals, the Hospital Council, Operation Access, the San Francisco Community Clinic Consortium, Service Employees International Union Local 250, and Consumers’ Union, worked collaboratively on the preparation of the Fiscal Year 2004 Charity Care Report Summary; and

WHEREAS, in addition to reporting the charity care data provided by hospitals, the Fiscal Year 2004 Charity Care Report Summary also incorporates information from a variety of sources, including the California Office of Statewide Health Planning and Development, the 2000 Census, the 2003 California Health Interview Survey, the Building a Healthier San Francisco 2004 Community Health Assessment, the 2005 Saint Francis Memorial Hospital Community Needs Index, 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 2004 Charity Care Report Summary finds that:

• Continued Increases in Outpatient Charity Care Will Benefit San Francisco;
• Promotion of the Public Health Institute’s Demonstration Project Will Advance Community Benefits for Populations with Disproportionate Unmet Needs;
• Expanded Discussion within the Charity Care Project Will Promote More Effective Planning of Access to Healthcare; and

WHEREAS, in accordance with these findings, the Fiscal Year 2004 Charity Care Report Summary makes the following recommendations:

• Hospitals should continue to pursue innovative approaches to increase outpatient charity care, especially for residents of the following high-risk neighborhoods: Bayview/Hunters’ Point, Potrero Hill; Tenderloin, Civic Center; and Bernal Heights, Mission;
• The Department and San Francisco’s hospitals should promote the institutional reforms and community benefits reporting recommended by the Public Health Institute in its ongoing demonstration project, Advancing the State of the Art in Community Benefit;
• The Charity Care Project should continue to expand its discussions to increase and improve the provision of charity care to poor, uninsured, and underinsured San Franciscans; and now, therefore be it,

RESOLVED, that the San Francisco Health Commission recognizes the Charity Care Report Working Group for working together on the Fiscal Year 2004 Charity Care Report to create a more complete picture of charity care in San Francisco, and 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 2004 Charity Care Report Summary and directs the Director of Health to work with San Francisco hospitals to implement these recommendations.

I hereby certify that the San Francisco Health Commission at its meeting of December 6, 2005 adopted the foregoing resolution.

Michele M. Seaton, Executive Secretary to the Health Commission