Hospital Topics

Overview

2016 Ballot Initiatives

Ballot initiatives impacting California hospitals will be voted on November 8 in the general election. A description of the initiatives, including CHA’s position, is provided below as well as other pertinent CHA News articles.

More information about CHA’s sponsored ballot initiative — the Medi-Cal Funding and Accountability Act of 2016 — is available at www.keepagoodideaworking.org.

CHA News Article

CHA-Supported Initiatives Assigned Proposition Numbers for November Ballot

Three key measures supported and/or sponsored by CHA were assigned proposition numbers and have qualified for the general election vote on Nov. 8.

CHA News Article

California Teachers Endorse Hospital Fee Ballot Initiative

The California Teachers Association (CTA) — one of the state’s oldest and most influential labor groups — has added its voice to a comprehensive and growing list of supporters backing CHA’s hospital fee initiative on the November 2016 ballot. CTA’s support is enormously important, as it represents more than 325,000 members, including teachers, counselors, librarians and health professionals in school districts across California.

CTA is the latest labor union to urge passage of the Medi-Cal Funding and Accountability Act. Others include the State Building and Construction Trades Council, the United Food and Commercial Workers Western States Council, the California Teamsters Public Affairs Council and the California School Employees Association.

CHA News Article

Signatures Submitted for Health Care-Related Ballot Initiatives

Several health care-related initiatives have moved a step closer to finding their way onto the Nov. 8 general election ballot.

Last week, a broad coalition involving CHA, Service Employees International Union (SEIU) California, the California Teachers Association, the California Medical Association (CMA) and others submitted signatures to qualify a constitutional initiative to extend the Proposition 30 (2012) personal income tax on the wealthiest Californians. The initiative, if passed by voters, is expected to produce more than $1 billion annually in Medi-Cal funding for California hospitals.

CHA News Article

Community Organizations Across California Join Coalition Supporting CHA’s Hospital Fee Ballot Initiative

Community organizations across California, recognizing the importance of stable Medi-Cal funding, have added their voices to an expanding coalition seeking voter approval of CHA’s hospital fee initiative on the upcoming November ballot. Supporters encompass a broad range of organizations that provide services and support for California’s most vulnerable citizens, including the Asian Pacific Islander American Public Affairs Association, the California Senior Advocates League, Family Voices of California, Sacramento Steps Forward, and the Solano Coalition for Better Health. More than 860 organizations and individuals statewide have endorsed the ballot measure.

The Medi-Cal Funding and Accountability Act, which has already qualified for the ballot, will provide greater certainty for California in accessing approximately $3 billion a year in federal funds to pay for health care for residents enrolled in the Medi-Cal program.

CHA News Article

Survey Finds Overwhelming Voter Support for CHA-Backed Prop. 30 Extension

The Public Policy Institute of California (PPIC) has released a new survey, finding that the majority of Californians — 61 percent — support the Children’s Education and Health Care Protection Act of 2016. The act would extend Proposition 30’s income tax rates on the wealthiest 2 percent of Californians and aims to protect education and other vital services from significant budget cuts. The poll, which was based on a survey of 1,710 residents conducted from March 6-15, also found that 70 percent of likely voters wish to see the extension measure on November’s ballot. This act was the only ballot measure tested in the survey.

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 Issues Updated SNF Relicensing Workbook
New version implemented March 1

The California Department of Public Health has issued the attached updated state relicensing survey workbook for skilled-nursing facilities. Licensing and Certification district offices began using the new workbook March 1. 

CHA News Article

CDPH Pilots Use of Non-RNs as Breach Investigators

SB 857 (Chapter 31, Statutes of 2014) required the California Department of Public Health (CDPH) to report on the possibility of using professional position classifications other than health facilities evaluator nurses (HFEN) for licensing and certification surveys or complaint investigation. CDPH’s licensing and certification program explored this issue, and— based on a review of federal requirements for survey staff, California civil service classification requirements and complaint investigation workload — determined that it would, beginning in 2015, conduct a pilot project to use associate governmental program analysts or special investigators to perform medical information breach investigations currently performed by HFENs. More information is available in the attached report. 

Recording

CDPH’s New Hospital Relicensing Survey Webinar
Important changes begin March 2016

Webinar Recorded Live February 18, 2016

Overview

Changes are coming!

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

Updated Hospital Financial Assistance Policies and Community Benefit Laws Guidebook Now Available

CHA is pleased to announce the release of the Hospital Financial Assistance Policies and Community Benefit Laws, third edition. The guidebook can help simplify compliance with charity care and community benefit laws and explains the requirements of the California Hospital Fair Pricing Policies law, the Emergency Physician Fair Pricing Policies law, the IRS financial assistance requirements for tax-exempt hospitals, and other related laws.

The third edition provides more comprehensive information than ever and has been updated to address:

  • IRS clarifications of hospital financial assistance policies and related requirements
  • IRS clarifications of community health needs assessments and community benefits plans
  • Details on new requirements for the provider list that must be given to patients
  • How the IRS will address minor omissions and errors in hospitals’ policies and operations
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

The End of Life Option Act Webinar
Understanding the law, considerations for developing and implementing policies

Webinar recorded live April 18, 2016

The End of Life Option Act is one of the most important bills the Governor signed into law this year. Individuals who have a terminal illness and meet certain qualifications may now ask their physician for prescription medication to end their life. The law is complicated and not without controversy.

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.

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.

Recording

Meeting New Requirements for Sterile Compounding Webinar
Learn about new and upcoming state regulations and federal standards, and how to comply

Webinar Recorded Live June 28, 2016

Overview

The California State Board of Pharmacy (BoP) and United States Pharmacopeia (USP) Convention are planning changes that will significantly impact hospital pharmacy compounding of hazardous and non-hazardous medications and facility structures.

CHA News Article

Webinar to Preview New OSHPD Portal for Construction Plan Submission
Learn how to submit construction plans online, accelerate review and approval processes

On June 27, the Office of Statewide Health Planning and Development (OSHPD) Facilities Development Division will launch ePlanCheck (ePC) — a program enhancement of their eServices Portal (eSP) — to allow hospital and design teams to submit construction plans online. Hospital construction project teams who use the powerful eSP and ePC software can expect to benefit from faster interaction and response from OSHPD review teams; concurrent plan review by multiple disciplines; customized comment reports tailored to specific task or team member focus; online archiving of plans for easy retrieval and review; and overall reduced cost and faster turnaround of plan review and approvals. CHA will hold a webinar June 23 from 1:30 – 3:00 p.m. (PT) to explain the benefits of the new program and key requirements for using the system effectively. Faculty for the program include Paul Coleman, OSHPD Facilities Development Division deputy director, and Gary Dunger, business process manager and program manager for the eSP. To learn more or to register, visit www.calhospital.org/integrating-oshpds-eportals-web.

CHA News Article

CHA Webinar Will Explain New Requirements for Sterile Compounding
Learn how to comply with new and upcoming state regulations and federal standards

New regulations and standards on hospital pharmacy compounding of hazardous and nonhazardous medications will significantly impact pharmacy processes and procedures, as well as facility structures. To help explain the upcoming regulations and standards, CHA will hold a webinar June 28 from 10 a.m. – noon (PT).

CHA News Article

FDA Seeks Comments on Repair of Medical Equipment in Hospitals
Comments due June 3

The U.S. Food and Drug Administration (FDA) is seeking comments on whether hospital employees, vendors and others should be allowed to perform service and repair activities on medical equipment or whether those activities should be limited to original equipment manufacturers. CHA, the California Society for Healthcare Engineering and the American Society for Healthcare Engineering believe that restricting this work could lead to significant safety and financial issues. Given the varying impact this may have on different types of hospitals, CHA recommends that hospital biomedical experts review and respond directly to the FDA, copying Cheri Hummel. The deadline for comments has been extended from May 3 to June 3. 

CHA News Article

CMS Releases Final Rule on Fire Safety Requirements
Applies to certain health care facilities, takes effect July 5

The Centers for Medicare & Medicaid Services (CMS) has released the attached final rule updating fire safety requirements for certain health care facilities, including hospitals, long-term care facilities, critical access hospitals, inpatient hospice facilities, ambulatory surgical centers and more. The rule adopts updated provisions of the National Fire Protection Association’s 2012 edition of the Life Safety Code, as well as provisions of its 2012 edition of the Health Care Facilities Code. CHA is working with the Office of Statewide Health Planning and Development and the state fire marshal to determine whether or how this may differ from current regulations, and will inform members of the rule’s impact.

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

23 California Hospitals Selected by OIG for Study of Emergency Preparedness

The U.S. Department of Health and Human Services, Office of Inspector General (OIG) has announced it will conduct a study focusing on hospital emergency preparedness for emerging infectious disease threats. OIG has randomly selected hospitals across the nation to participate, including 23 California hospitals. OIG will send selected hospitals more information about the study along with a survey link within the next six weeks. Following the study, the data gathered will be consolidated and shared without disclosure of specific individual hospital information.

OIG has confirmed that this study is not related to any investigation or financial audit; the purpose is to gather and share valuable information on how hospitals across the nation are preparing and handling infectious disease threats. The Dallas Ebola outbreak prompted the need for such a study to better understand the threat of infectious diseases on hospitals and the general population.

CHA will continue to share information about the study as it is received via CHA News and the Emergency Preparedness website.

CHA News Article

CHA Disaster Planning Conference Will Highlight Lessons from 2015 NorCal Wildfires
More than 900 people expected to attend; hospitals share practical solutions

CHA’s Disaster Planning for California Hospitals Conference, to be held Sept. 19-21 in Sacramento, will provide an inside look at the response to and recovery from the 2015 Butte and Valley wildfires that ravaged Northern California and ultimately became the most destructive in state history. Presenters will discuss how the fires impacted multiple Sutter Health facilities, as well as collaboration with community partners and key suppliers, and lessons learned. In a separate session, a panel of presenters from the American Red Cross, law enforcement agencies and Petaluma Valley Hospital will recount how the call for evacuation was determined, and will share the successes and shortfalls of their efforts to meet the needs of thousands of evacuees.

Other conference features include the health care response to the San Bernardino terrorist attack that claimed 14 lives, as well as Kaiser Permanente’s approach to emergency management planning for Super Bowl 50 and the 2015 Special Olympics.

CHA News Article

Resources Available to Help Hospitals Prepare for Fire Season

A bark beetle epidemic driven by drought is killing off millions of trees in the Sierra Nevada and increasing the area’s fire risk as California begins another summer plagued by drought and high temperatures. While communities throughout the state brace themselves for another fire season, hospitals and health care providers should review their emergency operations plans, policies and procedures. To prepare, hospitals can download checklists for evacuation, shelter-in-place and repopulation activities at www.calhospitalprepare.org/evacuation. Additional resources for hospital employees on personal, family and pet preparedness are available at www.calhospitalprepare.org/personal-preparedness. For more information on this fire season, visit the Cal Fire website.     

CHA News Article

Disaster Planning Conference Registration Now Open

Registration is now open for CHA’s Disaster Planning for California Hospitals Conference, to be held Sept. 19-21 in Sacramento. The conference brings together more than 800 emergency preparedness professionals, community responders and officials from state and local agencies to share industry resources, tools and best practices to fortify their emergency management programs.

“The theme, ‘Driving readiness in dynamic times,’ reflects that dangerous and diverse threats are increasing globally and within our own communities,” said Cheri Hummel, CHA’s vice president of emergency management and facilities. “What hospitals must prepare for — and how they prepare — is constantly evolving.”

CHA News Article

Governor Issues Order Extending Water Conservation

This week, Gov. Brown issued an executive order establishing longer-term water conservation measures, including permanent monthly water use reporting, new permanent water use standards in California communities and bans on wasteful practices such as hosing off sidewalks, driveways and other hardscapes. The order, which aims to build on temporary statewide emergency water restrictions introduced due to drought, also identifies new water use efficiency targets beyond the 20 percent reduction in per capita urban water use by 2020, which was established in 2009. The State Water Board will adjust emergency water conservation regulations through the end of January 2017, in recognition of the differing water supply conditions across the state, and develop proposed emergency water restrictions for 2017 if the drought persists. During the coming months, the administration will seek public input on the new standards called for in the executive order. 

Overview

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.  

Recording

Meeting New Requirements for Sterile Compounding Webinar
Learn about new and upcoming state regulations and federal standards, and how to comply

Webinar Recorded Live June 28, 2016

Overview

The California State Board of Pharmacy (BoP) and United States Pharmacopeia (USP) Convention are planning changes that will significantly impact hospital pharmacy compounding of hazardous and non-hazardous medications and facility structures.

CHA News Article

Toolkit Aims to Help Hospitals Reduce Food Waste

Practice Greenhealth has released a new “Less Food to Landfill” toolkit, intended to support the U.S. Department of Agriculture’s and Environmental Protection Agency’s shared goal to reduce food waste by 50 percent by 2030. The “Less Food to Landfill” goal aims to feed hungry people, reduce waste and reduce methane gases by not landfilling food waste. Experts have found that hospitals can reduce pre-consumer food waste by 50 percent, resulting in a 2-6 percent savings on annual food purchases. In addition to providing step-by-step guidance and best practices, the toolkit facilitates goal-setting, standardized tracking and setting up a safe food donation program. The toolkit and other related resources can be found at https://practicegreenhealth.org/topics/less-waste/less-food-landfill.

CHA News Article

CHA Webinar Will Explain New Requirements for Sterile Compounding
Learn how to comply with new and upcoming state regulations and federal standards

New regulations and standards on hospital pharmacy compounding of hazardous and nonhazardous medications will significantly impact pharmacy processes and procedures, as well as facility structures. To help explain the upcoming regulations and standards, CHA will hold a webinar June 28 from 10 a.m. – noon (PT).

CHA News Article

FDA Seeks Comments on Repair of Medical Equipment in Hospitals
Comments due June 3

The U.S. Food and Drug Administration (FDA) is seeking comments on whether hospital employees, vendors and others should be allowed to perform service and repair activities on medical equipment or whether those activities should be limited to original equipment manufacturers. CHA, the California Society for Healthcare Engineering and the American Society for Healthcare Engineering believe that restricting this work could lead to significant safety and financial issues. Given the varying impact this may have on different types of hospitals, CHA recommends that hospital biomedical experts review and respond directly to the FDA, copying Cheri Hummel. The deadline for comments has been extended from May 3 to June 3. 

CHA News Article

CMS Releases Final Rule on Fire Safety Requirements
Applies to certain health care facilities, takes effect July 5

The Centers for Medicare & Medicaid Services (CMS) has released the attached final rule updating fire safety requirements for certain health care facilities, including hospitals, long-term care facilities, critical access hospitals, inpatient hospice facilities, ambulatory surgical centers and more. The rule adopts updated provisions of the National Fire Protection Association’s 2012 edition of the Life Safety Code, as well as provisions of its 2012 edition of the Health Care Facilities Code. CHA is working with the Office of Statewide Health Planning and Development and the state fire marshal to determine whether or how this may differ from current regulations, and will inform members of the rule’s impact.

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

Governor Releases 2016-17 State Budget

Today, Gov. Brown released his state budget plan for the 2016-17 fiscal year, a few days ahead of schedule. The Governor proposes allocating much of this year’s $170 billion budget to schools, some to the developmentally disabled and several billion to the rainy day reserve, staying consistent with his past budgets. Tax revenues continue to come in well ahead of projections, but the Governor remains cautious in his budgeting. In his press conference, he emphasized the possibility of another economic downturn and the importance of funding the rainy day fund.

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

Senate Finance Committee Issues White Paper on Stark Law Reform

Senate Finance Committee Chairman Orin Hatch (R-UT) released the attached white paper this week calling for reform to the Stark Law, which prohibits a physician from referring Medicare patients to a facility in which that physician has a financial stake. The committee requested comments on the Stark Law last December, and CHA submitted a letter with suggestions on how to improve the law. CHA’s letter, among the nearly 50 that were submitted, formed the basis of Sen. Hatch’s white paper. 

In the white paper, the committee concludes that the Stark Law is costly, burdensome to providers and needlessly complex. Of chief concern to the committee is that technical violations unknowingly committed may result in substantial penalties. The white paper echoes CHA’s comments that the Stark Law prevents desirable changes in health care and delivery payment models, that technical violations should be differentiated from substantial ones, and that it may be best to repeal the law in its entirety.

CHA News Article

DHCS to Host Webinar on Global Payment Program Tomorrow

The Department of Health Care Services (DHCS) will host a webinar on the Global Payment Program (GPP) tomorrow at 3 p.m. (PT); registration is available online. The GPP is a new program under California’s section 1115(a) demonstration waiver – “California’s Medi-Cal 2020 Demonstration,” which is effective Dec. 30, 2015, through Dec. 31, 2020.

The new program aims to improve the way care is delivered to California’s remaining uninsured individuals by establishing a statewide funding pool that combines federal disproportionate share hospital (DSH) and uncompensated care funding and distributing it to select designated public hospitals that meet their goal of moving patients from high-cost, avoidable services to higher value, preventive services. Webinar slides will be posted on the GPP web page prior to the start of the webinar.

CHA News Article

DHCS Announces Webinar on Specialty Mental Health Services Waiver
Save the date for follow-up meeting in June

The Department of Health Care Services (DHCS) will host a webinar May 26 from 3-4:30 p.m. (PT) addressing the 1915(b) Specialty Mental Health Services (SMHS) waiver’s special terms and conditions. The waiver, approved on June 24 by the Centers for Medicare & Medicaid Services (CMS) under Section 1915(b) of the Social Security Act, is effective for a five-year term from July 1, 2015, through June 30, 2020, and grants DHCS authority to implement the Medi-Cal SMHS program. In the attached approval letter, CMS outlines various requirements that were a condition of the waiver approval, due to its overarching concerns about the SMHS program’s integrity and compliance.

CHA News Article

County Medical Services Program to Offer New Primary Care Benefit May 1

The County Medical Services Program (CMSP) — which provides limited-term health coverage for uninsured low-income, indigent adults who are not otherwise eligible for other publicly-funded health programs in the 35 primarily rural California counties participating in CMSP — has announced that, beginning May 1, eligible members will not be charged a copay or share of cost for medical services, and prescription medications will require a $5 copay. This new primary care benefit will be provided to eligible members in aid code 89 (legal residents) and aid code 50 (undocumented), in addition to their CMSP standard benefit that has a monthly share of cost. The new benefit aims to assist these CMSP members in obtaining access to a specified set of primary care and/or specialty care services, including medical office visits, various diagnostic tests and prescription medications, with little or no beneficiary cost. This change — along with a number of changes to CMSP eligibility that the CMSP Governing Board approved on a two-year pilot project basis — is designed to reach more of the remaining uninsured.

CHA News Article

Report Identifies Characteristics of Uninsured Men

The Kaiser Family Foundation (KFF) has released a report, Characteristics of Remaining Uninsured Men and Potential Strategies to Reach and Enroll them in Health Coverage, that provides information on remaining nonelderly uninsured men ages 19-64. The report provides national estimates of their eligibility for Affordable Care Act (ACA) coverage options, and discusses strategies for reaching and enrolling them into health coverage. It also notes that, although the number of uninsured adults ages 19-64 declined significantly in 2014, more than 27 million nonelderly adults in the U.S. remained uninsured at the start of 2015, based on analysis of 2015 Current Population Survey data. More than half of these adults, or nearly 15 million, were nonelderly uninsured men.

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

Applications Due July 1 for EHR Incentive Program 2017 Hardship Exceptions

The Centers for Medicare & Medicaid Services (CMS) has issued a reminder that hardship exception applications for the Medicare Electronic Health Record (EHR) Incentive program are due July 1. Eligible professionals, eligible hospitals and critical access hospitals may access the instructions and application on the EHR Incentive program website; providers are also encouraged to view the FAQs page. More information is available on the CMS website

CHA News Article

CMS to Host Webinar on Proposed eCQM Changes

The Centers for Medicare & Medicaid Services will host a webinar May 17 at 11:30 a.m. (PT) on provisions of the federal fiscal year 2017 inpatient prospective payment system proposed rule that align electronic clinical quality measure (eCQM) reporting requirements in the inpatient quality reporting and electronic health record incentive programs. The webinar will identify changes proposed for eCQM requirements and provide an overview of how to submit comments on the proposed rule. To register for the webinar, visit https://cc.readytalk.com/r/a74×0biqau5t&eom

CHA News Article

ONC Seeks Comments on Measuring Interoperability of HIT
Comments due June 3

The Department of Health and Human Services (HHS) Office of the National Coordinator (ONC) for Health Information Technology has  issued the attached request for information on measuring interoperability and the exchange of health information. The Medicare Access and CHIP Reauthorization Act of 2015 set an objective to achieve the widespread exchange of health information through the use of interoperable certified electronic health records and directed HHS to establish metrics to determine if that objective has been met. In the request, ONC seeks comments on whether a national survey — such as the American Hospital Association’s Health IT Supplement Survey — is an appropriate data source for measurement, and if ONC should combine that data with the agency’s Medicare EHR Incentive Program data. Comments on the request are due June 3. 

CHA News Article

CMS Releases Measure Specifications for 2017 eCQMs

The Centers for Medicare & Medicaid Services (CMS) has posted its annual update of measure specifications for electronic clinical quality measures (eCQMs) for eligible hospitals and eligible professionals. Providers will use these updated measures to electronically report 2017 quality data for CMS quality reporting programs. The measure specifications are available for download on the CMS website’s eCQM library and the Electronical Quality Improvement Resource Center

CHA News Article

Application Deadline Extended for EHR Hardship Exception
Eligible hospitals and CAHs must apply by July 1

The Centers for Medicare & Medicaid Services (CMS) has extended the application deadline for the Medicare EHR Incentive program hardship exception process to July 1 for eligible professionals, eligible hospitals and critical access hospitals (CAHs). The exceptions apply to the Medicare EHR program 2017 payment adjustments. The previous deadline was March 15 for eligible professionals and April 1 for eligible hospitals and CAHs. The hardship application and instructions are available on CMS’ 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. 

CHA News Article

Process to Apply for Functional Affirmative Action Programs Revised
Applies to federal contractors, defined broadly by the OFCCP

The Office of Federal Contract Compliance Programs (OFCCP) has updated its guidance on the process federal contractors may use to apply for and maintain a functional affirmative action program (FAAP). An FAAP is based on a contractor or subcontractor’s business functions or business units, rather than the contractor’s physical locations. A contractor must seek approval and reach an agreement with the OFCCP before it can begin submitting FAAPs. Earlier this month, OFCCP explained the updated guidance in a webinar, which should be available on its website in the coming weeks.

Whenever OFCCP’s rules change, the question of which employers fall under its jurisdiction arises. Historically, employers receiving “federal financial assistance,” such as Medicare and Medicaid, have not been subject to OFCCP’s oversight and enforcement. However, the effect of participation in other federal programs has not been as clear.

CHA News Article

CHA Participates in ASHHRA Advocacy Day

On May 15 and 16, CHA participated in the American Society for Healthcare Human Resources Administration (ASHHRA) Capitol Hill visits in Washington, D.C. ASHHRA, a membership group of the American Hospital Association, met with staff for various California congressional representatives – including Sen. Feinstein and Reps. Honda, Davis, DeSaulnier and Hunter – to discuss issues of concern to hospital human resources executives. CHA took the opportunity to thank Rep. Honda for a letter he provided to CHA last year in support of efforts to enact SB 327. A copy of the ASHHRA advocacy white paper and Rep. Honda’s letter are attached.

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.

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.

CHA News Article

Supreme Court Rules on Providers’ Liability Under False Claims Act
Finds that material misrepresentation may trigger liability

Last week, the U.S. Supreme Court ruled on whether providers may be liable under the False Claims Act for seeking payment while out of compliance with regulatory requirements. In Universal Health Services, Inc. v. United States, a Medicaid beneficiary was prescribed a medicine that ultimately caused her death. After finding that the clinic’s employees were improperly supervised or licensed, her parents filed suit alleging that Universal Health Services had defrauded Medicaid by receiving payments for services rendered, despite being out of regulatory compliance.

CHA News Article

Appeals Court Rules on Hospital’s Elder Abuse Liability
May be premised on understaffing in violation of regulations

Last week, a state appeals court reversed a previous decision in Fenimore v. The Regents of the University of California, holding that the trial court improperly sustained the University’s claim that there was no legal basis for the lawsuit. In this case, plaintiffs alleged that the hospital committed neglect as defined in the Elder Abuse and Dependent Adult Civil Protection Act (EADACPA) by allowing the patient to fall minutes after entering the facility, failing to treat his fractured hip for four days and violating state staffing regulations. The Court of Appeal found that the first two allegations were insufficient to support elder abuse liability because they demonstrated no more than mere negligence. However, plaintiffs’ additional allegation that the hospital violated state staffing regulations provided a sufficient basis for finding neglect.

CHA News Article

Appeal Filed in Interdisciplinary Team Consent Case

Both the plaintiff and the defendant in an Alameda County Superior Court case have appealed a new ruling finding unconstitutional a California statute that allows skilled-nursing facilities (SNFs) to use an interdisciplinary team to make medical decisions for patients who lack capacity and have no family or other representative to make those decisions. The decision and the order in the case, California Advocates for Nursing Home Reform (CANHR) v. Chapman (Director of the Department of Public Health), are attached. They are not in effect pending the appeal.

CHA News Article

CDI Issues Permanent Regulations on Network Adequacy
Regulations effective immediately

The California Department of Insurance (CDI) has issued permanent regulations on provider network adequacy that go into effect immediately. The regulations were approved by the Office of Administrative Law and replace the emergency regulations issued in January 2015. The new network adequacy regulations will apply to insurers regulated by the CDI. Plans regulated by the Department of Managed Health Care — typically health care plans such as HMOs and some PPOs — are subject to different network adequacy laws and regulations.

Recording

The End of Life Option Act Webinar
Understanding the law, considerations for developing and implementing policies

Webinar recorded live April 18, 2016

The End of Life Option Act is one of the most important bills the Governor signed into law this year. Individuals who have a terminal illness and meet certain qualifications may now ask their physician for prescription medication to end their life. The law is complicated and not without controversy.

Overview

Patient Rights

California and federal laws give hospital patients many rights. Hospitals must notify patients of these rights by giving patients a handout and/or by putting posters up in the hospital.

CHA has developed a sample handout that hospitals may use to notify patients of their rights under state hospital licensing regulations, the Medicare Conditions of Participation, and The Joint Commission.

Publication

Principles of Consent and Advance Directives
UPDATED MAY 2016! A handbook on patient consent for treatment and other health care decisions, including the End of Life Option Act

This handbook guides you through the basic principles of patient consent for health care treatment. In clear, simple terms this publication explains why and when consent is necessary, who may give consent, how consent for minors is different, and procedures that require special consent. It also describes the hospital’s obligations when dealing with complicated issues like advance health care directives, California’s POLST form, refusal of treatment, and end-of-life decisions, including the new End of Life Option Act effective June 9, 2016.

Publication

2016 Consent Manual
The trusted resource for consent and related health care law

From basic principles to specific procedures, the Consent Manual is your one-stop resource for all legal requirements related to patient consent for medical treatment, release of medical information, reporting requirements and more. Learn exactly what the law requires and what you need to do to comply.

CHA News Article

CDPH Provides Guidance for Submitting End of Life Option Act Forms

 California’s new End of Life Option Act — which allows terminally ill patients to obtain a prescription from their attending physician for medication to end their life — requires physicians who write such prescriptions to submit specified documentation to the California Department of Public Health (CDPH).  While the Act itself does not specify how the documentation should be submitted, CDPH recently announced those details.

Recording

The End of Life Option Act Webinar
Understanding the law, considerations for developing and implementing policies

Webinar recorded live April 18, 2016

The End of Life Option Act is one of the most important bills the Governor signed into law this year. Individuals who have a terminal illness and meet certain qualifications may now ask their physician for prescription medication to end their life. The law is complicated and not without controversy.

CHA News Article

New Law Establishes Requirements for Post-Hospital Patient Care

Gov. Brown has signed SB 675 (Liu, D-La Canada Flintridge), which requires a hospital to provide an opportunity for each inpatient to identify a family caregiver who may assist in post-hospital care, and to provide an opportunity for the patient and caregiver to participate in the discharge planning process. The hospital must provide information and, when appropriate, instruction about the patient’s post-hospital care needs and medications. The instructions must be provided in a culturally competent manner and in a language that is comprehensible to the patient and caregiver, and must include an opportunity for the caregiver to ask questions. The law also requires hospitals to attempt to notify the patient’s designated family caregiver about the patient’s discharge or transfer to another facility as soon as possible. However, the discharge or transfer does not have to be delayed until notification is accomplished. Hospitals should document all steps required by this law, which becomes effective Jan. 1, 2016.

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 Releases Overall Star Ratings on Hospital Compare
Hospital field strongly objects to methodology used

Today, the Centers for Medicare & Medicaid Services (CMS) released its new hospital star ratings on the Hospital Compare website. CMS states that these ratings reflect comprehensive quality information about hospital care, summarizing 64 quality measures into a rating system of one to five stars. However, CHA and hospital associations nationwide have opposed the ratings system as it ignores social determinants of health, such as the hospital’s community and patient income, unfairly penalizing teaching hospitals and those serving higher numbers of the poor. The star ratings conflict with other rating and ranking systems, causing confusion for patients and their families, and a recent analysis by an independent expert found that the assumptions upon which the current model is based are flawed. CHA, along with other state associations and the American Hospital Association, urged CMS to work with hospitals to validate the methodology or withhold publication. CHA remains committed to sharing quality and safety information and — through the Hospital Quality Institute — aims to accelerate the rate of patient safety and quality care improvement for all Californians.

CHA News Article

CMS Issues Report on Hospice HIS Submissions

The Centers for Medicare & Medicaid Services (CMS) has released the Hospice Timeliness Compliance Threshold report. The report displays provider-level data on the hospice item set (HIS), including provider identification information, number of HIS records submitted and number of HIS records submitted on time, as well as percentage of HIS records submitted on time. Additional information is available on the CMS website

CHA News Article

Expert Committee Releases Report on Social Risk Factors in VBP

An expert committee convened by the National Academies of Sciences, Engineering, and Medicine has released a new report — titled Accounting for Social Risk Factors in Medicare Payment — requested by the Department of Health and Human Services (HHS). As Medicare replaces fee-for-service payments with value-based payments, concerns have been raised over social risk factors’ effect in determining the quality of care provided and corresponding value-based payments. Health providers that predominantly care for patients with social risk factors may fare poorer on quality rankings and be unfairly reimbursed at lower rates.

The committee’s primary task was to determine the social risk factors that could be accounted for in evaluating the quality of care provided, including income, education, dual eligibility, race, ethnicity, language, nativity, marital/partnership status, living alone, neighborhood deprivation, urbanity and housing. HHS will conduct a webinar on the report on July 20; registration is available online. The committee is now tasked with designing a method for collecting data that could be used in accounting for social risk factors, to be detailed in its next report.

CHA News Article

Data Submission Deadlines Approaching for Hospital IQR Program

The deadline for hospitals participating in the hospital inpatient quality reporting (IQR) program to submit Q1 population and sampling data is Aug. 1. Inpatient prospective payment system hospitals participating in IQR must submit Q1 data to receive the full annual payment update. Hospitals must submit the quarterly aggregate Medicare and non-Medicare population and sample counts for the required IQR measure sets to receive the full annual payment update. 

The submission period for hospitals participating in the IQR program to submit Q1 perinatal care elective delivery measure data has been delayed. It is currently expected to begin July 21 and end Aug. 15.  

CHA News Article

Hospitals Asked to Report Cases of Bukholderia cepacia

The California Department of Public Health (CDPH) Healthcare-Associated Infections (HAI) program, in partnership with the Centers for Disease Control and Prevention, is attempting to identify hospitals that have detected clusters of Burkholderia cepacia cases among pediatric or adult ICU patients, particularly since January 2016. To report clusters, please contact the CDPH HAI program at haiprogram@cdph.ca.gov. More information about the virus is available at www.cdc.gov/HAI/organisms/bCepacia.html

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

DHCS Issues Guidance on Inpatient Billing to Medi-Cal Managed Care Health Plans

Yesterday, the Department of Health Care Services (DHCS) issued two all-plan letters (APLs) to provide Medi-Cal managed care health plans (MCPs) information about the appropriate billing of inpatient services for beneficiaries with California Children’s Services (CCS)-eligible conditions who are also enrolled in a MCP. One APL provides instructions for billing inpatient services at private, municipal and district hospitals; the other provides instructions for billing the same services at designated public hospitals.

CHA News Article

HRSA to Host July 20 Webinar on 340B Recertification

The Health Resources and Services Administration’s (HRSA) Office of Pharmacy Affairs (OPA) will host a webinar July 20 from 10-11 a.m. (PT) to assist covered entities with the recertification process for the 340B Drug Pricing program. All 340B hospitals are required to recertify with HRSA to ensure they continue to meet the 340B hospital eligibility requirements. The hospital recertification process runs from mid-August to mid-September. Hospitals can join the webinar by visiting https://hrsa.connectsolutions.com/recertification/; the conference number is (888) 787-0207, and the participant passcode is 7814467.

CHA News Article

CMS Conducts Medicaid Payment Error Rate Measurement Review
California providers may be asked to respond

The Department of Health Care Services (DHCS) has notified Medi-Cal providers that the Centers for Medicare & Medicaid Services (CMS) is conducting a payment and error rate measurement (PERM) review in California. The review measures improper payments in Medicaid and the Children’s Health Insurance Program (CHIP), as required by the Improper Payments Information Act. Error rates are based on reviews of the fee-for-service, managed care and eligibility components of Medicaid and CHIP in the fiscal year under review.

Approximately 383 Medi-Cal claims will be selected from each quarter between Oct. 1, 2015, and Sept. 30, 2016. Providers whose claims have been selected for review will receive requests from CNI Advantage, the review contractor, for copies of medical records. Providers will also be required to send a duplicate copy of the requested records to DHCS, which is taking this proactive step to review the submitted documentation and determine if further information is needed to support the claim.

CHA News Article

DHCS Temporarily Suspends EHR Payments and Attestations
CHA seeks feedback from affected hospitals

This week, the Department of Health Care Services (DHCS) announced it will temporarily suspend all hospital attestation reviews and payments related to the Electronic Health Record (EHR) Incentive program. DHCS recently received preliminary results from EHR audits that the Office of the Inspector General (OIG) conducted at 60 hospitals, which found overpayments and underpayments at a number of hospitals; DHCS is awaiting the OIG’s final report to determine the full impact of its findings. CHA is aware that some hospitals that have undergone an EHR audit by the OIG have concerns about next steps the state may take in implementing the OIG findings, and the appropriateness of those actions in light of providers’ concerns raised during the audits. To discuss further and provide feedback, contact Amber Ott, CHA’s vice president, finance, at aott@calhospital.org

CHA News Article

Subscription Service Offers Latest Medi-Cal News

Providers who wish to receive Medi-Cal news updates may register for the Medi-Cal Subsciption Service, a free mailing that provides urgent announcements and other Medi-Cal news. Subscribers can sign up to receive NewsFlash announcements, Medi-Cal update bulletins and/or system status alerts. Registration is available at http://files.medi-cal.ca.gov/pubsdoco/mcss/mcss.asp

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

Children’s Hospitals GME Payment Program Now Accepting Applications

The Health Resources and Services Administration’s Bureau of Health Workforce is accepting applications for the Children’s Hospital Graduate Medical Education Payment program. The program will grant between 55 and 65 awards, totaling approximately $295 million for fiscal year 2017, to freestanding children’s hospitals that participate in an approved graduate medical education program and that have a Medicare payment agreement. Funding will support training for pediatric and other residents in graduate medical education programs at freestanding children’s teaching hospitals.

The application deadline is July 15. For information, technical assistance or to apply, visit the program website.

CHA News Article

Family Medicine and Primary Care Residency Applications Available
Song-Brown program applications due June 3

This year, the Song-Brown program will award $4.13 million to family medicine programs and $2.84 million to primary care residency programs, demonstrating a commitment to increasing the number of family medicine and primary care providers in California.

The applications were released April 26 and are due by 3 p.m. on June 3. Family medicine and primary care hospital residency programs are eligible for the awards and should consider applying. For more information, visit the Song-Brown website

CHA News Article

National Health Service Corps Accepting Applications for Approved Sites
Application webinar to be held April 26

The National Health Service Corps (NHSC) is accepting applications for facilities to become approved NHSC sites. The NHSC provides assistance for qualifying practice sites in recruiting and retaining community-responsive, culturally competent primary care clinicians. Once a facility is approved as an NHSC site, position vacancies will be published on the NHSC Jobs Center and viewed by hundreds of clinicians, including NHSC Scholars and those interested in the loan repayment program.

CHA News Article

Commission to Discuss Health Care Workforce Training Programs
Meeting to be held May 18 in Sacramento

The California Healthcare Workforce Policy Commission (CHWPC) will hold a policy meeting on May 18 to discuss Song-Brown health care workforce training programs, including the family nurse practitioner and registered nurse application criteria and evaluation criteria; allocation of surplus primary care residency funds; nurse mid-wifery programs and more. The Song-Brown Program, which is aided by CHWPC, provides financial support to family medicine, internal medicine, OB/GYN and pediatric residency programs, as well as family nurse practitioner, physician assistant and registered nurse education programs throughout California. CHWPC is a 15-member citizen advisory board that provides expert guidance and statewide perspectives on health professional education issues, reviews applications and recommends contract awards to the OSHPD director. More information is available at www.oshpd.ca.gov/hwdd/song-brown-program.html.

CHA News Article

Song-Brown Webinars Will Address Upcoming Application Release
Family medicine and primary care residency applications to be available soon

This year, the Song-Brown program will award more than $12 million to medical programs that are committed to increasing the number of family medicine and primary care providers in California. Family medicine hospital residency programs are eligible for the funding and should consider applying.

In anticipation of the approaching release date for family medicine and primary care residency applications, the program will conduct several webinars. The webinars will provide an overview of the application, registration and lessons learned, and will address applicant questions. Visit the Song-Brown website for dates, times and links to webinars.

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