Hospital Topics

Overview

CDPH Licensing & Enforcement

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

CHA News Article

CHA Webinar Will Highlight Cybersecurity Threats to Hospitals
Learn how to protect against cyberattacks

With the rapid increase in cybercrime globally, more businesses and institutions are being targeted — including hospitals, where access to electronic health records is critical to sustaining operations and providing patient care. Because ransomware and other cyber threats can effectively disrupt and disable computer systems, hospitals must not only arm themselves against destructive cyberattacks, but also have a plan in place to mitigate the effects if they fall victim.

CHA will hold a webinar June 9 from 1:30-3:30 p.m. (PT) to explain how hospitals can protect themselves from cyberattacks, and steps to take if their systems are breached.

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!

Education event

Consent Law Seminar
End of Life Option Act, labor and delivery, decision-making process, new laws and updates

Two Locations Remain:
May 25, San Ramon
June 1, Sacramento

Managing risk in a hospital is hard. In many situations, the laws aren’t clear or conflict — but a decision has to be made anyway. The annual Consent Law seminar is the one educational program that will expand your knowledge and critical thinking to help you make tough decisions with confidence. As an added bonus, all attendees take home a free copy of CHA’s 2016 Consent Manual.

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
CHA News Article

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

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

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

Overview

Clinical Care

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

Education event

Consent Law Seminar
End of Life Option Act, labor and delivery, decision-making process, new laws and updates

Two Locations Remain:
May 25, San Ramon
June 1, Sacramento

Managing risk in a hospital is hard. In many situations, the laws aren’t clear or conflict — but a decision has to be made anyway. The annual Consent Law seminar is the one educational program that will expand your knowledge and critical thinking to help you make tough decisions with confidence. As an added bonus, all attendees take home a free copy of CHA’s 2016 Consent Manual.

CHA News Article

End of Life Option Act Webinar Now Available

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

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

Recording

The End of Life Option Act Webinar
Understanding the 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.

CHA News Article

Budget Gives CDPH New Investigation Timelines
Also adds L&C positions to address survey activities

The 2015-16 state budget provides the California Department of Public Health’s (CDPH) Licensing and Certification (L&C) Division with 237 additional positions to assist with its workload, including addressing “past failures to complete its survey workload and close/complete complaint investigations.” In addition, the budget increases hospital fees and adjusts the timelines for CDPH to complete investigations of skilled-nursing facilities (SNFs).

Many provider fees were increased in the budget to correspond to the associated survey activity within each type of provider (hospital, clinic, etc.). Hospitals and SNFs will likely experience increased survey and investigation activities as L&C will have additional staff to complete this work. In addition, providers fees may increase in coming years as the L&C workload continues to increase.

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

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. 

CHA News Article

CMS Releases Final Rule on Fire Safety Requirements
Applies to certain health care facilities, takes effect July 5

The Centers for Medicare & Medicaid Services (CMS) has released the attached final rule updating fire safety requirements for certain health care facilities, including hospitals, long-term care facilities, critical access hospitals, inpatient hospice facilities, ambulatory surgical centers and more. The rule adopts updated provisions of the National Fire Protection Association’s 2012 edition of the Life Safety Code, as well as provisions of its 2012 edition of the Health Care Facilities Code. CHA is working with the Office of Statewide Health Planning and Development and the state fire marshal to determine whether or how this may differ from current regulations, and will inform members of the rule’s impact.

Education event

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

June 28, 2016
10:00 a.m. – 12:00 p.m., Pacific Time

The California State Board of Pharmacy and United States Pharmacopeia Convention are planning changes that will significantly impact hospital pharmacy compounding of hazardous and non-hazardous medications and facility structures. All of the changes will impact numerous hospital departments, including pharmacy, human resources and facilities.

CHA News Article

HVAC Guidance Available for ORs, Sterile Processing Departments

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

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

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

Governor Issues Order Extending Water Conservation

This week, Gov. Brown issued an executive order establishing longer-term water conservation measures, including permanent monthly water use reporting, new permanent water use standards in California communities and bans on wasteful practices such as hosing off sidewalks, driveways and other hardscapes. The order, which aims to build on temporary statewide emergency water restrictions introduced due to drought, also identifies new water use efficiency targets beyond the 20 percent reduction in per capita urban water use by 2020, which was established in 2009. The State Water Board will adjust emergency water conservation regulations through the end of January 2017, in recognition of the differing water supply conditions across the state, and develop proposed emergency water restrictions for 2017 if the drought persists. During the coming months, the administration will seek public input on the new standards called for in the executive order. 

CHA News Article

CDC Updates Maps on Zika Mosquito Potential Locations

The Centers for Disease Control and Prevention (CDC) has released new maps of the United States that show the potential location of the two species of mosquitoes associated with Zika virus transmission. The updated maps show where these mosquitoes are now or have been previously found within the continental United States, based on data gathered by CDC and its state and local partners, but do not show the numbers or density of mosquitoes within each area. While these maps do not indicate the risk of potential disease spread or risk of infection, they can help individuals and health care providers assess potential health risks and take appropriate precautions.

CHA News Article

Heightened Awareness Advised for Health Care Providers After Brussels Attack

Following Tuesday’s terror attack in Brussels, the Department of Homeland Security urges health care providers to increase awareness of activities that prompt suspicion or raise security concerns. The department stressed that early recognition and reporting of potential terrorist activity is the first line of defense against those who intend harm. Health care providers are encouraged to:

CHA News Article

Institute of Medicine Is Now Health and Medicine Division

The Institute of Medicine — the division of the National Academies of Sciences, Engineering, and Medicine that focuses on health and medicine — has been renamed the Health and Medicine Division. This new name builds on the heritage of the institute’s work in medicine, while emphasizing its increased focus on a wider range of health matters. Any questions about the division’s name change should be directed to Clyde Behney, executive director, at cbehney@nas.edu.

CHA News Article

Homeland Security to Fund Innovative Critical Infrastructure Projects
Webinar for applicants is Monday

The Department of Homeland Security (DHS) has announced that it will fund 10 regional innovation projects to develop technologies, tools, processes and methods that strengthen the security and resilience of the nation’s critical infrastructure. The Security and Resilience Challenge Initiative seeks applications from non-federal partners within the critical infrastructure community that address physical and/or cyber threats. DHS will host a webinar March 21 at 8:30 a.m. (PT) to provide details on the application process, selection specifics and other questions from interested applicants. To join the webinar, dial in using (888) 469-3352 and passcode 6081104, and link to the webinar at https://share.dhs.gov/nipp_challenge_21march2016/.

Additional information is available at www.thenihs.org. Questions about proposals can be directed to cip@hhs.gov.

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

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. 

CHA News Article

CMS Releases Final Rule on Fire Safety Requirements
Applies to certain health care facilities, takes effect July 5

The Centers for Medicare & Medicaid Services (CMS) has released the attached final rule updating fire safety requirements for certain health care facilities, including hospitals, long-term care facilities, critical access hospitals, inpatient hospice facilities, ambulatory surgical centers and more. The rule adopts updated provisions of the National Fire Protection Association’s 2012 edition of the Life Safety Code, as well as provisions of its 2012 edition of the Health Care Facilities Code. CHA is working with the Office of Statewide Health Planning and Development and the state fire marshal to determine whether or how this may differ from current regulations, and will inform members of the rule’s impact.

CHA News Article

New Prop. 65 Website Geared Toward Consumer Education

The California Office of Environmental Health Hazard Assessment (OEHHA) recently established a new website to provide the public with information on chemicals, products and locations often associated with Proposition 65 warnings, which emphasize exposure to chemicals that cause cancer, birth defects or other reproductive harm. The OEHHA website offers information on laws and regulations, frequently asked questions, fact sheets and other resources.

Education event

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

June 28, 2016
10:00 a.m. – 12:00 p.m., Pacific Time

The California State Board of Pharmacy and United States Pharmacopeia Convention are planning changes that will significantly impact hospital pharmacy compounding of hazardous and non-hazardous medications and facility structures. All of the changes will impact numerous hospital departments, including pharmacy, human resources and facilities.

Overview

Finance

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

Education event

Hospital Finance and Reimbursement Seminar
Medi-Cal and Medicare updates, Quality Assurance Fee, Covered California evolves

June 15, Sacramento
June 22, Costa Mesa
June 23, Pasadena

Government has been busy this year. There’s been a lot of activity at federal and state levels that will impact how hospitals are reimbursed and also change the way we care for patients. New this year: NOTICE Act; CJR program and MACRA. Covered California is actively working to tie payment to outcomes, while Medi-Cal is considering implementing readmission measures. Plus, two important ballot initiatives have the potential to significantly impact your hospital’s bottom line.

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

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.

CHA News Article

DHCS to Host Behavioral Health Forum April 25

The California Department of Health Care Services (DHCS) will host a Behavioral Health Forum on April 25 from 9:30 to 11 a.m. (PT) via webinar. The webinar will include an update on the Certified Community Behavioral Health Clinics (CCBHC) demonstration, including the CCBHC planning process and upcoming stakeholder engagement opportunities. In October 2015, California was awarded a CCBHC planning grant to support the state in soliciting and certifying clinics to become CCBHCs; establishing a prospective payment system rate for Medi-Cal reimbursable services; and preparing an application to participate in the two-year CCBHC demonstration program. On April 11, Governor Brown signed Assembly Bill 847, which provides DHCS with the additional funds necessary to embark on the CCBHC planning grant process. Registration is available online; meeting materials will be posted on the DHCS website in advance of the meeting.

CHA News Article

CACHI Proposals Due April 29

The California Health and Human Services Agency and Community Partners are soliciting proposals for up to six accountable communities for health (ACHs) under the Accountable Communities for Health Initiative (CACHI). During its three-year span, CACHI will assess the feasibility, effectiveness and potential value of a more expansive, connected and prevention-oriented health system. Grant proposals are being accepted for the initiative’s first year, and should identify a set of short- and medium-term goals related to a specific health issue, such as a chronic condition like diabetes, cardiovascular disease or asthma. Proposals should be submitted online by noon on April 29. More information is available at www.communitypartners.org/cachi

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

CHA Webinar Will Highlight Cybersecurity Threats to Hospitals
Learn how to protect against cyberattacks

With the rapid increase in cybercrime globally, more businesses and institutions are being targeted — including hospitals, where access to electronic health records is critical to sustaining operations and providing patient care. Because ransomware and other cyber threats can effectively disrupt and disable computer systems, hospitals must not only arm themselves against destructive cyberattacks, but also have a plan in place to mitigate the effects if they fall victim.

CHA will hold a webinar June 9 from 1:30-3:30 p.m. (PT) to explain how hospitals can protect themselves from cyberattacks, and steps to take if their systems are breached.

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. 

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.

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.

Education event

Consent Law Seminar
End of Life Option Act, labor and delivery, decision-making process, new laws and updates

Two Locations Remain:
May 25, San Ramon
June 1, Sacramento

Managing risk in a hospital is hard. In many situations, the laws aren’t clear or conflict — but a decision has to be made anyway. The annual Consent Law seminar is the one educational program that will expand your knowledge and critical thinking to help you make tough decisions with confidence. As an added bonus, all attendees take home a free copy of CHA’s 2016 Consent Manual.

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

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

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 CDPH

CHA News Article

New Law Establishes Requirements for Post-Hospital Patient Care

Gov. Brown has signed SB 675 (Liu, D-La Canada Flintridge), which requires a hospital to provide an opportunity for each inpatient to identify a family caregiver who may assist in post-hospital care, and to provide an opportunity for the patient and caregiver to participate in the discharge planning process. The hospital must provide information and, when appropriate, instruction about the patient’s post-hospital care needs and medications. The instructions must be provided in a culturally competent manner and in a language that is comprehensible to the patient and caregiver, and must include an opportunity for the caregiver to ask questions. The law also requires hospitals to attempt to notify the patient’s designated family caregiver about the patient’s discharge or transfer to another facility as soon as possible. However, the discharge or transfer does not have to be delayed until notification is accomplished. Hospitals should document all steps required by this law, which becomes effective Jan. 1, 2016.

CHA News Article

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

Gov. Brown has signed AB 1085 (Gatto, D-Glendale), which allows a court to grant a conservator the power to enforce a conservatee’s right to receive visitors, telephone calls and personal mail. The bill also allows the court to direct a conservator to allow specific visitors, telephone calls and personal mail. This bill was introduced as a result of a highly-publicized situation in which radio host Casey Kasem’s second wife allegedly prevented daughters with his first wife from visiting him. The law also requires a conservator to inform certain persons, and an agent under a power of attorney for health care to inform any individuals identified by the patient, of the patient’s death. Hospitals should always get a copy of conservatorship orders for conserved patients and read them to fully understand the authority of the conservator and any limitations. The law takes effect Jan. 1, 2016.

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.

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 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

CMS Adds Six New Quality Measures to Nursing Home Compare

The Centers for Medicare & Medicaid Services (CMS) has announced the addition of six new quality measures to its Nursing Home Compare website. Three of the new measures — rate of rehospitalization, emergency room use and community discharge among nursing home residents — are based on Medicare-claims data submitted by hospitals, marking the first time CMS has included quality measures not solely based on data that are self-reported by nursing homes. These measures, along with two others on functional improvement and worsening ability to move independently, will be factored into the calculation of the Nursing Home Five-Star Quality Ratings beginning in July 2016. The final measure, which addresses residents receiving antianxiety or hypnotic medications, will not be included in the ratings calculation because CMS has not yet determined appropriate benchmarks for the use of those medications. More information is available on the CMS website

CHA News Article

CMQCC Releases Toolkit to Support Vaginal Birth and Reduce Primary Cesareans

The California Maternal Quality Care Collaborative (CMQCC) has released its Toolkit to Support Vaginal Birth and Reduce Primary Cesareans, which contains key strategies and resources to:

  • Improve the culture of care, awareness and education for cesarean reduction
  • Support intended vaginal birth
  • Manage labor abnormalities and safely reduce cesarean births
  • Use data to drive reduction in cesareans

The free toolkit is available to download on the CMQCC website. Users will be required to either log into their existing CMQCC.org account or create a new one.

Education event

Governance Role in Quality and Performance Improvement Webinar
What governance boards need to know to improve quality of care and patient outcomes

June 1, 2016
12:00 – 1:00 p.m., Pacific Time
A complimentary, CHA members-only webinar

Hospital quality and performance improvement start at the top. As the hospital’s highest governing authority, the governance board must understand and help move the organizational strategy forward. Now that hospital reimbursement and quality performance are tightly aligned, governance boards have the opportunity to improve the quality of care and outcomes that patients need and deserve while preserving their organization’s bottom line. Gather your governance board together for this complimentary webinar and learn how to be a driver of continuous improvement in your facility.

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

Overview

Reimbursement

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

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

CHA News Article

Medi-Cal DRG Provider Webinars Highlight Changes Effective July 1

The Department of Health Care Services will host a series of webinars addressing upcoming changes to the DRG payment methodology, including a transition to the statewide base rate. The 90-minute webinars will be offered at two times: May 24 at 1:30 p.m. (PT) and June 2 at 9:30 a.m. (PT). Both sessions address the same information. Attendees must register prior to the start of the webinar in order to receive meeting details, and will receive instructions for joining the meeting after the registration request has been approved. 

CHA News Article

AHA to Host Public Webinar on OMHA Settlement Conference Facilitation Pilot

The American Hospital Association (AHA) will host a webinar on May 19 at 11 a.m. (PT) to address the Department of Health and Human Services’ Office of Medicare Hearings and Appeals (OMHA) Settlement Conference Facilitation pilot project. The webinar, which is open to the public, will provide an overview of the pilot’s progress since its launch in June 2014 and will outline future phases. Participants will also receive practical tips and considerations for hospitals evaluating whether to participate in the pilot. Registration is available online

CHA News Article

Revised Medicare Ambulance Transports Booklet Available

The Centers for Medicare & Medicaid Services (CMS) has issued the attached materials on the Medicare ambulance transport benefit, including updated information about documentation requirements, coverage, billing and payments, and advance beneficiary notice of noncoverage.  

CHA News Article

Providers Encouraged to Revalidate Medicare Enrollment Information

CMS has posted deadlines by which providers must submit revalidation applications for their cycle 2 enrollment information. If a due date is listed, providers will need to submit a complete revalidation application by that time. If one is not listed, providers should continue to check back for a due date. Unsolicited revalidation applications submitted six months prior to the due date will be returned. Providers are still encouraged to submit their revalidation via Internet-based PECOS, as it is the most efficient and cost effective way to revalidate. Providers that miss their deadlines will be deactivated and required to submit a new application.

Education event

Hospital Finance and Reimbursement Seminar
Medi-Cal and Medicare updates, Quality Assurance Fee, Covered California evolves

June 15, Sacramento
June 22, Costa Mesa
June 23, Pasadena

Government has been busy this year. There’s been a lot of activity at federal and state levels that will impact how hospitals are reimbursed and also change the way we care for patients. New this year: NOTICE Act; CJR program and MACRA. Covered California is actively working to tie payment to outcomes, while Medi-Cal is considering implementing readmission measures. Plus, two important ballot initiatives have the potential to significantly impact your hospital’s bottom line.

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

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.

CHA News Article

Song-Brown Webinars Will Address Upcoming Application Release
Family medicine and primary care residency applications to be available soon

This year, the Song-Brown program will award more than $12 million to medical programs that are committed to increasing the number of family medicine and primary care providers in California. Family medicine hospital residency programs are eligible for the funding and should consider applying.

In anticipation of the approaching release date for family medicine and primary care residency applications, the program will conduct several webinars. The webinars will provide an overview of the application, registration and lessons learned, and will address applicant questions. Visit the Song-Brown website for dates, times and links to webinars.

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