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

CHA Cybersecurity Webinar Is Next Week
Register today to learn how to prevent a cyberattack

The recent ransomware attack against Wichita-based Kansas Heart Hospital has heightened already growing concerns about cybersecurity — especially in the health care realm, as attacks against hospitals become more frequent. Cyberattacks can significantly disrupt hospital operations, and hospitals are faced with the challenge of maintaining the security and integrity of patient health information while preserving its availability to those providing care to patients.

CHA News Article

CHA Webinar Will Highlight Cybersecurity Threats to Hospitals
Learn how to protect against cyberattacks

With the rapid increase in cybercrime globally, more businesses and institutions are being targeted — including hospitals, where access to electronic health records is critical to sustaining operations and providing patient care. Because ransomware and other cyber threats can effectively disrupt and disable computer systems, hospitals must not only arm themselves against destructive cyberattacks, but also have a plan in place to mitigate the effects if they fall victim.

CHA will hold a webinar June 9 from 1:30-3:30 p.m. (PT) to explain how hospitals can protect themselves from cyberattacks, and steps to take if their systems are breached.

CHA News Article

CDPH Issues Updated SNF Relicensing Workbook
New version implemented March 1

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

CHA News Article

CDPH Pilots Use of Non-RNs as Breach Investigators

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

Recording

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

Webinar Recorded Live February 18, 2016

Overview

Changes are coming!

Overview

Community Benefit Programs
Hospitals give back to their communities

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

Tax-Exempt Status of Nonprofit Hospitals

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

CHA News Article

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

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

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

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

Clinical Care

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

Recording

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

Webinar recorded live April 18, 2016

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

CHA News Article

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

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

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

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.

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.

Education event

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

June 28, 2016
10:00 a.m. – 12:00 p.m., Pacific Time

The California State Board of Pharmacy and United States Pharmacopeia Convention are planning changes that will significantly impact hospital pharmacy compounding of hazardous and nonhazardous medications and facility structures. All of the changes will impact numerous hospital departments, including pharmacy, human resources and facilities.

CHA News Article

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

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

CHA News Article

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

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

CHA News Article

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

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

CHA News Article

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

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

Overview

Emergency Preparedness
Is your hospital prepared?

Visit CHA’s Emergency Preparedness website at calhospitalprepare.org

About

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

   
CHA News Article

Governor Issues Order Extending Water Conservation

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

CHA News Article

Non-English Resources Available for Behavioral Health Disaster Preparedness

The Substance Abuse and Mental Health Services Administration has gathered resources in languages other than English to assist with disaster behavioral health preparedness.

CHA News Article

CDC Updates Maps on Zika Mosquito Potential Locations

The Centers for Disease Control and Prevention (CDC) has released new maps of the United States that show the potential location of the two species of mosquitoes associated with Zika virus transmission. The updated maps show where these mosquitoes are now or have been previously found within the continental United States, based on data gathered by CDC and its state and local partners, but do not show the numbers or density of mosquitoes within each area. While these maps do not indicate the risk of potential disease spread or risk of infection, they can help individuals and health care providers assess potential health risks and take appropriate precautions.

CHA News Article

Heightened Awareness Advised for Health Care Providers After Brussels Attack

Following Tuesday’s terror attack in Brussels, the Department of Homeland Security urges health care providers to increase awareness of activities that prompt suspicion or raise security concerns. The department stressed that early recognition and reporting of potential terrorist activity is the first line of defense against those who intend harm. Health care providers are encouraged to:

CHA News Article

Institute of Medicine Is Now Health and Medicine Division

The Institute of Medicine — the division of the National Academies of Sciences, Engineering, and Medicine that focuses on health and medicine — has been renamed the Health and Medicine Division. This new name builds on the heritage of the institute’s work in medicine, while emphasizing its increased focus on a wider range of health matters. Any questions about the division’s name change should be directed to Clyde Behney, executive director, at cbehney@nas.edu.

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.  

Education event

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

June 28, 2016
10:00 a.m. – 12:00 p.m., Pacific Time

The California State Board of Pharmacy and United States Pharmacopeia Convention are planning changes that will significantly impact hospital pharmacy compounding of hazardous and nonhazardous medications and facility structures. All of the changes will impact numerous hospital departments, including pharmacy, human resources and facilities.

CHA News Article

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

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

CHA News Article

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

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

CHA News Article

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

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

CHA News Article

New Prop. 65 Website Geared Toward Consumer Education

The California Office of Environmental Health Hazard Assessment (OEHHA) recently established a new website to provide the public with information on chemicals, products and locations often associated with Proposition 65 warnings, which emphasize exposure to chemicals that cause cancer, birth defects or other reproductive harm. The OEHHA website offers information on laws and regulations, frequently asked questions, fact sheets and other resources.

Overview

Finance

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

CHA News Article

Governor Releases 2016-17 State Budget

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

Recording

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

Webinar Recorded Live on June 19, 2014

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

General information

Video Describes Vital Role Nonprofit Hospitals Play in Their Communities

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

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

Overview

Health Care Reform

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

CHA News Article

DHCS to Host Webinar on Global Payment Program Tomorrow

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

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

CHA News Article

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

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

CHA News Article

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

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

CHA News Article

Report Identifies Characteristics of Uninsured Men

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

CHA News Article

DHCS to Host Behavioral Health Forum April 25

The California Department of Health Care Services (DHCS) will host a Behavioral Health Forum on April 25 from 9:30 to 11 a.m. (PT) via webinar. The webinar will include an update on the Certified Community Behavioral Health Clinics (CCBHC) demonstration, including the CCBHC planning process and upcoming stakeholder engagement opportunities. In October 2015, California was awarded a CCBHC planning grant to support the state in soliciting and certifying clinics to become CCBHCs; establishing a prospective payment system rate for Medi-Cal reimbursable services; and preparing an application to participate in the two-year CCBHC demonstration program. On April 11, Governor Brown signed Assembly Bill 847, which provides DHCS with the additional funds necessary to embark on the CCBHC planning grant process. Registration is available online; meeting materials will be posted on the DHCS website in advance of the meeting.

Overview

Health Information Management & Technology

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

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

CHA News Article

Applications Due July 1 for EHR Incentive Program 2017 Hardship Exceptions

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

CHA News Article

CHA Cybersecurity Webinar Is Next Week
Register today to learn how to prevent a cyberattack

The recent ransomware attack against Wichita-based Kansas Heart Hospital has heightened already growing concerns about cybersecurity — especially in the health care realm, as attacks against hospitals become more frequent. Cyberattacks can significantly disrupt hospital operations, and hospitals are faced with the challenge of maintaining the security and integrity of patient health information while preserving its availability to those providing care to patients.

CHA News Article

CHA Webinar Will Highlight Cybersecurity Threats to Hospitals
Learn how to protect against cyberattacks

With the rapid increase in cybercrime globally, more businesses and institutions are being targeted — including hospitals, where access to electronic health records is critical to sustaining operations and providing patient care. Because ransomware and other cyber threats can effectively disrupt and disable computer systems, hospitals must not only arm themselves against destructive cyberattacks, but also have a plan in place to mitigate the effects if they fall victim.

CHA will hold a webinar June 9 from 1:30-3:30 p.m. (PT) to explain how hospitals can protect themselves from cyberattacks, and steps to take if their systems are breached.

CHA News Article

CMS to Host Webinar on Proposed eCQM Changes

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

CHA News Article

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

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

Overview

Human Resources

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

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

CHA News Article

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

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

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

CHA News Article

CHA Participates in ASHHRA Advocacy Day

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

CHA News Article

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

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

Overview

Legal

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

CHA News Article

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

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

CHA News Article

Appeal Filed in Interdisciplinary Team Consent Case

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

CHA News Article

CDI Issues Permanent Regulations on Network Adequacy
Regulations effective immediately

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

Recording

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

Webinar recorded live April 18, 2016

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

Overview

Patient Rights

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

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

Publication

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

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

Publication

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

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

CHA News Article

CDPH Provides Guidance for Submitting End of Life Option Act Forms

California’s new End of Life Option Act — which allows terminally ill patients to obtain a prescription from their attending physician for medication to end their life — requires physicians who write such prescriptions to submit specified documentation to CDPH

Recording

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

Webinar recorded live April 18, 2016

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

CHA News Article

New Law Establishes Requirements for Post-Hospital Patient Care

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

Overview

Quality & Patient Safety

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

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

CHA News Article

CHA Reminds Hospitals to Submit First Quarter 2016 HCAHPS Data by July 6

The deadline to submit first quarter Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data to the Centers for Medicare & Medicaid Services (CMS) is July 6. Inpatient prospective payment system (IPPS) hospitals participating in the Hospital Inpatient Quality Reporting program must submit HCAHPS data to receive their full annual payment update. Non-IPPS hospitals must submit HCAHPS data for their data to be published on CMS’ Hospital Compare website. The review and corrections period is July 7-13, during which hospitals and supply vendors may use the QualityNet Secure Portal to review and, if needed, resubmit corrected data. For general questions about HCAHPS data, please contact CMS at HospitalCAHPS@cms.hhs.gov

Education event

Covered California’s Quality and Delivery System Reform Strategy Webinar
Health plan contract changes, payment strategies, quality measures

June 29, 2016
1:30 – 3:00 p.m., Pacific Time

The imperative to achieve the triple aim has never been greater. Fee-for-service payment structures are giving way to new payment models based on quality and performance by health care providers. Covered California is at the forefront of these efforts.

CHA News Article

National Weather Service Warns of Excessive Heat Through Tomorrow

The National Weather Service has issued an excessive heat alert from 7 a.m. June 19 through 7 p.m. June 21 for portions of Southern California, with a reminder that elderly and other health-compromised individuals are more susceptible to extreme temperature and dehydration.

Facilities must implement recommended precautionary measures to keep individuals safe and comfortable during extremely hot weather and must have contingency plans in place to deal with the loss of air conditioning, or, if air conditioning is not available, take measures to ensure patients and residents are free of adverse conditions that may cause heat-related health complications. More information is available in the attached fact sheet. 

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

CMS Delays Data Collection on Three IPF Quality Reporting Program Measures

The Centers for Medicare & Medicaid Services has announced that, because measure specifications have not yet been finalized, it will postpone data collection for three measures in the inpatient psychiatric facility quality reporting program: transition record with specified elements received by discharged patients, timely transmission of transition record measures and screening for metabolic disorders. Data collection, which was scheduled to begin July 1, will now begin Jan. 1, 2017, and will apply to the federal fiscal year 2019 payment determination. CHA has supported efforts by the American Hospital Association, the Federation of American Hospitals, the National Association of Psychiatric Health Systems and the National Association of State Mental Health Program Directors Research Institute to delay data collection on the measures. 

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 Mailing Address Announced for Paper TAR Submissions

The California Department of Health Care Services has announced that, effective immediately, all paper treatment authorization requests (TARs) should be sent to: 

TAR Processing Center
820 Stillwater Road
West Sacramento, CA 95605-1630

If a provider submits a TAR to a field office, the TAR will be returned to the provider with instructions to send it to the TAR Processing Center. For TAR status or issues, providers may call (800) 541-5555.

CHA News Article

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

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

Education event

Covered California’s Quality and Delivery System Reform Strategy Webinar
Health plan contract changes, payment strategies, quality measures

June 29, 2016
1:30 – 3:00 p.m., Pacific Time

The imperative to achieve the triple aim has never been greater. Fee-for-service payment structures are giving way to new payment models based on quality and performance by health care providers. Covered California is at the forefront of these efforts.

CHA News Article

Hospitals Encouraged to Submit Medicare Provider Revalidation Applications
Payments may be suspended if responses are late

The Centers for Medicare & Medicaid Services (CMS) began cycle two of its Medicare provider revalidation process this year, with the first responses due May 31. Medicare administrative contractor Noridian reports that, of the Medicare Part A providers in California with applications due through Nov. 30, only 17 percent have responded. It is important for providers to submit their applications to Noridian prior to the due date. Providers that do not submit a timely revalidation application risk the chance of their payments being suspended, with the possibility of their enrollment file being end-dated and a resulting gap in coverage.  

CHA News Article

Medi-Cal DRG Provider Webinars Highlight Changes Effective July 1

The Department of Health Care Services will host a series of webinars addressing upcoming changes to the DRG payment methodology, including a transition to the statewide base rate. The 90-minute webinars will be offered at two times: May 24 at 1:30 p.m. (PT) and June 2 at 9:30 a.m. (PT). Both sessions address the same information. Attendees must register prior to the start of the webinar in order to receive meeting details, and will receive instructions for joining the meeting after the registration request has been approved. 

Overview

Workforce

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

CHA News Article

Children’s Hospitals GME Payment Program Now Accepting Applications

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

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

CHA News Article

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

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

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

CHA News Article

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

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

CHA News Article

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

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

CHA News Article

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

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

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

Commands