Competency reviews trap people in Pa. jails

A six-month investigation by Spotlight PA and the Pittsburgh Institute for Nonprofit Journalism found that Pennsylvania laws and policies meant to aid people who have severe mental health issues and have been accused of a crime often do just the opposite.

The investigation also found there is no single state agency tracking what happens to people once their competency is questioned.

Instead, a patchwork of state and local agencies facilitates the detention, treatment, and trial of someone found incompetent, with little oversight.

The result is a system that can strand people with serious mental health needs in jail, where their conditions may worsen; a system that prolongs detention for low-level crimes that experts say are often a symptom of mental illness; and a system so broken, some defense attorneys avoid it altogether.

Also this week, Gov. Josh Shapiro has proposed his first budget as Pennsylvania's chief executive. He is calling for $1 billion in new education spending, permanent state funding for public defenders, and an expansion of a shrinking rebate program for older people.

Finally, state Rep. Mike Zabel (D., Delaware) will resign later this month after being accused of sexual harassment by at least four people. Zabel, an attorney who was first elected to a suburban Philadelphia district in 2018, initially rebuffed calls to resign, telling leadership he would seek inpatient treatment for an unnamed illness.
 

"There were a lot of things we can all get on board with. We just have to figure out how we’re gonna pay for those things."

—State Senate President Pro Tempore Kim Ward (R., Westmoreland) reacts to Democratic Gov. Josh Shapiro's first budget

VITAL DATA: Join us during Sunshine week on Thursday, March 16 from 6-7 p.m. on Zoom for a free panel on health care reporting in Pennsylvania, how we fight for open records, and your rights under the Right-to-Know Law. Register here and submit your questions to events@spotlightpa.org. 
 

What new court rulings mean for Pa.'s nonprofit hospitals

A Commonwealth Court judge recently revoked a Southeastern Pennsylvania hospital’s property tax exemption and denied appeals regarding three others, decisions that one expert said should serve as a “warning shot” for nonprofit facilities statewide.

In response to a case brought by the Pottstown School District, Judge Christine Fizzano Cannon found that the nonprofit Tower Health system was operating a Montgomery County hospital with the motive of profit. She also upheld rulings that three Chester County hospitals owned by Tower Health aren’t eligible for property tax exemptions.

In Pennsylvania, a nonprofit organization must prove it is a “purely public charity” to qualify for a property tax exemption. The state Supreme Court in a 1985 ruling created five standards. An organization must show it:

• Advances a charitable purpose. 

• Donates or renders gratuitously a substantial portion of its services. 

• Benefits a substantial and indefinite class of persons who are legitimate subjects of charity.

• Relieves the government of some of its burden.

• Operates entirely free from private profit motive.

Cannon said that Tower Health charged the hospitals exorbitant management fees and rewarded executives for the financial success of the hospitals, meaning it did not meet the fifth standard. 

Tower Health did not respond to a request for comment about whether it plans to appeal. Court records show the three Chester County hospitals have filed motions for reconsideration.

Pennsylvania schools are primarily funded by property taxes, and tax exemptions can add up to millions of dollars every year. 

Stephen Rodriguez, superintendent of the Pottstown School District — which brought the case against Pottstown Hospital and Tower Health —said the tax exemption made the district lose out on roughly $900,000 annually. 

“A million dollars is, you know, 10, 12 teachers,” he said.

Of the state’s 148 general, medical, and surgical hospitals, 131 were nonprofits in 2021, according to the Pennsylvania Department of Health.

Cannon’s decisions are a “warning shot” to those facilities, said David Hyman, a professor of health law and policy at Georgetown who studies nonprofit hospitals’ tax exemptions. But the repercussions for other hospitals, he said, will depend, in part, on whether local taxing authorities are willing to bring lawsuits. 

The last time there was a significant push by taxing authorities to challenge the tax-exempt status of hospitals in Pennsylvania was three decades ago, Modern Healthcare reported. 

In 1990, an Erie County judge ruled the parent corporation of Hamot Medical Center used the hospital to generate money for real estate investments. The facility lost its exemption.

Three years later, the hospital regained tax-exempt status and agreed to pay 50% of the taxes it would otherwise owe to the city, the county, and the school district. The hospital, now UPMC Hamot, currently has a similar agreement.

Since then, several other hospitals in Pennsylvania have also agreed to make payments in lieu of taxes, or PILOTs, in order to avoid the risk of litigation. —Ashad Hajela, Spotlight PA State College

Read the full version of this story next week on spotlightpa.org.

BOARD WARS: 

» ABC 27: State Senate confirms Shapiro's pick for AG

» AP: Pennsylvania school allies criticize Shapiro’s budget plan

» INQUIRER: Lawmakers want to make insurers pay for virtual health care

» PENNLIVE: How much do state government workers make?

» PRISM: Hospital moves to deport undocumented woman in a coma