Hospital Topics

Overview

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

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.”

CHA News Article

CDPH Guidance Emphasizes CDC Ebola Recommendations

The California Department of Public Health (CDPH) has issued the attached All Facilities Letter (AFL) to acute psychiatric hospitals and general acute care hospitals, sharing recent recommendations from the Centers for Disease Control and Prevention (CDC) for Ebola preparedness and recourse.

CHA News Article

CDPH Launches Open Data Portal

The California Department of Public Health (CDPH) has launched its Open Data Portal, a tool that allows user-friendly access to the data it collects about important health issues. The first data tables available through the portal include birth profiles, poverty rates, the location of vendors who accept vouchers from the Women, Infants and Children program, health care facilities data, and surveillance for West Nile virus and asthma. Upcoming data will include newborn screening disorders, licensed medical device retailers and leading causes of death. Eventually, CDPH will offer data from other state departments within the California Health and Human Services Agency. For additional information, visit the CDPH Open Data Portal.

Recording

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

Overview

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.

CHA News Article

CDPH Updates Title 22 Licensing Fee, Diesel Generator Regulations

The California Department of Public Health has updated sections of Title 22 of the California Code of Regulations related to licensing fees and diesel generator testing so they conform to changes previously enacted in statute. Because the changes were enacted through statute, they do not have a “regulatory effect” and are not required to go through the standard regulatory development process. A list of the affected Title 22 sections that have been amended or repealed is attached. Also attached are the updated sections.

Overview

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

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.

CHA News Article

CHA Highlights Innovative Mobile Health Van Threatened by AB 503
Services for underserved at risk

CHA issued the attached press release today highlighting CareVan, a mobile health van that provides free health care services throughout San Joaquin County. The program — along with community benefit programs throughout the state — is threatened by AB 503 (Wieckowski, D-Fremont; Bonta, D-Alameda).

News Release

New Study by Economist and Former Finance Director Tom Campbell Shows Access to Care At Risk from Mandates
Thousands of Californians Could be Shut Out From Needed Health Care if Legislation Is Passed

(SACRAMENTO – January 16, 2014) – Former Congressman and State Finance Director Tom Campbell released results today of a new study that warns that thousands of Californians could be shut out of the health care they need, even if they have health coverage, if new regulations and mandates are approved by the state Legislature.  

Overview

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.

Recording

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

Webinar Recorded Live on November 14, 2014

Overview

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.

Recording

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

Overview

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.

CHA News Article

CDPH Issues Risk-Based Ebola Quarantine Order and Guidelines for Counties
State to assess individuals returning from Ebola-affected regions; updated federal guidelines recommend also monitoring those potentially exposed in U.S.

While there are no reported or confirmed cases of Ebola in California, the California Department of Public Health (CDPH)  took action Oct. 29 to help prevent any potential spread of the disease in the state by issuing a quarantine order and guidelines that require counties to assess individuals at risk for Ebola and tailor an appropriate level of quarantine as needed.

Recording

Principles of Consent and Advance Health Care Directives Webinar
A program for those new to health care or professionals seeking to refresh their knowledge

Webinar Recorded Live on October 1, 2014

Overview

Consent is more than a signature on a form
Patients have the right to make treatment decisions, but ensuring that they understand their options and associated risks is not easy. And while the responsibility for obtaining informed consent falls to physicians, your hospital is responsible for making sure that consent was obtained and documented.

Recording

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

Overview

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.

Overview

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

CMS Issues Direction on Lowering OR Humidity Below 30 Percent

The Centers for Medicare & Medicaid Services has issued the attached memorandum to state survey agencies providing direction on how hospitals, critical care hospitals and ambulatory surgical care centers can obtain a categorical waiver to lower operating room relative humidity (RH) below 30 percent. The memo also addresses the need for humidity levels to be compatible with manufacturer requirements for storage and use of equipment.

Earlier this year, CHA issued a report, developed by a broad group of stakeholders, which identified issues hospitals may confront when lowering operating room humidity below 30 percent and urged hospitals to conduct risk assessments. The stakeholders who developed the guidelines were particularly concerned about manufacturers’ warnings related to RH levels lower than 30 percent – specifically regarding the impact on the integrity and functionality of equipment and supplies used in the operating room.

CHA News Article

Refrigerant Management Program Registration, Reporting Deadline March 1

CHA reminds hospitals with medium and large refrigeration systems that they must submit their 2015 annual reports and implementation fee to the California Air Resources Board’s (ARB) Refrigerant Management Program by March 1. To access the ARB online Refrigerant Registration and Reporting tool, known as R3, visit www.arb.ca.gov/rmp-r3. ARB’s Refrigerant Management Program requires the upcoming annual report for hospitals with large and medium refrigeration systems — those with 200 pounds of refrigerant or more — to include calendar year 2014 refrigeration system leak inspections, leak repairs and other system servicing.

For more details on the requirements of the regulation, visit www.arb.ca.gov/rmp. Additional questions can be directed to ARB through email at rmp@arb.ca.gov or by calling (916) 324-2517.

CHA News Article

OSHPD Showcases Online System for Plan Review and Construction

The Office of Statewide Health Planning and Development (OSHPD) Facilities Development Division (FDD) showcased its eServices Portal (eSP) and its integration with Google Earth at the 2015 Government Transformation Showcase in Sacramento earlier this month. The eSP is an online system that replaces OSHPD’s logbook and assists in expediting plan review and construction. At the showcase, it was selected as one of the top 15 examples of California government transformation. To learn more about the eSP and how it has enhanced FDD’s emergency response capabilities, see the attached report.

CHA News Article

Hospitals Should Conduct Risk Assessments When Lowering OR Humidity Below 30 Percent
Report identifies issues, offers guidance

The attached report, Relative Humidity Levels in the Operating Room Joint Communication to Healthcare Delivery Organizations, January 2015, was developed by a broad group of interested stakeholders to identify issues hospitals may confront and offers assessment guidance for lowering the operating room relative humidity (RH) below 30 percent.

CHA News Article

ARB to Host Refrigerant Management Webinar Dec. 11
Annual reports due March 1 to Refrigerant Management Program

Hospitals with medium and large refrigeration systems, refrigerant distributors and refrigerant reclaimers are required to submit their 2015 annual reports to the California Air Resources Board’s (ARB) Refrigerant Management Program by March 1, 2015. In addition, facilities with large and medium refrigeration systems must pay their annual implementation fee by March 1. To review the requirements and procedures for filing annual reports and pay fees using ARB’s online Refrigerant Registration and Reporting tool (known as R3), ARB will hold a free webinar Dec. 11 from 9 a.m. – 11 a.m. (PT). The webinar will also highlight and demonstrate recent updates to the R3 tool. To register, visit https://www1.gotomeeting.com/register/125965233. The webinar will be recorded and posted to the program web page and will be repeated Jan. 13, 2015, at 1 p.m. (PT).

Overview

Emergency Preparedness
Is your hospital prepared?

Visit CHA’s Emergency Preparedness website at calhospitalprepare.org

About

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 www.calhospitalprepare.org.

   
CHA News Article

CDPH to Host Business Continuity Webinar for Hospital Executives

As part of the federal hospital preparedness program grant, the California Department of Public Health Emergency Preparedness Office will host a one-hour business continuity webinar for hospital executive leaders March 5 at 12:30 p.m. The webinar is intended to help health care organizations build on their efforts to continue operations and maintain services during and following disasters, using real-world incidents as the context for strengthening a hospital’s capacity and strategic planning. For more information, see the attached flyer or visit www.calhospitalprepare.org/continuity-planning.

CHA News Article

CDC Releases Guidance for Labs Testing Ebola Specimens

The Centers for Disease Control and Prevention (CDC) has released guidance for laboratory and other health care personnel handling and testing routine clinical specimens for suspected or confirmed Ebola cases. CDC notes the guidance should be used to supplement its previously released guidance on collecting, transporting and submitting specimens for Ebola testing.

CHA News Article

Guidance Available for Hospitals That May Need Triage Tent During Flu Season

Flu season is here, and some hospitals are experiencing an influx of patients in their emergency departments, which may require the need to set up a triage tent.

CHA News Article

2014 California Hospital Emergency Code Survey Results Available

CHA has announced that its 2014 Hospital Emergency Code Survey results are now available. While most health care facilities use some form of emergency code system to relay urgent information to hospital personnel during emergency incidents, the application of the codes is not always consistent between facilities. Standardizing hospital emergency codes is vital to reducing confusion and allowing staff to appropriately respond to emergency incidents. The third survey conducted in the past five years, this year’s report incorporates data from the previous surveys (2009 and 2011). The findings — including statewide data as well as data for the three Regional Associations — reveal sustained progress in hospital emergency code implementation among California health care facilities.

CHA News Article

Disaster Planning Conference Fortifies Hospital Preparedness

More than 800 people — including hospital staff, local, state and federal officials – gathered this week in Sacramento (see photo gallery) to strengthen hospital disaster preparedness and build collaboration to ensure continuity of care. The conference theme – Get Ready, Stay Ready – highlighted readiness and resilience in the aftermath of a disaster.

Overview

Finance

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

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.

CHA News Article

Governor Signs Bill Revising Charity Care Law

Governor Brown has signed SB 1276 (chapter 758, statutes of 2014), revising the existing law for hospital fair pricing policies. The bill changes the definition of a person with high medical costs to include those who have third-party coverage. While current charity care and discount payment policies provide hospitals and patients with the flexibility to negotiate the terms of a payment plan, this bill requires hospitals to consider the patient’s family income and essential living expenses. The bill also requires hospitals to agree to a default “reasonable payment plan” that is not more than 10 percent of a patient’s income, excluding deductions for essential living expenses, in the event the hospital and patient cannot agree on the terms of a payment plan. This bill goes into effect Jan. 1, 2015.

CHA encourages hospitals to work with their legal counsel when updating their charity care and discount payment policies. The bill is attached.

Recording

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.

General information

Video Describes Vital Role Nonprofit Hospitals Play in Their Communities

In opposition to AB 975 (Wieckowski/Bonta), CHA has embarked on a comprehensive public advocacy campaign to increase awareness of the importance of not-for-profit hospitals and the diverse array of community benefit programs they provide throughout California.  A new video (below) describes the vital role nonprofit hospitals play in the communities they serve. 

AB 975 would establish a “guilty until proven innocent” presumption for hospitals that report an operating margin of more than 10 percent.Under current law, nonprofit hospitals are required to invest their funds int

Overview

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 1915(b) Specialty Mental Health Services Waiver Renewal Stakeholder Meeting

The California Department of Health Care Services (DHCS) will hold a meeting March 2 from 9 a.m. – noon (PT) to outline the 1915(b) Specialty Mental Health Services waiver renewal application that must be submitted to the Centers for Medicare & Medicaid Services by March 31. The existing waiver expires June 30. DHCS will provide stakeholders with an update on the status of the waiver application, including the timeline for submission, proposed modifications to the current waiver, opportunities for stakeholder input and next steps. Stakeholders will have an opportunity to provide feedback to DHCS on the waiver renewal. The current 1915(b) waiver is available at www.dhcs.ca.gov/services/MH/Pages/MCMHP.aspx

CHA News Article

Upcoming Policy Briefing to Examine Safety Net Programs for Children
Will examine health and nutrition safety net in California

The Public Policy Institute of California (PPIC) will host a policy briefing on safety net programs for California’s children Feb. 20 from noon – 1:30 p.m. PPIC staff will present recent trends in the use of safety net programs and factors that affect enrollment across California. “The Affordable Care Act has expanded opportunities to make enrollment in one safety net program a gateway to others. This integration can help California achieve a longstanding priority: increasing the participation of low-income children in health and nutrition programs,” notes PPIC. For more information and to register, visit the PPIC event web page.

Event Location
Capitol Event Center, 2nd Floor
1020 11th Street
Sacramento

CHA News Article

Ninth Circuit Confirms Hospital-Physician Practice Merger Must be Unwound

Last week, the Ninth Circuit Court of Appeals upheld a judgment by an Idaho district court that the 2012 merger of St. Luke’s Health System with Saltzer Medical Group violated Section 7 of the Clayton Act, which bars mergers that may substantially lessen competition or tend to create a monopoly. The court also upheld the district court’s order that St. Luke’s must divest itself of the physician group.

CHA News Article

DHCS Releases Cal MediConnect HRA Dashboard

The California Department of Health Care Services (DHCS) has released the attached new data on health risk assessment (HRA) completion rates in the Cal MediConnect program. Cal MediConnect aims to coordinate medical, behavioral health, long-term institutional, and home- and community-based services through a single health plan for beneficiaries dually eligible for both Medicare and Medi-Cal. The HRA survey tool assesses all of a beneficiary’s needs, including the areas of medical and behavioral health, chronic conditions, disabilities, functional impairments, assistance in key activities of daily living, dementia, and cognitive and mental status. Used as a basis to develop a beneficiary’s individual care plan and make sure the beneficiary is connected to the care and services they need, the HRA is a critical part of the Cal MediConnect care coordination process.

CHA News Article

CHCF to Conduct Data Symposium on High Utilizers of Medi-Cal Services
Will discuss implications for program design and policy development

The California HealthCare Foundation (CHCF) has announced a one-day symposium to discuss new research by state officials and university partners on the characteristics, health care usage and costs associated with Medi-Cal’s high-cost populations, as well as research emerging from the state of Washington. California’s government collects vast amounts of clinical and cost data about the care it provides to the 12 million individuals enrolled in Medi-Cal, the nation’s largest Medicaid program. Staff from the California Department of Health Care Services (DHCS) and other experts will join the symposium to discuss the implications for program design and policy development. To register, visit the event registration site.

Overview

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

Medicare EHR Incentive Program Attestation Deadline Extended for Eligible Professionals

The Centers for Medicare & Medicaid Services (CMS) has extended the attestation deadline for eligible professionals (EPs) participating in the Medicare Electronic Health Record (EHR) Incentive Program to 8:59 p.m. (PT) on March 20 for the 2014 reporting year. This extension also applies to EPs who have not already used their one allowed “switch,” enabling them to switch programs (from Medicare to Medicaid, or vice versa) for the 2014 payment year. After March 20, EPs will no longer be able to switch programs. The Medicare extension does not affect deadlines for the Medicaid EHR Incentive Program. More information can be found on the EHR Incentive Programs website.

CHA News Article

Audit Report Examines BRN’s BreEZe System

Since its implementation, BreEZe, a new information system implemented last year in 10 of the 40 licensing boards housed in the Department of Consumer Affairs, has consistently had problems. Those problems have been exacerbated at the Board of Registered Nursing because of the volume of licensees it manages, and many hospitals have had difficulty obtaining timely endorsement and license renewals. As a result, the Legislature’s Joint Audit Committee held a hearing last fall and requested that the California State Auditor perform an extensive review of the system. In summary, the audit report determined that Consumer Affairs failed to adequately plan, staff and manage the BreEZe project, which has had performance problems, significant delays and escalating costs. The report recommends that Consumer Affairs develop processes that ensure it performs all required oversight activities to identify and prevent future problems.

CHA News Article

CMS Plans to Modify EHR Incentive Programs to Reduce Provider Burden

The Centers for Medicare & Medicaid Services (CMS) announced today in a blog post that it intends to engage in rulemaking this spring to revise the Medicare and Medicaid electronic health record (EHR) incentive programs to make them less burdensome for providers. CMS states it is considering proposals to shorten the 2015 reporting period to 90 days, realign hospital reporting periods to the calendar year, and modify additional aspects of the program to match long-term goals, reduce complexity, and lessen providers’ reporting burden. CHA supports the goals that CMS has laid out and is looking forward to engaging members in responding to the specifics proposed in future rulemaking.

CHA News Article

CDC to Release Information on Infection Ratios Tomorrow
CHA to provide hospital talking points

Tomorrow the Centers for Disease Control and Prevention (CDC) will release health care-associated standardized infection ratios for central line-associated bloodstream infections, catheter-associated urinary tract infections, surgical site infections, and methicillin-resistant staphylococcus aureus and clostridium difficile infections. CDC will compare rates from 2012 to 2013 and from 2008 (or the earliest year data were reported on a measure) to 2013 in its report, which will include national data, as well as a “progress report” tracking specific infections by state. CHA will include details of the CDC announcement and provide member hospitals with talking points in tomorrow’s CHA News.  

CHA News Article

ONC Issues 2015-20 Strategic Plan Focusing on Interoperability of Health IT

The U.S. Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology (ONC) has issued its Federal Health IT Strategic Plan 2015-2020. The plan describes the government’s strategies to achieve five goals: expand the adoption of health information technology (IT); advance secure and interoperable health information; strengthen health care delivery; advance the health and well-being of individuals and communities; and advance research, scientific knowledge and innovation. Federal partners, in coordination with federal advisory committees — including the Health IT Policy and Standards Committees, interagency groups and ONC — will implement the plan and review progress for each goal, including identifying milestones, measurement and reporting tools, and risk mitigation. ONC is accepting public comments on the plan, which are due by Feb. 6. The full plan is available for download on ONC’s website.

Overview

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. 

Education event For Members

Hospital Employee Health and Safety Seminar
Integrating employee and patient safety, Cal/OSHA updates, leaves and reasonable accommodation, safe patient handling practices

March 24, Glendale
April 2, Sacramento
A CHA members-only program

Quality patient care and employee safety are intertwined.
The ACA has elevated attention on patient safety. At the same time, special interest groups, regulators and legislators have been active and vocal about the importance of health care workplace safety. To better serve the needs of both patients and employees, hospitals are striving to create a holistic culture of safety. It’s a complicated process that requires buy-in at all levels.

Recording

New California Pregnancy and Disability Regulations Webinar DVD
What the new regulations mean to hospitals and employees

Webinar Recorded Live February 28, 2013

Recently, California’s Fair Employment and Housing Commission issued new regulations to guide compliance with pregnancy and disability laws. Some aspects of the new regulations confirm what we “thought” the rules meant. Others impose entirely new standards to follow and raise the bar on existing obligations. It’s imperative for employers to closely review and understand the new state regulations.

Publication

Employee Handbook and Personnel Policies Manual
Covers the full range of policies

Designed for all employers, this manual covers the full range of policies included in personnel handbooks. It is a must-have for employers who want to avoid common pitfalls.

Please note: This manual is available to members only and is offered at a special CHA discount.

(13th edition, 2014)

 

Publication

Employment Discrimination and EEO Practice Manual for California Employers
A complete, nontechnical guide

Human resources professionals will learn how to comply with applicable state and federal employment discrimination laws and the cost of noncompliance.

Please note: This manual is available to members only and is offered at a special CHA discount.

(10th edition, 2015)

Publication

Wage and Hour Manual for California Employers
A guide on legal requirements affecting wage and hour practices

Covers state and federal wage and hour laws, the Fair Labor Standards Act, Industrial Welfare Commission wage orders and Labor Commission policies.

Please note: This manual is available to members only and is offered at a special CHA discount.

(18th edition, 2015)

Overview

Legal

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.

Recording

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

Webinar Recorded Live on November 14, 2014

Overview

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.

Recording

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

Overview

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.

CHA News Article

California Supreme Court Denies Review in Hospital Case Against Blue Cross
Case focused on calculating payment for authorized post-stabilization emergency medical services

Yesterday, the California Supreme Court denied review in Children’s Hospital Central California v. Blue Cross of California, and denied a request that the Court of Appeal’s decision be “depublished.” The case arose from a dispute between the hospital and Blue Cross over the basis for calculating the amount Blue Cross owed the hospital for authorized post-stabilization emergency medical services provided to beneficiaries enrolled in Blue Cross’ Medi-Cal managed care plan during a 10-month period when the parties were not in contract. Under the appellate court’s decision, hospitals may be paid less by non-contracted plans for authorized post-stabilization emergency medical services.

Recording

Principles of Consent and Advance Health Care Directives Webinar
A program for those new to health care or professionals seeking to refresh their knowledge

Webinar Recorded Live on October 1, 2014

Overview

Consent is more than a signature on a form
Patients have the right to make treatment decisions, but ensuring that they understand their options and associated risks is not easy. And while the responsibility for obtaining informed consent falls to physicians, your hospital is responsible for making sure that consent was obtained and documented.

CHA News Article

California Supreme Court Extends Deadline for Deciding Whether to Review Hospital Case Against Blue Cross

Last week, the California Supreme Court extended its deadline from Sept. 16 to Oct. 16 to decide whether to grant review in the Children’s Hospital Central California v. Blue Cross California case. The case arose from a dispute between the hospital and Blue Cross of California over the basis for calculating the amount Blue Cross owed the hospital for authorized post-stabilization emergency services provided to beneficiaries enrolled in Blue Cross’s Medi-Cal managed care plan while the hospital and Blue Cross were not in contract.

Overview

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

CMS Finds Hospital Quality Improvement in 2015 Impact Report

The Centers for Medicare & Medicaid Services (CMS) this week released the 2015 National Impact Assessment of Quality Measures Report, which outlines hospitals’ performance and improvements on federal quality measures. The report concludes that clear progress has been made in improving the health care delivery system to achieve the triple aim of better care, smarter spending and healthier people. Among the report’s key findings, CMS found 95 percent of publicly reported measures showed improvement, with 35 percent classified as high performing. CMS also found that racial and ethnic disparities in publicly reported measures declined during the study period. CMS estimates that 7,000 to 10,000 lives were saved between 2006 and 2012 because of providers’ improved performance on inpatient hospital heart failure process measures, and 4,000 to 7,000 infections were averted through improved performance on inpatient hospital surgical process measures. CMS also found that the improvements in quality performance extend beyond the Medicare population, an example of the public-private collaboration that CMS hopes to expand. CMS will use the report’s findings to refine future quality measurement strategies.

CHA News Article For Members

CHA Comments on CMS Five-Star Quality Rating Measure Selection Criteria

Today CHA sent the attached comments on measure selection for hospital star ratings to the Centers for Medicare & Medicaid Services (CMS) Technical Expert Panel (TEP). While CHA is concerned that the proliferation of private and public sector hospital ratings diminishes their value for both patients and providers, CMS’ perspective on moving to an overall star rating system across all of its Compare websites is understandable.

CHA News Article

Hospitals Encouraged to Participate in Webinar on New Hospital Quality Scorecard
Webinar scheduled for March 5 at 9 a.m. (PT)

CHA encourages hospitals to participate in a webinar March 5 at 9 a.m. (PT) about the new U.S. News and World Reports hospital quality scorecard. The scorecard will be publicly released this spring and will include new ratings for common inpatient procedures and conditions, including coronary artery bypass grafting, total hip and knee replacement, congestive heart failure and chronic obstructive pulmonary disease. During the webinar, U.S. News journalists and data analysts will describe their data sources and the methodology behind the forthcoming ratings, and provide information on important upcoming dates.

Registered users of the Best Hospitals Dashboard can access a detailed report on the methodology behind the ratings. Dashboard users will also be able to access the ratings of their own hospital under embargo before U.S. News publishes its findings. To register as a dashboard user, visit https://hospitaldashboard.usnews.com/login. To participate in the webinar, register with U.S. News and World Reports at https://attendee.gotowebinar.com/register/3845683019917935873.

CHA News Article

New Resources Available to Assist IPF Quality Reporting

The Centers for Medicare & Medicaid Services (CMS) has announced the availability of several new tools to assist providers participating in the inpatient psychiatric facility quality reporting (IPFQR) program. The tools include a manual with an overview of the program, measure specifications, step-by-step guidance on the QualityNet secure portal registration, data submission using the web-based measures application and preview report processes. CMS has also made available paper abstraction tools designed as an optional, informal mechanism to assist IPFs in collecting certain measure data for the IPFQR program. Finally, CMS has posted frequently asked questions about existing measures, use of an electronic health record, new measures for calendar year 2015, and the Facility, State and National report. For more information, visit www.qualityreportingcenter.com/resources/tools/ipf.

CHA News Article

Submission Deadline for HAI Data Extended Through Feb. 27

The Centers for Medicare & Medicaid Services (CMS) has extended the submission deadline for health care-associated infection (HAI) data for hospitals participating in the inpatient quality reporting (IQR), PPS-exempt cancer hospital reporting (PCHQR), inpatient rehabilitation facility (IRF) reporting, and long-term care hospital (LTCH) reporting programs. The original deadline was Feb. 15 and has been extended to Feb. 27 at 11:59 p.m. (PT). CMS notes the extension only applies to the HAI data submission deadline. The Feb. 15 submission deadline for Clinical Process of Care and Perinatal Care (PC-01) data remains in effect. CHA reminds hospitals that do not deliver babies that they must enter a zero for the Perinatal Care Elective Delivery Measure (PC-01) each discharge quarter, rather than leave the field blank. Questions about the various programs may be submitted as follows:

Overview

Reimbursement

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

Medicare Physician Fee Schedule Claims Held Until Jan. 14

To correct technical errors discovered after publication of the calendar year (CY) 2015 Medicare physician fee schedule (PFS) final rule and to process claims correctly, Medicare Administrative Contractors will hold claims containing 2015 services paid under the PFS for the first 14 calendar days of January 2015 (Jan. 1 – Jan. 14). The hold should have minimal impact on provider cash flow as, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt. PFS claims for services rendered on or before Dec. 31, 2014, are unaffected by the 2015 claims hold and will be processed and paid under normal procedures and time frames. 

CHA News Article

VA Issues Interim Final Rule Implementing Veterans Choice Program
Establishes payment rates, eligibility criteria for participating non-VA health care providers

The Department of Veterans Affairs (VA) has released the attached interim final rule implementing provisions of the Veterans Access, Choice, and Accountability Act of 2014. The final rule establishes payment rates and methodologies for reimbursing participating non-VA health care entities and providers furnishing care and services through the Veterans Choice Program. The final rule also establishes the scope of the program, including the types of care and services that are covered, and defines eligibility criteria both for veterans and non-VA health care providers. In addition, the rule establishes a claims processing system to be managed by the Veterans Health Administration’s chief business office. The interim final rule will be effective Nov. 5, and the Centers for Medicare & Medicaid Services will accept comments for 120 days. CHA is currently reviewing the rule and will provide a detailed summary in the coming weeks.

CHA News Article

Noridian to Host Open Door Coverage Meeting Sept. 16

Noridian will hold a public Part A open door coverage meeting Sept. 16 from 11 a.m. – 12:30 p.m. in Los Angeles. Discussion will include information on the Recovery Audit Contractor program; local coverage determinations in various stages; medical review; comprehensive error rate testing; contractor medical director updates; and a question-and-answer period.

CHA News Article For Members

CHA Summary Details Payment, Policy Provisions of FFY 2015 IPPS Final Rule

The Centers for Medicare & Medicaid Services (CMS) estimates that national hospital inpatient payments will decrease by 0.6 percent in FFY 2015 as compared to FFY 2014, despite a positive market basket update. CHA estimates that total payments to California hospitals will increase by 0.8 percent, or approximately $90.7 million, compared to FFY 2014. While overall the impact for California is positive, this masks the continued reductions for documentation and coding, the devastating cuts to Medicare DSH payments, and significant penalties for readmissions and hospital acquired conditions that many hospitals will experience when the policies take effect Oct. 1. Details of the impacts are outlined in the attached CHA summary of the inpatient prospective payment system (IPPS) final rule for federal fiscal year (FFY) 2015.

CHA News Article

DHCS Announces Fix for Certain Erroneously Denied Medi-Cal Claims

The California Department of Health Care Services (DHCS) has announced that Medi-Cal has fixed an issue with an erroneous denial of All Patient Refined Diagnosis Related Group (APR-DRG) type of bill code 121.

Overview

Workforce

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

Deadline to Apply for OSHPD Primary Care Residency Funding Is March 10

In January, the Office of Statewide Health Planning and Development (OSHPD) issued a request for applications for $4 million in state funding to support new primary care residency slots. Eligible residency programs include family medicine, internal medicine, obstetrics and gynecology, and pediatrics. Funding is available for new programs that have received accreditation and will enroll their first class by July 1, 2015, or will not graduate students as of June 30, 2015. It is also available for established programs that have received accreditation and have graduated at least one class by June 30, 2015. Applications are due March 10 at 3 p.m. Additional information is available in the RFA at www.oshpd.ca.gov/HWDD/2015/Song-Brown/New-Slots-Information-Guidance.pdf.  

CHA News Article

CHA Co-Hosts Legislative Briefing on Strategic Health Workforce Development

Yesterday, CHA, along with other members of the California Health Workforce Development Council (HWDC), hosted a well-attended briefing at the state Capitol. The briefing, for legislative staff, focused on the importance of strategic health workforce development as the Affordable Care Act continues to be implemented. HWDC is a special committee of the California Workforce Investment Board and is comprised of stakeholder members representing health employers, health associations, legislators, philanthropy, labor and education.

CHA News Article

Rural Network Allied Health Training Program Grants Available

The Health Resources and Services Administration is accepting applications through March 31 for its Rural Network Allied Health Training Program Grant. With an estimated $2 million in funding, the pilot program seeks to strengthen the rural health care system by supporting the development of formal, mature rural health networks; utilize partnerships with local colleges, vocational and technical schools to develop clinical training programs that target rural allied health profession students and veterans; and serve as a vehicle for addressing workforce challenges. Awardees will be required to focus their efforts to recruit, train and retain allied health professionals. For more information, visit www.grants.gov/web/grants/view-opportunity.html?oppId=272369.

CHA News Article

OSHPD Offers $4 Million for Primary Care Residency Funding
RFA to be released this week

The Office of Statewide Health Planning and Development (OSHPD) has announced $4 million in state funding to support new primary care residency slots. Eligible residency programs include family medicine, internal medicine, obstetrics and gynecology (OB/GYN) and pediatrics. Additional state funding of $2.84 million is available to expand the Song-Brown Program to include internal medicine, OB/GYN and pediatric residency programs. OSHPD expects to release the RFA Jan. 14.

For additional information about applicant registration and submission, webinars, application instructions/guidance and meeting dates, www.oshpd.ca.gov/HWDD/Song_Brown_Prog.html.

CHA News Article

HRSA to Offer Grant Funding for Advanced Nursing Education

The Health Resources and Services Administration has announced a funding opportunity to support the enhancement of advanced nursing education and practice. It is anticipated that projects will develop and test innovative academic-practice partnership models for clinical training in graduate nursing education programs that prepare students to provide safe, quality care within the complex practice-based environment of the nation’s evolving health care system. Awardees will create one or more innovative partnerships between academic institutions and rural or underserved clinical practice sites to improve the quality of clinical sites and preceptors, improve preceptor training and promote students’ readiness to practice when they graduate.

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