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.

Education event

Consent Law Seminar
Mandated reporting, end-of-life decisions, privacy breach updates, electronics in health care settings

April 28, San Diego; April 29, Ontario
May 12, Glendale; May 13, Costa Mesa
May 20, Sacramento; May 21, Berkeley
May 28, Fresno

Simple or informed consent? Federal law or state law? Reportable or not reportable? Health care professionals consider these questions every day — and it’s not always clear how to proceed. At this year’s seminar, you will gain the knowledge and tools to sort through the situational clutter and make decisions with confidence. Plus, all attendees take home a free copy of CHA’s 2015 Consent Manual.

CHA News Article

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

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

CHA News Article

CDPH Guidance Emphasizes CDC Ebola Recommendations

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

CHA News Article

CDPH Launches Open Data Portal

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

Recording

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

Webinar Recorded Live on May 21, 2014

Overview

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

Overview

Community Benefit Programs
Hospitals give back to their communities

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

Tax-Exempt Status of Nonprofit Hospitals

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

CHA News Article

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

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

CHA News Article

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

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

CHA News Article

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

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

News Release

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

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

Overview

Clinical Care

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

Education event

Consent Law Seminar
Mandated reporting, end-of-life decisions, privacy breach updates, electronics in health care settings

April 28, San Diego; April 29, Ontario
May 12, Glendale; May 13, Costa Mesa
May 20, Sacramento; May 21, Berkeley
May 28, Fresno

Simple or informed consent? Federal law or state law? Reportable or not reportable? Health care professionals consider these questions every day — and it’s not always clear how to proceed. At this year’s seminar, you will gain the knowledge and tools to sort through the situational clutter and make decisions with confidence. Plus, all attendees take home a free copy of CHA’s 2015 Consent Manual.

Recording

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

Webinar Recorded Live on November 14, 2014

Overview

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

Recording

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

Webinar Recorded Live on October 29, 2014

Overview

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

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

CHA News Article

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

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

Recording

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

Webinar Recorded Live on October 1, 2014

Overview

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

Overview

Construction / Renovation

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

CHA News Article

CMS Issues Direction on Lowering OR Humidity Below 30 Percent

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

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

CHA News Article

Refrigerant Management Program Registration, Reporting Deadline March 1

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

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

CHA News Article

OSHPD Showcases Online System for Plan Review and Construction

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

CHA News Article

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

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

CHA News Article

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

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

Overview

Emergency Preparedness
Is your hospital prepared?

Visit CHA’s Emergency Preparedness website at calhospitalprepare.org

About

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

   
CHA News Article

California Continues to Face One of Most Severe Droughts on Record

Gov. Brown announced new emergency drought legislation, calling on all Californians to reduce their water use by 20 percent and prevent water waste. Hospitals are encouraged to continue to conserve water where appropriate.

CHA News Article

CDPH to Host Business Continuity Webinar for Hospital Executives

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

CHA News Article

CDC Releases Guidance for Labs Testing Ebola Specimens

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

CHA News Article

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

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

CHA News Article

2014 California Hospital Emergency Code Survey Results Available

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

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

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

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

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

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

CHA News Article

CDPH Stakeholder Meetings on Medical Waste Haulers Begin March 25

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

Technical Advisory Meetings

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

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

Overview

Finance

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

CHA News Article

LAO Recommends Performance Goals for Reuniting Unclaimed Property With Owners

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

CHA News Article

Governor Unveils 2015-16 State Budget

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

CHA News Article

Governor Signs Bill Revising Charity Care Law

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

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

Recording

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

Webinar Recorded Live on June 19, 2014

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

General information

Video Describes Vital Role Nonprofit Hospitals Play in Their Communities

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

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

Overview

Health Care Reform

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

CHA News Article

DHCS Submits Medi-Cal 2020 Waiver Renewal Proposal to CMS
Approval expected by Nov. 1

On March 27, the California Department of Health Care Services (DHCS) submitted its final draft 1115 Medi-Cal 2020 waiver renewal application to the Centers for Medicare & Medicaid Services for approval by Nov. 1. DHCS is requesting approximately $17 billion in federal investments to advance several payment and delivery system transformation strategies, including: 1) shared savings with the federal government to be reinvested into the Medi-Cal program; 2) delivery system transformation and alignment programs; and 3) a redesign of reimbursement methods for public hospital systems that is tied to providing care for the remaining uninsured. DHCS will continue to engage stakeholders over the coming months to refine proposals included in the waiver renewal application.

The final Medi-Cal 2020 waiver application is attached. For more information, visit the DHCS 1115 Wavier Renewal website.

CHA News Article

Seminar to Examine Undocumented Population Eligible for Deferred Action
Will focus on immigrants’ income, access to health insurance, Medi-Cal impact

The UCLA Center for Health Policy Research will conduct the first of its 2015 Health Policy Seminar Series tomorrow, March 31 from noon – 1 p.m. The seminar will include discussion of findings from a new study on the health insurance status and characteristics — including age, income level and work status — of eligible California immigrants. More than 1 million undocumented immigrants in California are estimated to be eligible for relief from deportation and work authorization as a result of recent executive actions. Nadereh Pourat, the Center’s director of research, will also examine the potential effect on immigrants’ income and access to health insurance, as well as the impact on Medi-Cal. Participants may join in person at 10960 Wilshire Blvd. in Los Angeles or by live-streaming webinar, accessible the day of the seminar.

CHA News Article

DHCS to Conduct Webinar on ACA Medicaid Health Home State Plan Option
Will accept stakeholder feedback on proposal through May 6

The Department of Health Care Services (DHCS) will host a webinar April 15 from 9 a.m. – 10 a.m. to release its updated Health Homes for Patients with Complex Needs Program concept paper, authorized under Section 2703 of the Affordable Care Act. Section 2703 allows states to create Medicaid health homes to coordinate the full range of physical health, behavioral health and community-based long-term services and supports (LTSS) required by Medicaid members with chronic conditions. Federal matching funds are available for two years at 90 percent. If the plan is implemented in California, The California Endowment has offered to fund the remaining 10 percent (up to $25 million per year) required for the additional services for the same two-year period. AB 361 (Chapter 642, Statutes of 2013) authorized California to submit a Section 2703 state plan amendment to the Centers for Medicare & Medicaid Services, subject to several conditions, including cost neutrality and an evaluation after the first two years. Registration for the webinar is available here.

CHA News Article

DHCS Releases Updated Medi-Cal Managed Care Performance Dashboard

The California Department of Health Care Services (DHCS) has released an updated edition of its Medi-Cal Managed Care Performance Dashboard. The dashboard is used to monitor Medi-Cal managed care plans to gain a better understanding of individual managed care plans, as well as assess the plans on a statewide aggregate level. The performance dashboard reports on measures including enrollment, appeals and grievances, network adequacy, financial standing and quality. In addition to performance measures, the data include subsets of the Medi-Cal population and provide basic facts about the program, such as number of enrollees in each plan, and demographics by county and plan (language, age, aid categories, etc.).

Subsequent editions will be published quarterly and made available on the DHCS website at www.dhcs.ca.gov/services/Pages/Medi-CalManagedCare.aspx.

CHA News Article

DHCS to Conduct CCI Stakeholder Call March 25

The California Department of Health Care Services (DHCS) will conduct its monthly Coordinated Care Initiative (CCI) stakeholder call March 25 from 1 p.m. – 2 p.m. (PT). DHCS will provide an update on CCI enrollment and would like to hear from stakeholders about CCI implementation in local counties. Meeting materials will be posted to the DHCS website prior to the call. Registration is available online, and more information about CCI is available at www.calduals.org. Questions or comments about CCI may be submitted to info@calduals.org.

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

Deadline for Medicare EHR Incentive Program Hardship Exception Approaching
Hardship exception applications due April 1

CHA reminds hospitals that payment adjustments will begin Oct. 1 for eligible hospitals that did not successfully participate in the Medicare Electronic Health Record (EHR) Incentive Program in 2014. Eligible hospitals can avoid the 2016 payment adjustment by applying for a 2016 hardship exception by April 1 at 8:59 p.m. (PT). To file a hardship exception, Medicare-eligible hospitals must:

  • Show proof of a circumstance beyond the hospital’s control; and
  • Explicitly outline how the circumstance significantly impaired the hospital’s ability to meet meaningful use.

Supporting documentation must also be provided. The Centers for Medicare & Medicaid Services will review applications to determine whether or not a hardship exception should be granted. The hardship exception application and instructions for Medicare-eligible hospitals are available on the EHR Incentive Programs website.

CHA News Article

Stage 3 EHR Incentive Program Draft Rules Released
CMS proposes rules for EHR, 2015 Edition Health IT Certification Criteria

The Centers for Medicare & Medicaid Services (CMS) today released the attached notice of proposed rulemaking for the Stage 3 Medicare and Medicaid Electronic Health Records (EHRs) Incentive Programs and 2015 Edition Health IT Certification. Comments on the proposed rules are due May 29.

The Meaningful Use Stage 3 proposed rule specifies new criteria that eligible professionals, eligible hospitals and critical access hospitals must meet to qualify for Medicaid EHR incentive payments. The rule also proposes criteria that providers must meet to avoid Medicare payment adjustments (Medicaid has no payment adjustments) based on program performance beginning in payment year 2018. CHA is currently analyzing the regulations and will provide a detailed summary and solicit member input in the coming weeks.

CHA News Article

Medicare EHR Incentive Program Attestation Deadline Extended for Eligible Professionals

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

CHA News Article

Audit Report Examines BRN’s BreEZe System

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

CHA News Article

CMS Plans to Modify EHR Incentive Programs to Reduce Provider Burden

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

Overview

Human Resources

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

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

Education event For Members

NLRB Expedited Election Rules and Other Major Labor Developments Webinar
Shortened election period, emails and non-work communications, union updates

April 30, 2015, 10:00 – 11:30 a.m. PT
A CHA members-only program

Two recent and important National Labor Relations Board (NLRB) changes will significantly impact employers — union and non-union alike. In late 2014, the NLRB issued a Final Rule that substantially shortens the period between the filing of a representation petition and a union election. Also in late 2014, the NLRB issued a controversial decision involving employee use of work email for non-work related communications. Find out about these key changes and other NLRB developments by registering for this important CHA members-only webinar.

Education event For Members

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

April 2, Sacramento
A CHA members-only program

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

Recording

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

Webinar Recorded Live February 28, 2013

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

Publication

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

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

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

(13th edition, 2014)

 

Publication

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

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

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

(10th edition, 2015)

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
Mandated reporting, end-of-life decisions, privacy breach updates, electronics in health care settings

April 28, San Diego; April 29, Ontario
May 12, Glendale; May 13, Costa Mesa
May 20, Sacramento; May 21, Berkeley
May 28, Fresno

Simple or informed consent? Federal law or state law? Reportable or not reportable? Health care professionals consider these questions every day — and it’s not always clear how to proceed. At this year’s seminar, you will gain the knowledge and tools to sort through the situational clutter and make decisions with confidence. Plus, all attendees take home a free copy of CHA’s 2015 Consent Manual.

Recording

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

Webinar Recorded Live on November 14, 2014

Overview

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

Recording

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

Webinar Recorded Live on October 29, 2014

Overview

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

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

CHA News Article

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

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

Recording

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

Webinar Recorded Live on October 1, 2014

Overview

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

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 Announces Data Collection for Sepsis Bundle Measure
Measure specifications will be posted to QualityNet April 1

The Centers for Medicare & Medicaid Services has notified hospitals participating in the inpatient quality reporting program that data collection of the Severe Sepsis and Septic Shock: Management Bundle measure (NQF #0500) will begin with discharges on or after Oct. 1, 2015. The measure was adopted for the fiscal year (FY) 2017 payment determination in the FY 2015 inpatient prospective payment system final rule. Additional details about the measure — including the information form and algorithm — and abstraction guidance will be provided in version 5.0 of the Specifications Manual for National Hospital Inpatient Quality Measures, which will be posted to QualityNet April 1. For more information about the Severe Sepsis and Septic Shock measure, visit the Hospitals-Inpatient Questions & Answers tool at https://cms-ip.custhelp.com

CHA News Article

Five-Star Ratings Announced for Home Health
CMS will host provider webinar

The Centers for Medicare & Medicaid Services (CMS) has finalized the methodology for a star ratings program to be added to the Home Health Compare (HHC) website. HHC star ratings will be published beginning in July, and preview reports will be available to providers in late March or early April. CMS will hold a webinar March 26 at 10 a.m. (PT) to review the report format as well as the process for requesting review of star ratings. To register for the webinar, visit www.livemeeting.com/lrs/8000055450/Registration.aspx?pageName=h1m25cfj95z4zdq0. Additional information on HHC star ratings is available on the HHC website. A document addressing frequently asked questions is attached. 

CHA News Article

California Joint Replacement Registry Releases Patient-Reported Outcomes by Hospital

The California Joint Replacement Registry (CJRR) yesterday released patient-reported outcome data by hospitals that voluntarily participate in the registry. It is the first orthopedic registry in the U.S. to publish such data by hospital, with 12 participating hospitals agreeing to release their outcome measures. The data, along with hospital ratings and methodology, are available at www.caljrr.org/pro/index.aspx.

The CJRR collects, reports and shares data on the results of hip and knee replacements performed in California to guide physician and patient treatment decisions and support programs for provider recognition and reward. The CJRR is funded primarily by the California HealthCare Foundation and has additional support from the Pacific Business Group on Health, the California Orthopedics Association, and health plans Anthem, Blue Shield of California and Cigna.

CHA News Article

CDPH Seeks Stakeholder Input on L&C Strategic Map

The California Department of Public Health (CDPH) Licensing and Certification (L&C) has developed a strategic map and is soliciting input from stakeholders. The strategic map is comprised of L&C’s central challenge to improve its effectiveness in promoting quality health care and facilities, with priorities and objectives to implement the plan. CHA encourages hospitals to take the time to compete this stakeholder survey as soon as possible and provide feedback to CDPH, including identifying improvements and priorities for the map. 

CHA News Article

National Patient Safety Awareness Week is March 8-15

Led by the National Patient Safety Foundation (NPSF), National Patient Safety Awareness Week is an annual health care safety education and awareness campaign. Hospital Quality Institute and the California Hospital Patient Safety Organization (CHPSO) encourage hospitals to participate in patient safety week by creating awareness in their communities.

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

Previously Denied DRG Claims Receive ‘Fix’ in Processing System
RAD code 9968 claims now correctly resolved

The Department of Health Care Services (DHCS) has notified providers that previously denied diagnosis related group (DRG) claims that included other health coverage are now being adjudicated appropriately. The claims — remittance advice detail code 9968, “No Approved TAR on File for APR-DRG Inpatient Admission” — have been fixed through edits to the claims processing system. The fix includes a timeliness override to allow claims erroneously denied for 9968 since July 1, 2013, to be processed without a timeliness cutback.

CHA News Article

Medicare Physician Fee Schedule Claims Held Until Jan. 14

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

CHA News Article

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

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

CHA News Article

Noridian to Host Open Door Coverage Meeting Sept. 16

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

CHA News Article For Members

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

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

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

Health Workforce Diversity Grants Available

The Department of Health and Human Services Office of the Assistant Secretary of Health is accepting applications through May 18 for its National Workforce Diversity Pipeline Program Grant. With approximately $2.5 million in funding, the program seeks to address health disparities among racial and ethnic minorities by supporting networks of institutions focused on increasing minority and disadvantaged students’ awareness and pursuit of careers in health care and behavioral health. Eligible applicants include hospitals, state and local governments, and universities, among others. Eight grants will be awarded, ranging from $350,000 to $500,000 per year for up to five years. For more information, visit www.grants.gov/view-opportunity.html?oppId=275242.

CHA News Article

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

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

CHA News Article

CHA Co-Hosts Legislative Briefing on Strategic Health Workforce Development

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

CHA News Article

Rural Network Allied Health Training Program Grants Available

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

CHA News Article

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

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

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

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