Hospital Topics


CDPH Licensing & Enforcement

The California Department of Public Health (CDPH) Licensing and Certification surveyors may visit a hospital at any time to determine whether the hospital is in compliance with state licensing requirements. Visits may result from a complaint by a patient, employee or other third party; a newspaper article; or a report by the hospital itself regarding an unusual occurrence, privacy breach or adverse event.

CHA News Article

2015-16 State Budget Increases Funding for Licensing Oversight in Los Angeles County

The 2015-16 state budget provided the California Department of Public Health’s (CDPH) Licensing and Certification (L&C) Division with additional funds to augment its contract with Los Angeles County. L&C has a long-standing contractual relationship  for Los Angeles County to provide licensing and certification oversight to facilities in the county. Recently, L&C renewed its contract with the county, including increased funding to hire approximately 70 additional L&C staff. In recent years, L&C (including its work in Los Angeles County) has been under scrutiny to improve performance related to timely completion of complaint investigations and mandated licensing surveys.

To allow Los Angeles County sufficient time to hire and train additional staff, the contract provides that CDPH L&C will assume the non-long-term care facility complaint investigations for one year, including hospitals and acute psychiatric facilities. Hospitals in Los Angeles County should continue to report adverse events and unusual occurrences to the county as usual. However, investigations may be performed by staff from other CDPH district offices.

L&C calculates provider fees based on the associated survey activity within each provider category (hospital, clinic, etc.). As L&C is able to hire and train additional staff and complete more survey work, provider fees may increase in coming years.

CHA News Article

CDPH Issues Hot Weather Advisory for Hospitals

The California Department of Public Health (CDPH) has released the attached All Facilities Letter (AFL) as a hot weather advisory to remind health care facilities that elderly patients and individuals with high health risk are more vulnerable in extreme heat and at risk of dehydration. The advisory outlines precautionary measures and informs health care facilities that they must have a contingency plan for facilitating patient safety during fluctuating high temperatures and any loss of air conditioning. CDPH also notes that health care facilities must report emergency/disaster-related occurrences, including extreme heat conditions, that could harm a patient’s health and safety, necessary evaluation, transfer or discharge. 

CHA News Article

CDPH Begins Pilot Testing for Hospital Relicensing Survey Process

The California Department of Public Health (CDPH) has announced the beginning of Phase II pilot testing for a new general acute care hospital relicensing survey process.

According to CDPH, its new survey process will evaluate general acute care hospitals’ compliance with state statutory and regulatory licensure requirements, including requirements previously evaluated through the Medication Error Reduction Plan and patient safety licensing surveys. The goal of the pilot-testing phase is to ensure the process will produce consistent, fair and useful information for both facilities and consumers before statewide implementation. For more information and for resources facilities may use to assess their readiness for the upcoming surveys, see the attached All Facilities Letter.

CHA News Article

CDPH Re-Issues AFL Related to California Hospital Fair Pricing Policies
Outlines recent changes to law under SB 1276

On Dec. 4, the California Department of Public Health (CDPH) re-issued an All Facilities Letter (AFL) notifying hospitals of recent changes to hospital fair billing policies — including charity care and discount payment plans — as a result of the enactment of SB 1276 (Chapter 758, Statutes of 2014). CDPH’s previous AFL 14-25 (dated Nov. 3) inaccurately stated that SB 1276 expands the availability of charity care and discount payment plans to all patients with high medical costs, including patients with third-party coverage. Under current hospital fair pricing policies, all uninsured patients or patients with high medical costs who are at or below 350 percent of the federal poverty level (FPL) are eligible to participate under a hospital’s charity care or discount payment policy (Health & Safety Code Section 127405(a)(1)(A)). The revised AFL clarifies the meaning of “patients with high medical costs” as “a person whose family income does not exceed 350 percent of the federal poverty level.”


Responding to Licensing and Certification Deficiencies Webinar
New CDPH penalties, working with surveyors, plans of correction, appeal process

Webinar Recorded Live on May 21, 2014


You’ve received a licensing violation. You may have been expecting it from a recent survey, or it may have come as a complete surprise. One thing is for certain, survey activity — and subsequent violations — will be more common now that California Department of Public Health (CDPH) has issued new regulations for hospital penalties, including non-immediate jeopardy violations.


Community Benefit Programs
Hospitals give back to their communities

Health care is undergoing tremendous change and uncertainty as California implements the federal Affordable Care Act (ACA). Hospitals are working to ensure there will be enough beds and an adequate supply of health care professionals to meet the demands of the millions of Californians who are signing up for health insurance coverage under the ACA. In addition, California hospitals are meeting the needs of their communities through locally developed community benefit plans by supporting health care programs that provide preventative care to those in need.

Tax-Exempt Status of Nonprofit Hospitals

The tax-exempt status of nonprofit hospitals is being reviewed by policymakers, regulators and public interest groups. There are various proposals to impose burdensome and inflexible standards on nonprofit hospitals in order to obtain tax-exempt status and financing. CHA supports the development of appropriate guidelines that are not unduly burdensome and will allow sufficient flexibility to ensure nonprofit hospitals are able to carry out their mission. They must be based on broad measures of community benefit without establishing rigid formulaic thresholds.

CHA News Article

CDC Announces New Community Health Improvement Navigator Framework and Tool
Website designed as one-stop-shop of tools and resources

The Centers for Disease Control and Prevention (CDC) recently launched a new website to support hospitals, health systems, public health and other community organizations interested in improving the health of their communities. Called the Community Health Improvement Navigator (CHI Navigator), the site is also intended for tax-exempt hospitals complying with the IRS final rule on community health needs assessments for charitable hospitals. 

CHI Navigator was designed as a one-stop-shop of expert-vetted tools and resources for individuals who lead or participate in CHI work within hospitals and health systems, public health agencies and other community organizations, to assist with:

CHA News Article

CHA Video Highlights Community Benefit of Interactive Cooking Lessons in San Diego

To help promote its sponsored bill AB 1046 (Dababneh, D-Encino), CHA has released a short video highlighting the effectiveness of nonprofit hospital community benefit programs. AB 1046 provides for greater transparency in nonprofit hospitals’ reporting of their community benefit programs such as the Teaching Kitchen. Introduced this week, AB 1046 would align state and federal laws to eliminate conflicting reporting requirements, ensuring hospitals can focus on investing in their community’s needs instead of spending resources on conflicting governmental mandates.

CHA News Article

CHA Sponsors Bill on Community Benefits Reporting for Nonprofit Hospitals
New legislation would strengthen hospitals’ ability to meet community health needs

Assemblymember Matt Dababneh (D-Encino) has introduced legislation to provide greater transparency and consistency in the reporting and disclosure of investments made by nonprofit hospitals to strengthen the health and well-being of the communities they serve. Sponsored by CHA, AB 1046 amends California law so nonprofit hospitals’ community benefit reports will be more accessible to the public. The reports include a hospital’s in-house investments, highlight hospital partnerships with local nonprofits and clinics, and account for costs — above state-funded reimbursements — to care for patients enrolled in Medi-Cal. The bill would also align federal and state community benefits laws, streamlining administrative mandates so that hospitals can focus on addressing local health care needs. Every year, California hospitals provide more than $13 billion in uncompensated health care services.


Clinical Care

Clinical care touches every aspect of hospital operations. Policies and procedures surrounding clinical care are of the utmost importance in meeting regulatory, legal and licensing requirements. CHA has numerous area-specific groups — including specialty centers and committees — that address the many aspects of clinical care. Some areas of clinical care are subject to rapid changes in public policy and regulations, creating additional challenges for hospitals. In addition to providing representation and advocacy to address these challenges, CHA focuses on the unique needs of certain facilities, and the services and programs they offer their communities.

CHA News Article

Budget Gives CDPH New Investigation Timelines
Also adds L&C positions to address survey activities

The 2015-16 state budget provides the California Department of Public Health’s (CDPH) Licensing and Certification (L&C) Division with 237 additional positions to assist with its workload, including addressing “past failures to complete its survey workload and close/complete complaint investigations.” In addition, the budget increases hospital fees and adjusts the timelines for CDPH to complete investigations of skilled-nursing facilities (SNFs).

Many provider fees were increased in the budget to correspond to the associated survey activity within each type of provider (hospital, clinic, etc.). Hospitals and SNFs will likely experience increased survey and investigation activities as L&C will have additional staff to complete this work. In addition, providers fees may increase in coming years as the L&C workload continues to increase.

CHA News Article

Clinical Imperatives to Be Focus of Third PHM Webinar

The third webinar in CHA’s five-part certification series on Population Health Management (PHM) is scheduled for July 14 from 9:30 –11:30 a.m. Titled Clinical Imperatives of Population Health Management, the webinar offers valuable information for a variety of clinical professionals, including chief medical officers, chief nursing officers, quality directors, outpatient and rehabilitation services directors, and individuals with supervisory responsibility for clinical staff.


Advanced Decision Making for EMTALA Webinar
EMTALA principles, case scenario learning, surveyor compliance tips

Webinar Recorded Live on November 14, 2014


Whether you are a sending or receiving hospital, many factors must be considered when dealing with a potential EMTALA situation. Knowing the right thing to do isn’t easy, especially in a stressful or busy emergency department.


Minors Health Care — The Basics of Consent, Privacy and More Webinar
Learn about the rules, exceptions to the rules, practical solutions to common problems

Webinar Recorded Live on October 29, 2014


This scenario plays out in hospitals every day: grandmother, teacher, neighbor or concerned friend brings a minor to the hospital. No parent in sight. Now what?

Can you treat the minor? Whose consent do you need? Who should you talk to about the minor’s treatment options? These are all too common questions that often challenge the most seasoned health care providers.


Construction / Renovation

In the area of construction and renovation, CHA assists hospitals by reviewing and commenting on proposed regulations, attending all Hospital Building Safety Board (HBSB) meetings, nominating hospital representatives to the HBSB Board and serving as liaison between hospitals and the Office of Statewide Health Planning and Development’s (OSHPD) Facility Development Division when issues need to be resolved.

CHA News Article

Hospitals With SPC 1 Buildings Must Submit Reports to OSHPD by Nov. 1

CHA reminds members that all hospitals with one or more Structural Performance Category 1 (SPC 1) buildings must submit a report to the Office of Statewide Health Planning and Development (OSHPD) on or before Nov. 1, 2015. As Nov. 1 falls on a Sunday this year, CHA encourages submission of the report by Oct. 30. Hospitals that fail to submit the mandatory report by the statutory deadline will be assessed a fine of $10 per licensed acute care bed per day, not to exceed $1,000 per day for each SPC 1 building, until they comply with the reporting requirements. More information about compliance is available at the OSHPD website. For questions or help completing the online report, contact Brett Beekman at (213) 897-3264 or by email at

CHA News Article

HVAC Guidance Available for ORs, Sterile Processing Departments

An HVAC task force, whose members include the American Hospital Association’s American Society for Healthcare Engineering (ASHE), has issued the attached interim guidance to help health care facilities maintain appropriate temperature and humidity control in operating rooms and sterile processing departments while it works to achieve consensus on conflicting standards. Among other actions, the task force said it plans to explain the conflicting standards to accreditors and state licensing agencies and ask them to work with health care organizations to establish a plan for resolving variance.

In addition to ASHE, task force members include the American Society of Heating, Refrigerating and Air-Conditioning Engineers; Association for the Advancement of Medical Instrumentation; Association for Professionals in Infection Control and Epidemiology; Association of periOperative Registered Nurses; and the Facility Guidelines Institute. 

CHA News Article

Redesigned Radiation Treatment Resource Launched

The Department of Health and Human Services (HHS) has launched a redesigned online radiation treatment resource. The first major redesign of the Radiation Emergency Medical Management (REMM) website since it launched in 2007 is available at Intended to help health care professionals find reliable guidance to help diagnose and treat patients who have been exposed to radiation, the site provides information about radiation injuries and access to interactive clinical tools and data. Physicians and medical staff also can download a majority of the information from the website to use during an emergency if the Internet is not accessible, and a smartphone app containing REMM information is available for the Apple and Android platforms. The REMM site is a collaboration of the HHS Office of the Assistant Secretary for Preparedness and Response and the National Library of Medicine, part of the National Institutes of Health. More information is available at

CHA News Article

OSHPD, Hospital Building Safety Board to Offer Hospital Construction Seminars

OSHPD has announced a one-day seminar titled “Building Relationships for a Successful Project,” intended to educate architects, engineers, hospitals, contractors and others on leveraging relationships to encourage successful project outcomes. The program will be offered on two dates: Oct. 21 in Anaheim and Oct. 27 in Concord. Attendees are encouraged to register soon, as space is limited. 

CHA News Article

Governor Signs CHA-Sponsored Bill on Medical Waste Management

Gov. Brown has signed SB 225 (Wieckowski, D-Fremont), a bill sponsored by CHA to clarify and streamline requirements of the Medical Waste Management Act. The bill took effect immediately upon signature by the Governor on Sept. 28. The bill:

  • Clarifies the definition of biohazard bag.
  • Requires a hazardous waste transporter of medical waste to maintain a tracking document, as specified, for the purpose of tracking medical waste from the point when the waste leaves the generator facility until the waste receives final treatment.
  • Requires the tracking document to be maintained only by hazardous waste transporters, and not by generators transporting waste.
  • Revises the container labeling requirements for specified medical wastes from “HIGH HEAT OR INCINERATION ONLY” TO “HIGH HEAT” or “INCINERATION ONLY.”

Details about the new law can be found at


Emergency Preparedness
Is your hospital prepared?

Visit CHA’s Emergency Preparedness website at


Through the Office of the Assistant Secretary for Preparedness and Response, Office of Preparedness and Emergency Operations, Hospital Preparedness Program (HPP) grant, CHA has created a web site specifically devoted to Emergency Preparedness at

CHA News Article

Homeland Security Calls For Enhanced Vigilance After Paris Terrorist Attacks

Following the terror attacks in Paris last week, the U.S. Department of Homeland Security (DHS) has issued a reminder to all health care providers to review with employees the importance of situational awareness and vigilantly watching for behaviors, objects and activities that depart from the norm of their experience.

CHA News Article

CDC Updates Screening Guidelines for Travelers from Sierra Leone
Active monitoring of travelers to be stopped

Effective Nov. 10, the Centers for Disease Control and Prevention (CDC) has updated its enhanced Ebola entry screening and monitoring program for travelers returning from Sierra Leone, and will no longer require active monitoring of those travelers. The California Department of Public Health (CDPH) has revised its procedure for monitoring returning travelers in accordance with the updated CDC guidelines. CDPH will continue to notify local health departments of travelers from Sierra Leone arriving in their jurisdictions; however, active monitoring of the traveler is not required. Guidance documents from both the CDC and CDPH are attached. 

CHA News Article

CDPH Announces Disease-Spreading Mosquitoes Detected

The California Department of Public Health (CDPH) this week issued a warning to all Californians about two invasive species of mosquitoes that have been found in different areas of the state. Both species are known to transmit infectious diseases, such as dengue fever, chikungunya and yellow fever. In September, the yellow fever mosquito was detected for the first time in San Bernardino and Riverside counties. Also in September, the Asian tiger mosquito was detected in Kern and San Diego counties and has expanded in regions of Los Angeles County. Neither of the mosquitoes is native to California. They are known for their black-and-white stripes, biting people during the middle of the day and readily entering buildings.

More information about the mosquitoes, how the diseases are spread and precautions Californians should take to prevent illnesses spread by mosquitoes is available at the CDPH website and in the attached press release.

CHA News Article

Redesigned Radiation Treatment Resource Launched

The Department of Health and Human Services (HHS) has launched a redesigned online radiation treatment resource. The first major redesign of the Radiation Emergency Medical Management (REMM) website since it launched in 2007 is available at Intended to help health care professionals find reliable guidance to help diagnose and treat patients who have been exposed to radiation, the site provides information about radiation injuries and access to interactive clinical tools and data. Physicians and medical staff also can download a majority of the information from the website to use during an emergency if the Internet is not accessible, and a smartphone app containing REMM information is available for the Apple and Android platforms. The REMM site is a collaboration of the HHS Office of the Assistant Secretary for Preparedness and Response and the National Library of Medicine, part of the National Institutes of Health. More information is available at

CHA News Article

CDC Issues Health Advisory Update on Reusable Medical Devices

The Centers for Disease Control and Prevention (CDC) has issued an update to September’s CDC Health Alert Network (HAN) 382, rescinding the recommendation that third-party vendors be certified or approved by the manufacturer to maintain or repair reusable medical devices. CDC HAN 383 provides additional clarification and recommendations on proper cleaning, disinfection and sterilization of reusable medical devices and emphasizes the importance of compliance with recommended reprocessing procedures. 


Environmental Health & Safety

CHA assists hospital environmental health and safety (EH&S) officers and other hospital personnel regarding compliance with the many — and frequently overlapping — state and federal EH&S requirements, including those related to  managing medical, hazardous and low-level radioactive waste. CHA also monitors EH&S legislation and regulation on behalf of hospitals and acts as their liaison with government agencies.  

CHA News Article For Members

CHA Provides Written Testimony on Proposed Prop. 65 Regulations
Comments on Cal EPA’s clear and reasonable warning regulations

CHA has submitted the attached comments to Cal EPA’s Office of Environmental Health Hazard Assessment (OEHHA) about proposed regulations related to Proposition 65 and prescription drug exposure warnings. CHA worked with the California Medical Association to develop new language to recommend to OEHHA, based on informed consent under prescribed conditions. In the comments, CHA also expressed concerns about the proposed regulations’ costs to California businesses — a minimum of $410 million, according to an analysis by the California Chamber of Commerce.

CHA News Article

New Amendments to Medical Waste Management Act Explained in Thursday Webinar
Still time to register for this important update

Significant new amendments — effective Jan. 1, 2015 — were made to the Medical Waste Management Act by AB 333 (Statutes of 2014). CHA will hold a webinar in conjunction with the California Department of Public Health (CDPH) on March 19 from 9 a.m. – 10 a.m. to explain the impact of those changes on the daily operations of hospitals and their handling and disposal of medical waste.

Webinar topics include CDPH and local enforcement agency inspections; new requirements for labeling, bagging and shipping forms; changes to the Medical Waste Management Plan; common violations; penalties for non-compliance; and Department of Transportation and CDPH regulations for medical haulers. The program is recommended for all staff in charge of medical waste at hospitals. For more information and to register, visit

In addition, CDPH will hold a series of stakeholder and technical advisory meetings — beginning March 25 in San Jose — to gather input on the interaction of federal and state law for the transport of regulated medical waste.

CHA News Article

CDPH Stakeholder Meetings on Medical Waste Haulers Begin March 25

The California Department of Public Health will hold a series of stakeholder and technical advisory meetings — beginning March 25 in San Jose — to gather input on the interaction of federal and state law for the transport of regulated medical waste. The meetings are being held in accordance with AB 333 (Chapter 564, Statutes of 2014), the Medical Waste Management Act. CDPH will use the information gathered at the meetings to inform a report that must be submitted, according to AB 333, to the Legislature by Jan. 2, 2016. All individuals responsible for medical waste management at hospitals are encouraged to attend at least one of the sessions.

Technical Advisory Meetings

March 25 – San Jose
100 Paseo de San Jose, Auditorium

10  a.m.      This portion of the meeting is designated for transporters, treatment facilities, and transfer stations
1:30 p.m. This portion of the meeting is designated for generators (i.e.,  hospitals, clinics, dental offices, etc.)



Hospital finance is complicated, and California hospitals operate in a challenging environment. Hospital executives are faced with the task of developing financial strategies that contain costs yet allow for the provision of health care to the state’s large uninsured population.

CHA News Article

Second Webinar in Population Health Management Series Is June 2
Still time to register for full series; catch up with access to program recording

The second of CHA’s five-part certification series on Population Health Management (PHM) continues June 2 from 9:30 –11:30 a.m., with the webinar Business Imperatives of Population Health Management. Registration remains open for all programs, including the April 28 webinar. Though the initial webinar has been held, it’s easy to catch up by viewing the recorded program.

“The value-driven approach to care delivery and financing under PHM alters the established business fundamentals,” said Anne McLeod, CHA’s senior vice president for health policy and innovation. “Hospital leaders will need to actively manage the transition and the impact on their business. This webinar will help members navigate that process.”

CHA News Article

First Population Health Management Webinar Lays the Framework for Series
Program begins April 28; includes extensive issue brief

CHA’s April 28 webinar on Population Health Management(PHM) will lay the framework for the five-part webinar series presented by a faculty of management consultants and thought leaders from Kaufman, Hall & Associates.

“CHA created this program to provide hospitals with the information and tools needed to move forward with PHM. It is the business challenge and opportunity for tomorrow’s hospitals and health systems, and it is the means to transform health care from a silo-like treatment of services to coordinated care across the continuum,” said Anne McLeod, CHA’s senior vice president, health policy and innovation. “California is at the forefront of this transformation by virtue of its size and unique demographic profile. I encourage all hospitals to consider participating.”

CHA News Article

LAO Recommends Performance Goals for Reuniting Unclaimed Property With Owners

California’s Legislative Analyst’s Office (LAO) has issued a new report on the state’s unclaimed property law. California law has long required hospitals to transfer to the State Controller’s Office (SCO) personal property considered abandoned by owners. The SCO has made important strides in reuniting this “unclaimed property” with owners, but faces budgetary and statutory constraints in reuniting even more such property. Since the 1950s, the state has accumulated more than $7 billion in unclaimed property belonging to individuals, businesses and local governments. Because hospitals spend significant time and resources transferring property to the state, it is important that the state be held accountable for reuniting more property with owners.

CHA News Article

Governor Unveils 2015-16 State Budget

Gov. Jerry Brown has released his $113 billion budget plan for 2015-16. In this year’s budget, elimination of the retroactive rate reductions imposed on hospital-based skilled-nursing facilities pursuant to AB 97 in 2011 remains a top priority for CHA.


Hospital Presumptive Eligibility Program Webinar
A vital tool for providing potentially-eligible individuals with on-the-spot Medi-Cal coverage

Webinar Recorded Live on June 19, 2014

Hospitals can play an important role in reducing the number of uninsured through the Hospital Presumptive Eligibility (HPE) program. The HPE program will allow all hospital Medi-Cal providers — including any clinic on a hospital’s license — to provide potentially-eligible individuals with temporary, full-scope Medi-Cal benefits.


Health Care Reform

Our nation’s health care system has entered a new era with the enactment of federal health care reform. This landmark legislation is resulting in many changes in how health care is financed and delivered for years to come. For nearly two decades, CHA has been at the forefront in advocating for meaningful health care reform — and we will continue to help shape the future of hospital care far into the future. CHA’s vision of an “optimally healthy society” is now a reality within reach.

CHA News Article

DHCS to Host Behavioral Health Forum Dec. 14

The Department of Health Care Services (DHCS) will conduct its next Behavioral Health Forum Dec. 14 from 9 a.m. – 2:30 p.m. (PT) to provide stakeholders with updates on critical policy and programmatic mental health and substance use disorder issues. Interested participants may attend in person or via webinar. To register for the webinar, visit A confirmation e-mail with information about joining the webinar will be sent upon registration. The meeting will be held at the DHCS Auditorium, 1500 Capitol Avenue in Sacramento. Meeting materials will be posted to the DHCS website in advance of the meeting. Questions or comments may be submitted to DHCS at

The forum is organized into the following five sub-forums:

  1. Client and Family Member Forum
  2. Strengthen Specialty Mental Health and Drug Medi-Cal County Programs and Delivery Systems (Strengthening) Forum
  3. Coordinated and Integrated Systems of Care for MHSUDS and Medical Care (Integration) Forum
  4. Coordinated and Useful Data Collection, Utilization, and Evaluation of Outcomes (Data) Forum
  5. Cost Effective and Simplified Fiscal Models (Fiscal) Forum
CHA News Article

Study Finds More Than 750,000 Older Californians ‘Unofficially’ Poor

According to a new study by the UCLA Center for Health Policy Research, more than one in five adults over 65 in California — more than three-quarters of a million people — are among the “hidden poor” who live in the gap between the federal poverty level and the Elder Index poverty measure. The Elder Index is considered a more accurate cost estimate of what is required for a decent standard of living. The national federal poverty level (FPL) guidelines say a single elderly adult living alone should be able to live on $10,890 per year, while the Elder Index estimates that same person in California, on average, requires $23,364. According to the study, about 772,000 elderly adults in California who are heads of households belong to the group of hidden poor, which is more than double the number of elderly (342,000) who meet official federal poverty level guidelines. Unlike the “official” poor, the hidden poor often do not qualify for public assistance.

CHA News Article

DHCS to Host Behavioral Health Forum Tomorrow

The California Department of Health Care Services (DHCS) will conduct a Behavioral Health Forum tomorrow from 9:30 a.m. to 5 p.m. (PT) in Sacramento. DHCS established the Behavioral Health Forum to prioritize behavioral health issues, establish policy recommendations, track progress and status of issues under consideration and oversee stakeholder engagement. The meeting will include the following forums: Client and Family Member; Strengthen Specialty Mental Health and Drug Medi-Cal County Programs and Delivery Systems; Coordinated and Integrated Systems of Care for Mental Health and Substance Use Disorders and Medical Care Integration; Coordinated and Useful Data Collection, Utilization, and Evaluation of Outcomes; and Cost Effective and Simplified Fiscal Models.

Participants may also choose to join via webinar/conference call. For more information, see attached agenda.

CHA News Article

CHHSA/CDPH Announce Let’s Get Healthy California ‘Innovation Challenge’
Accepting submissions through Sept. 30

The California Health and Human Services Agency (CHHSA) and the California Department of Public Health have launched the Let’s Get Healthy California “Innovation Challenge,” which  invites community and health advocates, health care providers, community-based organizations and health care practitioners to share innovations that promote health equity and further the Triple Aim — better health, better care, and lower costs. The agencies are specifically looking for  innovations that promote health equity, showcase data use, engage community partners, help drive measurable health outcomes, are rooted in strong research or theoretical evidence, demonstrate credibility and influence in their targeted communities and provide scalable approaches to be used in different community settings. Submissions will be accepted through Sept. 30.

The Innovation Challenge furthers the goal set by Gov. Brown in 2012 when he issued an Executive Order to create the Let’s Get Healthy California Taskforce and make California the healthiest state in the nation by 2022. More information is available on the CHHSA website and in attached pamphlet.

CHA News Article

U.S. Supreme Court Issues Decision in King v. Burwell
Upholds IRS regulations making subsidies available in states with federally facilitated marketplaces

Today, the U.S. Supreme Court issued its decision in King v. Burwell, the second challenge to the Affordable Care Act (ACA) to reach the Court. The Supreme Court decided by a 6-3 vote to uphold the Internal Revenue Service (IRS) regulation making subsidies available in states with federally facilitated marketplaces (FFM). Subsidies will continue to be administered through all marketplaces. The petitioners challenged the legality of premium and cost-sharing subsidies on the exchanges that were established by the Department of Health and Human Services (HHS) in 34 states. They contended that the tax code restricts subsidies to individuals who enroll in coverage through a state-based marketplace (SBM) when it provides that the amount of the subsidy is based on premiums in an exchange “established by the State.”


Health Information Management & Technology

Hospitals are moving away from paper-based records to electronic medical records and electronic health records to retain patient-care data. Electronic formatting facilitates data capture in a “real-time” environment, and allows many users to access the data at the same time.

CHA supports the capture and availability of secure patient-care data through the use of health information technology (HIT) across the continuum of care. CHA believes HIT will serve as a tool to enhance patient safety, promote information for preventative health and reduce health care costs.

CHA News Article

CMS Issues Final Rules on Stage 3 Meaningful Use, EHR Incentive Program Updates for 2015-17
2015 EHR certification criteria also finalized

The Centers for Medicare & Medicaid Services (CMS) has issued the attached final rule with comment period, modifying the reporting period for the Medicare and Medicaid Electronic Health Records (EHR) Incentive programs in 2015 and defining stage 3 of meaningful use. In the final rule, CMS finalized provisions for two separate proposed rules issued in March. In addition, the Office of the National Coordinator for Health Information Technology released a companion rule that finalizes 2015 certification criteria, standards and implementation specifications for EHR technology.

The finalized modifications to EHR Incentive programs for 2015 through 2017 include moving from fiscal year to calendar year reporting for all providers beginning in 2015 and offering a 90-day reporting period in 2015 for all providers, as well as for new participants in 2016 and 2017, and for any provider moving to Stage 3 in 2017. CMS also reduces the number of objectives for eligible hospitals and critical access hospitals (CAHs) from 20 to nine — including one public health reporting objective — and maintains electronic clinical quality measure (eCQM) reporting as previously finalized.

CHA News Article

Next Population Health Webinar Is Tomorrow
Final programs to address technology and leadership considerations

Two webinars remain in CHA’s five-part certification series on Population Health Management (PHM). Member hospitals have offered many positive comments on the series including:

“This webinar series is wonderful with assisting in implementation of a population health program.”

“This series has started to connect the dots for me regarding population health and how to implement it in my facility.”

The next webinar, Technology for Population Health Management, will be held tomorrow from 9:30 – 11:30 a.m. (PT). Geared toward health information professionals, the webinar will address key PHM technology capabilities, including care coordination monitoring and tracking; patient-centric disease registries; advanced health analytics, including predictive modeling; enterprise risk management; cost management; and virtual/mobile health.

CHA News Article

Q & A Available for ICD-10 Claims Flexibility

Last month the Centers for Medicare & Medicaid Services (CMS) announced that, for 12 months after ICD-10 implementation, Medicare audit contractors will not deny certain Part B physician fee schedule claims based solely on the specificity of the ICD-10 code. Now, CMS has released guidance related to that announcement, providing answers to frequently asked questions and addressing related quality reporting flexibility.

Beginning Oct. 1, ICD-10 codes for medical diagnoses and inpatient hospital procedures must be included on health care claims. More information about the transition to ICD-10 is available on the CMS website.

CHA News Article

Report Makes Recommendations for HIT Interoperability

The American Hospital Association’s (AHA) Interoperability Advisory Group issued a report this month recommending steps hospitals, health systems, vendors and the government can take to advance health information technology (HIT) exchange. The report recommends hospitals and health systems engage more fully to identify priorities for sharing data and contribute to creating better testing of HIT systems. The report also recommends that vendors align their business case with the needs of their customers so that information can be shared efficiently and effectively without repeated and expensive “tolls” for creating interfaces and completing transactions. In addition, according to the report, the federal government should continue to support interoperability with a focus on standards, certification and testing. AHA’s report is available at

CHA News Article

CMS Allows Hospitals in First Year of Meaningful Use to Attest This Summer

The Centers for Medicare & Medicaid Services (CMS) has reopened the attestation process for hospitals participating in the Medicare Electronic Health Record Incentive program for the first time in 2015. Hospitals new to the meaningful use program can attest between now and Aug. 14. Eligible hospitals and critical access hospitals participating in meaningful use for the first time this year may attest to a 90-day reporting period for fiscal year 2015. CHA strongly advocated for this change in its comments to CMS on the meaningful use modification rule. Hospitals that have previously participated in the meaningful use program will not be able to access the attestation portal until after Jan. 1, 2016.

The process will be implemented on a case-by-case basis for hospitals that register through the CMS Registration and Attestation System at Once the registration is active, hospitals should contact Elizabeth Holland at to provide their hospital name, CMS Certification Number and contact information. Additional information about Electronic Health Records Incentive program attestation can be found on the CMS website.


Human Resources

California hospitals and health systems employ more than half a million people — from entry-level positions to senior executives. Many health care human resources (HR) departments are responsible for a wide range of issues, such as recruitment, staffing, compensation, benefits, labor/employee relations and employee health. Navigating the complex regulatory environment, while monitoring how it applies to HR in the health care setting, can be a challenging and dynamic task.

Representing hospitals and health systems in California, CHA provides leadership in HR policy on state and federal levels. In addition, CHA advocates on behalf of hospitals and health systems before the federal and state legislatures, federal and state administrative agencies and the public. CHA also provides educational opportunities, such as the annual Labor & Employment Law seminar, to help hospital leaders sharpen their skills and knowledge in health care HR. CHA members also participate on an HR executive e-mail list and receive periodic informational memoranda. 

CHA News Article

New Budget Repeals Requirement for Automatic Health Plan Enrollment of Employees
Applies to employers with 200 or more full-time employees

With the signing of the Bipartisan Budget Act of 2015, President Obama has repealed Section 18A of the Fair Labor Standards Act, enacted as part of the Affordable Care Act (ACA). As originally written, the ACA would have required employers with 200 or more full-time employees to automatically enroll new full-time employees in an employer health plan and to continue enrolling current employees in the health plan offered. Additionally, employers were required to give automatically enrolled employees adequate notice and an opportunity to opt-out of the employer health plan. Because the requirements raised concern about coordination with other ACA provisions, employers were not required to comply until final regulations were issued. With the passage of the Bipartisan Budget Act, the automatic enrollment requirements have now been repealed and employers will not have to comply with them.

CHA News Article

PHM Webinar Series to Conclude With Leadership and Talent Considerations

The final webinar in CHA’s five-part certification series on Population Health Management (PHM), to be held Oct. 6 from 9:30-11:30 a.m., will address key leadership and talent considerations for hospitals and health providers using, or considering implementing, a PHM strategy and approach.

As PHM makes new demands on leadership and talent, understanding the leadership and governance mindset necessary for successful PHM – including new perspectives on scale, volume and partnerships – is critical. The webinar will describe leadership’s role in fostering key PHM capabilities and introduce new leadership positions that focus on important facets of the PHM model, such as chief transformation officer, chief population health officer, chief medical informatics officer, and a leader for product and benefit design. Participants will also learn new metrics of leadership performance and accountability for a PHM environment.



CHA’s legal department advocates vigorously before the courts on behalf of California hospitals, both as a party in litigation and as amicus curiae in important appellate cases. In addition, the CHA legal department prepares legal memoranda and manuals to help hospitals understand and comply with state and federal laws. The CHA legal department also supports CHA staff in their advocacy efforts before the state legislature and regulatory agencies.

CHA News Article

CMS Issues Final Rule With Comment Period on Access to Covered Medicaid Services
Releases RFI to solicit feedback on Medicaid access requirements

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule with comment period that aims to allow states and CMS to make better informed, data-driven decisions when considering whether proposed changes to Medicaid fee-for-service payment rates are sufficient to ensure that Medicaid beneficiaries have access to covered Medicaid services. The final rule also intends to strengthen CMS’ ability to review Medicaid payment rates to ensure they are consistent with efficiency, economy and quality of care, as well as ensure sufficient beneficiary access to care under the Medicaid program. CMS also issued a Request for Information (RFI) to gather input into additional approaches that it and states may consider to better ensure compliance with Medicaid access requirements. The RFI asks for comments on the potential development of standardized core set measures of access, access measures for long-term care and home and community-based services, national access to care thresholds, and resolution processes that beneficiaries could use when they have problems accessing essential health care services.

CHA News Article

New Law Aims to Protect Conservatees’ Rights
Hospitals advised to review conservatorship orders

Gov. Brown has signed AB 1085 (Gatto, D-Glendale), which allows a court to grant a conservator the power to enforce a conservatee’s right to receive visitors, telephone calls and personal mail. The bill also allows the court to direct a conservator to allow specific visitors, telephone calls and personal mail. This bill was introduced as a result of a highly-publicized situation in which radio host Casey Kasem’s second wife allegedly prevented daughters with his first wife from visiting him. The law also requires a conservator to inform certain persons, and an agent under a power of attorney for health care to inform any individuals identified by the patient, of the patient’s death. Hospitals should always get a copy of conservatorship orders for conserved patients and read them to fully understand the authority of the conservator and any limitations. The law takes effect Jan. 1, 2016.

CHA News Article

Police Use of Body Cameras Could Have Privacy Implications for Hospitals

As police forces increasingly use body cameras to film potentially problematic encounters with the public, the California Legislature has worked in the past year to establish standards for law enforcement body camera policies. Because police officers may be wearing body cameras – small devices, worn like a police radio on an officer’s shirtfront – in hospitals or health care facilities, their use raises questions about patient privacy.

Law enforcement officers are not covered entities under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and they are not subject to the state privacy laws found in the Confidentiality of Medical Information Act or the Lanterman-Petris-Short Act. Under HIPAA, hospitals do have an obligation to take reasonable steps to prevent unauthorized disclosure of protected health information, including patient identities. CHA is tracking all pending legislation related to body cameras and ensuring hospitals’ interests are protected, and will keep members informed of legal and policy developments on this issue.

CHA News Article

Department of Insurance Issues Proposed Permanent Regulations on Provider Network Adequacy

The California Department of Insurance (CDI) last week replaced its January 2015 emergency regulations on provider network adequacy standards with permanent regulations. The emergency regulations required hospitals to disclose to patients, prior to a scheduled procedure, non-network providers who are likely to provide care and the estimated costs of that care. CDI recognizes that this would be an impossible undertaking for hospitals, and has deleted the requirement in its proposed permanent regulations. CDI also defined an adequate network as “one in which the care provided to an insured person in a network facility is provided by network providers.” If an insured person chooses to receive care while in a network facility from a provider who is not in the insurer’s network, then the use of that out-of-network provider does not render the network inadequate. Health plans are obligated to provide their members with directories clearly explaining out-of-network options and cost-sharing tiers as well as a sufficient list of hospitals, physicians and specialists with admitting privileges to in-network hospitals. This is very positive news for hospitals. 


Quality & Patient Safety

CHA is committed to helping hospitals improve quality, reduce medical errors and adverse events, and maximize patient safety.

CHA’s vision is an “optimally healthy society.” CHA’s goal is for “every Californian to have equitable access to affordable, high-quality, medically necessary health care.”

CHA News Article

California Hospitals Invited to Participate in Project ACHIEVE

The Health Research and Educational Trust of the American Hospital Association is recruiting hospital participation for a care transitions study called Project ACHIEVE. Funded by the Patient-Centered Outcomes Research Institute, the study aims to identify which transitional care services most effectively improve health outcomes and are of high value to patients and their caregivers. Hospitals may be contacted about participating in the initiative, which would include a survey and an on-site visit by researchers.

CHA News Article

HQI Launches CalHEN 2.0, Invites Hospitals to Join

Hospital Quality Institute (HQI) is partnering with California hospitals to join the national Hospital Engagement Network (HEN) to reduce hospital-acquired conditions by 40 percent and 30-day readmissions by 20 percent. HQI seeks commitments from hospitals to become part of this unprecedented opportunity to improve health care. The HEN initiative ends Sept. 23, 2016, so participating hospitals will be part of an accelerated improvement sprint. HQI will work with hospital partners to build the necessary infrastructure and support for sustainability by focusing on building a framework of reliability while performing with distinction on the HEN’s task orders for improvement.

CHA News Article

Upcoming Webinar Series to Educate Hospitals on Sepsis Bundle Measure

The Centers for Medicare & Medicaid Services has announced it will hold a three-part educational series on the “Early Management Bundle, Severe Sepsis/Septic Shock” measure (SEP-1). The webinar series will describe the rationale for the measure, detail the abstraction process, provide mock case review and answer provider questions in advance of data submission deadlines. The webinars are scheduled for:

  • Early Management Bundle, Severe Sepsis/Septic Shock Part I
    Aug. 24, 11 a.m. – noon (PT)
  • Early Management Bundle, Severe Sepsis/Septic Shock Part II
    Sept. 21, 11 a.m. – noon (PT)
  • Sepsis Mock Case Review and FAQs
    Oct. 26, 11 a.m. – noon (PT)

Additional details on the individual events will be made available two weeks in advance of each webinar. More information is available in the attached flyer.

CHA News Article

CHPSO/HQI Issues Patient Safety Alert on Hospital Hardware Hacking

On July 31, the Food and Drug Administration (FDA) issued a safety alert encouraging health care facilities to stop using Hospira Symbiq pumps due to cybersecurity concerns. If a hospital must temporarily continue using Symbiq pumps until replacements are in place, a list of FDA-recommended temporary measures, along with more information, is available on the CHPSO website.

CHA News Article

CHA Reminds Hospitals of Outpatient Quality Reporting Deadlines

CHA reminds hospitals that the data for the Hospital Outpatient Quality Reporting (OQR) program web-based measures are now being accepted into the QualityNet Secure Portal and must be submitted by Nov. 1. If the data are not submitted by the deadline, a hospital’s annual payment update may be reduced by 2 percent. Once logged into the secure portal, hospitals should select “2016″ from the payment year (PY) drop down window under “Outpatient Web-Based Measures.” If PY 2015 is selected, data entered last year will be shown (hospitals may not submit data under PY 2015).



California hospitals’ revenue stream is critical to their overall mission of providing care and cures in the communities they serve. While over half of hospitals’ revenue, nearly $30 billion a year, is derived from government-funded programs, including Medicare, Medi-Cal, Healthy Families and county indigent programs – Private Insurance revenues are also significant.

CHA believes that hospitals should be reimbursed adequately to cover the cost of care for enrollees.

CHA News Article

DHCS Announces Mapping Requirements for 2015-16

The Department of Health Care Services (DHCS) has provided hospitals information to assist in setup for the APR-DRG desktop grouper for state fiscal year 2015-16, including claims with admission dates on and between July 1, 2015, and June 30, 2016. For discharges after Oct. 1, 2015, mapping is required due to ICD-10 implementation, even if the admission was prior to that date. Therefore, for state fiscal year 2015-16, any claim with a discharge date on or after Oct. 1, 2015, will require historical mapping. Mapping is also required for admissions on or after Oct. 1, 2015.

DHCS is evaluating version 33 of the APR-DRG grouper and continues to use version 32 in the meantime. Currently, version 32 of the mapper will not recognize approximately 50 new ICD-10 PCS (surgical) codes effective Oct. 1. For updates and more information, continue to monitor the DHCS DRG website for provider bulletins.

CHA News Article

CMS to Host Webinar on CCJR Model Final Rule
Webinars to be held Nov. 19 & 30

Yesterday the Centers for Medicare & Medicaid Services (CMS) issued its final rule implementing the Comprehensive Care for Joint Replacement model, set to begin April 1, 2016. Acute care hospitals in certain selected geographic areas, including three in California, will receive retrospective bundled payments for episodes of care for hip and knee replacements. The CMS Innovation Center will host a webinar, offered on two dates, to describe the final rule and respond to questions. Online registration for the Nov. 19 and Nov. 30 webinars is now available. CMS urges early registration, as large audiences are expected. 

CHA News Article

CMS Announces Changes to Recovery Audit Program

The Centers for Medicare & Medicaid Services (CMS) last week announced important changes to the recovery audit program. Effective Jan. 1, the additional documentation request (ADR) limits for the recovery audit contractors (RACs) will be reduced to one-half of one percent of the hospital’s total number of paid Medicare claims from the previous year. In addition, CMS is establishing future ADR limits based on a provider’s compliance with Medicare rules. Providers with low denial rates will have lower ADR limits, while providers with high denial rates will have higher ADR limits. CMS also released a summary of the past and future scheduled enhancements to the recovery audit program, including reducing the look-back period for patient status reviews to 6 months and requiring RACs to maintain an overturn rate of less than 10 percent at the first level of appeal.

CHA News Article

Waiver to Modify Hospital Admissions Process Approved
Applies to Medi-Cal fee-for-service beneficiaries

The Centers for Medicare & Medicaid Services this week approved the Superior Systems Waiver (SSW) renewal application, effective for the period from Oct. 1, 2015 through Sept. 30, 2017. The SSW describes the utilization review process for acute inpatient hospitals that serve fee-for-service Medi-Cal patients. It also specifies how non-designated public hospitals and private hospitals will transition from using the current treatment authorization requests to using their own utilization management systems based on nationally recognized, evidence-based medical criteria. Under a previous waiver, California’s 21 designated public hospitals have piloted this new method. More information is available in CHA’s article on the proposed waiver, and the approved waiver is available on the DHCS website

CHA News Article

Hospitals Encouraged to Submit Data to RACTrac Survey by Oct. 16

CHA encourages hospitals to submit data to the American Hospital Association’s (AHA) quarterly RACTrac survey by Oct. 16. The free web-based survey helps CHA measure the impact of Medicare’s Recovery Audit Contractor program on hospitals and advocate for needed changes. A hospital does not need to be an AHA member to participate in the survey. For more information on the RACTrac initiative, visit To register for the survey or for technical assistance, contact RACTrac support at (888) 722-8712 or



California hospitals are concerned about the need for an adequate supply of highly skilled health professionals to meet the demands for health care services now and in the future. Numerous studies have been completed that validate the need to address critical health professional shortages in nursing and the allied health occupations.  However, efforts to implement recommended strategies have been hindered by a lack of a coordinated statewide effort involving health employers, as well as other necessary partners. 

CHA News Article

Funding Available for Primary Care Training and Enhancement Program

The Health Resources and Services Administration’s Bureau of Health Workforce/Division of Medicine and Dentistry is soliciting applications for the Primary Care Training and Enhancement (PCTE) program. Eligible applicants include accredited public or nonprofit private hospitals, schools of medicine or osteopathic medicine, academically affiliated physician assistant training programs, and public or private nonprofit entities. Applications for funding are due by Dec. 16.

The PCTE program strengthens the primary care workforce by supporting training for future primary care clinicians and by promoting primary care practices in rural and underserved areas. The program aims to improve access and quality of care, as well as to increase cost effectiveness. Awardees must focus on transforming health care systems while enhancing trainees’ clinical training experience. For more information, visit

CHA News Article

OSHPD Seeks Experts to Review Residency Grant Applications

The Office of Statewide Health Planning and Development (OSHPD) is soliciting applications for subject matter experts during the review and scoring of Song-Brown program funding applications. The program provides grant funds to family medicine and primary care residencies, family nurse practitioner/physician assistant programs, and registered nurse education programs. 

For a complete list of roles and responsibilities and an application, visit If interested, submit the information along with a current resume to Tyfany Frazier at

CHA News Article

2016 Workforce Grant Bulletin Now Available

The Bureau of Health Workforce recently released its 2016 Application Bulletin and 2016 Grants Bulletin, which provide a snapshot of the bureau’s health workforce funding opportunities in 2016 by program, eligibility and discipline. Health care facilities are eligible for many of the grants listed in the one-page bulletins, which also include estimated open/release dates for each opportunity.  

CHA News Article

CHA Releases Roadmap to Creating a Health Care Work-Based Learning Program

In 2014-15, with support from the James Irvine Foundation, CHA partnered with hospitals, educators, funders and other experts to identify strategies for increasing the number of high-quality, health care work-based learning opportunities for California high school students. Health care as a whole is one of the fastest growing industries in the nation. According to the U.S. Department of Labor, Bureau of Labor Statistics, 17 of the 30 fastest growing occupations are in the health sector. To meet long-term demand for health workers, a variety of strategies must be employed throughout the workforce continuum. Work-based learning, the result of carefully planned and executed partnerships between health employers and educational entities, is one strategy that can increase the supply of health professionals serving California patients.

CHA News Article

Annual Area Health Resources Files Now Available

The Health Resources and Services Administration National Center for Health Workforce Analysis has released its annual Area Health Resources Files (AHRF). This data is available at no cost to the public, federal agencies, Congress and policymakers as a research tool to inform policy decisions.

A comprehensive volume of information on national, state and county-specific health and health-related information, the AHRF  includes health care profession, health care facility, hospital and population health data. To access the 2014-15 data files, visit