Clinical Care


Behavioral Health

Patients with mental health and substance-use disorders are commonly seen in general hospitals. The behavioral health disorder may be a patient’s primary diagnosis, or it may be a co-morbid condition accompanying a physical health disorder, such as diabetes, cancer or coronary artery disease.

Mental illnesses are extremely common, affecting almost every family in California, from every background and of all ages. More than 2 million children, adults and seniors in California are affected by a potentially disabling mental illness every year. Generally speaking, a danger of suicide, harm to self, harm to others or being gravely disabled qualify an individual for acute psychiatric care.


Hospital-Based Outpatient Clinics

A hospital-based outpatient clinic (HBOC) is defined as a clinic providing “outpatient service” as listed on the hospital’s general acute-care license issued by the State Department of Public Health.

The HBOC is a setting in which integrated and accessible primary and specialty health care services are provided by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustainable partnership with patients, and practicing in the context of family and community.


Emergency Department/Trauma

Emergency services and trauma care in California are being threatened. Financial pressures, infra-structure requirements and shortages of licensed health care professionals have caused numerous emergency department (ED) and trauma center closures or downgrades.

The willingness of physician specialists to take calls in hospital EDs has also become increasingly problematic for California hospitals. Physicians are less willing to voluntarily serve on call panels because of low or no payments, liability concerns, impact on their regular medical practices, family obligations and loss of personal flexibility. As a result, the quality of ED care for many patients is in serious jeopardy.

CHA supports improvements to California’s emergency care medical system that will facilitate timely availability of physician specialists in hospital EDs. CHA believes that additional funding for hospital EDs and trauma care is essential to ensure access to care for all patients.

To access behavioral health resources, please visit CHA’s Emergency Department Toolkit web page.


Palliative Care

Palliative care is used to relieve the pain, symptoms and stress of serious illness, with a goal to improve quality of life for patients and their families. Palliative care, which may be used in any patient-care setting, is appropriate at any point in an illness and may be provided at the same time as curative treatments.



Case Management

Case management is a collaborative process that includes the assessment, planning and coordination of options and services to meet a patient’s medical care needs. Effective case management utilizes available resources to achieve high-quality and cost-effective outcomes.

Transition planning is one function of case management. In the hospital setting, case managers assist patients and families in developing a discharge plan, including coordination of community based medical services and, when necessary, admission to a post-acute care facility, such as an acute rehabilitation unit or hospital, or skilled-nursing facility.



CHA represents hospitals in the regulatory and legislative arenas related to the environment in which hospital laboratories must operate. This includes testing and quality-assurance standards, equipment and procedure requirements and staffing.

CHA works in conjunction with the Healthcare Laboratory Workforce Initiative (HLWI), a grant funded project that addresses the shortage of laboratory professionals and other policy issues. HLWI was instrumental in establishing the medical laboratory technician category.



As an integral part of hospital staffing, nursing is front and center for California hospitals. CHA works closely on many nurse-related issues with the Association of California Nurse Leaders, California Institute for Nursing and Health Care, California Board of Registered Nursing and other related organizations to address clinical, quality, safety and practice issues.

Education and scope-of-practice issues are also addressed in an ongoing dialogue with nurses throughout the state. In addition, CHA has a registered nurse on staff to liaison with the various organizations.



As an integral part of the health care delivery system, pharmacies present many high-priority issues for hospitals. CHA works with the California Society for Health Systems Pharmacists to assure legislation and regulations pertaining to the administration of pharmaceutical products are safe for patients, cost-effective and realistic.

CHA advocates for technology that is internationally accepted by drug manufacturers and has reasonable implementation timelines. For example, CHA supports an electronic-pedigree system, which would make changes to the drug distribution process to protect against counterfeit, misbranded, adulterated or diverted drugs. CHA also coordinates issues between pharmacists and other disciplines, such as nursing, in hospitals.


Post-Acute Care

Following a hospitalization for injury or illness, many patients require continued medical care, either at home or in a specialized facility. Post-acute care refers to a range of medical care services that support the individual’s continued recovery from illness or management of a chronic illness or disability.


Telemedicine & Telehealth

Telemedicine and telehealth use videoconferencing and specially adapted diagnostic tools to allow providers to care for patients located in distant locations. Telemedicine and telehealth are transforming the way health care is provided around the country, and California is a national leader in the development and deployment of telemedicine programs. California began operating telemedicine programs in the early 1990s and was one of the first states to enact telemedicine authorization legislation. Currently, there are hundreds of telemedicine programs in operation, and hospitals, clinics and home care are rapidly implementing additional telemedicine and telehealth programs to improve access to care and efficiency of services.


Women & Children

General acute-care and children’s hospitals are committed to improving the health status of women, children and adolescents in their communities. Specific issues include preventing and treating birth defects and developmental disabilities; reducing maternal mortality; understanding normal and abnormal development and genetic susceptibility to disease; addressing the major causes of perinatal and neonatal morbidity and mortality (including low-birth weight); and preventing and treating infectious diseases that affect women and children.

Working with advocacy partners, including the California Children’s Hospital Association, CHA supports policies and regulations to improve the health care delivery system for all women and children throughout the state.