Colorado § 25.5-1-703 - Hospitals - community health needs assessments - community benefit implementation plans - reports - rules.

§ 25.5-1-703. Hospitals - community health needs assessments - community benefit implementation plans - reports - rules.

(1) On or before a date to be determined by rules promulgated by the state board, and on or before such date every three years thereafter, each reporting hospital shall complete a community health needs assessment.

(2) On or before a date to be determined by rules promulgated by the state board, and on or before such date each year thereafter, each reporting hospital shall complete a community benefit implementation plan that:

(a) Addresses the needs described by the reporting hospital's community health needs assessment;

(b) Includes an explanation of the community served by the reporting hospital; and

(c) Describes how the community was determined pursuant to 26 CFR 1.501(r)-3 (b).

(3) On or before a date to be determined by rules promulgated by the state board, and on or before such date each year thereafter, each reporting hospital shall prepare and submit to the state department a report on certain community benefits, costs, and shortfalls. The report must include:

(a) The reporting hospital's most recent community health needs assessment completed pursuant to subsection (1) of this section;

(b) The reporting hospital's community benefit implementation plan for the coming year completed pursuant to subsection (2) of this section;

(c) A copy of the reporting hospital's most recent form 990 submitted to the federal internal revenue service; and

(d) A description of certain spending and investments made by the reporting hospital during the preceding year, including:

(I) A list of the investments made by the reporting hospital that were included in part I, part II, and part III of schedule H of the reporting hospital's form 990. For each such investment, the reporting hospital shall:

(A) Indicate the cost of the investment;

(B) Indicate whether the investment addressed a community-identified health need;

(C) For any investment that addressed a community-identified health need, identify any of the following categories, which may be further defined by rules promulgated by the state board, that are applicable: Free or discounted health-care services; behavioral health; community-based health care; social determinants of health spending, including spending to address individuals' needs, such as housing, food, transportation, interpersonal violence, education, and job opportunities; and provider recruitment, education, and research and training. In identifying these categories, the reporting hospital shall distinguish direct or cash expenditures from in-kind contributions.

(D) For any investment that addressed a community-identified health need, provide evidence showing how the investment improves community health outcomes and how the investment directly corresponds to community-identified needs.

(II) The reporting hospital's total expenses included in line 18 of section 1 of the form 990 submitted by the reporting hospital or by the reporting hospital's ownership entity; and

(III) The reporting hospital's revenue less expenses included in line 19 of section 1 of the form 990 submitted by the reporting hospital or by the reporting hospital's ownership entity.

(3.5) On or before a date to be determined by rules promulgated by the state board, and on or before such date every three years thereafter, the state department shall review each reporting hospital's community health needs assessment and each reporting hospital's annual community benefit implementation plan to identify the highest priority areas as reported by communities as compared to the reporting hospital's reported spending. The state department shall include such information in the report described in subsection (7) of this section.

(4) A reporting hospital that prepares and submits a report pursuant to subsection (3) of this section shall post the report to the reporting hospital's public website.

(5) (a) The state board shall promulgate rules that establish:

(I) Reporting requirements for reporting hospitals that are not required to complete schedule H of the form 990. The rules must promote uniformity with the requirements set forth in subsection (3) of this section.

(II) Requirements for the evidence-based supporting documentation that is required pursuant to subsection (3)(d)(I)(D) of this section.

(b) A general hospital that is licensed as a general hospital pursuant to part 1 of article 3 of title 25 and that is not a reporting hospital may submit a report on certain community benefits, costs, and shortfalls that is consistent with this section.

(6) To facilitate the submission of the reports described in subsection (3) of this section, the state department shall develop and provide a website at which each reporting hospital shall submit the reports. The state department shall ensure that the website and the reports remain available to the public.

(7) As part of the report authorized in section 25.5-4-402.8, the state department shall include a summary of the reports submitted to the state department pursuant to subsection (3) of this section during the preceding year. The summary must include:

(a) The amount that each reporting hospital invested in:

(I) Free or reduced-cost health-care services that addressed community-identified health needs;

(II) Programs that addressed health behaviors or risks;

(III) Programs that addressed social determinants of health; and

(IV) All services and programs that addressed community-identified health needs;

(b) A summary of the reporting hospitals' investments that have been effective in improving community health outcomes;

(c) Any legislative recommendations the state department has for the general assembly; and

(d) The estimated federal and state income tax exemptions and the property tax exemptions received by each hospital, which shall be calculated by the department of revenue.

(8) The state department shall post the reports completed pursuant to subsection (7) of this section to a public web page that the state department creates for this sole purpose.

Source: L. 2019: Entire part added, (HB 19-1320), ch. 191, p. 2108, § 1, effective August 2. L. 2023: (2), (3)(d)(I)(C), (3)(d)(I)(D), (5)(a), (7)(b), and (7)(c) amended and (3.5) and (7)(d) added, (HB 23-1243), ch. 156, p. 673, § 3, effective August 7. L. 2024: (2)(b) amended, (HB 24-1450), ch. 490, p. 3419, § 58, effective August 7.

Cross references: For the legislative declaration in HB 23-1243, see section 1 of chapter 156, Session Laws of Colorado 2023.