Hospital Topics


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

CDPH Updates Zika Virus Guidance

The California Department of Public Health has issued updated guidelines for managing possible Zika virus infections in pregnant or preconception patients. For all pregnant patients, providers should:

  • Screen for exposure to Zika virus and, if exposed in the last 12 weeks, ask about signs and symptoms such as fever, rash, conjunctivitis or joint pain since exposure.
  • Promptly test if a patient becomes symptomatic or her partner tests positive for Zika virus infection.
  • If a patient has a one-time risk of exposure, follow previously recommended steps.
  • If a patient has ongoing risk of exposure, conduct polymerase chain reaction testing at least once per trimester, unless a previous test has been positive.
  • Counsel pregnant women on the limitations of testing during each trimester.

If a symptomatic patient has no identifiable Zika exposure, providers should contact their local health department. Providers should remind patients who want to conceive in the near future, and who have an ongoing risk of Zika exposure, of recommendations to delay pregnancy until exposure can be reduced. Preconception patients should also consider immunoglobulin M testing to establish a baseline to inform future Zika test results, should the patient be exposed in an ensuing pregnancy.

CHA News Article

CDPH to Host Webinar on Candida Auris Identification and Response

The California Department of Public Health (CDPH) will host a webinar June 27 from 11 a.m. – noon (PT) to assist providers in identifying Candida auris and describe infection control and public health response to these cases. The webinar will also describe the epidemiology of C. auris in the U.S., along with laboratory considerations for identifying the pathogen. Presenters include representatives from CDPH as well as the Centers for Disease Control and Prevention. More information is available in the attached flyer; registration is available online.  

CHA News Article

CDPH Seeks Input on Certification Regulations for CNAs, Home Health Aides
Comments due June 30

The California Department of Public Health has issued the attached All Facilities Letter seeking public comment on updates to training and certification regulations for certified nurse assistants and home health aides. The updated regulations will address qualifications for initial certification and renewals; approval of certification training programs, training personnel and program components; competency evaluations; dual certifications, in-service training and continuing education; and training program noncompliance and withdrawal of approval. Comments should be submitted by 5 p.m. (PT) on June 30.

CHA News Article

CDPH Website Redesign Improves Licensing and Certification Information

The California Department of Public Health this week launched its redesigned website, including improvements to the Center for Health Care Quality’s Licensing and Certification Program pages. The site aims to highlight the work of public health and promote the department’s protection of California health and wellness. The old site, which has been archived and will be taken down in the next few months, is available at

CHA News Article

CDPH Updates Regulations on Reporting Disaster-Related Occurrences

The California Department of Public Health (CDPH) has issued the attached All Facilities Letter updating its previous guidance related to reporting emergency and disaster occurrences that threaten the welfare, safety or health of patients. The updated guidelines provide contact information for reporting an emergency that results in patient evacuation, transfer or discharge. During normal business hours, facilities are reminded to report to their local CDPH Licensing & Certification district office. After hours, or if the district office is non-operational, facilities should contact the Office of Emergency Services Warning Center or, if in Los Angeles County, the Los Angeles County Operator.  


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.

CHA News Article

Webinar Provides Guidance for Reporting Community Benefit Investments

CHA will hold a webinar June 29 from 10 a.m.–noon (PT) to provide not-for-profit hospitals with in-depth analysis and strategies for accurate reporting of their community benefit investments to the Internal Revenue Service (IRS). The program will include detailed guidance on completing IRS Form 990, Schedule H, which not-for-profit hospitals are required to submit annually.

Keith Hearle, founder and president of Verité Healthcare Consulting and advisor to the IRS on the Form 990, Schedule H, will outline what qualifies as a community benefit as well as key accounting principles for reporting. Ways to demonstrate community need, how population health approaches can or cannot translate to community benefit activities, and issues and opportunities for each of the IRS Form 990, Schedule H reporting areas will also be presented.

To view the full program agenda and to register visit,

CHA News Article

Webinar Will Cover IRS Community Benefit Reporting Fundamentals for NFP Hospitals
Register now for June 29 program

The Internal Revenue Service (IRS) requires not-for-profit hospitals to submit IRS Form 990, Schedule H, each year to report their community benefit investments. CHA will hold a webinar June 29 from 10 a.m.-noon (PT) to offer not-for-profit hospital executives line-by-line guidance on how to accurately report such investments.

Led by Keith Hearle, founder and president of Verité Healthcare Consulting and author of major sections of the instructions for IRS Form 990, Schedule H, the program will cover the fundamentals of community benefit reporting and provide in-depth analysis of what hospitals can and should include in the form. Participants will learn what does and does not qualify as a community benefit activity, how to demonstrate community need and key accounting principles for community benefit programs. The program will also highlight issues and opportunities for each of the reporting areas, including financial assistance, community benefit operations, health professions education, Medicaid and other means-tested government programs, and cash and in-kind contributions.

To view the program agenda and to register, visit

CHA News Article

CHA Webinar to Explore NFP Hospital Financial Reporting for Community Benefit Programs
Register now for June 29 program

Each year, not-for-profit hospitals are required to complete and submit to the Internal Revenue Service (IRS) a report of their community benefit investments using IRS Form 990, Schedule H. CHA will hold a webinar June 29 from 10 a.m.– noon (PT) to explain what qualifies as a community benefit, as well as how to properly and accurately report such activities. 

Program faculty Keith Hearle — founder and president of Verité Healthcare Consulting and author of major sections of the instructions for IRS Form 990, Schedule H — will define community benefit, provide participants with a line-by-line analysis of the form and share key accounting principles for community benefit programs and activities. Information on financial assistance, patient care cost to charges ratio, Medicaid and other means-tested programs, subsidized health services, and cash and in-kind contributions will also be presented.

CHA News Article For Members

CHA Releases Brochure Highlighting California’s Community Benefit History

CHA has released the attached educational brochure highlighting California’s community benefit history. For more than 20 years, California’s not-for-profit (NFP) hospitals have led the nation in ensuring that vulnerable populations have access to much needed health care services and health improvement programs. Each year, they contribute an estimated $12 billion to their communities through community benefit programs and activities, including mobile units serving disadvantaged families, classes on disease management and violence prevention, health professions education programs that train the next generation of health care providers, research in clinical and community health that contributes to evidence-based practices, leadership development and training for community members, and much more.

The brochure highlights the ways NFP hospitals partner with their communities to assess community health needs, and explains why flexibility in program development is critical.


Clinical Care

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

CHA News Article

CMS to Host IMPACT Act Forum on June 20

The Centers for Medicare & Medicaid Services (CMS) will conduct a special open door forum to provide information and solicit feedback on the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) on June 20 from 11 a.m. to noon (PT). The forum will focus on the goals of the IMPACT Act; update attendees on RAND contract activities for item development, including the upcoming national testing; and identify opportunities for providers, consumers, stakeholders, researchers and advocates to become involved over the next year. CMS encourages providers and other key stakeholders to submit questions in advance to

Additional information, including presentation materials for the call, is available on the CMS website. To join the call, dial (800) 837-1935 and enter conference ID 22857942.

CHA News Article

CMS Provides Resources on Post-Acute QRP ‘Review and Correct’ Reports

The Centers for Medicare & Medicaid Services (CMS) has posted resources from its recent webcast training on post-acute care quality reporting program (QRP) review and correct reports. Among the resources are a video recording and post-training materials, including a question and answer document. The materials are accessible on the CMS QRP training pages for inpatient rehabilitation facilities, long-term care hospitals and skilled-nursing facilities

General information

Emergency Department Toolkit
Behavioral health resources for the emergency department

Special resource toolkit developed by CHA’s EMS/Trauma Committee and the Center for Behavioral Health.  Designed to help staff provide support to patients in the ED with psychosis and/or substance abuse disorders, this toolkit provides access to articles, policies, management techniques, assessment tools and more. Click the topic tabs below to access resources and information.


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

Webinar recorded live April 18, 2016

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


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

OSHPD Moves to New Location in Sacramento

Last month, the Office of Statewide Health Planning and Development moved to a new location. Its headquarters are now at 2020 West El Camino Ave., Sacramento, CA 95833. Email addresses and phone numbers remain the same. Effective immediately, Hospital Building Safety Board (HBSB) meetings have also moved to the same location; details are available on the OSHPD website.

CHA News Article

Deadline for Reporting Large Spark-Ignition Engine Fleets Is June 30

Specific equipment – including class 1,2,4 and 5 forklifts, as well as industrial tow tractors and sweepers/scrubbers – subject to the Large Spark-Ignition Engine Fleet Requirements Regulation must be reported to the California Air Resources Board (CARB) by June 30; this requirement may apply to some hospitals.  Information is available on the CARB website; registration is available online.

CHA News Article

Building Standards Code Webinar Series Continues With Administrative, Architectural Changes
Next webinar is May 15

The second webinar of the three-part series on the 2016 update to the California Building Standards Code (CBSC) will be held May 15 from 1:30-3:30 p.m. (PT) and will cover changes to the code’s administrative, architectural, mechanical, electrical and plumbing systems, as well as pharmacy provisions. Hospital construction teams who are planning new projects — including remodels — should have a solid understanding of the 2016 code to ensure full compliance.

Program faculty from the Office of Statewide Health Planning and Development Facilities Development Division and Hospital Building Safety Board will outline and explain updates to the California Administrative Code; CBSC Section 1224; CBSC Title 24, Parts 3, 4 and 5; Sterile Compounding Pharmacies Advisory Guide; and more.

CHA News Article

New Hospital Construction Projects Must Comply With 2016 Building Standards Code
Still time to register for webinar series — first program is Monday

Hospitals planning or considering new construction projects must ensure their plans comply with the 2016 California Building Standards Code. Effective Jan. 1, 2017, the code includes significant changes across a wide range of categories. CHA will host a three-part webinar series to outline the changes and explain how hospitals can achieve compliance. Programs will be held May 1, May 15 and May 22 from 1:30-3:30 p.m. (PT).  

Faculty include representatives from the Office of Statewide Health Planning and Development Facilities Development Division and the Hospital Building Safety Board, who will detail recent updates to the code:

  • Webinar 1 – Fire and life safety provisions
  • Webinar 2 – Administrative, architectural, mechanical, electrical and plumbing systems, and pharmacy provisions
  • Webinar 3 – Structural provisions

Sterile Compounding Pharmacies — Planning, Construction and Licensing Guidance Webinar
Gain insights from CA Board of Pharmacy, OSHPD, CDPH Licensing & Certification


Effective January 2017, hospitals that perform sterile compounding must meet new regulatory requirements from the California State Board of Pharmacy. Beyond updating processes and procedures, hospitals will be required to improve or reconfigure facilities for ventilation, install new equipment for sterility and ensure employee protections.


Emergency Preparedness
Is your hospital prepared?

Visit CHA’s Emergency Preparedness website at


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

CHA News Article

CHA Joins Effort to Test Response to Extended Power Outages
Hospitals encouraged to participate in upcoming exercise

Earlier this month, CHA participated in the Black Sky West TTX, held at the California Office of Emergency Services and presented by Electric Infrastructure Security Council. The same exercise was also conducted with the Governor and his cabinet on the previous day. Black Sky hazards can result from a variety of factors ranging from severe regional earthquakes, extreme weather and solar storms to electromagnetic pulse, cyber and coordinated physical assaults on power generation and transmission. These events could cause subcontinent-scale power outages with widely distributed damage to key elements of the national power grid, resulting in cascading impacts.

CHA encourages participation in a similar upcoming event, the EARTH Ex 2017 Exercise, planned for Aug. 23. Hosted by the Electric Infrastructure Security Council, the exercise will focus on processes and tools to support response and recovery from a long duration power outage. It will also provide participants with a unique opportunity to examine response and restoration without a long build-up or preparation cycle. More information is available at

CHA News Article

CHA’s Disaster Planning Conference Highlights the Power of Partnerships
Registration now open

Registration is open for CHA’s Disaster Planning for California Hospitals, set for Sept. 18-20 in Sacramento. The largest statewide gathering of hospital emergency preparedness coordinators, the conference offers a wealth of information, resources and lessons learned to help hospitals bolster their readiness.

This year’s theme, Powering Readiness Through Partnerships, signifies the importance of establishing, nurturing and maintaining relationships with other hospitals, health care providers, community partners and government agencies.

“Building relationships with key partners is perhaps one of the most powerful and essential elements of disaster planning and response,” said Cheri Hummel, CHA vice president, emergency management and facilities. “When disaster strikes, there’s strength and confidence in knowing you’re not alone, and that a support system is with you every step of the way.”

CHA News Article

CMS Issues Interpretive Guidelines for Emergency Preparedness Final Rule

The Centers for Medicare & Medicaid Services (CMS) has released a new Appendix Z of the State Operations Manual (SOM), which contains interpretive guidelines and survey procedures for the emergency preparedness final rule. The new rule affects 17 providers and suppliers; Appendix Z applies to all 17 providers and suppliers included in the final rule. The advance copy of the interpretive guidelines can be downloaded from the CMS website. The compliance deadline for the new rule is Nov. 15. Additional information is also available for CHA members at

CHA News Article

Hospitals Encouraged to Respond to Homeland Security Questionnaire
Study gauges impact of unmanned aircraft systems on various sectors

The U.S. Department of Homeland Security encourages hospitals to complete the attached questionnaire. Completed questionnaires will be used to inform expansion of efforts relating to risks, challenges and opportunities associated with unmanned aircraft systems (UAS). Focusing specifically on developing resources for the critical infrastructure community, the initiative will evaluate the beneficial uses of UAS and risk mitigation solutions in support of counter-UAS efforts. DHS requests information related to whether the health care sector considers UAS a potential physical or cyber threat; whether emergency operations and/or incident management plan(s) ever include UAS and/or counter-UAS response; and how common it is for facilities to work with law enforcement, security or first responder organizations to address a UAS threat. Completed forms should be emailed to by May 26.

CHA News Article

Webinar Will Feature Highly Pathogenic Infectious Disease Exercise

The National Ebola Training and Education Center and ASPR’s Technical Resources, Assistance Center, and Information Exchange, will hold a webinar May 24 at 11 a.m. (PT) to address exercise planning for highly pathogenic infectious diseases. Intended for frontline facilities – defined as acute care hospitals and other emergency care settings, such as critical access hospitals and urgent care clinics — the webinar will provide exercise templates and lessons learned from a frontline facility, as well as perspective on the relevance of exercise planning. Registration is available online.


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

CDC Highlights Hospital Patients’ Risk of Exposure to Legionella Bacteria

The Centers for Disease Control and Prevention (CDC) has released a new Vital Signs report highlighting patients’ risks of exposure to Legionella bacteria in health care facilities, including hospitals and long-term care facilities. According to the report, one in four people who contract Legionnaires’ disease as a health care-associated infection will die. Effective water management is key to preventing health care-associated outbreaks. The CDC has made available resources and tools to assist providers in reducing the threat from this bacteria. The American Society of Healthcare Engineers has also released tools to assist its members in managing water systems. Additionally, the Centers for Medicare & Medicaid Services has released the attached guidance providing more information about infections, tips for prevention and expectations of health care facilities.

CHA News Article

CDPH Approves Medical Waste Treatment Facilities

The California Department of Public Health (CDPH) has approved two California pyrolysis treatment facilities — managed by Aemerge and Medical Waste Services, LLC — to treat all types of medical waste. Additional alternative medical waste treatment technologies approved by CDPH are available online. Hospitals that have questions can contact Alison Dabney, CDPH supervisor, medical waste, at

CHA News Article

State to Provide Guidance for Sterile Compounding Construction Projects
Still time to register for next week’s webinar

Hospitals that perform sterile compounding must meet new regulatory requirements from the California Board of Pharmacy, including improving or reconfiguring facilities for ventilation, installing new equipment for sterility and ensuring employee protections. CHA will hold a webinar April 21 from 10 a.m. to noon (PT) to explain the new requirements. Representatives from the California Board of Pharmacy will share strategies to manage services while under construction, as well as the waiver application and renewal process; the Office of Statewide Health Planning and Development Facilities Development Division will review its new Sterile Compounding Advisory Guidebook; and the California Department of Public Health Licensing and Certification Program will discuss what to expect from surveyors under the new regulations. 

CHA News Article

Draft Air Pollution Guidelines Developed
Hospitals should work with local AQMD to develop district standards

The California Air Pollution Control Officers Association has developed the attached draft guidelines updating procedures for public notification of air pollution risks and incorporating advances in the field of risk assessment. Current law requires regulated facilities, including hospitals (under certain conditions), to report the types and quantities of toxic air pollutants they routinely emit. For hospitals, this includes emissions from back-up diesel generators. The law, known as the “Hot Spots” Act, also requires air quality management districts (AQMDs) to determine which facilities must conduct health risk assessments using the California Air Resources Board’s Emission Inventory Criteria and Guidelines. The draft guidelines, developed with assistance from the California Office of Environmental Health Hazard Assessment and the California Air Resources Board, are intended to be used by local districts in evaluating their Hot Spots programs. Hospitals should work with local AQMDs to learn how these guidelines will be implemented at the district level and whether their district will also update its pollution emission standards.

CHA News Article

Seminar to Explain Wise Water Use in Hospitals

Next week, Practice Greenhealth will hold a repeat presentation of its webinar for hospitals on effective water reduction and conservation policies. To be held March 23 at 11 a.m. (PT), the webinar will explain how to reduce potable water consumption; explore harvesting, managing and reusing water; and steps hospitals can take to ensure their facilities are resilient to the impact of climate change, such as drought and flooding. For more information and to register, visit the Greenhealth Academy website.



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

Annual Hospital Finance and Reimbursement Seminars Begin in Two Weeks
Still time to register for June 7 in Sacramento, June 20 & 21 in Southern California

CHA’s Hospital Finance and Reimbursement seminar will help executives effectively manage in an increasingly dynamic health care environment and prepare for what lies ahead. The program will open with Medi-Cal updates, including changes to the APR-DRG payment system, Office of Inspector General audits of electronic health record incentive payments, the Medicaid managed care final rule and the Quality Assurance Fee Program. A session on reimbursement for treating mental health patients will explain counties’ legal financial requirements, as well as the relationships and division of financial responsibilities between counties and the state. The seminar also includes updates on the inpatient prospective payment system proposed rule, including proposed changes to payments for Medicare disproportionate share hospitals.

CHA News Article

Annual Hospital Finance and Reimbursement Seminar Begins in Early June
Will include Medi-Cal and Medicare updates, Quality Assurance Fee program information, federal policy insights

CHA’s Hospital Finance and Reimbursement seminar will be held June 7 in Sacramento, June 20 in Glendale and June 21 in Costa Mesa. Finance and reimbursement executives who attend will gain information and insights to help effectively manage in the current health care environment, as well as prepare for what lies ahead. The program opens with Medi-Cal updates, including changes to the APR-DRG payment system, Office of Inspector General audits of electronic health record incentive payments, the Medicaid managed care final rule and the Quality Assurance Fee program. A session on reimbursement for treating mental health patients will explain counties’ legal financial requirements as well as the relationships and division of financial responsibilities between the counties and the state.

CHA News Article

Senate Finance Committee Reintroduces Bill to Address Chronic Illness

Yesterday, the U.S. Senate Finance Committee reintroduced S. 870, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017. Aiming to strengthen and improve health outcomes for Medicare beneficiaries living with chronic conditions, the bill would:

  • Expand the Independence at Home program, which allows seniors to receive specialized care at home
  • Improve flexibility in the Medicare Advantage program by allowing plans to tailor coordination and benefits to specific patient groups, permanently extending special needs plans and expanding supplemental benefits
  • Allow certain accountable care organizations to use their own money to help patients afford primary care services, and provide the option to assign beneficiaries prospectively rather than retrospectively
  • Expand the use and flexibility of telehealth services

A one-page summary and a section-by-section summary of the bill are attached. The bill was previously introduced in December 2016 and remains largely unchanged.

CHA News Article

HFMA Northern California Spring Conference Is Near
Still time to register for this year’s event in Sacramento

The Healthcare Financial Management Association (HFMA) Northern California Spring Conference is set for April 13-14 at the Sheraton Grand Hotel in Sacramento. CHA and the Hospital Council of Northern and Central California are proud to support this annual event tailored for health care financial management professionals. The spring conference features keynote addresses and 20 breakout sessions over five tracks: innovation, back-to-basics, LEAN, legislative/compliance, finance/business/analytics and revenue cycle. Supplemental sessions on creating wealth for retirement and time management will also be offered. A preconference on the PEAK program will be held the evening of April 12. For more information or to register, visit the HFMA event web page.   

CHA News Article

DHCS Announces Fiscal Intermediary Name Change

The Department of Health Care Services (DHCS) has announced that the current Medi-Cal fiscal intermediary for its fee-for-service system, Xerox State Healthcare, LLC, has been rebranded to Conduent State Healthcare, LLC. This shift, caused by the entity’s separation from its parent company, reflects its shift to a new independent, publicly traded company called Conduent Incorporated. The rebranding process began Jan. 3, when the separation was finalized.

It is essential for Medi-Cal-enrolled providers, beneficiaries and stakeholders to know that, effective Jan. 3, 2017, correspondence bearing the name Conduent may be related to Medi-Cal.

To stay informed about any changes occurring within Medi-Cal, enrolled providers, beneficiaries and stakeholders should open and read all information sent from DHCS, Xerox or Conduent. More information is available on the DHCS website.


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

New Analysis Shows Premium Increases, Drop in Coverage if Federal Policies Change

Covered California has released a new analysis showing the consequences California faces if federal policies are changed – specifically, if funding for cost-sharing reduction reimbursements is ended and the individual shared responsibility payment is not enforced for consumers who choose not to purchase coverage. According to the report, Covered California’s premiums could rise 28 to 49 percent in 2018, and changes to federal policy could result in up to 340,000 consumers losing coverage. This would lead to increased federal spending, anticipated to be in the billions of dollars. More information is available in Covered California’s press release.

CHA News Article

CMS Finalizes Rules for the Health Insurance Marketplace

Last week, the Centers for Medicare & Medicaid Services (CMS) issued the Notice of Benefit and Payment Parameters final rule and the final Annual Letter to Issuers for 2018 in the Federally Facilitated Marketplaces. The final rule establishes standards for issuers and each health insurance marketplace, generally for plan years that begin on or after Jan. 1, 2018. The policies in the final rule include updates to the risk adjustment program and to eligibility, enrollment and benefits, as well as other changes that aim to streamline the marketplace consumer experience and strengthen the marketplaces’ individual and small group markets as a whole. The final rule builds on other actions CMS has taken to strengthen the marketplaces in recent weeks and months, including an interim final rule addressing concerns about third-party premium payments and a pilot that will test whether pre-enrollment verification of special enrollment periods strengthens the marketplace risk pool while maintaining access to coverage.

CHA News Article

CHA to Host Webinar on Policy and Politics of ACA Repeal, Replace, Delay
Members-only program is Dec. 20; register today

CHA will hold a complimentary, members-only webinar Dec. 20 from 9-11 a.m. (PT) to address the next Congress and the direction of federal health care policy. With the transition to the Trump Administration, the balance of power will shift in Washington, D.C. — and health care policy will likely face dramatic changes.

“One point is clear — what will happen in health care policy is unknown,” said CHA President/CEO C. Duane Dauner. “California could suffer severe losses or might gain new opportunities. With so much at stake, CHA is working diligently to convey CHA’s key principles to Congressional leaders as 2017 legislation is being developed.”

CHA News Article

Report Examines Efforts to Improve Care Quality, Coordination and Costs Through Provider Collaborations
Highlights efforts of CHA member hospitals, health systems

The California HealthCare Foundation has released a report that examines efforts to improve care quality, coordination and costs through provider collaborations. The report acknowledges that California providers — many of them CHA members — have been particularly active in developing collaborations among themselves and with commercial health plans in response to the Affordable Care Act. Many of these partnerships have been driven by key market factors characteristic of many California communities — most notably, the presence of large providers experienced in managing financial risk for patient care, as well as competitive pressure on both insurers and providers. Most of these initiatives aim to slow the growth of health care spending and improve the coordination and quality of patient care. 

The report describes integration efforts that have proliferated in California since 2013, highlights leading examples from the seven regions studied, discusses collaborators’ key goals and strategies, and explores how market conditions spurred each major type of partnership and influenced their structure.

CHA News Article

Members of Congress Sign Letter Calling for Liver Transplantation Reform

Working with colleagues in New York and New Hampshire, CHA asked members of the California congressional delegation to sign a letter addressed to Secretary of Health and Human Services Sylvia Burwell, urging reform of the current liver distribution methodology.  A total of 68 members of the U.S. House of Representatives, including 27 from California, signed the letter.  

The current methodology — which is based on 58 local donation service areas (DSAs) of varying size, density and health — creates large disparities in access to liver transplantation between patients in different regions of the country. To increase fairness of liver allocation, the signatories of the letter recommend that the Department of Health and Human Services adopt the United Network for Organ Sharing (UNOS) committee’s proposal to condense the 58 DSAs to between four and eight districts. The proposal also specifies that each district would contain at least six liver transplant centers that support a maximum median transplant-volume-weighted transport time between DSAs of no more than three hours. The letter echoes CHA’s beliefs, outlined in a comment letter to UNOS last week in support of their recommendations.


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

Cyberattack Affects Businesses Globally
Hospitals should notify CDPH if they experience attacks

Yesterday, a cyberattack using a variant of ransomware hit businesses in Ukraine, India, France, Russia and Spain, as well as a U.S. pharmaceutical company. Although some hospitals in West Virginia and Pennsylvania also reported attacks, it is unclear whether those were related to the worldwide event. Because the source of the attack remains unknown, the Department of Health and Human Services (HHS) advises vigilance and reminds providers to ensure their systems and anti-virus definitions are updated. Facilities are reminded to use caution when opening links or attachments from unknown sources. If aware of a credible threat or attack on the public health or medical infrastructure, facilities should notify local law enforcement and the California Department of Public Health Duty Officer Program at or (916) 328-3605. For more information about cybersecurity, visit CHA’s dedicated web page.

CHA News Article

Updated eCQM Specifications Available for Calendar Year 2018

The Centers for Medicare & Medicaid Services (CMS) has posted the 2017 annual update for electronic clinical quality measures (eCQMs) for calendar year 2018 reporting for eligible hospitals and critical access hospitals (CAHs), as well as eligible professionals and clinicians. The updated eCQMs may be included in the future in any of the following programs:

  • Hospital Inpatient Quality Reporting Program
  • Medicare Electronic Health Record (EHR) Incentive Program for eligible hospitals and CAHs
  • Medicaid EHR Incentive Program for eligible professionals, hospitals and CAHs
  • Quality Payment Program: The Merit-based Incentive Payment System (MIPS) for MIPS-eligible clinicians and alternative payment models
CHA News Article

Important Changes Announced for Medi-Cal EHR Incentive Program

The Department of Health Care Services (DHCS) has changed an eligibility rule for hospitals applying to the program year 2016 Medi-Cal Electronic Health Record Incentive Program for the first time. Previously, DHCS required hospitals to submit cost report data for a continuous 12-month period ending before the start of the federal fiscal year (Oct. 1-Sept. 30) that serves as the program year for the Medi-Cal EHR Incentive Program. Under the recent change, hospitals will be able to submit data for the 12-month period before the fiscal year ends. In addition, hospitals with a new CCN must reapply to the program.

Hospitals are reminded that program year 2016 marks the last opportunity to start the program; applications from hospitals that have not successfully participated in the 2016 program will not be accepted for 2017 and subsequent years. Applications are due May 2. For more information, visit or call (916) 552-9181.

CHA News Article

GAO Reports on Patient Access to Electronic Health Information

The U.S. Government Accountability Office (GAO) recently issued a report that reviewed the state of patients’ electronic access to their health information. The report found that relatively few patients electronically access their health information when offered the ability to do so and that – while patients generally find access beneficial — there are limitations, such as the inability to aggregate health information from multiple providers into a single record. The GAO recommended that the Department of Health and Human Services develop performance measures to assess outcomes of efforts related to patients’ electronic access to longitudinal health information, and use the information from these measures to help achieve program goals. The full report is available on the GAO website.

CHA News Article

EHR Hospital Reports Now Available for CY 2016

The Centers for Medicare & Medicaid Services (CMS) has announced that electronic health record hospital reports for the Inpatient Quality Reporting program are now available for calendar year 2016. Hospitals should visit the QualityNet portal to access their reports and should begin process improvement based on the reporting. Hospitals that were unable to report electronic clinical quality measure data prior to the deadline may request an extraordinary circumstances exemption, which must be submitted by April 1. For more information, see CMS’ recently released guidance, attached.


Human Resources

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

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

CHA News Article

New Criminal Background Regulations Approved
Rules will take effect July 1

The Office of Administrative Law (OAL) has approved new regulations, adopted by the California Fair Employment and Housing Council (FEHC), concerning employers’ use of criminal background information when making employment decisions. The regulations, which take effect July 1, require employers to demonstrate that any criminal history information sought is job-related and consistent with a business need. To meet this obligation, employers may either 1) conduct an individual assessment of circumstances and qualifications of applicants excluded by the conviction screen and determine whether an exception is warranted, or 2) demonstrate that its conviction disqualification policy, though not based on individual assessment, nonetheless properly distinguishes between those who do and do not pose an acceptable level of risk.

Any policy that is not based on individual assessment and is seven or more years old will be presumed not to meet the standards of the new regulations; employers must rebut this presumption proactively. Additionally, prior to taking any adverse action, employers who obtain criminal information from a source other than the applicant must notify the individual and provide him or her an opportunity to challenge the information’s accuracy.

CHA News Article

Deadline Approaching for RNs to Submit Complete Fingerprint Records
Failure to submit complete records may result in citation, fine

As previously reported in CHA News, a significant number of registered nurses (RNs) do not have complete fingerprints on file with the Board of Registered Nursing (BRN). Last December, the BRN notified these RNs that their information was incomplete, but many did not respond, according to the BRN. A second notice was sent Jan. 30, with a deadline of Feb. 8. CHA urges RNs to review their fingerprint requirements, particularly the section on determining whether to submit new fingerprints. Failure to submit fingerprints by the Feb. 8 deadline could result in a citation and fine of up to $2,500, or referral to the Attorney General’s office for possible disciplinary action. 

CHA News Article

Save the Date for CHA’s Hospital Employee Safety and Workers’ Compensation Seminar

CHA’s annual Hospital Employee Safety and Workers’ Compensation Seminar will be held March 22 in Sacramento and March 30 in Costa Mesa. Make plans now to attend the hospital-focused seminar that offers practical guidance and comprehensive information to improve and manage employee safety and workers’ compensation programs. The one-day, members-only program includes sessions on Cal/OSHA’s workplace violence prevention regulation, managing employee leaves of absence, using data and metrics to improve employee programs, employer leading practices and more. A detailed agenda and program registration will be available later this month.

CHA News Article

CDPH Urges Vaccination as Influenza Cases Spread in California

The California Department of Public Health (CDPH) has announced that influenza activity has reached “widespread” levels and urges vaccination. Since the season began, CDPH has received reports of three deaths as well as 29 severe influenza cases that resulted in intensive care unit admission in patients 64 years of age and younger. In the U.S., influenza activity reaches its highest levels between December and February, and may continue through May. According to CDPH, the flu specimens that have been tested match very closely to the current vaccine strains, assuring protection against the flu.

CHA News Article

RNs With Incomplete Records Must Submit Fingerprints
BRN to notify affected RNs, provide instructions

The Board of Registered Nursing (BRN) has determined that certain registered nurses do not have both Department of Justice (DOJ) and Federal Bureau of Investigation (FBI) fingerprint results on file with the BRN. LiveScan testing incorporates both DOJ and FBI requirements; however, if the LiveScan technology did not produce clear results or an outdated method of fingerprinting was used, the RN may not have acceptable fingerprints on file. 

The BRN is working to contact all affected RNs via mail and/or email with instructions. To avoid potential delays in license renewal or other action, RNs should read the information carefully and respond accordingly. In most cases, RNs will be required to submit fingerprints within 60 days of notification or risk citation, fines or referral to the Attorney General’s office for possible disciplinary action.

Detailed information is available at



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

CHA News Article

Final Programs Approaching for Annual Consent Law Seminar
Learn about consent for patients with mental health issues, new laws, pain management and more

The final two programs in the Consent Law Seminar series will be held May 31 in Sacramento and June 1 in San Ramon.

This year’s seminar features sessions on hot spots in reporting; consent rules related to mental capacity, minors, 5150 patients and non-consent; lessons learned during implementation of the End of Life Option Act; pain management in an era of opioid addiction; and new laws and updates for 2017. The popular critical thinking session has been expanded to include more common, but complicated, topics and challenge participants’ analytical skills case scenarios.

CHA News Article

No Private Lawsuit Allowed Under Involuntary Mental Health Evaluation Laws

Last week the California Court of Appeals ruled in Julian v. Mission Community Hospital, finding that California’s involuntary mental health evaluation and treatment laws do not confer a private cause of action. This means that a patient cannot sue a hospital or physician for involuntarily detaining, evaluating or treating him or her. The court held that only administrative agencies — such as the California Department of Public Health or the Medical Board of California — can enforce these laws against a hospital or physicians. The court also held that the hospital and physicians were not state actors under civil rights laws and, therefore, could not be liable for violating the plaintiff’s rights under the federal and California constitutions. 

The case was certified for publication, which means that it may be cited as precedent in future lawsuits. It is unknown at this time whether the plaintiff will ask the California Supreme Court to review the case. The court’s decision is attached.

CHA News Article

2017 Consent Manual Released
CHA mails each member organization a free manual

CHA is pleased to announce the 2017 Consent Manual is now available. Updated to reflect changes to state and federal consent law through January 2017, the Consent Manual explains the law and what hospitals need to do to comply. As a service to members, one complimentary copy of this acclaimed publication is being sent to each member hospital and system CEO this week.

The Consent Manual is the most comprehensive resource available on consent for medical treatment, covering situations involving minors, mental health, end-of-life issues and advance health care directives, patients’ rights, privacy basics, reporting requirements and related health care law. It is designed to help keep hospital executives abreast of the law and provide answers to difficult questions faced by staff every day.

CHA News Article For Members

FDA Identifies Hospitals That Have Not Reported Device Malfunctions

The Food and Drug Administration (FDA) has publicly disclosed multiple hospital violations of the mandatory reporting requirement when a medical device may have caused harm. Hospitals and other health care providers (“device user facilities”) must report to the FDA any event that reasonably suggests that a medical device has or may have caused or contributed to a death or serious injury of a patient. This includes user error; improper or inadequate design, manufacture or labeling; or any other cause of harm related to a device, as well as device malfunction.


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

Webinar recorded live April 18, 2016

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


Patient Rights

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

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

CHA News Article

Hospitals Should Review Child Abuse Reporting Policies

Effective Jan. 1, a hospital’s internal child abuse reporting policy may not direct employees to allow their supervisor to file or process a mandated report under any circumstances. The law was enacted because of concerns that supervisors at private foster family agencies had impeded social workers and teachers from making reports when they suspected child abuse.

CHA News Article

New Nondiscrimination Policies in Effect
Providers must ensure compliance with new federal and state regulations

Several updated nondiscrimination policies took effect this month, requiring health care providers to ensure their programs are compliant. New requirements under Section 1557 of the Affordable Care Act took effect July 18; the U.S.


Principles of Consent and Advance Directives Guidebook
A guidebook on patient consent for treatment and other health care decisions, including the End of Life Option Act

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


2017 Consent Manual
The trusted resource for consent and related health care law

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


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

Webinar recorded live April 18, 2016

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

General information

Population Health Management
Listen to podcasts and webinar recordings to master PHM


A major transformation is underway in health care to enhance patient care quality, access and experience, and reduce costs. Because population health management (PHM) is the direction in which health care is moving, the California Hospital Association is pleased to provide member hospitals with comprehensive and substantive podcasts and webinar recordings designed to enhance the knowledge and skills needed to succeed under a PHM construct.

Master PHM
Based on CHA’s webinar series, Population Health Management: A comprehensive, five-part program for hospital leaders, the podcasts and recordings offer critical information for executives and professionals in a wide range of organizations. Five key areas are presented:

  • The PHM Framework
  • Business Considerations for PHM
  • Clinical Considerations for PHM
  • Technology for PHM
  • Leadership and Talent for PHM


Jan. 4, 2017 Podcast
A Framework for Population Health Management — From Providing Care to Managing Health
Jan. 11, 2017 Podcast
Drivers of the Population Health Management Imperative
Jan. 18, 2017 Podcast
Nine Population Health Management Key Competencies
Jan. 25, 2017 Podcast
Comprehensive Care Management — Clinical and Business Competencies
Feb. 1, 2017 Podcast
Types of Risk Assumed by Hospitals and Health Systems Under PHM
Feb. 8, 2017 Podcast
Provider Organization Roles Under PHM
Feb. 15, 2017 Podcast
A Framework for the Pursuit of PHM
Feb. 22, 2017 Podcast
Determining the Market’s Stage and Pace of Change
March 1, 2017 Podcast
Evaluating Organizational Position and Competence Gaps
March 8, 2017 Podcast
Identifying PHM Opportunities, Determining Scope and Scale
March 15, 2017 Podcast
Defining a Contracting Strategy to Support PHM Opportunities
March 22, 2017 Podcast
Identifying the Appropriate PHM Path for the Organization — Build, Buy or Partner

Webinar Recordings

Webinar 1: A Framework for Population Health Management
Webinar 2: Business Imperatives for Population Health Management
Webinar 3: Clinical Imperatives for Population Health Management
Webinar 4: Technology for Population Health Management
Webinar 5: Leadership and Talent for Population Health Management

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

HQI Launches QuietNight™ Mobile App to Help Hospitals Reduce Noise

The Hospital Quality Institute (HQI) is pleased to announce the launch of QuietNight™, a next generation mobile tool designed to measure noise in hospital environments and provide real-time feedback.

Excessive noise negatively impacts patient rest and healing. According to Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data, reducing noise has been a steady challenge for California hospitals. Accurate to within -/+ 1 decibel, QuietNight rapidly measures the sound floor in any environment and quantifies opportunities for noise mitigation based on deviation from recommended levels. The app registers and tracks baseline as well as startle noise and provides actionable guidance when noise levels are moving to unacceptable levels. It also integrates HQI’s Journey to a Quiet Night toolkit, which contains best practices for noise reduction, abatement and maintaining a quiet, therapeutic environment.

CHA News Article

Analysis Finds HCAHPS Response Rates Matter
Higher response rate linked to increased performance ratings

California hospitals are currently ranked in the bottom tier nationwide on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. In its examination of methods to improve these scores, the Hospital Quality Institute (HQI) analytics team found that a percent increase in response rate is predictive of a one-half percent increase in overall mean score. Therefore, HQI has set a target for hospitals to increase their overall response rate by at least 3 percent, which would advance statewide performance ratings to a score of 68 — and out of the bottom quartile. In California, response rates range from 8 to 60 percent. HQI urges hospitals with response rates of less than 25 percent to consider the following evidence-based recommendations:

CHA News Article

HQI Receives National Award for Leadership in Quality Improvement
AHA award recognizes demonstrated leadership and innovation in health care

HQI was recognized for its multiple quality improvement initiatives that have resulted in improved patient safety and clinical outcomes and enhanced the experience of care at hospitals throughout California. 

CHA News Article

Medication Shortages Continue
FDA works to increase supply of key emergency medications

As previously reported in CHA News, Pfizer has reported shortages of key emergency medications, particularly atropine, dextrose and epinephrine. Over the last several days, recalls have been announced for sodium bicarbonate manufactured by Hospira as well as succinylcholine and potassium phosphate manufactured by Pfizer. The Food and Drug Administration (FDA) is working to alleviate the shortages, in part by allowing vetted Australian drugmaker Phebra to export vials of sodium bicarbonate to the U.S. In addition, the FDA has published a list of drugs that may be used beyond their labeled expiration dates. The FDA has stated that it will continue to develop additional supply sources, to be posted on its website as they are secured. Pfizer and the other sodium bicarbonate manufacturer, Amphastar Pharmaceuticals, expect to restock supplies by mid-August, according to the American Society of Health-System Pharmacists. CHA will continue to monitor the situation and encourages members to direct questions to BJ Bartleson, vice president, nursing and clinical services, at or (916) 552-7537.

CHA News Article

Registration Now Open for 2017 HQI Annual Conference
Poster presentations sought for California's preeminent quality and patient safety conference

The 2017 Hospital Quality Institute Conference, taking place Nov. 1-3 in Monterey, will help hospital staff, health care providers, students and medical residents achieve increasing levels of performance through a culture of respect and professionalism. 

The conference features interactive learning and networking opportunities, and will provide attendees with strategies and take home tools for achieving reliable care and delivering value to each patient, each time and in each community.

Call for Posters

Attendees are invited to showcase their accomplishments in reliability, quality, patient safety and person-centered care. HQI seeks poster presentations that demonstrate innovative, sustainable approaches to improving safety, clinical outcomes and experience of care. Competitive posters will address the conference themes of respect, reliability and resilience.

The submission deadline for posters is Sept. 8. Accepted presenters will receive half off their registration fee.



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 also believes every Californian who is eligible should be enrolled in the appropriate federal, state or local governmental program. Hospitals and private payers should not be responsible to pay for government underpayments. CHA dedicates many resources to advocate for fair government reimbursement. CHA DataSuite is an information-based toolset, available only to CHA members, that helps hospitals analyze government reimbursement changes, and the potential impact of regulatory and legislative actions on hospitals.

CHA News Article

CMS Issues OPPS, PFS Proposed Rules for Calendar Year 2018

The Centers for Medicare & Medicaid Services (CMS) has issued the attached proposed rules updating the outpatient prospective payment system (OPPS) and physician fee schedule (PFS) for calendar year 2018. Fact sheets for both the OPPS and PFS proposed rules are also available. CHA is currently analyzing the proposed rules and will provide members with additional information in CHA News tomorrow.

CHA News Article

DWC Posts Adjustments to Official Medical Fee Schedule
Affects hospital outpatient departments, ambulatory surgical centers

The Division of Workers’ Compensation (DWC) has posted an order adjusting the hospital outpatient departments and ambulatory surgical centers section of the Official Medical Fee Schedule (OMFS) to conform to changes in the Medicare payment system as required by the California Labor Code. Effective for services rendered on or after July 1, the order adopts the following changes:

  • For the Centers for Medicare & Medicaid Services (CMS) Medicare hospital outpatient prospective payment system, the July 1 Addenda A and B ZIP file quarterly updates
  • For the CMS ambulatory surgical center (ASC) payment system, the July ASC approved HCPCS code and payment rates ZIP file, Column A of “Jul 2017 ASC AA” and Column A of “Jul 2017 ASC EE”
CHA News Article

MedPAC Issues June 2017 Report to Congress

The Medicare Payment Advisory Commission (MedPAC) released its June 2017 Report to the Congress: Medicare and the Health Care Delivery System. The document includes 10 chapters covering key issues facing the Medicare program and offers solutions to ensure the program’s continued viability. 

In its June report the commission continues its work, required by the Improving Medicare Post-Acute Care Transformation (IMPACT) Act, evaluating the feasibility of a unified prospective payment system (PPS) spanning post-acute care (PAC) settings (e.g., skilled-nursing facility, inpatient rehabilitation facility, long-term care hospital and home health agency). After determining a unified PPS is feasible in its 2016 report, the commission studied three implementation issues: a transition period with blended setting-specific and unified PPS rates, appropriate levels of aggregate PAC payments, and ways to address ongoing refinements to the system after implementation. MedPAC recommends that a unified PAC PPS be implemented beginning in 2021 with a three-year transition, and that aggregate payments should be reduced by 5 percent.

CHA News Article For Members

CHA Letter Recaps Meeting with CMS on Medicaid Managed Care Rules

Today, CHA sent the attached letter to the Centers for Medicare & Medicaid Services (CMS) following up on its meeting with the agency earlier this month.

CHA News Article

New Request for ALJ Hearing or Review of Dismissal Form Available

The Office of Medicare Hearings and Appeals (OMHA) has released a new form that providers may use to request an administrative law judge (ALJ) hearing or review of dismissal. OMHA encourages appellants to use this form to help ensure the request includes all information necessary to docket the appeal. However, OMHA will continue to accept requests that are filed in other formats, so long as the request is in writing (except for requests for expedited Part D hearings, which may be made orally) and includes all of the information required by regulation. Parties or their representatives must follow the appeal instructions that come with a notice of reconsideration or dismissal for specific instructions on how to appeal the reconsideration or dismissal, and where to send a request for an ALJ hearing or review of dismissal. The new form also includes a toll-free telephone number in large print (18-point font) to assist the visually impaired with obtaining a large-print version of the form or other assistance.


Amber Ott
Vice President, Strategic Financing Initiatives

Amber Ott represents members’ financial interests related to Medicare, Medi-Cal, commercial payers and other government entities. She is responsible for providing advocacy and support on financial and reimbursement issues affecting California hospitals and health systems, and represents CHA with state agencies and other stakeholders where hospital finance and technical knowledge is needed. 

Amber is also involved with the development and implementation of the hospital fee and other financing programs.

1215 K Street, Suite 800
Sacramento, CA 95814
(916) 443-7401
(916) 552-7669 Direct


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.

In response to the need for focus on this issue and the need for statewide solutions, CHA established the CHA Workforce Committee in 2007. Members of the committee include a broad cross-section of California’s hospitals, both urban and rural, and also represent the various geographic regions of the state. The committee has been focused primarily on allied health professional shortages, but in 2013 broadened its mission and focus to include supporting various statewide nursing and physician shortage initiatives. The committee recognizes that current challenges in the area of health workforce will be exacerbated by an aging population and implementation of the Affordable Care Act and is dedicated to working as a group and with other stakeholders to develop and implement solutions that will address the numerous barriers that constrict the supply of health care professionals in California.

CHA News Article

Behavioral Health Workforce Research Center Releases New Studies

The Behavioral Health Workforce Research Center has released two studies to help inform workforce development and planning, as related to the prevention and treatment of mental health and substance use disorders. The first study found that care integration appears to be most effectively implemented in organizations that foster a strong culture of collaboration, including employee engagement through orientation and training programs. Recognizing that a diverse workforce contributes to greater patient satisfaction, the second study seeks to identify organizational barriers to recruiting and retaining behavioral health workers representing racial, ethnic and sexuality minority groups. Specific factors include work location, organizational mission, job security and flexible work schedules affect recruitment and retention.

CHA News Article

Hospital Training Programs Reminded to Apply for Song-Brown Funding

As previously reported in CHA News, the Office of Statewide Health Planning and Development will release applications for the Song-Brown Healthcare Workforce Training Programs July 18 for family medicine, Aug. 2 for family nurse practitioners/physician assistants and Oct. 3 for registered nurses. Currently, 42 family medicine residency programs, nine primary care residency programs, 33 registered nurse education programs and 18 family nurse practitioner/physician assistant programs receive ongoing support from the Song-Brown program to improve access to health care services. For a complete list of application dates and deadlines, as well as webinar dates and other important information, visit

Established in 1973 to increase the number of family physicians serving Californians, the program encourages universities and primary care health professionals to provide health care in medically underserved areas by financially supporting primary care and family practice residency programs in hospital and health care settings throughout California. It does not provide funding to individual students.

CHA News Article

Song-Brown Application Release Dates Announced

The Office of Statewide Health Planning and Development has announced that applications for the Song-Brown Healthcare Workforce Training Programs will be released July 18 for family medicine, Aug. 2 for family nurse practitioners/physician assistants, and Oct. 3 for registered nurses. Established in 1973 to increase the number of family physicians providing needed medical services to Californians, the program encourages universities and primary care health professionals to provide health care in medically underserved areas by providing financial support for primary care and family practice residency programs throughout California. It does not provide funding to individual students.

Currently, 42 family medicine residency programs, nine primary care residency programs, 33 registered nurse education programs and 18 family nurse practitioner/physician assistant programs receive ongoing support from the Song-Brown program to improve access to health care services.

CHA News Article

Community Colleges Emphasize Key ‘Soft Skills’ in Health Care Training Programs
Hospitals apply curriculum to nurse residency, volunteer programs

The CHA Workforce Committee has long advocated for the need to develop industry specific “soft skills” training that can be embedded in health professions training programs, as well as used by employers with their existing workforce. Critical skills such as problem solving, teamwork, professionalism, ethics, compassion and communication are necessary for health professionals and are central to patient-centered care, regardless of an employee’s position in the health care setting.

CHA News Article

Report Highlights Importance of Aligning Strategic Workforce Development, Planning

The American Hospital Association’s 2016 Committee on Performance Improvement has issued the attached report to help hospital and health system leaders align the skills and abilities of their organization’s current workforce with anticipated needs as health care continues to change. CHA staff served on the special subcommittee that developed the report, and the CHA Workforce Committee’s recommendations are reflected in the key messages.

The report includes a tool to help initiate strategic workforce conversations, as well as specific recommendations and examples from hospital leaders and experts in the field.

“There is a critical need to elevate the discussion about workforce planning and development so that it becomes part of a comprehensive strategic plan for hospitals and systems and not just an issue to respond to in a crisis situation,” the report notes. “Current employee shortages, an older health care workforce nearing retirement coupled with the aging patient population, the changing health care delivery system, and limited access to behavioral health services all align to make workforce planning an immediate priority.”