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 Posts Quarterly Reports on Facility Performance Metrics

The California Department of Public Health Center for Health Care Quality has released quarterly performance metrics on long-term care facilities and — for the first time — non-long-term care facilities, including general acute hospitals. The reports provide data through Sept. 30, 2016, on facility complaints, entity-reported incidents and relicensure surveys. 

CHA News Article

CDPH Funding Available for Regional Perinatal Programs
Applications due March 23

The California Department of Public Health (CDPH) is now accepting applications for state funding to assist with implementing the Regional Perinatal Programs of California (RPPC). Under CDPH’s direction, grant recipients will develop and maintain a network of providers and facilities within specific geographic areas and match the needs of high-risk perinatal patients with the appropriate type and level of care. Applications will be accepted through March 23; eligible entities include public or private nonprofit health agencies, hospitals, nonprofit community-based organizations and community clinics classified as 501 (c)(3) tax exempt. Total funding for the program is estimated to be $3.9 million for two years, and will be allocated from the state general fund. For more information and to apply, visit the CDPH website.

CHA News Article

CDPH Issues AFL on Primary Care Clinic Consolidated Licensure

The California Department of Public Health  has released the attached All-Facilities Letter outlining compliance requirements for licensed primary care clinics (PCCs) under AB 2053 (Chapter 639, Statutes of 2016), which took effect Jan. 1. AB 2053 established consolidated licensure for PCCs, allowing eligible clinics to add additional physical plants to their current license maintained and operated on separate premises. A PCC or affiliate clinic may add additional locations that are no more than one-half mile from the licensed clinic adding the additional physical plant. A licensing fee is required for each additional physical plant approved on the license. For more information, see the attached letter.

CHA News Article

CDPH Revises New Hospital Relicensing Survey

The California Department of Public Health (CDPH) Licensing and Certification (L&C) program earlier this year implemented a new general acute care hospital relicensing survey, intended to evaluate facility compliance with statutory and regulatory requirements addressed in Title 22 and the Health and Safety Code. CDPH has reissued the relicensing survey protocol with several changes.

Focused on quality of care, the survey will consist of a review of nursing and pharmacy as well as identified past compliance concerns. L&C will review three years of past compliance, including deficiencies and associated plans of correction — all of which could be areas of emphasis during the survey. Hospitals should be prepared to provide a full list of services and locations to the survey team, including outpatient services, and should review all past compliance issues (including 2567s, plans of corrections, etc.) as well as every complaint, entity-report incident and breach of medical information reported. To help hospitals better understand the survey process, CHA hosted a webinar, available for purchase, on the upcoming changes and has developed the California Hospital Survey Manual. Hospitals are encouraged to review information about the survey on the CDPH website.

Recording

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

Webinar Recorded Live February 18, 2016

Overview

Changes are coming!

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.

CHA News Article For Members

CHA Releases Brochure Highlighting California’s Community Benefit History

CHA has released the attached educational brochure highlighting California’s community benefit history. For more than 20 years, California’s not-for-profit (NFP) hospitals have led the nation in ensuring that vulnerable populations have access to much needed health care services and health improvement programs. Each year, they contribute an estimated $12 billion to their communities through community benefit programs and activities, including mobile units serving disadvantaged families, classes on disease management and violence prevention, health professions education programs that train the next generation of health care providers, research in clinical and community health that contributes to evidence-based practices, leadership development and training for community members, and much more.

The brochure highlights the ways NFP hospitals partner with their communities to assess community health needs, and explains why flexibility in program development is critical.

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.

Education event

Consent Law Seminar
Consent rules for mental capacity, opioid addiction issues, reporting hot spots, new laws

Location:
April 24, San Diego             April 25, Ontario
May 9, Fresno                      May 16, Irvine
May 17, Glendale                 May 31, Sacramento
June 1, San Ramon

The annual Consent Law Seminar is the one educational program that will expand your knowledge and critical thinking to help you make tough decisions with confidence. As an added bonus, all attendees take home a free copy of CHA’s 2017 Consent Manual.

General information

Emergency Department Toolkit
Behavioral health resources for the emergency department

Special resource toolkit developed by CHA’s EMS/Trauma Committee and the Center for Behavioral Health.  Designed to help staff provide support to patients in the ED with psychosis and/or substance abuse disorders, this toolkit provides access to articles, policies, management techniques, assessment tools and more. Click the topic tabs below to access resources and information.

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.

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

State to Provide Guidance for Sterile Compounding Construction Projects
Hear insights from Board of Pharmacy, OSHPD and CDPH

Hospitals that perform sterile compounding must meet new regulatory requirements from the California Board of Pharmacy, including improving or reconfiguring facilities for ventilation, installing new equipment for sterility and ensuring employee protections. CHA will hold a webinar April 21 from 10 a.m. to noon (PT) to explain the new requirements. Representatives from the California Board of Pharmacy will share strategies to manage services while under construction, as well as the waiver application and renewal process; the Office of Statewide Health Planning and Development Facilities Development Division will review its new Sterile Compounding Advisory Guidebook; and the California Department of Public Health Licensing and Certification Program will discuss what to expect from surveyors under the new regulations. 

Education event

Sterile Compounding Pharmacies — Planning, Construction and Licensing Guidance Webinar
Gain insights from CA Board of Pharmacy, OSHPD, CDPH Licensing & Certification

April 21, 2017
10:00 a.m. – 12:00 p.m., Pacific Time

New CA Board of Pharmacy sterile compounding regulations were effective January 2017. Beyond updating processes and procedures, hospitals will be required to improve or reconfigure facilities for ventilation, install new equipment for sterility and ensure employee protections. Learn the necessary steps for compliance from three California entities: the Board of Pharmacy, OSHPD Facilities Development Division and CDPH Licensing and Certification Division.

CHA News Article

New Federal Standards for Medical Diagnostic Equipment Released
Now under consideration by California Access Program

This month, the federal Architectural and Transportation Barriers Compliance Board issued the attached final rule updating standards for medical diagnostic equipment. The new standards — which would impact examination tables and chairs, weight scales, mammography and other imaging equipment — would allow independent entry to, use of and exit from the equipment by individuals with disabilities, to the maximum extent possible. The federal standards do not impose requirements on health care providers or medical device manufacturers. However, access enforcement authorities, such as the California Division of the State Architect Access Compliance Program, may issue regulations or adopt policies that would require health care providers to acquire accessible medical diagnostic equipment that complies with these standards.

CHA News Article

OSHPD Issues Guidance on All-Gender Toilet Facilities

The Office of Statewide Health Planning and Development has issued the attached Policy Intent Notice (PIN) to help providers implement requirements of AB 1732 (Chapter 818, Statutes of 2016). Under the new law, which takes effect March 1, all single-user toilet facilities in any business, place of public accommodation or state or local government agency must be 1) identified as “all-gender” toilet facilities by signage that complies with Title 24 of the California Building Standards Code and 2) designated for use by no more than one occupant at a time or for family or assisted use. More details, including signage requirements, are provided in the attached PIN.

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

CMS to Host Training Call on Emergency Preparedness Final Rule

The Centers for Medicare & Medicaid Services (CMS) will host a call detailing requirements of its emergency preparedness final rule on April 27 from 11:30 a.m. to 12:30 p.m. (PT). During the call, CMS will provide an overview of the regulation and training and testing requirements, and will allow time for a question and answer session. For more information and to register, visit the CMS website.

CHA News Article

CDPH to Host Call Wednesday on 2017-18 Hospital Preparedness Grants

The California Department of Public Health will host a conference call March 29 to discuss changes in the 2017-18 Public Health Emergency Preparedness and Hospital Preparedness programs. To be held from 3-4 p.m. (PT), the call will also include discussion of new five-year local contracts and changes to the minimum core membership for qualifying as a health care coalition beginning July 1. To join the call, dial (800) 230-1766 and reference “CDPH, FY 17-18 Local Grant Application & Contract.”

CHA News Article

Deadline Approaching to Submit Presentations for Disaster Planning Conference
Submission deadline is April 7

CHA is now accepting submissions for presentations and best practices posters at CHA’s 2017 Disaster Planning for California Hospitals conference, taking place Sept. 18-20 in Sacramento. The conference is a unique opportunity for members to share their emergency preparedness knowledge, innovative programs, tools and lessons learned with other member hospitals. More than 700 hospital emergency preparedness coordinators, hospital administrators, CNOs, EMS personnel and public health officials are expected to attend. Presentation submissions will be reviewed by the conference committee and considered for pre-conference workshop, plenary and breakout sessions. The submission deadline is April 7. For more information and to submit an application, visit www.calhospital.org/disaster-planning.

CHA News Article

Active Shooter Planning Document Updated for Health Care Setting

Updated annually, the Active Shooter Planning and Response document includes a new pocket tool for health care active shooter scenarios as well as advice on how to survive such a scenario.

CHA News Article

CDC Tool Helps Public Health Officials Communicate Radiation Emergency

The Centers for Disease Control and Prevention (CDC) has released the newly developed Radiation Hazard Scale to help public health officials communicate with the public in a radiation emergency. Designed to be simple to understand, the tool’s scale is intended to communicate relative hazards to people under emergency conditions when exact radiation exposure parameters are not available. During the emergency, environmental scientists and radiation safety experts will evaluate the data and, in conjunction with emergency management authorities and public health officials, assign radiation hazard categories. More information is available on the CDC website.

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.  

CHA News Article

Draft Air Pollution Guidelines Developed
Hospitals should work with local AQMD to develop district standards

The California Air Pollution Control Officers Association has developed the attached draft guidelines updating procedures for public notification of air pollution risks and incorporating advances in the field of risk assessment. Current law requires regulated facilities, including hospitals (under certain conditions), to report the types and quantities of toxic air pollutants they routinely emit. For hospitals, this includes emissions from back-up diesel generators. The law, known as the “Hot Spots” Act, also requires air quality management districts (AQMDs) to determine which facilities must conduct health risk assessments using the California Air Resources Board’s Emission Inventory Criteria and Guidelines. The draft guidelines, developed with assistance from the California Office of Environmental Health Hazard Assessment and the California Air Resources Board, are intended to be used by local districts in evaluating their Hot Spots programs. Hospitals should work with local AQMDs to learn how these guidelines will be implemented at the district level and whether their district will also update its pollution emission standards.

CHA News Article

State to Provide Guidance for Sterile Compounding Construction Projects
Hear insights from Board of Pharmacy, OSHPD and CDPH

Hospitals that perform sterile compounding must meet new regulatory requirements from the California Board of Pharmacy, including improving or reconfiguring facilities for ventilation, installing new equipment for sterility and ensuring employee protections. CHA will hold a webinar April 21 from 10 a.m. to noon (PT) to explain the new requirements. Representatives from the California Board of Pharmacy will share strategies to manage services while under construction, as well as the waiver application and renewal process; the Office of Statewide Health Planning and Development Facilities Development Division will review its new Sterile Compounding Advisory Guidebook; and the California Department of Public Health Licensing and Certification Program will discuss what to expect from surveyors under the new regulations. 

CHA News Article

Seminar to Explain Wise Water Use in Hospitals

Next week, Practice Greenhealth will hold a repeat presentation of its webinar for hospitals on effective water reduction and conservation policies. To be held March 23 at 11 a.m. (PT), the webinar will explain how to reduce potable water consumption; explore harvesting, managing and reusing water; and steps hospitals can take to ensure their facilities are resilient to the impact of climate change, such as drought and flooding. For more information and to register, visit the Greenhealth Academy website.

CHA News Article

New Courses Available for Emergency Response to Radiation Incidents

In partnership with the Oak Ridge Institute for Science and Education (ORISE), the Radiation Emergency Assistance Center/Training Site (REAC/TS) provides emergency response advice and consultation for the National Nuclear Security Administration’s Office of Emergency Response as well as a number of continuing education classes geared toward health care professionals. Medical personnel, emergency planners, public health professionals and others will learn about the medical management of radiological/nuclear incidents through didactic and hands-on education. An additional course accredited by the American Academy of Health Physics is available for health physicists, medical physicists, radiation safety officers and nuclear medicine personnel.

The REAC/TS course brochure for October 2016 – September 2017 is available on the ORISE website, and online registration is now available. Courses are held at the REAC/TS Facility in Oak Ridge, TN. REAC/TS is also available to conduct one or two-day training programs at hospital locations. For more information, contact reacts@orau.org or call (865) 576-3131.

Post

CDC releases toolkit to reduce risk of Legionella

The Centers for Disease Control and Prevention (CDC) released a new toolkit to prevent Legionnaires’ disease outbreaks. The toolkit builds off of ASHRAE 188: Legionellosis: Risk Management for Building Water Systems.

The toolkit provides an easy-to-understand interpretation of ASHRAE Standard 188, as well as worksheets, checklists and scenarios of common water-quality problems. It also contains special sections and considerations for health care facilities.

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

HFMA Northern California Spring Conference Is Near
Still time to register for this year’s event in Sacramento

The Healthcare Financial Management Association (HFMA) Northern California Spring Conference is set for April 13-14 at the Sheraton Grand Hotel in Sacramento. CHA and the Hospital Council of Northern and Central California are proud to support this annual event tailored for health care financial management professionals. The spring conference features keynote addresses and 20 breakout sessions over five tracks: innovation, back-to-basics, LEAN, legislative/compliance, finance/business/analytics and revenue cycle. Supplemental sessions on creating wealth for retirement and time management will also be offered. A preconference on the PEAK program will be held the evening of April 12. For more information or to register, visit the HFMA event web page.   

CHA News Article

DHCS Announces Fiscal Intermediary Name Change

The Department of Health Care Services (DHCS) has announced that the current Medi-Cal fiscal intermediary for its fee-for-service system, Xerox State Healthcare, LLC, has been rebranded to Conduent State Healthcare, LLC. This shift, caused by the entity’s separation from its parent company, reflects its shift to a new independent, publicly traded company called Conduent Incorporated. The rebranding process began Jan. 3, when the separation was finalized.

It is essential for Medi-Cal-enrolled providers, beneficiaries and stakeholders to know that, effective Jan. 3, 2017, correspondence bearing the name Conduent may be related to Medi-Cal.

To stay informed about any changes occurring within Medi-Cal, enrolled providers, beneficiaries and stakeholders should open and read all information sent from DHCS, Xerox or Conduent. More information is available on the DHCS website.

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

CMS Finalizes Rules for the Health Insurance Marketplace

Last week, the Centers for Medicare & Medicaid Services (CMS) issued the Notice of Benefit and Payment Parameters final rule and the final Annual Letter to Issuers for 2018 in the Federally Facilitated Marketplaces. The final rule establishes standards for issuers and each health insurance marketplace, generally for plan years that begin on or after Jan. 1, 2018. The policies in the final rule include updates to the risk adjustment program and to eligibility, enrollment and benefits, as well as other changes that aim to streamline the marketplace consumer experience and strengthen the marketplaces’ individual and small group markets as a whole. The final rule builds on other actions CMS has taken to strengthen the marketplaces in recent weeks and months, including an interim final rule addressing concerns about third-party premium payments and a pilot that will test whether pre-enrollment verification of special enrollment periods strengthens the marketplace risk pool while maintaining access to coverage.

CHA News Article

CHA to Host Webinar on Policy and Politics of ACA Repeal, Replace, Delay
Members-only program is Dec. 20; register today

CHA will hold a complimentary, members-only webinar Dec. 20 from 9-11 a.m. (PT) to address the next Congress and the direction of federal health care policy. With the transition to the Trump Administration, the balance of power will shift in Washington, D.C. — and health care policy will likely face dramatic changes.

“One point is clear — what will happen in health care policy is unknown,” said CHA President/CEO C. Duane Dauner. “California could suffer severe losses or might gain new opportunities. With so much at stake, CHA is working diligently to convey CHA’s key principles to Congressional leaders as 2017 legislation is being developed.”

CHA News Article

Report Examines Efforts to Improve Care Quality, Coordination and Costs Through Provider Collaborations
Highlights efforts of CHA member hospitals, health systems

The California HealthCare Foundation has released a report that examines efforts to improve care quality, coordination and costs through provider collaborations. The report acknowledges that California providers — many of them CHA members — have been particularly active in developing collaborations among themselves and with commercial health plans in response to the Affordable Care Act. Many of these partnerships have been driven by key market factors characteristic of many California communities — most notably, the presence of large providers experienced in managing financial risk for patient care, as well as competitive pressure on both insurers and providers. Most of these initiatives aim to slow the growth of health care spending and improve the coordination and quality of patient care. 

The report describes integration efforts that have proliferated in California since 2013, highlights leading examples from the seven regions studied, discusses collaborators’ key goals and strategies, and explores how market conditions spurred each major type of partnership and influenced their structure.

CHA News Article

Members of Congress Sign Letter Calling for Liver Transplantation Reform

Working with colleagues in New York and New Hampshire, CHA asked members of the California congressional delegation to sign a letter addressed to Secretary of Health and Human Services Sylvia Burwell, urging reform of the current liver distribution methodology.  A total of 68 members of the U.S. House of Representatives, including 27 from California, signed the letter.  

The current methodology — which is based on 58 local donation service areas (DSAs) of varying size, density and health — creates large disparities in access to liver transplantation between patients in different regions of the country. To increase fairness of liver allocation, the signatories of the letter recommend that the Department of Health and Human Services adopt the United Network for Organ Sharing (UNOS) committee’s proposal to condense the 58 DSAs to between four and eight districts. The proposal also specifies that each district would contain at least six liver transplant centers that support a maximum median transplant-volume-weighted transport time between DSAs of no more than three hours. The letter echoes CHA’s beliefs, outlined in a comment letter to UNOS last week in support of their recommendations.

CHA News Article

CHA Comments on Recommendations for Liver Transplant Regions

CHA has submitted the attached comment letter to the United Network for Organ Sharing (UNOS), supporting the Liver and Intestinal Organ Transplantation Committee’s recommendations to reduce geographic and economic disparities in access to liver transplantation. CHA believes the current liver allocation methodology, which operates under 58 local donation service areas (DSAs), is responsible for the unfair disparities that deprive many Californians of life-saving liver transplants.

In the letter, CHA comments on the high barriers Californians face in receiving liver transplantation compared with patients in other areas of the nation, who are arbitrarily favored due to the unbalanced structure of the 58 DSAs. In addition, because Californians suffer from a higher incidence of liver disease, patients wait longer, receive livers when they are sicker and die at substantially higher rates. 

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

GAO Reports on Patient Access to Electronic Health Information

The U.S. Government Accountability Office (GAO) recently issued a report that reviewed the state of patients’ electronic access to their health information. The report found that relatively few patients electronically access their health information when offered the ability to do so and that – while patients generally find access beneficial — there are limitations, such as the inability to aggregate health information from multiple providers into a single record. The GAO recommended that the Department of Health and Human Services develop performance measures to assess outcomes of efforts related to patients’ electronic access to longitudinal health information, and use the information from these measures to help achieve program goals. The full report is available on the GAO website.

CHA News Article

EHR Hospital Reports Now Available for CY 2016

The Centers for Medicare & Medicaid Services (CMS) has announced that electronic health record hospital reports for the Inpatient Quality Reporting program are now available for calendar year 2016. Hospitals should visit the QualityNet portal to access their reports and should begin process improvement based on the reporting. Hospitals that were unable to report electronic clinical quality measure data prior to the deadline may request an extraordinary circumstances exemption, which must be submitted by April 1. For more information, see CMS’ recently released guidance, attached.

CHA News Article

Deadline to Submit eCQMs, Attest to Meaningful Use Is March 13

CHA reminds members that the deadline to attest to the Medicare electronic health record (EHR) program, as well as the deadline to submit electronic clinical quality measures (eCQMs) for the EHR and inpatient quality reporting programs, is Monday, March 13. CHA members have reported experiencing challenges submitting eCQMs via the QualityNet Portal; CHA is working with the American Hospital Association to advocate that the Centers for Medicare & Medicaid Services extend the submission deadline. CHA urges members that encounter submission problems to document each submission attempt, both successful and unsuccessful, in the event a payment penalty must be appealed.

CHA News Article

CMS Extends Attestation Deadline for Medicare EHR Program
Hospitals must attest by March 13 to avoid 2018 payment adjustment

The Centers for Medicare & Medicaid Services (CMS) has extended the attestation deadline for providers participating in the Medicare Electronic Health Record (EHR) Incentive Program from Feb. 28 to March 13, at 11:59 p.m. (PT). Providers participating in the Medicare EHR Incentive Program must attest to the 2016 program requirements by the deadline to avoid a 2018 payment adjustment. CMS had previously extended the submission deadline for electronic clinical quality measure  data for both the Medicare EHR Incentive and the Hospital Inpatient Quality Reporting Programs. For questions about the registration and attestation system, contact the EHR information center at (888) 734-6433 (press option 1). The EHR information center is open Monday through Friday from 3:30 a.m. to 2:30 p.m. (PT), except federal holidays. 

Education event

Consent Law Seminar
Consent rules for mental capacity, opioid addiction issues, reporting hot spots, new laws

Location:
April 24, San Diego             April 25, Ontario
May 9, Fresno                      May 16, Irvine
May 17, Glendale                 May 31, Sacramento
June 1, San Ramon

The annual Consent Law Seminar is the one educational program that will expand your knowledge and critical thinking to help you make tough decisions with confidence. As an added bonus, all attendees take home a free copy of CHA’s 2017 Consent Manual.

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

Deadline Approaching for RNs to Submit Complete Fingerprint Records
Failure to submit complete records may result in citation, fine

As previously reported in CHA News, a significant number of registered nurses (RNs) do not have complete fingerprints on file with the Board of Registered Nursing (BRN). Last December, the BRN notified these RNs that their information was incomplete, but many did not respond, according to the BRN. A second notice was sent Jan. 30, with a deadline of Feb. 8. CHA urges RNs to review their fingerprint requirements, particularly the section on determining whether to submit new fingerprints. Failure to submit fingerprints by the Feb. 8 deadline could result in a citation and fine of up to $2,500, or referral to the Attorney General’s office for possible disciplinary action. 

CHA News Article

Save the Date for CHA’s Hospital Employee Safety and Workers’ Compensation Seminar

CHA’s annual Hospital Employee Safety and Workers’ Compensation Seminar will be held March 22 in Sacramento and March 30 in Costa Mesa. Make plans now to attend the hospital-focused seminar that offers practical guidance and comprehensive information to improve and manage employee safety and workers’ compensation programs. The one-day, members-only program includes sessions on Cal/OSHA’s workplace violence prevention regulation, managing employee leaves of absence, using data and metrics to improve employee programs, employer leading practices and more. A detailed agenda and program registration will be available later this month.

CHA News Article

CDPH Urges Vaccination as Influenza Cases Spread in California

The California Department of Public Health (CDPH) has announced that influenza activity has reached “widespread” levels and urges vaccination. Since the season began, CDPH has received reports of three deaths as well as 29 severe influenza cases that resulted in intensive care unit admission in patients 64 years of age and younger. In the U.S., influenza activity reaches its highest levels between December and February, and may continue through May. According to CDPH, the flu specimens that have been tested match very closely to the current vaccine strains, assuring protection against the flu.

CHA News Article

RNs With Incomplete Records Must Submit Fingerprints
BRN to notify affected RNs, provide instructions

The Board of Registered Nursing (BRN) has determined that certain registered nurses do not have both Department of Justice (DOJ) and Federal Bureau of Investigation (FBI) fingerprint results on file with the BRN. LiveScan testing incorporates both DOJ and FBI requirements; however, if the LiveScan technology did not produce clear results or an outdated method of fingerprinting was used, the RN may not have acceptable fingerprints on file. 

The BRN is working to contact all affected RNs via mail and/or email with instructions. To avoid potential delays in license renewal or other action, RNs should read the information carefully and respond accordingly. In most cases, RNs will be required to submit fingerprints within 60 days of notification or risk citation, fines or referral to the Attorney General’s office for possible disciplinary action.

Detailed information is available at www.rn.ca.gov.

CHA News Article For Members

Labor and Employment Law Seminar to Cover Wage and Hour Pitfalls, New Case Law
First program begins Oct. 19 in Sacramento

Hospital human resources and legal professionals who attend CHA’s annual Labor and Employment Law Seminar will learn practical, useful information to help successfully structure policies, procedures and programs that encompass new developments and ensure compliance. Set for Oct. 19 in Sacramento and Oct. 26 in Los Angeles, the seminar opens with an analysis of wage and hour case law, including meal and rest period developments and calculating overtime. Attendees will also learn steps to avoid wage and hour pitfalls related to alternative work schedules, joint employer issues and liability, and more.

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.

Education event

Consent Law Seminar
Consent rules for mental capacity, opioid addiction issues, reporting hot spots, new laws

Location:
April 24, San Diego             April 25, Ontario
May 9, Fresno                      May 16, Irvine
May 17, Glendale                 May 31, Sacramento
June 1, San Ramon

The annual Consent Law Seminar is the one educational program that will expand your knowledge and critical thinking to help you make tough decisions with confidence. As an added bonus, all attendees take home a free copy of CHA’s 2017 Consent Manual.

CHA News Article For Members

FDA Identifies Hospitals That Have Not Reported Device Malfunctions

The Food and Drug Administration (FDA) has publicly disclosed multiple hospital violations of the mandatory reporting requirement when a medical device may have caused harm. Hospitals and other health care providers (“device user facilities”) must report to the FDA any event that reasonably suggests that a medical device has or may have caused or contributed to a death or serious injury of a patient. This includes user error; improper or inadequate design, manufacture or labeling; or any other cause of harm related to a device, as well as device malfunction.

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.

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.

CHA News Article

Hospitals Should Review Child Abuse Reporting Policies

Effective Jan. 1, a hospital’s internal child abuse reporting policy may not direct employees to allow their supervisor to file or process a mandated report under any circumstances.

CHA News Article

New Nondiscrimination Policies in Effect
Providers must ensure compliance with new federal and state regulations

Several updated nondiscrimination policies took effect this month, requiring health care providers to ensure their programs are compliant. New requirements under Section 1557 of the Affordable Care Act took effect July 18; the U.S.

Publication

Principles of Consent and Advance Directives
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.

General information

Population Health Management
Listen to podcasts and webinar recordings to master PHM

Overview

A major transformation is underway in health care to enhance patient care quality, access and experience, and reduce costs. Because population health management (PHM) is the direction in which health care is moving, the California Hospital Association is pleased to provide member hospitals with comprehensive and substantive podcasts and webinar recordings designed to enhance the knowledge and skills needed to succeed under a PHM construct.

Master PHM
Based on CHA’s webinar series, Population Health Management: A comprehensive, five-part program for hospital leaders, the podcasts and recordings offer critical information for executives and professionals in a wide range of organizations. Five key areas are presented:

  • The PHM Framework
  • Business Considerations for PHM
  • Clinical Considerations for PHM
  • Technology for PHM
  • Leadership and Talent for PHM

Podcasts

Jan. 4, 2017 Podcast
A Framework for Population Health Management — From Providing Care to Managing Health
Jan. 11, 2017 Podcast
Drivers of the Population Health Management Imperative
Jan. 18, 2017 Podcast
Nine Population Health Management Key Competencies
Jan. 25, 2017 Podcast
Comprehensive Care Management — Clinical and Business Competencies
Feb. 1, 2017 Podcast
Types of Risk Assumed by Hospitals and Health Systems Under PHM
Feb. 8, 2017 Podcast
Provider Organization Roles Under PHM
Feb. 15, 2017 Podcast
A Framework for the Pursuit of PHM
Feb. 22, 2017 Podcast
Determining the Market’s Stage and Pace of Change
March 1, 2017 Podcast
Evaluating Organizational Position and Competence Gaps
March 8, 2017 Podcast
Identifying PHM Opportunities, Determining Scope and Scale
March 15, 2017 Podcast
Defining a Contracting Strategy to Support PHM Opportunities
March 22, 2017 Podcast
Identifying the Appropriate PHM Path for the Organization — Build, Buy or Partner

Webinar Recordings

Webinar 1: A Framework for Population Health Management
Webinar 2: Business Imperatives for Population Health Management
Webinar 3: Clinical Imperatives for Population Health Management
Webinar 4: Technology for Population Health Management
Webinar 5: Leadership and Talent for Population Health Management
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 to Hold Training on Home Health Quality Reporting Program

The Centers for Medicare & Medicaid Services (CMS) has announced it will host a two-day, in-person training event on the home health quality reporting program on May 3-4 in Baltimore, MD. For more information and to register, visit the CMS website

CHA News Article

CMS Provides Post-Acute Care Quality Reporting Resources

The Centers for Medicare & Medicaid Services (CMS) has posted the attached quick reference guides for quality reporting programs for several post-acute care providers, including home health agencies, hospice providers, inpatient rehabilitation facilities and long-term care hospitals. The guides include frequently asked questions, information on quality reporting help desks, and links to additional resources.  

CHA News Article

CDPH Updates Guidance to Reflect New State Law for Observation Services
CHA to host webinar explaining state, federal notification laws

CDPH has updated its previous All Facilities Letter (AFL) clarifying the process by which hospitals may apply for an observation services unit, and addressing notification of patients receiving observation services. SB 1076 (Chapter 723, Statutes of 2016), which took effect Jan. 1, requires hospitals to provide a written notice to a patient on observation status who is cared for in a hospital’s inpatient unit or in an observation unit, or following a change in a patient’s status from inpatient to observation.

The law requires the notice to state that while on observation status, the patient’s care is being provided on an outpatient basis, which may affect his or her health care coverage reimbursement. In addition to the notification requirement, SB 1076 allows for the designation and use of observation units for the first time. Many hospitals have developed clinical decision units or emergency department-adjacent units to care for patients on observation status; this was not specifically permitted by state law until now.

CHA News Article

Hospitals Encouraged to Transition to New Tubing Connectors, Review Safety Plans

The law prohibiting hospitals from using tubing “connectors that would fit into a connector other than the type it was intended for” goes into effect this year. Hospitals are encouraged to develop a careful and methodical transition to the new connectors, once an evaluation of marketplace availability shows a stable supply. Hospitals should also review their patient safety plans to ensure that the prevention of misconnecting intravenous (IV), enteral and epidural lines is adequately addressed. More details about patient safety plan requirements are available in Chapter 21 of CHA’s Consent Manual.

Currently, all tubing attached to one of three connector types (epidural, IV and enteral) can be interconnected. Until these connectors are reengineered, approved by the International Organization for Standardization (ISO) and the Food & Drug Administration (FDA), and adequately distributed throughout the health care industry, the possibility of human error remains.   

CHA News Article

CDPH Urges Vaccination as Influenza Cases Spread in California

The California Department of Public Health (CDPH) has announced that influenza activity has reached “widespread” levels and urges vaccination. Since the season began, CDPH has received reports of three deaths as well as 29 severe influenza cases that resulted in intensive care unit admission in patients 64 years of age and younger. In the U.S., influenza activity reaches its highest levels between December and February, and may continue through May. According to CDPH, the flu specimens that have been tested match very closely to the current vaccine strains, assuring protection against the flu.

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

New Request for ALJ Hearing or Review of Dismissal Form Available

The Office of Medicare Hearings and Appeals (OMHA) has released a new form that providers may use to request an administrative law judge (ALJ) hearing or review of dismissal. OMHA encourages appellants to use this form to help ensure the request includes all information necessary to docket the appeal. However, OMHA will continue to accept requests that are filed in other formats, so long as the request is in writing (except for requests for expedited Part D hearings, which may be made orally) and includes all of the information required by regulation. Parties or their representatives must follow the appeal instructions that come with a notice of reconsideration or dismissal for specific instructions on how to appeal the reconsideration or dismissal, and where to send a request for an ALJ hearing or review of dismissal. The new form also includes a toll-free telephone number in large print (18-point font) to assist the visually impaired with obtaining a large-print version of the form or other assistance.

CHA News Article

DHCS Updates Providers on 2017 Medicare Payment Adjustments
Some providers erroneously receiving letters on Meaningful Use from CMS

Due to the late closure of applications for Meaningful Use (MU) for the 2015 program year, the California Department of Health Care Services (DHCS) was unable to send the Centers for Medicare & Medicaid Services (CMS) information on 2015 MU attestations until late December 2016. As a result, some Medi-Cal providers are now erroneously receiving letters from CMS warning that they are subject to Medicare payment adjustments in 2017 because they did not attest to MU in 2015. DHCS has received assurance from CMS that all providers who attested to MU with the Medi-Cal EHR Incentive program for 2015, even as late as Dec. 13, 2016, will not be subject to Medicare payment withholds in 2017. A complete list of providers that attested to MU is available on the DHCS website. CMS has now removed these providers from its list of those subject to payment adjustments in 2017. Questions should be directed to medi-cal.ehr@dhcs.ca.gov.

CHA News Article

DHCS Announces Fiscal Intermediary Name Change

The Department of Health Care Services (DHCS) has announced that the current Medi-Cal fiscal intermediary for its fee-for-service system, Xerox State Healthcare, LLC, has been rebranded to Conduent State Healthcare, LLC. This shift, caused by the entity’s separation from its parent company, reflects its shift to a new independent, publicly traded company called Conduent Incorporated. The rebranding process began Jan. 3, when the separation was finalized.

It is essential for Medi-Cal-enrolled providers, beneficiaries and stakeholders to know that, effective Jan. 3, 2017, correspondence bearing the name Conduent may be related to Medi-Cal.

To stay informed about any changes occurring within Medi-Cal, enrolled providers, beneficiaries and stakeholders should open and read all information sent from DHCS, Xerox or Conduent. More information is available on the DHCS website.

CHA News Article

Final Rule Issued on 340B Drug Ceiling Prices, Manufacturer Penalties
Enforcement to begin April 1

The Health Resources and Services Administration has released its final rule addressing drug ceiling prices and civil monetary penalties for manufacturers in the 340B Drug Pricing program. Required by the Affordable Care Act, the rule amends Section 340B of the Public Health Service Act to impose monetary sanctions on drug manufacturers who intentionally charge a 340B hospital or covered entity more than the ceiling price established under the procedures of the 340B program. It also establishes a new drug pricing policy when sufficient information to establish a 340B ceiling price for a new drug is not yet available, requires manufacturers to refund 340B covered entities within 120 days if the manufacturer determines an overcharge occurred, and requires greater transparency in calculating the 340B ceiling drug prices to ensure that drug manufacturers are not overcharging 340B covered entities.

HRSA plans to begin enforcing the final rule on April 1, and to issue further guidance on the 340B ceiling price reporting system and how 340B covered entities can access ceiling price information.

CHA News Article

President Signs 21st Century Cures Legislation
Includes provision to extend Section 603 grandfather date for off-campus PBDs

President Obama today signed the 21st Century Cures Act, placing the date of enactment as Dec. 13. The legislation includes a provision revising Section 603 of the Bipartisan Budget Act of 2015 to move the grandfather date for off-campus provider based departments (PBDs) under development from Nov. 2, 2015 to 60 days after the law is enacted, as long as the PBD was under development prior to Nov. 2, 2015. CHA expects the new deadline to be on or around Feb. 10, 2017, and will notify members as additional guidance is issued.

This provision would allow PBDs that narrowly missed the November 2015 deadline for furnishing covered outpatient department services, but already have opened or will soon open, to qualify for the higher outpatient prospective payment services (OPPS) rate. There are two tracks for which a provider may be eligible for full OPPS payments in either calendar year (CY) 2017 or 2018 and several steps in the process.

CHA expects additional guidance to be forthcoming from the Centers for Medicare & Medicaid Services (CMS) in the coming weeks to ensure that all providers can appropriately certify as required to receive CY 2018 OPPS payments. 

Profile

Amber Ott
Vice President, Finance

Amber Ott represents members’ financial interests related to Medicare, Medi-Cal, commercial payers and other government entities. She is responsible for providing advocacy and support on financial and reimbursement issues affecting California hospitals and health systems, and represents CHA with state agencies and other stakeholders where hospital finance and technical knowledge is needed. 

Amber is also involved with the development and implementation of the hospital fee and other financing programs.

1215 K Street, Suite 800
Sacramento, CA 95814
(916) 443-7401
(916) 552-7669 Direct
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

Community Colleges Emphasize Key ‘Soft Skills’ in Health Care Training Programs
Hospitals apply curriculum to nurse residency, volunteer programs

 Critical skills such as problem solving, teamwork, professionalism, ethics, compassion and communication are necessary for health professionals and are central to patient-centered care, regardless of an employee’s position in the health care setting.

CHA News Article

Report Highlights Importance of Aligning Strategic Workforce Development, Planning

The American Hospital Association’s 2016 Committee on Performance Improvement has issued the attached report to help hospital and health system leaders align the skills and abilities of their organization’s current workforce with anticipated needs as health care continues to change. CHA staff served on the special subcommittee that developed the report, and the CHA Workforce Committee’s recommendations are reflected in the key messages.

The report includes a tool to help initiate strategic workforce conversations, as well as specific recommendations and examples from hospital leaders and experts in the field.

“There is a critical need to elevate the discussion about workforce planning and development so that it becomes part of a comprehensive strategic plan for hospitals and systems and not just an issue to respond to in a crisis situation,” the report notes. “Current employee shortages, an older health care workforce nearing retirement coupled with the aging patient population, the changing health care delivery system, and limited access to behavioral health services all align to make workforce planning an immediate priority.”

CHA News Article

Health Careers Training Program Now Accepting Mini Grant Applications

The Health Careers Training Program, administered by the Office of Statewide Health Planning and Development’s Health Workforce Development Division, is now accepting applications for its Mini Grant program. The program awards up to $15,000 to cover a variety of activities, such as health career conferences, workshops and health career exploration to underrepresented and/or economically disadvantaged students who wish to pursue careers in the health industry. Public and private nonprofit, as well as private for-profit entities, including hospitals, are eligible to apply. The application deadline is March 1. A technical assistance webinar will be held for prospective applicants on Feb. 8 from 2-3 p.m. (PT). For more information, visit the program website

CHA News Article

CareerSTAT Seeks Frontline Health Care Worker Champion Nominations

CareerSTAT is accepting nominations for its Frontline Health Care Worker Champion recognition program. Champions will receive awards in one of two categories — national champion or emerging champion. Emerging champions will receive targeted technical assistance to expand their programs and an invitation to participate in the CareerSTAT Employer Academy

CareerSTAT is a network of nearly 200 health care and workforce leaders who promote investment in the skills and careers of frontline health care workers using workforce development programs that increase business impact, improve health outcomes and provide good jobs. The deadline to apply is Feb. 17. Interested organizations can read the criteria, review the full application and apply at https://nationalfund.org/initiatives/careerstat/frontline-health-care-champions/.

Questions should be directed to Kelly Aiken, vice president and CareerSTAT director, at kaiken@nationalfund.org.

CHA News Article

Allied Healthcare Loan Repayment Program Expanded

The Allied Healthcare Loan Repayment program has been expanded to 35 counties participating in the County Medical Services Program (CMSP). Eligible applicants may qualify to receive loan repayment benefits of up to $16,000 in exchange for a one-year service obligation providing direct patient care at a qualified and contracted facility.

The program aims to encourage allied health care professionals to work in underserved areas of California. The program includes over two dozen approved allied health professions; a complete listing of CMSP approved professions is available at www.oshpd.ca.gov/HPEF.

The application cycle closes Nov.18. For questions or assistance with the application process, contact the Health Professions Education Foundation at (916) 326-3640.

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