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

New CDPH Relicensing Survey Launches in March
CHA will host webinar Feb. 18

This March, the California Department of Public Health (CDPH) will launch its new general acute care hospital relicensing survey, which will merge California’s licensing requirements with elements of the Medication Error Reduction Plan and Patient Safety Licensing Surveys. As all facilities can expect to be surveyed every three years, it is important that hospitals understand the changes that were made, what to expect when a survey team visits and how to prepare in advance for the survey process.

CHA News Article

Center for Health Care Quality to Hold Semi-Annual Meeting Feb. 25

The California Department of Public Health’s (CDPH) Center for Health Care Quality (CHCQ) will hold its semi-annual stakeholder forum in Sacramento on Feb. 25. The meeting provides an opportunity for CHCQ to share program updates and solicit feedback on improving CDPH’s Licensing and Certification Program. Stakeholders may attend or participate via webinar, and the meeting is open to the public. The agenda and webinar instructions will be posted online in mid-February. For more information, visit CHCQ’s Stakeholder Forum website or email questions and comments to CHCQStakeholderForum@cdph.ca.gov.

Education event

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

February 18, 2016
9:00 – 11:00 a.m., Pacific Time

The California Department of Public Health (CDPH) will launch its new general acute care hospital relicensing survey in March 2016. The new relicensing surveys will be unannounced and hospitals will be surveyed every three years, as required by law. Learn about the new survey process, as well as how you can prepare in advance for a surveyor visit.

CHA News Article

2015-16 State Budget Increases Funding for Licensing Oversight in Los Angeles County

The 2015-16 state budget provided the California Department of Public Health’s (CDPH) Licensing and Certification (L&C) Division with additional funds to augment its contract with Los Angeles County. L&C has a long-standing contractual relationship  for Los Angeles County to provide licensing and certification oversight to facilities in the county. Recently, L&C renewed its contract with the county, including increased funding to hire approximately 70 additional L&C staff. In recent years, L&C (including its work in Los Angeles County) has been under scrutiny to improve performance related to timely completion of complaint investigations and mandated licensing surveys.

To allow Los Angeles County sufficient time to hire and train additional staff, the contract provides that CDPH L&C will assume the non-long-term care facility complaint investigations for one year, including hospitals and acute psychiatric facilities. Hospitals in Los Angeles County should continue to report adverse events and unusual occurrences to the county as usual. However, investigations may be performed by staff from other CDPH district offices.

L&C calculates provider fees based on the associated survey activity within each provider category (hospital, clinic, etc.). As L&C is able to hire and train additional staff and complete more survey work, provider fees may increase in coming years.

CHA News Article

CDPH Issues Hot Weather Advisory for Hospitals

The California Department of Public Health (CDPH) has released the attached All Facilities Letter (AFL) as a hot weather advisory to remind health care facilities that elderly patients and individuals with high health risk are more vulnerable in extreme heat and at risk of dehydration. The advisory outlines precautionary measures and informs health care facilities that they must have a contingency plan for facilitating patient safety during fluctuating high temperatures and any loss of air conditioning. CDPH also notes that health care facilities must report emergency/disaster-related occurrences, including extreme heat conditions, that could harm a patient’s health and safety, necessary evaluation, transfer or discharge. 

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

CDC Announces New Community Health Improvement Navigator Framework and Tool
Website designed as one-stop-shop of tools and resources

The Centers for Disease Control and Prevention (CDC) recently launched a new website to support hospitals, health systems, public health and other community organizations interested in improving the health of their communities. Called the Community Health Improvement Navigator (CHI Navigator), the site is also intended for tax-exempt hospitals complying with the IRS final rule on community health needs assessments for charitable hospitals. 

CHI Navigator was designed as a one-stop-shop of expert-vetted tools and resources for individuals who lead or participate in CHI work within hospitals and health systems, public health agencies and other community organizations, to assist with:

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.

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.

CHA News Article

End of Life Option Act Webinar Now Available

On Nov. 19, CHA hosted a webinar explaining the End of Life Option Act signed into law by Gov. Brown on Oct. 5. The Act will allow individuals who have a terminal illness and who meet certain qualifications to ask their physician for a prescription for medication to end their life. Because the bill was introduced in a special legislative session, it will become effective 90 days after the session is closed; that date is still uncertain.

The webinar provided an overview of the legislation, discussed the impact on hospitals and medical staffs, and explained the requirements that must be met by the individual to be able to request aid-in-dying medication, and by the physician to prescribe it. Hospitals are encouraged to begin work now to determine whether they will participate in activities under the Act, and to develop policies and procedures whether they choose to participate or not.

Recording

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

Webinar recorded live November 19, 2015

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 bill 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.

CHA News Article

Clinical Imperatives to Be Focus of Third PHM Webinar

The third webinar in CHA’s five-part certification series on Population Health Management (PHM) is scheduled for July 14 from 9:30 –11:30 a.m. Titled Clinical Imperatives of Population Health Management, the webinar offers valuable information for a variety of clinical professionals, including chief medical officers, chief nursing officers, quality directors, outpatient and rehabilitation services directors, and individuals with supervisory responsibility for clinical staff.

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

Hospitals With SPC 1 Buildings Must Submit Reports to OSHPD by Nov. 1

CHA reminds members that all hospitals with one or more Structural Performance Category 1 (SPC 1) buildings must submit a report to the Office of Statewide Health Planning and Development (OSHPD) on or before Nov. 1, 2015. As Nov. 1 falls on a Sunday this year, CHA encourages submission of the report by Oct. 30. Hospitals that fail to submit the mandatory report by the statutory deadline will be assessed a fine of $10 per licensed acute care bed per day, not to exceed $1,000 per day for each SPC 1 building, until they comply with the reporting requirements. More information about compliance is available at the OSHPD website. For questions or help completing the online report, contact Brett Beekman at (213) 897-3264 or by email at SB499@oshpd.ca.gov.

CHA News Article

HVAC Guidance Available for ORs, Sterile Processing Departments

An HVAC task force, whose members include the American Hospital Association’s American Society for Healthcare Engineering (ASHE), has issued the attached interim guidance to help health care facilities maintain appropriate temperature and humidity control in operating rooms and sterile processing departments while it works to achieve consensus on conflicting standards. Among other actions, the task force said it plans to explain the conflicting standards to accreditors and state licensing agencies and ask them to work with health care organizations to establish a plan for resolving variance.

In addition to ASHE, task force members include the American Society of Heating, Refrigerating and Air-Conditioning Engineers; Association for the Advancement of Medical Instrumentation; Association for Professionals in Infection Control and Epidemiology; Association of periOperative Registered Nurses; and the Facility Guidelines Institute. 

CHA News Article

Redesigned Radiation Treatment Resource Launched

The Department of Health and Human Services (HHS) has launched a redesigned online radiation treatment resource. The first major redesign of the Radiation Emergency Medical Management (REMM) website since it launched in 2007 is available at www.remm.nlm.gov. Intended to help health care professionals find reliable guidance to help diagnose and treat patients who have been exposed to radiation, the site provides information about radiation injuries and access to interactive clinical tools and data. Physicians and medical staff also can download a majority of the information from the website to use during an emergency if the Internet is not accessible, and a smartphone app containing REMM information is available for the Apple and Android platforms. The REMM site is a collaboration of the HHS Office of the Assistant Secretary for Preparedness and Response and the National Library of Medicine, part of the National Institutes of Health. More information is available at www.phe.gov/Preparedness/news/Pages/remm.aspx.

CHA News Article

OSHPD, Hospital Building Safety Board to Offer Hospital Construction Seminars

OSHPD has announced a one-day seminar titled “Building Relationships for a Successful Project,” intended to educate architects, engineers, hospitals, contractors and others on leveraging relationships to encourage successful project outcomes. The program will be offered on two dates: Oct. 21 in Anaheim and Oct. 27 in Concord. Attendees are encouraged to register soon, as space is limited. 

CHA News Article

Governor Signs CHA-Sponsored Bill on Medical Waste Management

Gov. Brown has signed SB 225 (Wieckowski, D-Fremont), a bill sponsored by CHA to clarify and streamline requirements of the Medical Waste Management Act. The bill took effect immediately upon signature by the Governor on Sept. 28. The bill:

  • Clarifies the definition of biohazard bag.
  • Requires a hazardous waste transporter of medical waste to maintain a tracking document, as specified, for the purpose of tracking medical waste from the point when the waste leaves the generator facility until the waste receives final treatment.
  • Requires the tracking document to be maintained only by hazardous waste transporters, and not by generators transporting waste.
  • Revises the container labeling requirements for specified medical wastes from “HIGH HEAT OR INCINERATION ONLY” TO “HIGH HEAT” or “INCINERATION ONLY.”

Details about the new law can be found at http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB225.

Overview

Emergency Preparedness
Is your hospital prepared?

Visit CHA’s Emergency Preparedness website at calhospitalprepare.org

About

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

   
CHA News Article

CDPH to Host Conference Call on Zika Virus Feb. 10

The California Department of Public Health (CDPH) will offer health care providers information and updates about the Zika virus on a conference call Feb. 10 from 9 – 10 a.m. (PT). The call will also include a question and answer period. To join the call, dial (866) 216-6835 and enter passcode 839641. Health care providers can access resources from CDPH and other agencies on the CHA preparedness website

CHA News Article

FEMA Recommends Preparing for El Niño Threat

 The Federal Emergency Management Agency and the California Office of Emergency Services (Cal OES) released a memo and California assessment on the anticipated impacts of El Niño.

CHA News Article

FEMA: Hospitals Should Prepare for El Nino Conditions in Early 2016
CHA participates in tabletop exercise on behalf of hospitals

Last week, the Federal Emergency Management Agency (FEMA) Region IX conducted a tabletop exercise at the California Office of Emergency Services in Sacramento to test its plan for potential impacts from the projected El Niño weather conditions in early 2016. CHA actively participated in the exercise on behalf of California’s acute care hospitals and health systems.

CHA News Article

CHA Commends Hospitals, Emphasizes Emergency Preparedness
Online training resources available

CHA commends the hospitals that received and treated patients from the active shooter tragedy that occurred in San Bernardino County this week, and is proud of the hospitals and health systems that have planned and trained with law enforcement agencies, local emergency medical services and fire agencies in preparing for and responding to such incidents. Additionally, CHA encourages all hospitals to utilize the multitude of resources that are available on the CHA emergency preparedness website. In addition to the existing CHA planning and training for active shooter resources and links, UCSF Medical Center has recently shared its training video and template table top exercise to assist other hospitals. All resources may be accessed at www.calhospitalprepare.org/active-shooter.

CHA News Article

Homeland Security Calls For Enhanced Vigilance After Paris Terrorist Attacks

Following the terror attacks in Paris, the U.S. Department of Homeland Security (DHS) has issued a reminder to all health care providers to review with employees the importance of situational awareness and vigilantly watching for behaviors, objects and activities that depart from the norm of their experience. The call for enhanced vigilance also notes that early recognition and reporting of potential terrorist activity are the first lines of defense against harm intended for critical infrastructure.

As the attacks occurred at multiple sites, law enforcement and emergency services personnel were spread across the city and multiple hospitals experienced surge. CHA’s emergency preparedness website includes information and resources on preparing for a hospital surge, as well as planning for active shooter incidents. The DHS site also features additional preparedness information for health care providers at www.phe.gov/preparedness/planning/cip/Pages/default.aspx.

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 Guidance Focuses on Cybersecurity Risks for Medical Device Manufacturers

The U.S. Food and Drug Administration (FDA) issued draft guidance Jan. 15 outlining important steps medical device manufacturers should take to continually address cybersecurity risks to keep patients safe and better protect the public health. The draft guidance, which recommends that manufacturers implement a structured and systematic comprehensive cybersecurity risk management program and respond in a timely fashion to identified vulnerabilities, is part of the FDA’s ongoing efforts to ensure the safety and effectiveness of medical devices in the face of potential cyber threats.

CHA News Article

Upcoming Call to Focus on Helping Hospitals Create Sustainability Internships

Greenhealth Academy will host a call Jan. 19 to share strategies for implementing sustainability initiatives in the hospital setting. Presenters will review Practice Greenhealth’s new sustainability intern toolkit and share tips for establishing sustainability intern positions. The call will also include strategies for energy and water conservation as well as solid waste reduction. Registration is available online

CHA News Article

Webinar Tomorrow Explores How Hospitals Can Address Climate Health

The Health Care Climate Council will host a free webinar tomorrow, Dec. 16, at noon (PT) addressing the connection between climate and health care. The webinar is aimed at hospital employees interested in learning more about the connection between climate and their facilities’ sustainability, including sustainability officers, energy managers, chief medical officers and wellness and emergency preparedness coordinators. Presentations will include examples of climate strategy from the Cleveland Clinic, Kaiser Permanente and Partners HealthCare.

CHA News Article For Members

CHA Provides Written Testimony on Proposed Prop. 65 Regulations
Comments on Cal EPA’s clear and reasonable warning regulations

CHA has submitted the attached comments to Cal EPA’s Office of Environmental Health Hazard Assessment (OEHHA) about proposed regulations related to Proposition 65 and prescription drug exposure warnings. CHA worked with the California Medical Association to develop new language to recommend to OEHHA, based on informed consent under prescribed conditions. In the comments, CHA also expressed concerns about the proposed regulations’ costs to California businesses — a minimum of $410 million, according to an analysis by the California Chamber of Commerce.

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.

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.

Education event

Hospital Compliance Seminar
Stark updates, observation changes, 60-day rule developments, new relicensing survey

February 17, 2016 Sacramento
February 23, 2016 Long Beach

At the annual Hospital Compliance Seminar participants will learn about new laws, regulations and judicial decisions impacting hospital operations. Expert faculty will simplify complex regulatory and legal actions into clear and practical terms and offer guidance for implementation in the hospital environment. All attendees receive a complimentary copy of the 2016 California Hospital Compliance Manual.

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.

CHA News Article

Second Webinar in Population Health Management Series Is June 2
Still time to register for full series; catch up with access to program recording

The second of CHA’s five-part certification series on Population Health Management (PHM) continues June 2 from 9:30 –11:30 a.m., with the webinar Business Imperatives of Population Health Management. Registration remains open for all programs, including the April 28 webinar. Though the initial webinar has been held, it’s easy to catch up by viewing the recorded program.

“The value-driven approach to care delivery and financing under PHM alters the established business fundamentals,” said Anne McLeod, CHA’s senior vice president for health policy and innovation. “Hospital leaders will need to actively manage the transition and the impact on their business. This webinar will help members navigate that process.”

CHA News Article

First Population Health Management Webinar Lays the Framework for Series
Program begins April 28; includes extensive issue brief

CHA’s April 28 webinar on Population Health Management(PHM) will lay the framework for the five-part webinar series presented by a faculty of management consultants and thought leaders from Kaufman, Hall & Associates.

“CHA created this program to provide hospitals with the information and tools needed to move forward with PHM. It is the business challenge and opportunity for tomorrow’s hospitals and health systems, and it is the means to transform health care from a silo-like treatment of services to coordinated care across the continuum,” said Anne McLeod, CHA’s senior vice president, health policy and innovation. “California is at the forefront of this transformation by virtue of its size and unique demographic profile. I encourage all hospitals to consider participating.”

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.

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

Proposals Sought for California Accountable Communities for Health Initiative
Applications due April 29

The California Health and Human Services Agency and Community Partners, with support from a consortium of funders, have released the attached request for proposals to support up to six accountable communities for health (ACHs) through the California Accountable Communities for Health Initiative (CACHI). ACHs seek to bring together community and health care stakeholders to advance a common health goal. This model builds on prior efforts to coordinate and integrate various organizations, programs and services by linking their activities and reinforcing a portfolio of interventions across five key domains – clinical services; community programs and social services; community-clinical linkages; public policy and system change; and environments.

Education event

Hospital Compliance Seminar
Stark updates, observation changes, 60-day rule developments, new relicensing survey

February 17, 2016 Sacramento
February 23, 2016 Long Beach

At the annual Hospital Compliance Seminar participants will learn about new laws, regulations and judicial decisions impacting hospital operations. Expert faculty will simplify complex regulatory and legal actions into clear and practical terms and offer guidance for implementation in the hospital environment. All attendees receive a complimentary copy of the 2016 California Hospital Compliance Manual.

CHA News Article

HHS Announces Accountable Health Communities Model

The Department of Health and Human Services (HHS) has announced the Accountable Health Communities (AHC) Model program, designed to assess whether screening Medicare / Medicaid beneficiaries for “health-related social needs and associated referrals to and navigation of community-based services” can improve patient outcomes and reduce costs. The five-year program, administered by the Centers for Medicare & Medicaid Services (CMS), could provide up to $157 million for participating grantees who use the AHC model at clinical delivery sites to address health-related social needs. AHC will support up to 44 bridge organizations to test three scalable approaches: community referral, community service navigation and community service alignment.

CMS will host a webinar to discuss AHC and the application process on Jan. 21 from 11 a.m. – 12:30 p.m. (PT) and again on Jan. 27 from noon – 1:30 p.m. (PT). Online registration is currently open.  

CHA News Article

CHHSA to Host Let’s Get Healthy California Innovation Conference Jan. 26

The California Health and Human Services Agency (CHHSA) will host a Let’s Get Healthy California Innovation Conference on Jan. 26 from 8 a.m. to 4 p.m. in Sacramento. The conference will showcase local and statewide innovations that promote the triple aim of better health, better care and lower cost, and will measure California’s progress to meet the six goal areas of the Let’s Get Healthy California framework. CHHSA will also unveil its new Let’s Get Healthy California website, announce its Innovation Challenge finalists, and provide an update on quality indicators. Online registration is currently full; those interested should register for the webinar’s wait list.

CHA News Article

2015 Scorecard on State Health System Performance Published

The Commonwealth Fund has released the 2015 edition of its Scorecard on State Health System Performance – the first to measure the effects of the Affordable Care Act’s 2014 coverage expansions. The scorecard finds extensive variation among states in individuals’ ability to access care when they need it, the quality of care they receive and their likelihood of living a long and healthy life. The report also finds broad-based improvements.

The 50 states and the District of Columbia are measured and ranked on 42 indicators grouped into five domains: access and affordability, prevention and treatment, avoidable hospital use and cost, healthy lives and equity. According to the report, California ranks among states as follows:

  • Access and Affordability – 30th
  • Prevention and Treatment – 37th
  • Avoidable Hospital Use and Cost – 14th
  • Healthy Lives -7th
  • Equity – 22nd
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

Comment Deadline Extended for HIT Certification RFI
Comments due Feb. 16

The Centers for Medicare & Medicaid Services (CMS), in conjunction with the Office of the National Coordinator (ONC), has extended the comment period for its request for information about the certification of health information technology (HIT). Comments, which were previously due Feb. 1, are now due Feb. 16.

CMS and ONC request feedback on how often to require recertification, the number of electronic clinical quality measures a certified HIT module should be required to certify to, and ways to improve testing of the modules. CHA has been working with members to develop comments and welcomes additional input ahead of the new comment deadline. Members who are interested in sharing their input should contact Debby Rogers at drogers@calhospital.org

CHA News Article

CMS Provides Updates on IMPACT Act
Comment deadline for post-acute care measure is tomorrow

The Centers for Medicare & Medicaid Services (CMS) will host two upcoming calls on the Improving Post-Acute Care Transformation (IMPACT) Act of 2014 and the standardization of patient assessment data across post-acute care settings, including skilled-nursing facilities, home health agencies, inpatient rehabilitation facilities and long-term care hospitals. Additionally, CMS has announced that the public comment period for “Medicare Spending Per Beneficiary – Post-Acute Care (MSPB-PAC) Resource Use Measures” has been extended to Jan. 29. Information on the measure is available on the public comment website. Comments should be submitted to mspb-pac-measures-support@acumenllc.com by 8:59 p.m. (PT) on Jan. 29.

CHA News Article

CMS Issues Application for new Medicare EHR Incentive Program Hardship Exception Process
Hospitals and CAHs must apply by April 1; EPs must apply by March 15

The Centers for Medicare & Medicaid Services (CMS) today announced changes to the Medicare Electronic Health Records (EHR) Incentive program hardship exception process, as required by the recently passed Patient Access and Medicare Protection Act. The exemptions apply to the Medicare EHR program 2017 payment adjustments. The streamlined hardship applications reduce the amount of information that eligible professionals (EPs), eligible hospitals and critical access hospitals (CAHs) must submit for an exception. In addition, the new process allows CMS to consider hardship exceptions for “categories” of EPs, eligible hospitals and CAHs, rather than the previous process that required a case-by-case process.

EPs must submit hardship applications by March 15; the deadline for hospitals and CAHs is April 1. The hardship application and instructions are available on CMS’ website. CAHs should use the form specific for the CAH hardship exceptions related to an EHR reporting period in 2015. CAHs that have already submitted a form for 2015 are not required to resubmit.

CHA News Article

President Signs Meaningful Use Blanket Hardship Exemption

In late December, President Obama signed a law creating a blanket hardship exemption for providers from 2015 meaningful use penalties, which were to be assessed in 2017. The law requires hospitals to apply for the hardship exemption by April 1. Eligible professionals must apply by March 15. Previously, the Centers for Medicare & Medicaid Services could only grant such exemptions on a case-by-case basis. CHA will notify members of the steps necessary to apply for the hardship exemption through CHA News as more details become available. 

CHA News Article

CMS Issues Request for Information on Electronic Clinical Quality Measures
Comments due Feb. 1

The Centers for Medicare & Medicaid Services (CMS), in conjunction with the Office of the National Coordinator (ONC), has issued the attached request for information about the certification of health information technology (HIT). CMS and ONC seek information on electronic health records (EHR) products used for reporting electronic clinical quality measures for EHR incentive programs, the hospital inpatient quality reporting program and the physician quality reporting system. CMS and ONC request feedback on how often to require recertification, the number of clinical quality measures a certified HIT module should be required to certify to, and ways to improve testing of the modules. Comments on the request are due Feb. 1. 

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

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.

CHA News Article

PHM Webinar Series to Conclude With Leadership and Talent Considerations

The final webinar in CHA’s five-part certification series on Population Health Management (PHM), to be held Oct. 6 from 9:30-11:30 a.m., will address key leadership and talent considerations for hospitals and health providers using, or considering implementing, a PHM strategy and approach.

As PHM makes new demands on leadership and talent, understanding the leadership and governance mindset necessary for successful PHM – including new perspectives on scale, volume and partnerships – is critical. The webinar will describe leadership’s role in fostering key PHM capabilities and introduce new leadership positions that focus on important facets of the PHM model, such as chief transformation officer, chief population health officer, chief medical informatics officer, and a leader for product and benefit design. Participants will also learn new metrics of leadership performance and accountability for a PHM environment.

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

Hospital Compliance Seminar
Stark updates, observation changes, 60-day rule developments, new relicensing survey

February 17, 2016 Sacramento
February 23, 2016 Long Beach

At the annual Hospital Compliance Seminar participants will learn about new laws, regulations and judicial decisions impacting hospital operations. Expert faculty will simplify complex regulatory and legal actions into clear and practical terms and offer guidance for implementation in the hospital environment. All attendees receive a complimentary copy of the 2016 California Hospital Compliance Manual.

Recording

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

Webinar recorded live November 19, 2015

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 bill is complicated and not without controversy.

CHA News Article

CMS Issues Final Rule With Comment Period on Access to Covered Medicaid Services
Releases RFI to solicit feedback on Medicaid access requirements

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule with comment period that aims to allow states and CMS to make better informed, data-driven decisions when considering whether proposed changes to Medicaid fee-for-service payment rates are sufficient to ensure that Medicaid beneficiaries have access to covered Medicaid services. The final rule also intends to strengthen CMS’ ability to review Medicaid payment rates to ensure they are consistent with efficiency, economy and quality of care, as well as ensure sufficient beneficiary access to care under the Medicaid program. CMS also issued a Request for Information (RFI) to gather input into additional approaches that it and states may consider to better ensure compliance with Medicaid access requirements. The RFI asks for comments on the potential development of standardized core set measures of access, access measures for long-term care and home and community-based services, national access to care thresholds, and resolution processes that beneficiaries could use when they have problems accessing essential health care services.

CHA News Article

New Law Aims to Protect Conservatees’ Rights
Hospitals advised to review conservatorship orders

Gov. Brown has signed AB 1085 (Gatto, D-Glendale), which allows a court to grant a conservator the power to enforce a conservatee’s right to receive visitors, telephone calls and personal mail. The bill also allows the court to direct a conservator to allow specific visitors, telephone calls and personal mail. This bill was introduced as a result of a highly-publicized situation in which radio host Casey Kasem’s second wife allegedly prevented daughters with his first wife from visiting him. The law also requires a conservator to inform certain persons, and an agent under a power of attorney for health care to inform any individuals identified by the patient, of the patient’s death. Hospitals should always get a copy of conservatorship orders for conserved patients and read them to fully understand the authority of the conservator and any limitations. The law takes effect 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

MAP Issues Final Recommendations for 2017 Federal Rulemaking

The Measures Applications Partnership (MAP) has issued its final recommendations to the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) for the federal fiscal and calendar year 2017 Medicare payment rules. The report provides strong insight into the quality measures that will be included in upcoming regulations, including measures required by the Improving Medicare Post-Acute Care Transformation Act of 2014 and the Medicare Access and CHIP Reauthorization Act of 2015. CHA members actively participated in the MAP process by providing input on member calls and public comments.

CHA News Article

CDC Issues Health Advisory on Treatment of Influenza Patients

Citing increased severe influenza illness across the country, the Centers for Disease Control and Prevention (CDC) has issued a health advisory to urge rapid antiviral treatment of very ill and high-risk suspected influenza patients without waiting for testing. CDC also recommends that clinicians encourage patients who have not yet received an influenza vaccine to do so as soon as possible. CDC guidelines for influenza antiviral use during the 2015-16 season are the same as during prior seasons. The entire health update is available on the CDC website.

CHA News Article

Application Deadline for HQI’s ENGAGE! Program Extended to Feb. 10

The Hospital Quality Institute (HQI) is now enrolling hospitals and health systems in a new program to collaborate with patients and their families as partners in patient safety and quality improvement.

ENGAGE! is part of HQI’s Partnership for Patient Experience strategy, developed in response to frequent hospital requests for practical assistance with strengthening patient and family engagement and improving HCAHPS scores. By facilitating engagement, the program will enhance hospital performance on the patient safety and readmissions objectives of CalHEN 2.0. All California hospitals are invited to participate in ENGAGE!; hospitals that are members of CalHEN 2.0 can participate free of charge. Interested hospitals should submit an application by Feb. 10.

CHA News Article

Institute of Medicine Report Examines Socioeconomic Risk Adjustment

The Institute of Medicine (IOM), in preparation for providing analysis for congressionally mandated reports in 2016 and 2019, issued the first in a series of five reports that will explore whether socioeconomic status (SES) and other social risk factors could be accounted for in Medicare payment and quality programs. The Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 requires the Secretary of Health and Human Services to issue a report to Congress by October 2016 that assesses the impact of SES on quality and resource use in Medicare, using measures such as poverty and rurality from existing Medicare data. It also requires a report to Congress by October 2019 on the impact of SES on quality and resource use in Medicare, using measures from other data sources.

CHA News Article

HQI Releases Advance Preview of 2014 Maternity Performance Data

The Hospital Quality Institute (HQI) has emailed CEOs hospital-specific 2014 maternity performance data that will be publicly accessible on Jan. 19 at www.calqualitycare.org. HQI encourages hospitals to review their data and participate in an upcoming webinar about using the data to improve perinatal care.

The large variation among hospital NTSV Cesarean birth rates, ranging between 11 percent and 60 percent, highlights the need for targeted quality improvement efforts. The California Maternal Quality Care Collaborative will host two separate webinars on available tools to reduce unnecessary Cesarean births and improve maternal and child health. Participants may register online for the Jan. 27 webinar or for the Feb. 11 webinar; both webinars will take place from noon-1:30 p.m. (PT). Contact Julie Morath, HQI president & CEO, or Claire Manneh, director of programs, HQI, with questions about the performance data.  

Overview

Reimbursement

California hospitals’ revenue stream is critical to their overall mission of providing care and cures in the communities they serve. While over half of hospitals’ revenue, nearly $30 billion a year, is derived from government-funded programs, including Medicare, Medi-Cal, Healthy Families and county indigent programs – Private Insurance revenues are also significant.

CHA believes that hospitals should be reimbursed adequately to cover the cost of care for enrollees.

CHA News Article

DHCS Resolves Processing Issue for Certain DRG Claims
Denied claims with RAD code 9953 may be resubmitted

The Department of Health Care Services (DHCS) has resolved a previously identified claim processing issue that caused diagnosis-related group (DRG) claims with remittance advice details code “9953: APR-DRG — Length of Stay Invalid for Interim Claim” to be erroneously denied. Hospital providers may resubmit previously denied level one or two administrative day claims and rehabilitation claims, provided the claims meet certain criteria. More information on resubmitting claims is available at the DHCS website.

CHA News Article

Timeliness Date Extended for Resubmission of Medi-Cal DRG Claims Over 22 Lines

Providers who wish to resubmit Medi-Cal diagnosis-related group (DRG) claims that exceed 22 lines may do so until Feb. 1. Providers should complete a claims inquiry form to void paid claims that were split-billed due to the 22-line restriction before July 28, 2014, where one of the following criteria applies:

  • First page paid, second page denied; or
  • Second page paid, first page denied; or
  • First and second pages paid separately.

Once the void appears on a future remittance advice details form, the claims may be resubmitted as a single claim.

For additional information about recent updates to electronic transactions, including specific processing instructions for inpatient claims submitted with more than 22 claim lines, providers should refer to the HIPAA 5010 Medi-Cal Companion Guide Update article.

CHA News Article

Hospitals Urged to Submit Data to AHA RACTrac Survey by Jan. 22

CHA encourages hospitals to submit data to the American Hospital Association’s (AHA) quarterly RACTrac survey by Jan. 22. The free web-based survey helps CHA measure the impact of Medicare’s Recovery Audit Contractor program on hospitals and advocate for needed changes. A hospital does not need to be an AHA member to participate in the survey. For more information on the RACTrac initiative, visit www.aha.org/RACTrac. To register for the survey or for technical assistance, contact RACTrac support at (888) 722-8712 or ractracsupport@providercs.com

CHA News Article

OMHA Publishes Quarterly Update of Case Processing Manual

The Office of Medicare Hearings & Appeals (OMHA) has published its quarterly update to the OMHA Case Processing Manual. The manual is used by OMHA adjudicators and staff to administer the OMHA program and offers day-to-day operating instructions, policies and procedures based on statutes, regulations and OMHA directives. The quarterly update addresses who qualifies as a party, as well as the roles and responsibilities of party representatives, the Centers for Medicare & Medicaid Services and its contractors in the administrative law judge hearing and review process. The full manual is available at www.hhs.gov/omha/OMHA_Case_Processing_Manual/index.html.  

CHA News Article

DHCS Announces Mapping Requirements for 2015-16

The Department of Health Care Services (DHCS) has provided hospitals information to assist in setup for the APR-DRG desktop grouper for state fiscal year 2015-16, including claims with admission dates on and between July 1, 2015, and June 30, 2016. For discharges after Oct. 1, 2015, mapping is required due to ICD-10 implementation, even if the admission was prior to that date. Therefore, for state fiscal year 2015-16, any claim with a discharge date on or after Oct. 1, 2015, will require historical mapping. Mapping is also required for admissions on or after Oct. 1, 2015.

DHCS is evaluating version 33 of the APR-DRG grouper and continues to use version 32 in the meantime. Currently, version 32 of the mapper will not recognize approximately 50 new ICD-10 PCS (surgical) codes effective Oct. 1. For updates and more information, continue to monitor the DHCS DRG website for provider bulletins.

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

State Mini Grants Available for Programs Encouraging Health Careers

The Office of Statewide Health Planning and Development announced its Mini Grant Program will be open from Jan. 22 through Feb. 22. The program encourages underrepresented and disadvantaged groups to pursue health careers in California.

CHA News Article

OSHPD Seeks Experts to Review Residency Grant Applications

The Office of Statewide Health Planning and Development (OSHPD) is soliciting applications from subject matter experts to review and score Song-Brown program funding applications. The program provides grant funds to family medicine and primary care residencies, family nurse practitioner/physician assistant programs, and registered nurse education programs.

For a complete list of roles and responsibilities, along with an application, visit the OSHPD website. The requested applicant information and a current resume may be submitted to Tyfany Frazier at songbrown@oshpd.ca.gov.

CHA News Article

Funding Available for Primary Care Training and Enhancement Program

The Health Resources and Services Administration’s Bureau of Health Workforce/Division of Medicine and Dentistry is soliciting applications for the Primary Care Training and Enhancement (PCTE) program. Eligible applicants include accredited public or nonprofit private hospitals, schools of medicine or osteopathic medicine, academically affiliated physician assistant training programs, and public or private nonprofit entities. Applications for funding are due by Dec. 16.

The PCTE program strengthens the primary care workforce by supporting training for future primary care clinicians and by promoting primary care practices in rural and underserved areas. The program aims to improve access and quality of care, as well as to increase cost effectiveness. Awardees must focus on transforming health care systems while enhancing trainees’ clinical training experience. For more information, visit www.grants.gov/web/grants/view-opportunity.html?oppId=279632.

CHA News Article

2016 Workforce Grant Bulletin Now Available

The Bureau of Health Workforce recently released its 2016 Application Bulletin and 2016 Grants Bulletin, which provide a snapshot of the bureau’s health workforce funding opportunities in 2016 by program, eligibility and discipline. Health care facilities are eligible for many of the grants listed in the one-page bulletins, which also include estimated open/release dates for each opportunity.  

CHA News Article

CHA Releases Roadmap to Creating a Health Care Work-Based Learning Program

In 2014-15, with support from the James Irvine Foundation, CHA partnered with hospitals, educators, funders and other experts to identify strategies for increasing the number of high-quality, health care work-based learning opportunities for California high school students. Health care as a whole is one of the fastest growing industries in the nation. According to the U.S. Department of Labor, Bureau of Labor Statistics, 17 of the 30 fastest growing occupations are in the health sector. To meet long-term demand for health workers, a variety of strategies must be employed throughout the workforce continuum. Work-based learning, the result of carefully planned and executed partnerships between health employers and educational entities, is one strategy that can increase the supply of health professionals serving California patients.

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