Hospital Topics

Overview

CDPH Licensing & Enforcement

The California Department of Public Health (CDPH) Licensing and Certification surveyors may visit a hospital at any time to determine whether the hospital is in compliance with state licensing requirements. Visits may result from a complaint by a patient, employee or other third party; a newspaper article; or a report by the hospital itself regarding an unusual occurrence, privacy breach or adverse event.

Education event

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

Remaining program:
May 28, Fresno

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

CHA News Article

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

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

CHA News Article

CDPH Guidance Emphasizes CDC Ebola Recommendations

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

CHA News Article

CDPH Launches Open Data Portal

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

Recording

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

Webinar Recorded Live on May 21, 2014

Overview

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

Overview

Community Benefit Programs
Hospitals give back to their communities

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

Tax-Exempt Status of Nonprofit Hospitals

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

General information

MOMS Orange County Provides Care to Low Income Pregnant Women

MOMS Orange County provides access to prenatal care, health screenings, health education, and referral services to more than 3,500 low income pregnant women annually in underserved communities in Orange County. Its services are offered at no cost to those who qualify, thanks in part to community benefit dollars from St. Joseph Health.

General information

Project Dulce Helps Diabetics Live Healthier Lives

Diabetes, which is especially prevalent among Latinos, often strikes fear in those who are newly-diagnosed.  To counter that, and to break through cultural misunderstandings, Scripps Health provides funding for a community benefit program called Project Dulce.  The program, which has been operating in San Diego County since 1997, provides diabetes-trained nurses and registered dieticians who work with patients to manage their disease and thus live longer, healthier lives.  It is especially effective since it uses peer counselors, fellow diabetics who can build trust since they are living with the disease themselves.  In this CHA video, a look at how the program works at one clinic in Escondido.

General information

Community Benefit Programs

California’s not-for-profit hospitals support a diverse array of community benefit programs across the state that are tailored to meet specific local health care needs. Those programs would be strengthened by Assembly Bill (AB) 1046 by Assemblymember Matt Dababneh (D-Encino), which provides greater transparency and accountability in the reporting of these programs. These community benefit programs, which provide help to millions of vulnerable Californians, are the subject of a new video produced by the California Hospital Association.

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.

Education event

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

Remaining program:
May 28, Fresno

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

Recording

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

Webinar Recorded Live on November 14, 2014

Overview

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

Recording

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

Webinar Recorded Live on October 29, 2014

Overview

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

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

CHA News Article

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

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

Recording

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

Webinar Recorded Live on October 1, 2014

Overview

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

Overview

Construction / Renovation

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

CHA News Article

CMS Issues Direction on Lowering OR Humidity Below 30 Percent

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

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

CHA News Article

OSHPD Showcases Online System for Plan Review and Construction

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

CHA News Article

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

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

CHA News Article

Categorical Waivers now Available for Power Strips in Patient Care Areas

The Centers for Medicare & Medicaid Services (CMS) has announced that it will permit categorical waivers for hospital power strip requirements under certain circumstances (the issue of power strips in patient care areas was detailed earlier this year in CHA News). CMS has determined that power strip provisions for health facilities in the National Fire Protection Association 101 Life Safety Code (LSC) may create unreasonable hardship for providers or suppliers. The CMS announcement notes that the 2012 edition of the LSC also offers an adequate alternative level of protection. The categorical waivers will be allowed for the use of power strips in existing and new health facility patient care areas if the provider/supplier complies with all applicable 2012 LSC power strip requirements, and with all other 2000 LSC electrical system and equipment provisions. To use the waiver, hospitals must supply written documentation that they have chosen to do so and notify the LSC survey team during its entrance conference. The policy change is effective immediately. For more information, visit the American Society for Healthcare Engineering website.

CHA News Article

FCC Requires Hospitals to Register Wireless Telemetry Devices With ASHE

All hospitals using wireless medical telemetry service (WMTS) devices must register them with the American Hospital Association’s American Society for Healthcare Engineering (ASHE) to avoid possible harmful interference with the operation of their equipment. As the designated WMTS coordinator, ASHE maintains a database of WMTS users, and the Federal Communications Commission (FCC) requires registration with ASHE before an organization operates a WMTS system in the TV channel 37 band (and in the upper bands of 1395-1400 MHz and 1427-1432 MHz). If a WMTS system is not registered, the FCC considers it to be unlicensed and not entitled to protection from interference caused by other transmitters.

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

Office of Administrative Law Approves Emergency Water Conservation Regulation

Yesterday, the California Office of Administrative Law approved the State Water Resource Control Board’s emergency conservation regulation to achieve the 25 percent statewide potable water usage reduction ordered by Gov. Brown in his April 1 executive order. The emergency regulations are effective May 18 and will expire on Feb. 13, 2016. The Governor’s executive order required, for the first time in the state’s history, mandatory conservation for all residents and directed several state agencies, including the State Water Board, to take immediate action to safeguard the state’s remaining potable urban water supplies in preparation for a possible fifth year of drought.

The regulations also require commercial, industrial, and institutional users to implement water efficiency measures; prohibit irrigation with potable water of ornamental turf in public street medians; and prohibit irrigation with potable water, if it is not delivered by drip or microspray systems, outside newly constructed homes and buildings.

CHA News Article

FCC Considering Proposal That Would Allow Harmful Interference With Wireless Patient Monitors
Urge FCC not to allow unlicensed devices to operate at the same frequency as medical wireless telemetry

The Federal Communications Commission is currently considering rules that would allow unlicensed devices to operate on the same frequencies as hospitals’ Wireless Medical Telemetry Service. Urge the FCC not to allow unlicensed devices to operate at the same frequency as medical wireless telemetry.

CHA News Article For Members

CHA Submits Comments on Draft Emergency Water Use Regulations
Webinar addressing impact of conservation mandate on hospitals is Monday — still time to register

On April 18, the State Water Resources Control Board (SWRCB) released draft emergency regulations pertaining to the drought and emergency water conservation. CHA worked with its Emergency Management Advisory Committee and hospital facilities directors to review the proposed regulations and the previous CHA comment letter in response to the state’s “framework” for the regulations. On April 22, CHA submitted a slightly revised comment letter, attached, to the SWRCB in response to the proposed regulations.

CHA News Article

IOM Report Provides Guidance to Multiple Sectors Engaged in Disaster Recovery

A report released last week by the Institute of Medicine (IOM) says U.S. communities and federal agencies should more intentionally seek to create healthier communities during disaster preparation and recovery efforts. According to the IOM, adding a health “lens” to planning and recovery helps communities mitigate the health damage caused by disasters and recover in ways that make the community healthier and more resilient than it was before. The report, Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities and Planning for Recovery, includes recommendations, case studies and other supportive material as practical guidance, in addition to specific guidance for federal agencies such as the Federal Emergency Management Agency, the Department of Health and Human Services, the Department of Housing and Urban Development and other agencies involved in implementing the National Disaster Recovery Framework. More information about the report is available at www.iom.edu/Global/News%20Announcements/Healthier-Communities-Post-Disaster-Report.aspx.

CHA News Article

Statewide Medical and Health Exercise Program Materials Now Available

The California Department of Public Health (CDPH) and the California Emergency Medical Services Agency have released materials for this year’s statewide medical health exercise, to be held Nov. 19. Using pandemic influenza as the scenario, this year’s exercise will focus on testing objectives designed to improve understanding of response procedures, building collaborative relationships and identifying areas of improvement. Participants may choose the objectives that will challenge and develop their emergency preparedness programs. The exercise materials and additional information are available on the CDPH website at www.californiamedicalhealthexercise.com/index.html.

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.”

Education event

Hospital Finance and Reimbursement Seminar
Medi-Cal and Medicare Updates, Quality Assurance Fee, 1115 Waiver, Covered California

June 11, Sacramento
June 16, Pasadena
June 17, Costa Mesa

Reimbursement is shrinking, while coverage and cost of care are expanding. Hospitals are now in the position of fighting for every dollar. Just to maintain the status quo, health care providers must navigate increasing and costly regulatory requirements while working to improve quality of care, reduce readmissions and comply with the complex two-midnight rule. More changes are ahead, too. Register now to gain a better understanding of how to effectively manage in the current health care environment, and also prepare for what lies ahead.

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.

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

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

Population Health Management Program Opens to Rave Reviews
Not too late to register; all programs will be recorded

CHA’s five part-certification series on Population Health Management (PHM) kicked off Tuesday with the first webinar, A Framework for PHM. Members who attended responded positively about the program, including:

“Very informative, insightful and visionary. I look forward to the future modules.”
“Excellent overview of PHM!”
“The Issue Brief provided an excellent foundation for the webinar.”
“We now have a better understanding of Population Health.”

“CHA engaged in this work with Kaufman Hall to help California member hospitals strengthen their position in the ever-changing health care delivery system,” said Anne McLeod, CHA’s senior vice president for health policy and innovation. “Population health management is the direction health care is moving as hospitals are challenged to enhance patient care quality, access and experience, while reducing costs.”

CHA News Article

Report Examines Californians with Chronic Conditions
Describes prevalence of conditions by region, age, federal poverty level, race/ethnicity and insurance type

The California HealthCare Foundation (CHCF) has released a report that examines five major chronic conditions — asthma, diabetes, heart disease, high blood pressure and serious psychological distress — and how each of these affects Californians. Titled Californians with the Top Chronic Conditions: 11 Million and Counting, the report details the prevalence of chronic conditions among adults by region, age, federal poverty level, race/ethnicity and insurance type. It also includes information on risk factors among adults with chronic conditions, emergency department visits and more.

CHA News Article

Report Highlights Findings of California Employer Health Benefits Survey

The California HealthCare Foundation (CHCF) has released a report that reveals only 58 percent of firms reported providing health insurance to employees, down from 69 percent in 2000. The data, compiled from the 2014 California Employer Health Benefits Survey, are outlined in the CHCF report titled California Employer Health Benefits: Rising Costs, Shrinking Coverage. The survey found that four in 10 firms said they expected to increase employees’ premium contributions in 2015, while 19 percent said they were likely to raise deductibles.

The report notes, “The percentage of employers offering coverage continues to decline in California, and many covered workers are seeing reduced benefits and increased cost sharing – trends with major implications for the household budgets of millions of people.”

CHA News Article

DHCS Releases Updated Health Homes for Patients with Complex Needs Concept Paper
Will accept stakeholder feedback on proposal through May 6

The Department of Health Care Services (DHCS) has released its Health Homes for Patients with Complex Needs California Concept Paper Version 2.0, authorized under Section 2703 of the Affordable Care Act. The paper is an update of the initial DHCS proposal, released in November 2014. Section 2703 allows states to create Medicaid health homes to coordinate the full range of physical health, behavioral health and community-based long-term services and supports required by Medicaid members with chronic conditions. Federal matching funds are available for two years at 90 percent. If the plan is implemented in California, The California Endowment has committed to funding the remaining 10 percent (up to $25 million per year) required for the additional services for the same two-year period. AB 361 (Chapter 642, Statutes of 2013) authorized California to submit a Section 2703 state plan amendment to the Centers for Medicare & Medicaid Services (CMS), subject to several conditions, including cost neutrality and an evaluation after the first two years.

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

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.

CHA News Article

ONC Reports Health IT Exchange Often Blocked

In a report released last week, the Office of the National Coordinator (ONC) told Congress that some IT developers and providers are deliberately interfering with the exchange of electronic health information in ways that limit its availability and its potential to improve health and health care. ONC officials outlined a series of steps that federal agencies are considering, including new rules to discourage the blocking of health record sharing, referring any illegal business practices to law enforcement agencies and coordinating with the Health and Human Services Office of Inspector General to deter interference with record transfers.

CHA News Article

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

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

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

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

CHA News Article

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

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

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

CHA News Article

Medicare EHR Incentive Program Attestation Deadline Extended for Eligible Professionals

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

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. 

Recording

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

Webinar Recorded Live February 28, 2013

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

Publication

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

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

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

(13th edition, 2014)

 

Publication

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

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

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

(10th edition, 2015)

Publication

Wage and Hour Manual for California Employers
A guide on legal requirements affecting wage and hour practices

Covers state and federal wage and hour laws, the Fair Labor Standards Act, Industrial Welfare Commission wage orders and Labor Commission policies.

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

(18th edition, 2015)

Overview

Legal

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

Education event

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

Remaining program:
May 28, Fresno

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

Recording

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

Webinar Recorded Live on November 14, 2014

Overview

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

Recording

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

Webinar Recorded Live on October 29, 2014

Overview

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

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

CHA News Article

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

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

Recording

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

Webinar Recorded Live on October 1, 2014

Overview

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

Overview

Quality & Patient Safety

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

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

CHA News Article

Hospitals Encouraged to Preview U.S. News Best Hospitals for Common Care Ratings
Preview period ends May 20

U.S. News & World Report has notified hospitals that its Best Hospitals for Common Care ratings (see previous CHA News article) are available for preview in the Best Hospitals Dashboard under embargo until May 20. The ratings place hospitals into performance tiers, with hospitals that performed consistently well rated highest. By logging into the dashboard, a hospital can access its ratings, the complete methodology report and key contacts for questions. CHA encourages hospitals to view their reports at https://hospitaldashboard.usnews.com/login?came_from=%2F during the preview period. Registration with the Hospital Dashboard is free, and more information is available on the U.S. News website.

CHA News Article

CMS Announces Strategic Vision for Physician Quality Reporting

The Centers for Medicare & Medicaid Services (CMS) has announced its Physician Quality Reporting Programs Strategic Vision. The document describes a long-term vision for CMS quality measurement for physicians and other health care professionals and public reporting programs, and how they can be optimized and aligned to support better decision-making from doctors, consumers and every part of the health care system. The strategic vision also includes five principles CMS believes will ensure that quality measurement and public reporting play a critical role in improving the health care system.  

CHA News Article

Updated 2014 Electronic CQMs for 2016 Reporting Now Available

The Centers for Medicare & Medicaid Services (CMS) has released the updated standards for the 2014 electronic clinical quality measures (eCQMs) for eligible hospitals and eligible professionals. These measures are required for compliance with the Meaningful Use Electronic Health Record (EHR) Incentive program. Eligible hospitals and providers should evaluate their EHR specifications to ensure the updated standards are in place to electronically report their quality data for 2016 reporting requirements for various programs. The updated measure specifications include 29 updated measures for eligible hospitals and 64 updated measures for eligible professionals. CMS strongly recommends that hospitals review the electronic specifications, which include human-readable descriptions and XML files, to build a complete understanding of each measure’s intent and operation prior to any implementation.

CHA News Article

Hospital Compare Outpatient Imaging Efficiency Measures Available for Preview
Preview reports available until May 2

The Centers for Medicare & Medicaid Services (CMS) has notified hospitals that preview reports for the Hospital Compare outpatient imaging efficiency measures are available for hospitals participating in the outpatient quality reporting (OQR) program until May 2. Preview reports can be accessed through QualityNet under the “My Reports” drop-down menu. Hospitals with questions about the preview reports should contact the hospital OQR program support contractor at (866) 800-8756 or at https://cms-ocsq.custhelp.com.

CHA News Article

Webinar Explains Hospital-Specific Reports for VBP Morality Measures, PSI-90

The Centers for Medicare & Medicaid Services will host a webinar April 21 at 11 a.m. (PT) about the hospital value-based purchasing program’s PSI-90 composite and 30-day mortality measures. The webinar will provide an overview of the hospital-specific reports (HSR) for the measures, guiding attendees through each section and explaining how to complete and submit a review and correction request. Presentation slides will be available online the day before the webinar at www.qualityreportingcenter.com/events. To register, visit https://cc.readytalk.com/r/e07eg98z1nip&eom.

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

DWC Issues Notice of Public Hearing on Revised Fee Schedules

The Division of Workers’ Compensation (DWC) has issued a notice of public hearing to revise the hospital outpatient departments and ambulatory surgical centers (HOPD/ASC) fee schedule. The hearing will be held June 17 at 10 a.m. in the auditorium of the Elihu Harris Building, 1515 Clay Street in Oakland. Members of the public may also submit written comment on the regulation until 5 p.m. that day.

The proposed amendment to the HOPD/ASC fee schedule regulation provides guidance on which HCPCS code to use when Medicare changes its coding practices – specifically, to describe comparable “Other Services” under the Centers for Medicare & Medicaid Services HOPD prospective payment system and the official medical fee schedule for physicians. The notice and text of the regulation are available on the DWC website.

CHA News Article

DHCS Seeks Comments on New Utilization Review Process

The California Department of Health Care Services (DHCS) has posted the draft Superior Systems Waiver (SSW) renewal application online for review and comment. The SSW describes the utilization review process for acute inpatient hospitals that serve fee-for-service Medi-Cal patients. Specifically, under the new waiver, private and non-designated public hospitals would transition to a utilization review system that no longer requires treatment authorization requests for the majority of acute inpatient stays. Instead, hospitals would use evidence-based medical criteria, such as Milliman or InterQual, to complete the utilization review. To ensure hospitals are appropriately using standardized medical review criteria, DHCS would review a statistically valid sample of cases approximately six months after claim submission.

The current SSW expires Sept. 30, and DHCS will submit the final renewal application to the federal Centers for Medicare & Medicaid Services no later than June 30. Comments on the draft may be submitted to DHCS no later than June 1 at SSWRenewal@dhcs.ca.gov. CHA requests that members who have comments also submit them to Amber Ott at aott@calhospital.org.

CHA News Article

Medi-Cal ICD-10 End-to-End Testing to Begin in July

The Department of Health Care Services has announced that Medi-Cal will conduct ICD-10 end-to-end testing in July. Providers and billers interested in participating in the testing can now register on the Medi-Cal website, which also includes instructions, more details about the testing and requirements for participation. The registration period ends June 5.

CHA News Article

CMS Announces Mass Adjustment of Some OPPS Claims
Will issue corrected payments

The Centers for Medicare & Medicaid Services (CMS) has notified providers that Medicare administrative contractors will be making a mass adjustment to certain outpatient prospective payment system (OPPS) claims and issuing corrected payments. The claims affected are for ambulatory payment classification 1448 (ophthalmic mitoymycin). The national unadjusted copayment for these claims was set to 20 percent when it should have been $0 for claims with dates of service from Jan. 1, 2014, through the installation of the April 2015 OPPS pricer. CMS has corrected the error in the April 2015 OPPS pricer, as well as in OPPS addendums A and B. Providers will be responsible for reimbursing beneficiaries for any overpayment due to the erroneous copayment.

CHA News Article

RACTrac Survey Deadline Extended to April 24
Data essential to CHA’s advocacy efforts

The deadline to complete the American Hospital Association’s (AHA) RACTrac survey has been extended to Friday, April 24. CHA encourages members to participate in the survey, which collects data about the impact of the Medicare recovery audit contractor (RAC) program and is essential to informing CHA’s advocacy efforts toward changing the program. AHA has added new elements to the survey to gather enhanced information on key RAC issues such as rebilling and the appeals process.

Hospitals should submit historical data even if they are not currently experiencing RAC audits. Hospitals do not need to be AHA members 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.

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

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.

CHA News Article

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

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

CHA News Article

CHA Co-Hosts Legislative Briefing on Strategic Health Workforce Development

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

CHA News Article

Rural Network Allied Health Training Program Grants Available

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

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