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.
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
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.
New regulations from the Emergency Medical Services Agency
(EMSA) establish standardized best practices for emergency
medical services for children programs. CHA and member hospitals
worked closely with EMSA’s Emergency Medical Services for
Children Committee to produce regulations to provide quality care
for children needing emergency services, and is pleased to see
the regulation finalized. It will take effect July 1.
On April 16, the California Emergency Medical Services Authority
announced that six entities had been awarded between $1.5 and
$4.9 million dollars to develop and implement interoperable
health information exchange (HIE) between emergency ambulance
service providers and hospitals/electronic health records via
health information exchange organizations (HIOs).
With 21 measles cases reported in California this year, the
California Department of Public Health has offered detailed
recommendations – through
All Facilities Letter 19-17 – for identifying and
addressing the disease. The cases reported so far have
resulted in hundreds of investigations of possible contact
as well as transmission of the disease in emergency departments
and other health care settings.
The California Department of Public Health (CDPH) Stroke
Registry/California Coverdell Program requests that hospitals
participate in its annual stroke survey. Responses to the survey
will be used to assess hospitals’ capacity to provide stroke
care, describe the quality improvement intervention work underway
in hospital settings, and identify acute stroke care service
The Emergency Medical Services Agency (EMSA) has issued
proposed regulations that, when finalized, will allow
emergency medical services providers to transport patients to the
hospital or other care setting that best meets the patient’s
needs. The proposed regulations address paramedic training and
establish other requirements for alternative destination
Influenza activity remains high across the United States,
according to a
health alert recently issued by the Centers for Disease
Control and Prevention (CDC). The CDC notes that the season is
likely to last several more weeks and continues to recommend
antiviral medications for influenza treatment, regardless of
whether a patient received the influenza vaccine.
health advisory from the California Department of Public
Health (CDPH) reminds providers to be aware of potential measles
cases, as 16 cases have been reported in California since
Jan. 1. CDPH notes that providers should not rule out a measles
diagnosis based solely on patients reporting they previously
received a measles immunization.
Wildfires. Mudslides. Floods. Mass shootings. These once rare or
infrequent events have become regular occurrences, and no two
disasters are ever the same. Now more than ever, hospitals
must reevaluate our procedures and redefine preparation.
new report from the Public Policy Institute of California
(PPIC) examines emergency department (ED) use across the state
from 2005-16, focusing on ED use after 2014 — when the Affordable
Care Act (ACA) insurance expansions were fully implemented.
While PPIC notes encouraging findings related to the ACA’s
impact, it also identifies a need to more closely examine the
role of EDs in an evolving health care system, especially since
ED use has grown since 2005.
Key findings include:
ACA expansions resulted in a large reduction of the number of
uninsured Californians, and did not increase ED use among adults
under the age of 65.
Among non-elderly adults, women ages 19-34 have the highest
rates of ED use, due in part to pregnancy-related visits.
Approximately 90 percent of ED visits are outpatient visits.
Since 2005, ED outpatient use has increased substantially
across all demographic groups and for all reasons.
health advisory from the Centers for Disease Control and
Prevention shares information about an investigation of a
penicillin-resistant strain of Brucella spreading across
the U.S. Suspected to be linked to consumption of unpasteurized
milk from a farm in Pennsylvania, cases have now been identified
in 19 states — including California. More information on the
infection and recommended treatment is available in the advisory.
The Emergency Medical Services Authority (EMSA) has released
three sets of proposed regulations for a 15-day comment period.
The proposals are intended to establish standardized best
practices for their respective systems.
The California Department of Public Health reminds
general acute care hospitals and acute psychiatric hospitals
that, effective Jan. 1, they may not require, as a condition of
admission, a person who voluntarily seeks care to be placed on an
involuntary hold under Section 5150 of the Welfare and
The Emergency Medical Services Authority (EMSA) is in the process
of updating its Statewide Trauma System Triage and Transfer
Resource Guide. The
draft guide incorporates feedback from a previous comment
period in 2017. Due to the time elapsed since then, EMSA has
offered another comment period.
The California Department of Public Health has issued All Facilities
Letter 19-01 reminding hospitals of the new law requiring
that they try to coordinate homeless patients’ discharge to
appropriate area shelters or other community-based
services. To help hospitals comply with the law, CHA
has developed a guidebook titled Discharge
Planning for Homeless Patients.
Hospitals and health care facilities across the state continue to
respond to, and be affected by, the devastation caused by the
Camp Fire in Northern California and the Woolsey and Hill fires
in Southern California. Members who wish to donate are encouraged
to support the following funds managed by hospitals:
CHA’s latest guidebook, Discharge Planning for Homeless
Patients, explains California’s new homeless patient
discharge planning law and offers insights to help hospitals
prepare to return homeless patients to the community.
CHA has submitted the attached comments to the Emergency Medical
Services Authority (EMSA) on
proposed changes to pediatric emergency care standards. The
changes are intended to ensure consistency in pediatric care
statewide. Among other items, CHA recommends that EMSA define
“pediatric patient” as one who is 13 years old or younger,
mirroring Title 22 regulations; remove the requirement that
pediatric receiving centers have a dedicated pediatric inpatient
unit to be considered “advanced”; and strengthen the disclosure
language for hospitals that share data.
The California Department of Public Health (CDPH) urges health
care providers to report cases in which patients experience acute
flaccid limb weakness. Nationally, 62 cases of acute flaccid
myelitis have been confirmed since the start of the year. This
rare neurological condition is characterized by sudden onset of
weakness in one or more limbs and distinct abnormalities in the
spinal cord. In the attached alert, CDPH provides guidance
related to case reporting and laboratory testing, as well as
precautions for infection control.