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Published: Monday, 10/25/2004

Fund-raising is becoming part of health care system

Although many people don t realize it, fund-raisers at hospitals, nursing homes, and other health-care facilities eyeball patients and their families as potential donors from the day of admission.

After discharge, patients or their parents may become like college alumni solicited for donations forevermore.

Health-care philanthropy, or fund-raising, is a huge and growing business in the United States.

The Association for Healthcare Philanthropy says that hospitals and health systems got $5.5 billion in charitable gifts in 2002, the most recent year with full data. About 60 to 90 percent of gifts to nonprofit hospitals and other institutions comes from grateful patients or their families.

Patients are getting more attention during the economic slowdown.

Charitable gifts from both individuals and corporations have been lagging in recent years. That $5.5 billion in 2002, for instance, was 30 percent less than the $8 billion donated in 2001.

The money helps buy new equipment, build new facilities, and start new programs that improve the care available to everyone in the community. In addition, it helps fund a wide range of community health programs. They include mobile mammography and other cancer-screening programs; free immunization, prenatal, and other clinics for people without health insurance; and hospice care.

Many big health-care facilities, or their fund-raising foundations, have staffs that focus on getting gifts from patients.

Hospitals and other facilities typically give the fund-raisers basic information about each patient. It includes name, address, and other contact information, and age, gender, and whether the person has health insurance.

Privacy clauses in the Federal Health Insurance Portability and Accountability Act (HIPA) of 1996, which went into effect in 2003, established those limits.

Before HIPA, fund-raisers sometimes got actual medical record information. HIPA also requires fund-raisers to give patients a chance to opt out and be taken off the list for future solicitations.

At some hospitals, fund-raisers operate with a beat system, just like the system used at newspapers, where reporters cover the business, sports, or medical beats. Gift officers are assigned to specific departments in the hospital.

Physicians long have been a key part of the solicitation process raising the topic of a donation directly with their wealthier patients, or working with the institution s gift officers.

In June, however, the American Medical Association (AMA) adopted a policy stating that physicians should avoid involvement in the solicitation of their own patients. The AMA s Council on Ethics and Judicial Affairs prepared the statement.

Soliciting contributions from patients helps the community, AMA acknowledged. But it does not immediately help the patient which should be the physician s main concern.

In addition, it may make patients feel that giving or not giving will affect the quality of care they get, AMA said.

AMA cited two ethically appropriate ways in which physicians can solicit contributions: Speaking at fund-raising events and making information available in a reception area of their offices.

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