Hospital Topics

Overview

2016 Ballot Initiatives

Ballot initiatives impacting California hospitals will be voted on November 8 in the general election. A description of the initiatives, including CHA’s position, is provided below as well as other pertinent CHA News articles.

More information about CHA’s sponsored ballot initiative — the Medi-Cal Funding and Accountability Act of 2016 — is available at www.keepagoodideaworking.org.

CHA News Article

Yes on 52 Campaign Emphasizes Measure’s Benefits for California Children

California’s children who are enrolled in Medi-Cal will be the biggest beneficiaries of Proposition 52, according to a host of children’s organizations that have endorsed the CHA-sponsored ballot measure. 

“By generating $3 billion a year – federal funds the state would otherwise not receive – Medi-Cal is able to deliver high quality, more accessible care for millions of California kids.  Better care means healthier kids who can stay in school,” said Sandy McBrayer, CEO of the California Children’s Initiative.

CHA News Article

CHA-Supported Initiatives Assigned Proposition Numbers for November Ballot

Three key measures supported and/or sponsored by CHA were assigned proposition numbers and have qualified for the general election vote on Nov. 8.

CHA News Article

California Teachers Endorse Hospital Fee Ballot Initiative

The California Teachers Association (CTA) — one of the state’s oldest and most influential labor groups — has added its voice to a comprehensive and growing list of supporters backing CHA’s hospital fee initiative on the November 2016 ballot. CTA’s support is enormously important, as it represents more than 325,000 members, including teachers, counselors, librarians and health professionals in school districts across California.

CTA is the latest labor union to urge passage of the Medi-Cal Funding and Accountability Act. Others include the State Building and Construction Trades Council, the United Food and Commercial Workers Western States Council, the California Teamsters Public Affairs Council and the California School Employees Association.

CHA News Article

Signatures Submitted for Health Care-Related Ballot Initiatives

Several health care-related initiatives have moved a step closer to finding their way onto the Nov. 8 general election ballot.

Last week, a broad coalition involving CHA, Service Employees International Union (SEIU) California, the California Teachers Association, the California Medical Association (CMA) and others submitted signatures to qualify a constitutional initiative to extend the Proposition 30 (2012) personal income tax on the wealthiest Californians. The initiative, if passed by voters, is expected to produce more than $1 billion annually in Medi-Cal funding for California hospitals.

CHA News Article

Community Organizations Across California Join Coalition Supporting CHA’s Hospital Fee Ballot Initiative

Community organizations across California, recognizing the importance of stable Medi-Cal funding, have added their voices to an expanding coalition seeking voter approval of CHA’s hospital fee initiative on the upcoming November ballot. Supporters encompass a broad range of organizations that provide services and support for California’s most vulnerable citizens, including the Asian Pacific Islander American Public Affairs Association, the California Senior Advocates League, Family Voices of California, Sacramento Steps Forward, and the Solano Coalition for Better Health. More than 860 organizations and individuals statewide have endorsed the ballot measure.

The Medi-Cal Funding and Accountability Act, which has already qualified for the ballot, will provide greater certainty for California in accessing approximately $3 billion a year in federal funds to pay for health care for residents enrolled in the Medi-Cal program.

Overview

CDPH Licensing & Enforcement

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

CHA News Article

CDPH Issues Updated SNF Relicensing Workbook
New version implemented March 1

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

CHA News Article

CDPH Pilots Use of Non-RNs as Breach Investigators

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

Recording

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

Webinar Recorded Live February 18, 2016

Overview

Changes are coming!

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.

CHA News Article

CDPH Updates Title 22 Licensing Fee, Diesel Generator Regulations

The California Department of Public Health has updated sections of Title 22 of the California Code of Regulations related to licensing fees and diesel generator testing so they conform to changes previously enacted in statute. Because the changes were enacted through statute, they do not have a “regulatory effect” and are not required to go through the standard regulatory development process. A list of the affected Title 22 sections that have been amended or repealed is attached. Also attached are the updated sections.

Overview

Community Benefit Programs
Hospitals give back to their communities

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

Tax-Exempt Status of Nonprofit Hospitals

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

CHA News Article

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

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

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

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

Clinical Care

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

Recording

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

Webinar recorded live April 18, 2016

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

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.

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

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

The Joint Commission Makes Major Changes to Plans for Improvement
Hospitals should correct deficiencies as soon as possible

Starting Aug. 1, The Joint Commission (TJC) will no longer accept plans for improvement for its Life Safety requirements. All life safety deficiencies identified by TJC must be corrected within 60 days; hospitals should work to correct these deficiencies as soon as possible because many California building requirements take longer than 60 days to complete. In some cases, hospitals may be eligible for a waiver through the Centers for Medicare & Medicaid Services regional offices. To help expedite the state approval process for hospitals, the Office of Statewide Health Planning and Development (OSHPD) will offer field review or rapid review. If necessary, OSHPD deputy division chiefs — Chris Tokas, Northern California or Gordon Oakley, Southern California —will work to assist hospitals. Hospitals in need of assistance should contact the OSHPD FDD administrative office at (916) 440-8381. For questions related to this change, contact TJC Department of Engineering at (630) 792-5900

Recording

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

Webinar Recorded Live June 28, 2016

Overview

The California State Board of Pharmacy (BoP) and United States Pharmacopeia (USP) Convention are planning changes that will significantly impact hospital pharmacy compounding of hazardous and non-hazardous medications and facility structures.

CHA News Article

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

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

CHA News Article

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

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

CHA News Article

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

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

Overview

Emergency Preparedness
Is your hospital prepared?

Visit CHA’s Emergency Preparedness website at calhospitalprepare.org

About

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

   
CHA News Article

New Resource Offers Tips for Retaining and Caring for Staff After a Disaster

The Office of the Assistant Secretary for Preparedness and Response has created the Technical Resources, Assistance Center, and Information Exchange (TRACIE) to meet the information and technical assistance needs of health care entities, providers, emergency managers and others working in disaster medicine, health care system preparedness and public health emergency preparedness. TRACIE is comprised of three domains: technical resources, where individuals can search for specific information; an assistance center, for submitting a request or asking a question; and an information exchange, where users can share real-time information with colleagues. Among its many resources is a compilation of tips, categorized by immediate and short-term needs, for providers to consider when trying to retain and care for staff after a disaster. More information about TRACIE is available at www.calhospitalprepare.org/post/aspr-tracie-now-open.

CHA News Article

Discount Deadline Extended for CHA Disaster Planning Conference
Register by Friday to save $100 on tuition

The deadline to receive discounted tuition for CHA’s Disaster Planning for California Hospitals conference has been extended to Aug. 26. CHA strongly encourages anyone interested in attending  to take advantage of reduced rates.

This year’s conference, set for Sept. 19-21 in Sacramento, features several compelling keynote presentations on recent national and state disaster events. Dr. Michael Cheatham, a trauma surgeon from Orlando Regional Medical Center, will share a firsthand account of how his team responded to a surge of 44 victims following the mass shooting at an Orlando nightclub in June. Attendees will also hear from Kerry Heinrich, CEO of Loma Linda University Medical Center, and a diverse panel of hospital and community representatives who will share the incredible story of their response and recovery after the December 2015 terrorist attack in San Bernardino. In another session, Sutter Health panelists will recount the impact of the Butte and Valley wildfires on several of their facilities, and how their collaboration with community partners and key suppliers ultimately strengthened their response and resolve.

CHA News Article

New Guidance Helps Emergency Preparedness, Response and Recovery Providers Comply With Law

The U.S. Departments of Health and Human Services, Justice, Housing and Urban Development, Homeland Security and Transportation have issued joint guidance to help agencies that receive federal funding comply with Title VI of the Civil Rights Act of 1964. The Act prohibits discrimination based on race, color or national origin, and the guidance recommends that, when providing emergency preparedness, response and recovery services, agencies should:

  • Share information about housing, health services or other emergency-related services and nondiscrimination rights to diverse racial, ethnic and limited English proficient (LEP) populations.
  • Engage and seek input from diverse racial, ethnic and LEP populations to determine how best to tailor emergency planning, response and recovery efforts.
  • Widely disseminate evacuation and disaster preparedness plans, including to LEP populations.
  • Ensure that all entities know that most public services for protection of life and safety provided by recipients of federal financial assistance do not have immigration status restrictions.
  • Routinely collect and analyze information about the potentially affected populations to help ensure effective, nondiscriminatory allocation of resources and services. 
CHA News Article

CDPH Requests Emergency Contact Information for Long-Term Care Facilities

Due to an upgrade of the California Health Alert Network (CAHAN) system, the California Department of Public Health (CDPH) has issued the attached All Facilities Letter (AFL), requesting that long-term care facilities provide emergency contact and AFL recipient information. CDPH uses the CAHAN system to send important mass notifications, such as emergency alerts and health notifications. Requested information should be submitted at www.surveymonkey.com/r/AllLTCEmerg_contacts.

CHA News Article

Friday is Discount Deadline for CHA’s Disaster Planning Conference
Register today to save $100 on tuition

Friday is the deadline for discounts for CHA’s Disaster Planning for California Hospitals conference, to be held Sept. 19-21 in Sacramento. After Aug. 19, tuition rates will increase by $100.

Numerous sessions will detail the lessons learned from recent disaster scenarios, including the terrorist attack that rocked the San Bernardino County community, the destruction and devastation left in the wake of the 2015 Butte and Valley Wildfires, and the extraordinary efforts involved in emergency management planning for Super Bowl 50 and the 2015 Special Olympics. Eighteen different breakout sessions will offer information and resources on wide-ranging topics such as using emergency management principles in managing staff shortages, disaster recovery funding essentials, EHR downtime and IT triage and maintaining readiness for emerging infectious diseases.

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

Air Resources Board to Host Event Focused on Enforcement, Compliance for Truck Fleets

The California Air Resources Board (ARB) has announced dates for its 2016-17 “One Stop Truck” events, which offer compliance assistance, as well as information and resources for clean technology options. At each event, participants will be able to take advantage of one-on-one regulatory and financial incentive assistance, participate in a number of breakout sessions including funding options for on-road trucks and an enforcement inspection demo, and interact with industry vendors and local agencies. More information is available online, along with registration and vendor information.

Recording

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

Webinar Recorded Live June 28, 2016

Overview

The California State Board of Pharmacy (BoP) and United States Pharmacopeia (USP) Convention are planning changes that will significantly impact hospital pharmacy compounding of hazardous and non-hazardous medications and facility structures.

CHA News Article

Toolkit Aims to Help Hospitals Reduce Food Waste

Practice Greenhealth has released a new “Less Food to Landfill” toolkit, intended to support the U.S. Department of Agriculture’s and Environmental Protection Agency’s shared goal to reduce food waste by 50 percent by 2030. The “Less Food to Landfill” goal aims to feed hungry people, reduce waste and reduce methane gases by not landfilling food waste. Experts have found that hospitals can reduce pre-consumer food waste by 50 percent, resulting in a 2-6 percent savings on annual food purchases. In addition to providing step-by-step guidance and best practices, the toolkit facilitates goal-setting, standardized tracking and setting up a safe food donation program. The toolkit and other related resources can be found at https://practicegreenhealth.org/topics/less-waste/less-food-landfill.

CHA News Article

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

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

CHA News Article

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

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

Overview

Finance

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

Education event

Implementing CJR – Strategies for Success
Nuts and bolts, analyzing your data, quality improvement, collaborator agreements, defining your post-acute strategy and more

October 25, Los Angeles

The triple aim is now front and center with the move to alternative payment models. A prime example is the mandatory CMS Comprehensive Care for Joint Replacement program, impacting 135 California hospitals in three MSAs. This one-day intensive program will provide your health care teams with the knowledge they will need to manage patient care, foster physician alignment and develop effective partnerships with post-acute care providers.

CHA News Article

Governor Releases 2016-17 State Budget

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

Recording

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

Webinar Recorded Live on June 19, 2014

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

General information

Video Describes Vital Role Nonprofit Hospitals Play in Their Communities

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

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

Overview

Health Care Reform

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

CHA News Article

Senate Finance Committee Issues White Paper on Stark Law Reform

Senate Finance Committee Chairman Orin Hatch (R-UT) released the attached white paper this week calling for reform to the Stark Law, which prohibits a physician from referring Medicare patients to a facility in which that physician has a financial stake. The committee requested comments on the Stark Law last December, and CHA submitted a letter with suggestions on how to improve the law. CHA’s letter, among the nearly 50 that were submitted, formed the basis of Sen. Hatch’s white paper. 

In the white paper, the committee concludes that the Stark Law is costly, burdensome to providers and needlessly complex. Of chief concern to the committee is that technical violations unknowingly committed may result in substantial penalties. The white paper echoes CHA’s comments that the Stark Law prevents desirable changes in health care and delivery payment models, that technical violations should be differentiated from substantial ones, and that it may be best to repeal the law in its entirety.

CHA News Article

DHCS to Host Webinar on Global Payment Program Tomorrow

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

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

CHA News Article

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

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

CHA News Article

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

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

CHA News Article

Report Identifies Characteristics of Uninsured Men

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

Overview

Health Information Management & Technology

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

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

CHA News Article

Applications Due July 1 for EHR Incentive Program 2017 Hardship Exceptions

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

CHA News Article

CMS to Host Webinar on Proposed eCQM Changes

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

CHA News Article

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

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

CHA News Article

CMS Releases Measure Specifications for 2017 eCQMs

The Centers for Medicare & Medicaid Services (CMS) has posted its annual update of measure specifications for electronic clinical quality measures (eCQMs) for eligible hospitals and eligible professionals. Providers will use these updated measures to electronically report 2017 quality data for CMS quality reporting programs. The measure specifications are available for download on the CMS website’s eCQM library and the Electronical Quality Improvement Resource Center

CHA News Article

Application Deadline Extended for EHR Hardship Exception
Eligible hospitals and CAHs must apply by July 1

The Centers for Medicare & Medicaid Services (CMS) has extended the application deadline for the Medicare EHR Incentive program hardship exception process to July 1 for eligible professionals, eligible hospitals and critical access hospitals (CAHs). The exceptions apply to the Medicare EHR program 2017 payment adjustments. The previous deadline was March 15 for eligible professionals and April 1 for eligible hospitals and CAHs. The hardship application and instructions are available on CMS’ 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. 

Education event For Members

Labor and Employment Law Seminar
Wage and hour compliance, hiring considerations, disruptive physicians, case law developments

October 19, Sacramento
October 26, Los Angeles

Managing HR for hospitals is a bit like playing chess. With all of the pieces in play – including new laws, rules and regulations – hospital employers must strategically develop and implement policies, procedures and programs that encompass these changes and adhere to legal requirements. As with chess, understanding the rules, and knowing when and how to effectively implement them, are key to success. Attend this year’s event to hear the latest updates on important court case decisions, federal and state regulations, and other issues impacting your work.

CHA News Article

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

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

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

CHA News Article

CHA Participates in ASHHRA Advocacy Day

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

CHA News Article

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

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

Overview

Legal

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

Education event For Members

Labor and Employment Law Seminar
Wage and hour compliance, hiring considerations, disruptive physicians, case law developments

October 19, Sacramento
October 26, Los Angeles

Managing HR for hospitals is a bit like playing chess. With all of the pieces in play – including new laws, rules and regulations – hospital employers must strategically develop and implement policies, procedures and programs that encompass these changes and adhere to legal requirements. As with chess, understanding the rules, and knowing when and how to effectively implement them, are key to success. Attend this year’s event to hear the latest updates on important court case decisions, federal and state regulations, and other issues impacting your work.

CHA News Article

Supreme Court Rules on Providers’ Liability Under False Claims Act
Finds that material misrepresentation may trigger liability

Last week, the U.S. Supreme Court ruled on whether providers may be liable under the False Claims Act for seeking payment while out of compliance with regulatory requirements. In Universal Health Services, Inc. v. United States, a Medicaid beneficiary was prescribed a medicine that ultimately caused her death. After finding that the clinic’s employees were improperly supervised or licensed, her parents filed suit alleging that Universal Health Services had defrauded Medicaid by receiving payments for services rendered, despite being out of regulatory compliance.

CHA News Article

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

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

CHA News Article

Appeal Filed in Interdisciplinary Team Consent Case

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

CHA News Article

CDI Issues Permanent Regulations on Network Adequacy
Regulations effective immediately

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

Overview

Patient Rights

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

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

CHA News Article

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

General acute care hospitals are now required to send their local CDPH district office a copy of their interpreter services policies and a description of their efforts to ensure adequate and speedy communication between patients with language or communication barriers and staff.

Publication

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

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

Publication

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

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

CHA News Article

CDPH Provides Guidance for Submitting End of Life Option Act Forms

 California’s new End of Life Option Act — which allows terminally ill patients to obtain a prescription from their attending physician for medication to end their life — requires physicians who write such prescriptions to submit specified documentation to the California Department of Public Health (CDPH).  While the Act itself does not specify how the documentation should be submitted, CDPH recently announced those details.

Recording

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

Webinar recorded live April 18, 2016

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

Overview

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

CMS to Host Call on IMPACT Act Data Elements

The Centers for Medicare & Medicaid Services will hold a call Aug. 31 from 10:30 a.m. – noon (PT) to explain how information from assessment instruments is used to calculate quality measures, as required by the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. For additional information or to register, visit https://blh.ier.intercall.com/details/b745cb4472bb40018189a1da9077eeee

CHA News Article

CMS Updates SNF Five-Star Ratings Program

The Centers for Medicare & Medicaid Services (CMS) has updated the Five-Star Quality Rating program for skilled-nursing facilities (SNFs) to incorporate five new measures addressing discharge to community, re-hospitalizations and visits to the emergency department, as well as changes in functional status and mobility.   

On the Nursing Home Compare website, SNFs receive four different star ratings ranging from one to five stars each. Three of the ratings address specific components — health inspections, staffing and quality measures — and one is an overall rating, calculated by combining each of the three component star ratings. With the new quality measures added to the calculations, each nursing home’s quality measures star rating, as well as the overall rating, will likely change. Additional information is available on the CMS website.

CHA News Article

CMS Releases Q&As on Inpatient Psychiatric Facility Quality Reporting

The Centers for Medicare & Medicaid Services (CMS) has released new information about data reporting for the Inpatient Psychiatric Facility Quality Reporting program. In addition to directing providers to materials from a July 7 webinar, it has made available new Q&As related to the training. For further help with fiscal year 2017 reporting, providers should refer to the various resources and tools available on the Quality Reporting Center website under Resources and Tools. Questions should be directed to https://cms-ip.custhelp.com or (844) 472-4477.

CHA News Article

Resources Available for Implementing Antibiotic Stewardship Programs

Beginning Jan. 1, 2017, The Joint Commission will require accredited hospitals and nursing homes to develop antimicrobial stewardship programs. To help hospitals prepare, the National Quality Forum has released a practical guide to implementing high-quality antibiotic stewardship programs that meet community needs. The guide builds on the Centers for Disease Control and Prevention’s Core Elements of Hospital Antibiotic Stewardship Programs and offers practical solutions to help hospitals establish antimicrobial stewardship as an organizational priority; educate staff, patients and families about the appropriate use of antibiotics; and create a multidisciplinary antimicrobial stewardship team.

Since 2015, California law has required general acute care hospitals to implement an antimicrobial stewardship policy in accordance with professional organization guidelines. Hospitals should review their policy in light of The Joint Commission’s guidelines.

Recording

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

Webinar Recorded Live June 29, 2016

Overview

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

Covered California is at the forefront of these efforts. Recent Covered California contract changes now include provisions that may exclude providers who cannot meet accelerating quality and performance standards of care.

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.

Education event

Implementing CJR – Strategies for Success
Nuts and bolts, analyzing your data, quality improvement, collaborator agreements, defining your post-acute strategy and more

October 25, Los Angeles

The triple aim is now front and center with the move to alternative payment models. A prime example is the mandatory CMS Comprehensive Care for Joint Replacement program, impacting 135 California hospitals in three MSAs. This one-day intensive program will provide your health care teams with the knowledge they will need to manage patient care, foster physician alignment and develop effective partnerships with post-acute care providers.

CHA News Article

GAO Releases Report on Uncompensated Care Payment Methodology

This week, the Government Accountability Office (GAO) released a report evaluating the current payment methodology used to allocate Medicare uncompensated care (UC) payments to hospitals. Medicare UC payments are based largely on hospitals’ historic Medicaid days, rather than actual costs incurred treating the uninsured. The report states that the Centers for Medicare & Medicaid Services (CMS) is responsible for using the best available data to allocate payments based on hospitals’ actual uncompensated costs of providing care. According to GAO, CMS’ use of Medicaid patient days as the basis for distributing these payments results in poor alignment between payments and hospitals’ uncompensated care costs.

The GAO recommends that, when making Medicare UC payments, CMS base  payments on uncompensated care costs and consider specific Medicaid supplemental payments a hospital has received that offset those costs. In its written response, the Department of Health & Human Services concurred with both recommendations. The GAO report was released one day prior to CMS’ inpatient prospective payment system final rule, which finalizes changes to the methodology used for distributing Medicare UC payments.

Recording

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

Webinar Recorded Live June 29, 2016

Overview

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

Covered California is at the forefront of these efforts. Recent Covered California contract changes now include provisions that may exclude providers who cannot meet accelerating quality and performance standards of care.

CHA News Article

DHCS Issues Guidance on Inpatient Billing to Medi-Cal Managed Care Health Plans

Yesterday, the Department of Health Care Services (DHCS) issued two all-plan letters (APLs) to provide Medi-Cal managed care health plans (MCPs) information about the appropriate billing of inpatient services for beneficiaries with California Children’s Services (CCS)-eligible conditions who are also enrolled in a MCP. One APL provides instructions for billing inpatient services at private, municipal and district hospitals; the other provides instructions for billing the same services at designated public hospitals.

CHA News Article

HRSA to Host July 20 Webinar on 340B Recertification

The Health Resources and Services Administration’s (HRSA) Office of Pharmacy Affairs (OPA) will host a webinar July 20 from 10-11 a.m. (PT) to assist covered entities with the recertification process for the 340B Drug Pricing program. All 340B hospitals are required to recertify with HRSA to ensure they continue to meet the 340B hospital eligibility requirements. The hospital recertification process runs from mid-August to mid-September. Hospitals can join the webinar by visiting https://hrsa.connectsolutions.com/recertification/; the conference number is (888) 787-0207, and the participant passcode is 7814467.

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

Clinical Laboratories to Receive New Communications From CDPH

The California Department of Public Health (CDPH) has announced that Laboratory Field Services will now distribute All Clinical Laboratories Letters (ACLLs) to facilities licensed or registered by CDPH. The letters will address standards CDPH is imposing, allow the public to observe which California laws are more stringent than federal standards, and specify which accrediting organizations have been approved to conduct inspections. Public comment on an ACLL will be received and considered by the department for 30 days after posting online. Forty-five days after being posted online, ACLLs will become final with the force of regulations. More information, including current ACLLs, can be found at www.cdph.ca.gov/programs/lfs/Pages/AllClinicalLaboratoriesLetters.aspx.

CHA News Article

Children’s Hospitals GME Payment Program Now Accepting Applications

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

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

CHA News Article

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

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

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

CHA News Article

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

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

CHA News Article

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

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

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