Our Policy Agenda
In alignment with our strategic issues, BACH supports and advocates for the following policy initiatives at the local, city and state levels:
Community Benefits Guidelines
All not-for-profit hospitals and health plans provide Community Benefits. They are required to complete a Community Health Needs Assessment (CHNA) every three years by both the Affordable Care Act and the Massachusetts Attorney General’s Office. These community benefits are voluntary but the Attorney General’s Office has guidelines both for what can be deemed a “community benefit” and a recommendation of how much each institution should aim to contribute towards community benefits.
Originally established in 1994, the Guidelines were most recently revised in 2009. The MA Attorney General’s Office is planning to revise the guidelines once again in 2017. One goal of the revision will be to align them with the recently revised Determination of Need requirements (see below).
Additionally, all Boston hospitals (with the exception of Boston Medical Center) completed their most recent CHNA in 2016. BACH and the Conference of Boston Teaching Hospitals (COBTH) collaborated with 5 of the hospitals to do community gatherings and focus groups in various neighborhoods in which the same questions were asked, in order to collect similar data from different neighborhoods. COBTH members have committed to do a collaborative CHNA for the 2019 triennial cycle, which would support community benefit program. BACH is committed to helping make this an inclusive and informative process.
Determination of Needs Regulations
An important source of funding for community health is the Massachusetts’ “Determination of Need” (DoN) process. When a health care institution intends to build a new facility or make a major capital purchase, it is required to file a DoN application with the Massachusetts Department of Public Health (MDPH). If the application is approved, the applicant facility then provides the equivalent of 5% of the capital outlay to support community health initiatives (CHI) which are non-clinical initiatives that, for the most part, take place outside of the hospitals and address a range of social determinants of health: built environment, social environment, housing, violence, education and employment. MDPH revised the DoN regulations and CHI Guidelines in 2017.
In addition to addressing MDPH’s health priorities, the CHI can also address other needs identified by hospitals’ Community Health Needs Assessments (CHNA) as well as other community needs assessments and community health improvement plans (CHIP) such as Boston’s CHIP which is based on the assessment BACH did on collaboration with the Boston Public Health Commission, the MAPP Report. BACH and other community groups serve as planning partners to prioritize the use of the CHI funds. The Planning Partners can design additional data and community opinion information in a variety of ways including additional surveys, on-line interactive games, and additional community meetings.
Having established the funding priorities the hospital then needs to develop and implement a process for determining exactly how the funds will be used and distributed. This is often in the form of a Request for Proposals process and evaluation of the merits of the specific proposals. Funding can be distributed over a number of years, usually 3-7 years.
Fight for 15
This legislation, H.2365 (filed by Rep. Dan Donahue) and S.1004 (filed by Sen. Ken Donnelly), would raise the state’s minimum wage by $1 each year over four years until it is $15 an hour in 2021. The minimum wage would then be adjusted each year to rise along with increases in the cost of living.
Our state’s economy works best for everyone when all working people are able to meet their basic needs. This economic security depends on access to good paying jobs. But today, a full-time worker in Massachusetts earning the current minimum wage of $11 an hour makes only $22,880 a year. A minimum wage earner would have to work 94 hours every week in order to afford a two-bedroom apartment. Many workers earning the minimum wage work three or more jobs and still can’t afford the cost of groceries, housing, heating and other basic needs.
Great Neighborhood Initiatives
H.2420: An Act Building for the Future of the Commonwealth
Sponsored by Reps. Stephen Kulik and Sarah Peake, the goal of this legislation is to reform our state’s planning, zoning, and permitting laws to support communities that work for families and seniors. Great neighborhoods make it possible for young families and seniors to stay in their communities by providing housing choices. They support thriving local businesses and are healthy, walkable places that preserve open space. Supporting great neighborhoods is vital for the long-term economic success of our communities and our state.
Housing Bond Bill
H 675: An Act Financing the Production and Preservation of Housing for Low and Moderate Income Residents
The Housing Bond Bill proposes a comprehensive approach to addressing the housing needs of the Commonwealth by providing resources to produce and preserve affordable housing. Sponsored by Rep. Kevin Honan & Sen. Linda Dorcena Forry, this legislation invests $1.7 billion in an affordable housing bond bill. This five-year authorization will provide critical funding for the production, preservation, and modernization of public and affordable housing in communities across the Commonwealth. The bill also extends the state Low Income Housing Tax Credit (LIHTC) and expands the annual authorization by $5 million for supporting the preservation of affordable housing at risk of being lost due to expiring affordability restrictions.
Jim Brooks Community Stabilization Act
Boston was named as the city with the third highest rate of income inequality and 4th highest in foreign speculation in the US, as well as one of the most rapidly gentrifying cities. Though wages remain stagnant, housing costs have skyrocketed. This puts thousands of families, especially low income & working class communities of color, at risk of being displaced from their homes and communities.
Landlords, tenants and homeowners have come together to introduce Just Cause Eviction legislation to put the brakes on displacement by protecting vulnerable renters.
The Jim Brooks Community Stabilization Act would:
- Require landlords to provide a reason when seeking to evict a tenant, like failure to pay rent, damaging property, or breaking a lease. Landlords who own 6 or fewer units will be exempt.
- Require owners to notify the City of any Notice To Quit issued to tenants, improving data collection about evictions.
- The City would be required to notify the tenant of their rights under current state law.
Jobs Not Jails
Jobs Not Jails is a statewide coalition end mass incarceration and redirect costly prison spending towards jobs, training and support for Massachusetts’ lowest income communities. Incarceration is up 236% since 1980 even though crime is down 26%. As a nation, in 2014, the rate of imprisonment for African-Americans was 5.8 times greater than for Whites; BUT in Massachusetts, it was nearly 8 times greater. As a nation, in 2014, the rate of imprisonment for Hispanics was 1.3 times greater than for Whites; BUT in Massachusetts, it was nearly 4.9 times greater. Within 3 years release from state DOC prison, over 1/2 of DOC releases and 2/3 House Of Correction releases had new criminal justice involvement. This hurts the prisoner, their family, the community, new victims, and taxpayers.The Justice Reinvestment Act, filed by Rep. Mary Keefe (HD 2714) and Sen. Sonia Chang-Diaz (SD 112B) goals are to:
- Raises the threshold for what’s a felony theft from $250 (the third lowest in the nation) up to $1500;
- Lowers probation and parole fees such as the $65 a month ex-prisoners have to pay in parole fees when ex-prisoners are already working at low wage jobs;
- Lessens the “sealing time” before employers can no longer see court appearances on a CORI (Criminal Offender Record Information). The current times leads people not to be able to be hired when they are released from prison;
- Increases funding for in-prison education and job training, and increases funding for reentry services especially for job training and job placement;
- Possible medical release of terminally ill prisoners if a judge approves.