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

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. 

CHA News Article

CDPH Begins Pilot Testing for Hospital Relicensing Survey Process

The California Department of Public Health (CDPH) has announced the beginning of Phase II pilot testing for a new general acute care hospital relicensing survey process.

According to CDPH, its new survey process will evaluate general acute care hospitals’ compliance with state statutory and regulatory licensure requirements, including requirements previously evaluated through the Medication Error Reduction Plan and patient safety licensing surveys. The goal of the pilot-testing phase is to ensure the process will produce consistent, fair and useful information for both facilities and consumers before statewide implementation. For more information and for resources facilities may use to assess their readiness for the upcoming surveys, see the attached All Facilities Letter.

CHA News Article

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

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

CHA News Article

CDPH Guidance Emphasizes CDC Ebola Recommendations

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

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.

CHA News Article

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

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

News Release

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

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

Overview

Clinical Care

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

Education event

Decision Making for Unrepresented Patients Webinar
Court decision expands patient protections, prompts change in policies and procedures

October 13, 2015
10:00 a.m.  — 12:00 p.m., PT

Recently, the Alameda County Superior Court found unconstitutional a California law that permits skilled-nursing facilities (SNFs) to use interdisciplinary teams to make medical decisions for patients who lack capacity and have no one to make decisions for them. While the law applies to SNFs, many hospital interdisciplinary teams have also been operating under a CHA/CMA/ACH model policy, which is based the SNF law. Participate in this webinar to learn about this important case decision and how SNFs and hospitals should revise policies and procedures to comply.

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.

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.

CHA News Article

Proposed Air Toxics Risk Assessment Methodology Could Affect Hospitals

CHA has been participating in meetings with the Office of Environmental Health Hazard Assessment (OEHHA), local air management districts and other businesses regarding guidance OEHHA issued on  March 6 — the revised Air Toxics Hot Spots Program Guidance Manual for Preparation of Health Risk Assessments. The guidance includes changes to air toxics risk assessment methodology that will increase facility risk estimates by 150-300 percent or more compared to the prior methodology, without any increases in actual facility emissions. The guidance would also require a number of hospitals and other businesses to provide written risk notification to their neighbors even though the hospital may have significantly reduced its diesel particulate matter (dpm) emissions. CHA is concerned that the OEHHA guidance lacks direction and information on how air districts should communicate expected increases in the facility risk estimates to the public.

Recording

OSHPD Proposes a New Seismic Design Category: SPC-4D
Details of the proposed SPC-4D building design category and how to determine eligibility

Webinar Recorded Live on May 12, 2015

Overview

The Office of Statewide Health Planning and Development (OSHPD) has developed proposed building standards for a new seismic design category — Structural Performance Category 4D (SPC-4D), which meets the requirements of the Hospital Facilities Seismic Safety Act and acceptable structural engineering practices. The proposed standards are under review by the California Building Standards Commission.

CHA News Article

New Behavioral Health Facilities Design Guide Released

The Facility Guidelines Institute (FGI) has released the seventh edition of the Design Guide for the Built Environment of Behavioral Health Facilities. Formerly hosted by the National Association of Psychiatric Health Systems, the guide helps behavioral health care provider organizations understand and analyze how the physical environment affects patient and staff safety, as well as offers best practices in protecting patients and staff. The guide can be accessed on the FGI website at www.fgiguidelines.org/beyond.

CHA News Article

CMS Issues Direction on Lowering OR Humidity Below 30 Percent

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

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

CHA News Article

OSHPD Showcases Online System for Plan Review and Construction

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

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

New HHS Resources Support Hospitals, Communities During Emergencies

Last week, the Department of Health and Human Services HHS launched an online collection of federal resources available to mitigate the health impacts of emergencies. Topics range from patient movement and hospital care to situational awareness and decontamination, with resources ranging from mapping tools and consultation services to personnel. The compendium is intended to support communities in emergency situations by helping them identify and access available resources. More information is available in the HHS press release.

CHA News Article

Disaster Planning Conference Celebrates 10 Years
Join us September 28-30 in Sacramento

Celebrating its 10th year, CHA’s Disaster Planning for California Hospitals Conference will be held Sept. 28-30 in Sacramento. The theme, Planning for today, tomorrow and beyond, acknowledges the efforts hospitals have made to be ever-ready and well prepared to serve their communities during and after a disaster.

“We are excited to celebrate this benchmark conference with our members,” said Cheri Hummel, vice president, emergency management & facilities. “As we continue to build upon our foundation of disaster preparedness, we also recognize all California hospitals have done to advance their readiness. By their longstanding and active participation in this conference, California hospitals have demonstrated their commitment to learn from each other and share best practices gleaned from real-life situations and exercises.”

CHA News Article

CDPH to Offer Free Orientation Webinar for Statewide Medical Health Exercise

The California Department of Public Health and the California Emergency Medical Services Agency will host a free webinar in preparation for this year’s Statewide Medical and Health Exercise, to be held Nov. 19. The training includes an orientation to the 2015 exercise materials and the updated website, tips on how an organization can customize the exercise for its needs, and a question-and-answer period.

Hospitals are invited to participate on either Aug. 4 from 1:30 – 3 p.m. or Sept. 16 from 2 – 3:30 p.m. For more information about the webinar or registering to participate, see the attached flyer.

CHA News Article

CDC Issues Ebola Advisory on Travelers From Liberia

The Centers for Disease Control and Prevention (CDC) has issued a health advisory on the clinical considerations for evaluating ill travelers from Liberia. CDC’s advisory is consistent with two sets of guidance issued earlier this month by the California Department of Public Health (CDPH) — Planning for and Management of Travelers from Ebola-Affected Countries for Local Health Departments, and Interim Guidance for Healthcare Providers – Travelers from Ebola-Affected Countries. Both CDPH documents are available at www.cdph.ca.gov/programs/cder/Pages/Ebola.aspx.

CHA News Article

CDC Issues Modified Protocols for Liberian Travelers
CDPH releases updated guidance: June 18 call scheduled

Today, the Centers for Disease Control and Prevention (CDC) modified protocols for travelers from Liberia to the United States, stipulating that those currently under active or direct active monitoring for Ebola Virus Disease (EVD) by local health departments (LHDs) no longer need monitoring. For California, the protocol for Liberian travelers is spelled out in the attached updated guidance from the California Department of Public Health (CDPH). The guidance provides LHDs with important elements of an Ebola plan, changes in notifications and monitoring of Liberian travelers, and outlines the responsibilities of CDPH and the Emergency Medical Services Authority (EMSA) in assisting LHDs.

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 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.

CHA News Article

CDPH Stakeholder Meetings on Medical Waste Haulers Begin March 25

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

Technical Advisory Meetings

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

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

Overview

Finance

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

CHA News Article

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.

CHA News Article

Governor Unveils 2015-16 State Budget

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

CHA News Article

Governor Signs Bill Revising Charity Care Law

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

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

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

U.S. Supreme Court Issues Decision in King v. Burwell
Upholds IRS regulations making subsidies available in states with federally facilitated marketplaces

Today, the U.S. Supreme Court issued its decision in King v. Burwell, the second challenge to the Affordable Care Act (ACA) to reach the Court. The Supreme Court decided by a 6-3 vote to uphold the Internal Revenue Service (IRS) regulation making subsidies available in states with federally facilitated marketplaces (FFM). Subsidies will continue to be administered through all marketplaces. The petitioners challenged the legality of premium and cost-sharing subsidies on the exchanges that were established by the Department of Health and Human Services (HHS) in 34 states. They contended that the tax code restricts subsidies to individuals who enroll in coverage through a state-based marketplace (SBM) when it provides that the amount of the subsidy is based on premiums in an exchange “established by the State.”

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.

CHA News Article

Health Affairs to Conduct Briefing on California’s Medi-Cal Waiver
Experts to discuss perspectives on promoting health system improvement

Health Affairs, with support from the Blue Shield of California Foundation and the California HealthCare Foundation, will conduct a briefing on California’s Medi-Cal waiver on June 11 from 10 a.m. – noon. California’s five-year section 1115 “Bridge to Reform” demonstration waiver is set to expire Oct. 31. On March 27, the California Department of Health Care Services (DHCS) submitted its final draft 1115 Medi-Cal 2020 waiver renewal application to the Centers for Medicare & Medicaid Services for approval by Nov. 1. At the briefing, experts will discuss how waivers are being used to promote system improvement, delve into California’s experiences with and lessons from the current waiver, and explore opportunities in the latest waiver renewal application.

To register for the event visit the online registration site. The event will be recorded and available on the Health Affairs website afterward.

CHA News Article

MACPAC Report Details Early Beneficiary Experience in Duals Demonstration
Highlights feedback from California, Massachusetts and Ohio enrollees

The Medicaid and CHIP Payment and Access Commission (MACPAC) has released a study on early experiences with the Duals Demonstration in California, Massachusetts and Ohio. MACPAC conducted seven focus groups with beneficiaries in the three states over a nine-month period to obtain feedback on the enrollment process, understanding care coordination and access to services. Conducted between June 2014 and February 2015 the focus groups were comprised of 55 dual-eligible enrolled beneficiaries, most of whom had been enrolled in the demonstration for at least six months prior to the focus group. The report focuses on the findings of the focus groups and illustrates the challenges and benefits beneficiaries have experienced as these programs are implemented throughout the country.

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.”

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

Final PHM Webinars to Address Technology and Leadership Considerations

Two webinars remain in CHA’s five-part certification series on Population Health Management (PHM). Member hospitals have offered many positive comments on the series including:

“This webinar series is wonderful with assisting in implementation of a population health program.”

“This series has started to connect the dots for me regarding population health and how to implement it in my facility.”

The next webinar, Technology for Population Health Management, will be held Aug. 25 from 9:30 – 11:30 a.m. (PT). Geared toward health information professionals, the webinar will address key PHM technology capabilities, including care coordination monitoring and tracking; patient-centric disease registries; advanced health analytics, including predictive modeling; enterprise risk management; cost management; and virtual/mobile health.

CHA News Article

Report Makes Recommendations for HIT Interoperability

The American Hospital Association’s (AHA) Interoperability Advisory Group issued a report this month recommending steps hospitals, health systems, vendors and the government can take to advance health information technology (HIT) exchange. The report recommends hospitals and health systems engage more fully to identify priorities for sharing data and contribute to creating better testing of HIT systems. The report also recommends that vendors align their business case with the needs of their customers so that information can be shared efficiently and effectively without repeated and expensive “tolls” for creating interfaces and completing transactions. In addition, according to the report, the federal government should continue to support interoperability with a focus on standards, certification and testing. AHA’s report is available at www.aha.org/content/15/1507-iagreport.pdf.

CHA News Article

CMS Allows Hospitals in First Year of Meaningful Use to Attest This Summer

The Centers for Medicare & Medicaid Services (CMS) has reopened the attestation process for hospitals participating in the Medicare Electronic Health Record Incentive program for the first time in 2015. Hospitals new to the meaningful use program can attest between now and Aug. 14. Eligible hospitals and critical access hospitals participating in meaningful use for the first time this year may attest to a 90-day reporting period for fiscal year 2015. CHA strongly advocated for this change in its comments to CMS on the meaningful use modification rule. Hospitals that have previously participated in the meaningful use program will not be able to access the attestation portal until after Jan. 1, 2016.

The process will be implemented on a case-by-case basis for hospitals that register through the CMS Registration and Attestation System at https://ehrincentives.cms.gov/hitech/login.action. Once the registration is active, hospitals should contact Elizabeth Holland at elizabeth.holland@cms.hhs.gov to provide their hospital name, CMS Certification Number and contact information. Additional information about Electronic Health Records Incentive program attestation can be found on the CMS website.

CHA News Article

CMS Seeks Volunteers for PSVA Pilot Program

The Centers for Medicare & Medicaid Services (CMS) is seeking volunteers to participate in a pilot of the Pre-Submission Validation Application (PSVA), which will allow hospitals to validate quality reporting document architecture (QRDA) Category I files for electronic clinical quality measure data submission. The pilot allows hospitals to catch and correct errors before submitting files to CMS. To be eligible, a hospital must be able to create QRDA Category I files based on the HL7 Base Standard for QRDA, as well as download and install PSVA in the hospital’s environment during the pilot period. Hospitals must also attend a 30-minute information session in June; attend two 30-minute feedback sessions in July; and record and submit feedback to CMS on their PSVA use. Hospitals interested in participating in the pilot should contact Stephanie Wilson by email at Stephanie.wilson@hcqis.org. Additionally, CHA requests that hospitals intending to participate notify CHA by email at akeefe@calhospital.org.

CHA News Article

CMS Proposes Modifying EHR Reporting Period to 90 Days in 2015

The Centers for Medicare & Medicaid Services (CMS) has released the attached proposed rule that would modify the reporting periods for the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs to a calendar year rather than a fiscal year. To accommodate the proposed changes, CMS proposes a 90-day reporting period for 2015 for all eligible hospitals and critical access hospitals, regardless of stage of meaningful use. In 2016, first-time demonstrators of meaningful use would also be allowed a 90-day reporting period. However, all returning participants would use an EHR reporting period of a full calendar year from Jan. 1, 2016, through Dec. 31, 2016. In 2017, all providers — both new and existing participants ­— would use an EHR reporting period of one full calendar year as proposed in the Stage 3 proposed rule.

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. 

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

Decision Making for Unrepresented Patients Webinar
Court decision expands patient protections, prompts change in policies and procedures

October 13, 2015
10:00 a.m.  — 12:00 p.m., PT

Recently, the Alameda County Superior Court found unconstitutional a California law that permits skilled-nursing facilities (SNFs) to use interdisciplinary teams to make medical decisions for patients who lack capacity and have no one to make decisions for them. While the law applies to SNFs, many hospital interdisciplinary teams have also been operating under a CHA/CMA/ACH model policy, which is based the SNF law. Participate in this webinar to learn about this important case decision and how SNFs and hospitals should revise policies and procedures to comply.

Recording

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

Webinar Recorded Live on November 14, 2014

Overview

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

Recording

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

Webinar Recorded Live on October 29, 2014

Overview

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

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

CHA News Article

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

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

Recording

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

Webinar Recorded Live on October 1, 2014

Overview

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

Overview

Quality & Patient Safety

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

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

Education event

2015 Hospital Quality Institute Annual Conference
Respect, Reliability, Resilience

November 11, Pre-Conference Workshops
November 12 – 13, Full Conference

Sacramento, CA

Join us for the 2015 Hospital Quality Institute Conference to achieve ever increasing higher levels of performance, through a culture of respect and professionalism.  This conference will showcase the pursuit of excellence in California and the nation. Participants will take home strategies and tools for achieving reliable care and delivering value to each patient, each time, and in each community. The content, interactive learning and networking opportunities are not to be missed.

CHA News Article

CHA Reminds Hospitals of Outpatient Quality Reporting Deadlines

CHA reminds hospitals that the data for the Hospital Outpatient Quality Reporting (OQR) program web-based measures are now being accepted into the QualityNet Secure Portal and must be submitted by Nov. 1. If the data are not submitted by the deadline, a hospital’s annual payment update may be reduced by 2 percent. Once logged into the secure portal, hospitals should select “2016″ from the payment year (PY) drop down window under “Outpatient Web-Based Measures.” If PY 2015 is selected, data entered last year will be shown (hospitals may not submit data under PY 2015).

CHA News Article

Budget Trailer Bill Recognizes Alternative Quality Control in Clinical Laboratories

The budget trailer bill adopted as part of the state’s final 2015-16 budget amends Section 1220 of the Business and Professions Code pertaining to clinical laboratories. Specifically, the budget trailer bill allows clinical laboratories to establish an alternative quality control program that meets federal regulations under the Clinical Laboratory Improvement Act and that may include the use of alternative quality control testing procedures already recognized by the Centers for Medicare & Medicaid Services (CMS). Until now, the California Department of Public Health has interpreted regulations in a way that did not recognize federally approved alternative quality control methods, requiring labs to perform frequent quality control tests, which are substantially more expensive than the current federally recognized equivalent quality control (EQC) procedures and the impending individualized quality control plans (IQCPs).

CHA News Article

CHA Encourages Members to View FSRs for Outpatient Colonoscopy Measure
National provider calls scheduled for July 14 and 16

CHA reminds hospitals of the upcoming dry run of the “Facility 7-Day Risk-Standardized Hospital Visit Rate after Outpatient Colonoscopy” measure for hospital outpatient departments and ambulatory surgical centers. The dry run will take place from July 1 through July 31. During that time, the Centers for Medicare & Medicaid Services (CMS) will provide facilities with facility-specific reports (FSRs) for the measure. The FSR contains patient-level data, facility-specific results, and state and national results for the colonoscopy measure. CMS encourages facilities to review their FSRs thoroughly and submit any questions and comments to CMSColonoscopyMeasure@yale.edu.

CMS will hold two national provider calls to present the measure methodology and address questions. Hospital outpatient departments are asked to participate on July 14 from 11 a.m. – noon (PT), and ambulatory surgical centers on July 16 from 11 a.m. - noon (PT). Additional information about registration for the calls will be provided on QualityNet in late June.

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

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

Hospitals Urged to Submit Data to AHA RACTrac Survey

The American Hospital Association’s (AHA) RACTrac survey data is used specifically to analyze the impact of the Medicare Recovery Audit Contractor (RAC) program on hospitals and helps to guide CHA’s advocacy for important and necessary changes in the RAC program. AHA membership is not required to participate in RACTrac; CHA encourages all hospitals to submit data to the quarterly RACTrac survey by Friday, July 24. For registration information, contact AHA’s RACTrac support at (888) 722-8712 or ractracsupport@providercs.com. For more on the survey, including the new RACTrac claim-level tool, visit www.aha.org/ractrac.

CHA News Article

CMS Withdraws RAC Program Request for Quotes
Current RACs to continue audits through Dec. 31

The Centers for Medicare & Medicaid Services (CMS) announced last week that it has withdrawn its current request for quotes for the next round of recovery audit contractor (RAC) contracts. CMS has stated that it will update the RAC program’s statement of work and issue new requests for proposals. Until then, current RACs will continue auditing through at least Dec. 31. In May, a Federal Claims Court ruled to prohibit CMS from proceeding with contracts under its original requests for quotation, after a March ruling from the U.S. Court of Appeals that proposed new RAC contracts violate contracting requirements.

Hospitals are reminded to reach out to their members of Congress to request that they cosponsor The Medicare Audit Improvement Act, H.R. 2156, to address the inefficiencies and misaligned incentives within the current RAC program. Gathering cosponsors is an important step toward advancing the legislation, and currently only nine members of the California delegation have signed on. CHA’s letter of support is attached.  

CHA News Article

DHCS Will Reprocess Certain DRG Claims

The Department of Health Care Services (DHCS) has resolved a claims processing issue that caused diagnosis-related group (DRG) claims that included other health coverage to be erroneously denied. Timeliness will be waived for claims that were previously denied with remittance advice details (RAD) code 9968 (“no approved TAR on file for APR-DRG inpatient admission working”) for dates of service from July 1, 2013, through March 1, 2015. Hospital providers may resubmit claims until November 20.

CHA News Article For Members

CMS Issues CY 2016 OPPS Proposed Rule
Includes proposed changes to two-midnight rule; comments due Aug. 31

The Centers for Medicare & Medicaid Services (CMS) has issued the attached proposed rule updating the outpatient prospective payment system (OPPS) for calendar year (CY) 2016. CMS estimates that overall payments for hospitals paid under the OPPS will decrease by 0.2 percent compared to CY 2015.

In addition to the payment and quality reporting provisions expected in the rule and discussed below, CMS proposes changes to the two-midnight policy — specifically to the requirements for the expectation of two midnights. However, CMS makes no changes to the presumption that any patient who remains in the hospital for two midnights is deemed to have a medically necessary stay. Further, CMS proposes to change its approach to education and review of patient status claims and give more authority and oversight to the quality improvement organizations.

CHA News Article

DHCS to Host Webinars on Medi-Cal DRG Year 3

The Department of Health Care Services (DHCS) has scheduled two training sessions to help providers prepare for year three of the DRG payment methodology, which begins July 1. DHCS will host webinars, in conjunction with Xerox, on June 11 from 9:30 – 11 a.m. (PT) and June 15 from 9:30 – 11 a.m. (PT). Online registration is required. Once registered, attendees will receive meeting details and instructions for joining the meeting.

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

Family Medicine Capitation Applications to Be Released June 30

The Healthcare Workforce Development Division’s (HWDD) Song-Brown program will release the Family Medicine Residency Capitation grant application June 30. Applications are due July 30. For those interested in submitting applications, HWDD will hold a Family Medicine Residency program webinar June 24 at 11 a.m. For more information, visit http://oshpd.ca.gov/hwdd/song_brown_prog.html.

The Song-Brown Health Care Workforce Training Act was established to increase the number of family physicians to provide needed medical services to Californians. The program encourages universities and primary care health professionals to provide health care in medically underserved areas while providing financial support to medical education programs throughout the state.

CHA News Article

CDPH Adds Staff to Assist With Delays in Phlebotomist Certification Renewals

Phlebotomist certification renewals are currently taking about 45 days to process, which is significantly longer than usual. Lab Field Services, under the California Department of Public Health, has added staff to alleviate the immediate backlog and is moving toward a more automated process to reduce future delays. Laboratory personnel can track certification renewals at https://www.cdph.ca.gov/programs/lfs/Pages/PersonnelWebsiteLookup.aspx, which is updated each Tuesday evening. An outline of the renewal process is available at https://www.cdph.ca.gov/programs/lfs/Pages/ContinuingEducation.aspx. California Code of Regulations (Title 17 CCR 1031.5 (c)) requires that renewal applications be submitted 60 days in advance of the expiration date.

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

Grants Available for Preventive Medicine Residency With Integrative Health Training Program

The Health Resources and Services Administration Bureau of Health Workforce is accepting applications through May 29 for its Preventive Medicine Residency with Integrative Health Care Training Program. With more than $5 million in funding, the program aims to improve the health of communities by increasing the number and quality of preventive medicine physicians who can address public health needs and advance preventive medicine practices, increase access to integrative health care and increase integration of the two fields into overall primary care training and practice. Grant funding will support efforts to plan, develop (including the development of curricula), operate or participate in an accredited residency or internship program in preventive medicine or public health. Eligible applicants include accredited public or private nonprofit hospitals; accredited schools of public health; schools of medicine; state, local or tribal health departments; and consortia of two or more eligible applicants. Approximately 14 grants of up to $400,000 per year for three years will be awarded. An application guide is available at www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf.

CHA News Article

Health Workforce Diversity Grants Available

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

Commands