Hospital Topics

Overview

CDPH Licensing & Enforcement

The California Department of Public Health’s (CDPH) Licensing and Certification Division (L&C) is responsible for the licensure, regulation, inspection, and certification of health care facilities and certain health care professionals in California. The division is organized into 14 district offices and Los Angeles County, which operates under a contract with the division. L&C staff conduct periodic inspections and investigation of complaints to ensure health care facilities comply with state and federal laws and regulations, conducting roughly 27,000 complaint investigations annually.

The federal Centers for Medicare & Medicaid Services (CMS) — which provides federal funding to ensure that facilities accepting Medicare and Medi-Cal payments comply with federal laws and regulatory requirements — contracts with L&C to perform federal surveys. In addition to facility oversight, L&C oversees the certification of nurse assistants, home health aides, hemodialysis technicians, and the licensing of nursing home administrators.

CHA News Article Jenna Eckert

Data Must Be Submitted by March 29 for Parkinson’s Disease Registry

Under a law that took effect last year, health care providers diagnosing or treating Parkinson’s disease patients must report each case to the California Department of Public Health (CDPH) by March 29.

CHA News Article Brianna Nathan

CDPH Proposes Increase in Hospital Licensing Fees

The California Department of Public Health (CDPH) proposes to increase hospital licensing fees by 20 percent for state fiscal year 2019-20, raising fees from $550 to $661 per bed.

CHA News Article Brianna Nathan

CDPH Seeks Hospital Feedback on Amending Respiratory Care Services Regulations
Comments due March 22

The California Department of Public Health’s Center for Health Care Quality has asked for stakeholder input on prospective amendments to respiratory care services regulations under Title 22.

CHA will work with members of its Certification and Licensing Committee to prepare comments, which are due March 22. Members who would like to provide input for CHA’s comments should contact Debby Rogers, CHA vice president, clinical performance and transformation. For more information, see All Facilities Letter 19-08.

CHA News Article

Providers Alerted About Resistant Infections in Patients Receiving Surgery Abroad

A travel alert recently issued by the Centers for Disease Control and Prevention notifies providers of recent cases of surgical site infections in U.S. residents who underwent invasive medical procedures in Tijuana, Mexico.

CHA News Article

Webinar Recording on Reporting Data to Parkinson’s Disease Registry Now Available

The California Department of Public Health (CDPH) has made available a recorded webinar addressing the new California Parkinson’s Disease Registry. To access the webinar, use the password CPDRdec2018.

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.

CHA News Article

CDPH Releases Questions for Meeting on Hospital Infection Control, Physical Plant Regulations

In preparation for an upcoming meeting to solicit stakeholder feedback on possible changes to Title 22  infection control and physical plant regulations for general acute care hospitals, the California Department of Public Health has released a series of questions. More details are available in All Facilities Letter 18-56.1.

CHA News Article

Health Care Facilities Reminded of New Requirement to Provide Plant-Based Meals

The California Department of Public Health reminds health care providers that, effective Jan. 1, they must make plant-based meal options — without meat, poultry, fish, dairy or eggs — available to patients, in accordance with their physician’s orders. For more information about the law, see page 15 of CHA’s 2018 Report on Legislation.

CHA News Article

CDC Updates Alert on Life-Threatening Coagulopathy Associated with Synthetic Cannabinoids

The Centers for Disease Control and Prevention has updated its health alertaddressing a multistate outbreak of coagulopathy — a bleeding disorder that impacts the way blood clots — that has been linked to synthetic cannabinoid use.

CHA News Article

CDPH Changes Name, Email Address of Centralized Applications Unit

The California Department of Public Health (CDPH) has reorganized its Center for Health Care Quality, Licensing & Certification Unit and Centralized Applications Unit. Now combined and renamed as the Centralized Applications Branch, the new structure consists of four distinct sections: Non-Long-Term Care, Long-Term Care, Report of Change, and Licensing-Certification and Policy. In the attached All Facilities Letter 18-44, CDPH notes that the change is intended to “provide additional resources and realign […] sections to better meet provider needs.” The new email address is CAB@cdph.ca.gov.

CHA News Article

CDPH Issues Guidance on Reducing Legionella Risk in Water Systems

The California Department of Public Health (CDPH) has issued the attached All Facilities Letter 18-39, which addresses Legionella risks in health care facility water systems. Hospitals, critical access hospitals and skilled-nursing facilities must develop and adhere to policies and procedures that inhibit microbial growth in building water systems, in order to reduce the growth and spread of Legionella and other pathogens in water. CDPH directs facilities to guidance issued by the Centers for Medicare & Medicaid Services, which clarifies expectations and notes that facilities must:

  • Conduct a facility risk assessment to identify where Legionella and other pathogens could grow and spread.
  • Develop and implement a water management program.
  • Specify testing protocols and document testing results.
  • Comply with other federal, state and local requirements.
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

$750 Million in Hazard Mitigation Grant Funding Could Assist Some Hospitals with Seismic Compliance Costs
Deadline for submitting notice of interest is March 15

A $750 million funding opportunity available through the Federal Emergency Management Agency (FEMA) Hazard Mitigation Grant Program (HMGP) could help some hospitals offset the cost of meeting seismic compliance requirements for certain acute care buildings.

CHA News Article

OSHPD Accepting Applications for Limited Seismic Compliance Extensions
Application deadline is April 1

Assembly Bill 2190 (Chapter 673, Statutes of 2018) grants specified hospitals the opportunity to apply for an extension of the Jan. 1, 2020, seismic compliance deadline. The law requires all hospitals seeking extensions to submit an application to the Office of Statewide Health Planning and Development (OSHPD) by April 1, 2019.

The law also requires OSHPD to grant an additional extension if certain conditions are met.

To assist hospitals with the application process, OSHPD has published a Public User Guide providing step-by-step instructions for creating and submitting an application for a seismic compliance extension. For more information about AB 2190 and seismic compliance extensions, visit the OSHPD website

CHA News Article

Building Standards Commission Provides Notice of Proposed Code Changes
Comments due Oct. 29

The California Building Standards Commission has announced proposed code changes to Title 24, intended for the 2019 California Building Standards Code. The changes were developed by the Office of Statewide Health Planning and Development in collaboration with the Hospital Building Safety Board, industry representatives and other stakeholders. The changes are consistent with the draft terms reviewed during the pre-regulatory phase, detailed in the attached memo. CHA has been engaged throughout this process and is currently reviewing the proposed changes with a workgroup to determine whether it will submit comments. Comments are due Oct. 29.

CHA News Article For Members

CHA Submits Pre-Regulatory Comments on Title 22 Regulations

Today, CHA submitted comments to the California Department of Public Health (CDPH) regarding several areas of Title 22 regulations that CDPH plans to revise. CDPH issued seven All Facilities Letters (AFLs) earlier this month, requesting stakeholder input to inform its regulation development process. CHA commented on the following:

Comments are due to CDPH on Aug. 31. Questions should be submitted to CHCQRegulationsUnit@cdph.ca.gov.​

Overview

Coverage

Providing access to health coverage is essential to improving population health in California. A strategic and collaborative approach between hospitals, Covered California, the California Department of Health Care Services, counties and local communities is critical to the continued expansion of health coverage through the Covered California marketplace and the Medi-Cal program.

Over 5 million Californians have insurance as a result of the Affordable Care Act (ACA) — roughly a quarter of all Americans covered under the law. In California, 91 percent of individuals are now insured. The uninsured rate in California fell from 17 percent in 2013 to a historic low of 7.3 percent by the end of 2016. Since 2014, more than 3 million people have purchased health coverage through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program — for a total of more than 13.5 million Californians now enrolled in Medi-Cal. Of Covered California’s 1.3 million enrolled consumers, nearly 90 percent receive some level of financial help.

Despite these coverage gains, about 3 million Californians will remain uninsured in 2017. The majority of those projected to remain uninsured in California are not eligible for Medi-Cal or Covered California due to their immigration status. Just under 25 percent of the remaining uninsured are eligible for either Medi-Cal or subsidized coverage through Covered California, while 18 percent are eligible through Covered California but would not receive subsidies.

CHA News Article

CHA Responds to Covered California RFI on Refreshing Contractual Expectations

Today, CHA submitted comments responding to Covered California’s request for information on contractual obligations for qualified health plans.

CHA News Article

DHCS Provides Health Homes Program Update

The Department of Health Care Services (DHCS) has released an update on the Health Homes Program, including current and future implementation counties, and counties where the program will not be implemented.

CHA News Article Lindsay Mohler

CHA Comments on Cal MediConnect Program Extension

The Department of Health Care Services (DHCS) recently requested input on how the Cal MediConnect program can provide a better member experience or otherwise improve care and care coordination. Today, CHA submitted comments that outline the challenges hospital case managers continue to experience in the discharge planning process.

CHA News Article

DHCS Posts February Stakeholder Update

The Department of Health Care Services has released its monthly Stakeholder Communication Update with information on key programs and services, including  the Assisted Living Waiver renewalDiabetes Prevention Program implementationPediatric Palliative Care Waiver, and Medi-Cal telehealth policy.

CHA News Article Lindsay Mohler

Hospitals Should Review New Requirements for Hospital Presumptive Eligibility Application Portal

Later this year, the Department of Health Care Services (DHCS) will modify access to the Hospital Presumptive Eligibility (HPE) Application Portal. Providers who have not yet updated their HPE user information should do so to ensure they do not lose access to the portal.

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

Annual FEMA Catastrophic Planning Workshop Set for May 16

On May 16 in Rancho Cucamonga, the Federal Emergency Management Agency (FEMA) will host its annual Catastrophic Planning Workshop. The workshop, specific to Southern California, will include a discussion of best practices and lessons learned from the past year of disasters in California, as well as interagency changes implemented during the year.

CHA News Article

Registration Open for Disaster Planning for California Hospitals Conference
Sept. 10-11 in Pasadena, livestreaming available

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. 

CHA News Article

New Resources Help Meet Serious Mental Illness Needs in Disasters
Emergency planning should consider strategies focused on mental health

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released a series of resources intended to help providers incorporate, in their disaster planning, strategies to care for patients with serious mental illness.

Education event For Members

Hospital Employee Safety and Workers’ Compensation Seminar
LOA interactive dialogues, experts discuss hospital WC programs, aftermath of California wildfires

March 20, Sacramento
A CHA members-only program

California hospitals treat thousands of patients a year and employ over half a million people. This means hospitals must do a number of things simultaneously. They must keep employees safe and adhere to employment laws while caring for their patients.

Given the number of employees most hospitals have, managing leaves of absences and remaining compliant with workers’ compensation laws and requirements can be formidable. The 2019 Hospital Employee Safety and Worker’s Compensation seminar will address those items and more. 

CHA News Article

House Reauthorizes Hospital Preparedness Program

The House of Representatives on Wednesday passed legislation (H.R. 269) that includes the Pandemic and All-Hazards Preparedness and Advancing Innovation Act. The measure reauthorized the Hospital Preparedness Program (HPP) at an increased amount, including reserving a percentage of HPP funds for the purpose of developing regional health care emergency preparedness and response systems. CHA supports the measure and is hopeful that the Senate will act soon. 

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

Hospitals Reminded to Post Updated Prop. 65 Signs
New signage requirements took effect Aug. 30

CHA reminds members that the Safe Drinking Water and Toxic Enforcement Act of 1986 (Proposition 65) requires hospitals and other businesses to post warning signs about potential exposure to certain chemicals. Beginning Aug. 30, the required content of the signs changed. Previously, the signs were not required to list any specific chemicals but now must inform consumers and employees of at least one specific chemical to which they may be exposed in the area.

Each sign must also include a symbol consisting of a black exclamation point in a yellow equilateral triangle with a bold black outline; if no color is used in printing, then black and white is acceptable. Many commercial vendors sell these signs.

CHA News Article

CDPH Issues Guidance on Reducing Legionella Risk in Water Systems

The California Department of Public Health (CDPH) has issued the attached All Facilities Letter 18-39, which addresses Legionella risks in health care facility water systems. Hospitals, critical access hospitals and skilled-nursing facilities must develop and adhere to policies and procedures that inhibit microbial growth in building water systems, in order to reduce the growth and spread of Legionella and other pathogens in water. CDPH directs facilities to guidance issued by the Centers for Medicare & Medicaid Services, which clarifies expectations and notes that facilities must:

  • Conduct a facility risk assessment to identify where Legionella and other pathogens could grow and spread.
  • Develop and implement a water management program.
  • Specify testing protocols and document testing results.
  • Comply with other federal, state and local requirements.
CHA News Article

Hospitals Reminded That Prop. 65 Warning Regulations Take Effect Aug. 30
New requirements apply to content and types of warnings

CHA reminds hospitals that new regulations related to Proposition 65 and warnings that must be publicly posted take effect Aug. 30. Failure to comply could subject hospitals to potential penalties of up to $2,500 per day, per violation. The new regulations specify separate safe harbor warnings based on the types of listed chemicals, the number of listed chemicals and the methods of transmission. They also significantly revise the required content, including adding these elements:

  • The name of at least one listed chemical that prompted the warning
  • The Internet address for the Office of Environmental Health Hazard Assessment’s (OEHHA) new Proposition 65 warnings website, www.P65Warnings.ca.gov, which includes additional information on the health effects of listed chemicals and ways to reduce or eliminate exposure to them
  • A triangular yellow warning symbol on most warnings
CHA News Article

Workshops Will Detail Proposed Regulations for Toxic Emissions Reporting

A new series of workshops presented by the California Air Resources Board (CARB) will share draft language and concepts for proposed regulations related to toxic emissions reporting. The regulations, required by Assembly Bill 617 (Chapter 136, Statutes of 2017), are intended to support certain CARB programs — including the Community Air Protection Program, established by AB 617, and the Air Toxics Hot Spots Program — as well as state implementation plans, air toxic control measures and monitoring studies. Workshops will be held in July and August throughout the state. A full list of dates and locations, as well as registration information, is available online.

CHA News Article

Hospitals Notified of Digital TV Channel Frequency Change
Potentially affects telemetry systems

The Federal Communications Commission requires television stations to notify health care facilities within their service area when they change the frequency on which they transmit, because such changes can affect hospitals’ wireless monitoring equipment. CHA has received the attached notice from Widelity ­— a company retained by KRNS-CD television station in Reno, NV — to make the required notifications that the frequency on which it transmits will change. Widelity is one of a few organizations along with select television stations that will notify health care facilities in their coverage of similar changes over the next three years.

While many hospitals no longer use television channels for wireless monitoring or equipment, those that do will need to move and retune equipment. Hospitals should work with the manufacturer of their telemetry systems to determine which channels and frequencies to use. Attached are a presentation that includes a list of facilities in the Widelity region and an overview of the process, as well as a list of California stations that are or will be changing frequencies.

Overview

Finance & Reimbursement

Hospital finance is complicated, and California hospitals operate in a challenging environment. Hospital executives are faced with the task of developing financial strategies that contain costs yet allow for the provision of health care to the state’s large uninsured population. CHA is committed to providing hospital financial executives with the resources needed to address these challenges, and believes that hospitals should be reimbursed adequately to cover the cost of care.

Through state and federal advocacy efforts, CHA dedicates many resources to fair government reimbursement and strives to improve hospitals’ financial outlook through legislative and regulatory channels. CHA’s statewide committees and workgroups help provide direction on how to best represent the diverse issues that affect hospitals’ financial performance. In addition, CHA DataSuite is an information-based toolset, available only to CHA members, that helps hospitals analyze government reimbursement changes, and the potential impact of regulatory and legislative actions on hospitals.  

CHA News Article

Senate Health Committee Holds Hearing on Improving Performance in Commercial Health Insurance and Medi-Cal
Addresses strategies to align incentives

Earlier this week, CHA attended a Senate Health Committee informational hearing that examined strategies across all purchasers and programs that have the objective of improving the care delivered to people with chronic conditions. 

CHA News Article

2019 California Hospital Compliance Manual Now Available

CHA has released the 10th edition of the Hospital Compliance Manual, written specifically to help California’s hospital compliance officers, chief financial officers, legal counsel, and risk managers stay abreast of pertinent state and federal laws. The manual focuses on high-risk compliance issues and addresses the key components of an effective compliance plan.

CHA News Article

DHCS Reminds Providers That New Fee-for-Service Pharmacy Reimbursement Begins Feb. 23

Beginning Feb. 23, the Department of Health Care Services (DHCS) will implement a new fee-for-service reimbursement methodology for covered outpatient drugs. The methodology will reimburse the lower of the actual acquisition cost (as determined by the Centers for Medicare & Medicaid Services), the federal upper limit, the maximum allowable ingredient cost, and the pharmacy’s usual and customary charge. For more details about the changes, visit the DHCS website.

CHA News Article

CHA Comments on Changes to Sales and Use Tax for Hospitals
Proposed regulations would change application of sales tax on items for Medicare Part A patients

On Jan. 16, CHA submitted a comment letter to the California Department of Tax and Fee Administration (CDTFA) on its proposed amendments that would clarify how sales and use tax is applied to medical items furnished by hospitals.

CHA News Article Brianna Nathan

Grant Applications Available for Programs That Strengthen Health Care Delivery
Applications due March 1

Nonprofit organizations and counties that participate in the County Medical Services Program (CMSP) are encouraged to apply for funding through the Health Systems Development Grant Program.

Overview

Health Information Management & Technology

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 serves as a tool to enhance patient safety, promote information sharing for preventative health services and reduce health care costs.

Hospitals face a number of challenges with HIT such as security and interoperability. The development of industry standards is crucial to successful interoperability and the safe and effective exchange of patient data. Certification of vendor systems, for example, involves compliance with industry-accepted data and technical standards.

CHA News Article

Proposed Rules Issued on Interoperability and Information Blocking

The Department of Health and Human Services has issued two proposed rules – one from the Centers for Medicare & Medicaid Services (CMS) and the other from the Office of the National Coordinator for Health Information Technology (ONC) –  intended to improve the interoperability of health information.

CHA News Article

CHA Comments on Draft Strategy to Reduce Health IT and Electronic Health Record Burden

Yesterday, CHA submitted comments on the Office of the National Coordinator’s (ONC) draft strategy to reduce regulatory and administrative burden related to health information technology and electronic health record (EHR) use.

CHA News Article

Updated Record and Data Retention Schedule Now Available
Available in print and electronic formats

CHA is pleased to announce the new release of its Record and Data Retention Schedule, the first update of this publication in seven years. The guidebook provides an overview of practical considerations in record retention policies and helps hospitals determine which records need to be kept and for how long.

The guide can help reduce storage costs and avoid legal pitfalls by making clear when it is safe to dispose of certain records.

CHA News Article

CHA Attends Site Visit With ONC Deputy National Coordinator

CHA last week joined the American Hospital Association in a site visit with Office of the National Coordinator for Health Information Technology (ONC) Deputy National Coordinator Jon White, MD. Dr. White visited Scripps Memorial Hospital La Jolla to understand the successes and challenges of meaningful use programs and to discuss how to improve interoperability in the exchange of health information.

From left: Megan Howard, senior policy analyst, CHA; Shane Thielman, AVP information services, Scripps Health; Joseph Stein, MD, Scripps Health; Jon White, MD, deputy national coordinator for health information technology, U.S. Department of Health and Human Services; David Wetherhold, MD, Scripps Health; Andy Crowder, corporate senior VP & CIO, Scripps Health; Chantal Worzala, VP health information & policy operations, American Hospital Association; Diane Jones, director IT health policy, American Hospital Association; Amber Ter-Vrugt, senior director government relations, Scripps Health
CHA News Article

Researchers Use Electronic Health Records to Study Mental Illnesses

A new method of scanning electronic health records has been found to identify associations between broad dimensions of behavioral function and genes relevant to mental disorders. The study, published in Biological Psychiatry earlier this year, analyzes use of a natural language processing method to help identify characteristics that might lead to a common genetic variation that is relevant to psychopathology. According to its authors, the technique allows researchers to access an enormous source of data that will assist in a dimensional approach to the study of mental illnesses, rather than using traditional diagnostic categories.

Overview

Hospital Fee Program

The hospital fee program is crucial to the preservation of California’s entire safety net, which is why California’s safety-net hospitals initiated provider fee legislation and why all California hospitals support it. The program uses fees assessed by the state on hospitals to draw down federal matching funds, which are then issued as supplemental payments to hospitals. It is an integral element to improving access to health care for some of California’s most vulnerable residents.

The hospital fee program and all of its statutory provisions and protections were made permanent through the passage of CHA’s ballot initiative, the Medi-Cal Funding and Accountability Act (Proposition 52), in the November 2016 General Election. By removing the sunset date of Jan. 1, 2018, in the existing statute (SB 239, 2013), the Act becomes the framework for all future hospital fee programs. Among other statutory provisions, Proposition 52 makes permanent the limit on the amount the state can take out of the program for the General Fund; the construct of the fee program (both the fee side and the payment mechanisms); and the source of data and information used to develop the program. The next program period covers Jan. 1, 2017, through June 30, 2019.

CHA News Article

DHCS Releases Final Guidance on Network Provider Status
CHA to host webinar on impact for Hospital Fee Program

Last week, the Department of Health Care Services (DHCS) issued its final All Plan Letter (APL) 19-001, specifying contractual requirements that must exist between Medi-Cal managed care plans (MCPs) and hospitals for a hospital to be considered a network provider.

CHA News Article

CMS Approves Hospital Fee Program Managed Care Rates
Rate package covers expansion population for Jan. 1 – June 30, 2015

Yesterday, the Department of Health Care Services (DHCS) shared four approval letters. dated Dec. 12, from the Centers for Medicare & Medicaid Services (CMS). Hospitals should share the relevant letters, linked here, with their accounting firms:

CHA News Article

Deadline Extended for Hospitals to Report Information for Statewide Directory
Due by July 13

The Department of Health Care Services’ (DHCS) has extended the deadline for private hospitals to submit contact information for the new statewide hospital and health plan directory. The directory, which will be publicly available online, will identify primary points of contact for each organization that other plans or hospitals may use for inquiries related to the Hospital Fee Program. Providers are encouraged to complete DHCS’ online form to identify points of contact for general inquiries, encounter data inquiries and contracting inquiries. Information should be submitted by July 13. If a hospital does not provide the requested contacts by the deadline, DHCS will list the primary contact provided in the National Provider Identifier spreadsheet as the contact for all general, encounter data and contracting questions in the statewide directory.   

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 at 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

CHA Asks Hospitals to Urge Legislators to Oppose Nurse Staffing Ratio Penalties

Today, CHA sent an Advocacy Alert to hospital leaders about Senate Bill 227 (Leyva, D-Chino), a bill that would create significant penalties for hospitals that do not meet nurse staffing ratios. CHA urges hospital leaders to contact their representatives about this harmful bill, which would increase costs without providing any benefit to patients.

CHA News Article

CHA Supports Resident Physician Shortage Act of 2019
Urges California delegation to cosponsor

CHA sent a letter to the California congressional delegation this week, urging support of the Resident Physician Shortage Act of 2019 (H.R. 1763), which takes steps to reduce nationwide physician shortages by increasing the number of Medicare-supported residency positions.

CHA News Article

CHA Submits Comments on Draft Regulations for Indoor Heat Illness
Requests a fresh approach from Division of Occupational Safety and Health

CHA recently submitted a comment letter to the Division of Occupational Safety and Health (DOSH) on its draft regulations for minimizing heat-related illness among workers in indoor places of employment.

CHA News Article For Members

Hospitals Should Review Policies on Reporting Time Pay
California appellate court issues new decision

Earlier this week, a California appellate court issued a published decision interpreting California’s reporting time pay requirement. While the decision in Ward v. Tilly’s Inc. was not unanimous and could be appealed to the California Supreme Court, employers should take note of the case’s reasoning.

Education event For Members

Hospital Employee Safety and Workers’ Compensation Seminar
LOA interactive dialogues, experts discuss hospital WC programs, aftermath of California wildfires

March 20, Sacramento
A CHA members-only program

California hospitals treat thousands of patients a year and employ over half a million people. This means hospitals must do a number of things simultaneously. They must keep employees safe and adhere to employment laws while caring for their patients.

Given the number of employees most hospitals have, managing leaves of absences and remaining compliant with workers’ compensation laws and requirements can be formidable. The 2019 Hospital Employee Safety and Worker’s Compensation seminar will address those items and more. 

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

Registration Open for Disaster Planning for California Hospitals Conference
Sept. 10-11 in Pasadena, livestreaming available

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. 

CHA News Article

Privacy Breach Reports Due March 1

Federal law requires hospitals and other HIPAA-covered entities to report all 2018 HIPAA privacy breaches affecting fewer than 500 patients to the Office for Civil Rights of the U.S. Department of Health and Human Services by March 1. This requirement also applies to hospitals that have already notified affected patients and the California Department of Public Health. 

CHA News Article

2019 California Hospital Compliance Manual Now Available

CHA has released the 10th edition of the Hospital Compliance Manual, written specifically to help California’s hospital compliance officers, chief financial officers, legal counsel, and risk managers stay abreast of pertinent state and federal laws. The manual focuses on high-risk compliance issues and addresses the key components of an effective compliance plan.

CHA News Article Lindsay Mohler

CHA Comments on Modifying HIPAA Provisions to Improve Coordinated Care

CHA has submitted comments to the Department of Health and Human Services Office for Civil Rights (OCR) in response to a request for information about modifying Health Insurance Portability and Accountability Act (HIPAA) privacy and security rules.

Education event

Consent Law Seminar
Serial consent, scope of practice, high utilizers, engaging law enforcement, homeless patient discharge, new laws and more!

Location:
April 17, Ontario                    April 18, San Diego
April 25, Fresno                     May 15, Pasadena
May 16, Costa Mesa              May 23, Oakland
June 6, Sacramento              June 6, Live Stream (New)

Consent for treatment decisions often must be made quickly and may carry significant ramifications for patients, their families and your hospital. Ever-changing regulations further complicate matters.

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. In addition, CHA publishes a corresponding poster.

Education event

Consent Law Seminar
Serial consent, scope of practice, high utilizers, engaging law enforcement, homeless patient discharge, new laws and more!

Location:
April 17, Ontario                    April 18, San Diego
April 25, Fresno                     May 15, Pasadena
May 16, Costa Mesa              May 23, Oakland
June 6, Sacramento              June 6, Live Stream (New)

Consent for treatment decisions often must be made quickly and may carry significant ramifications for patients, their families and your hospital. Ever-changing regulations further complicate matters.

CHA News Article

CHA Guidebook Explains Discharge Planning for Homeless Patients

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.

CHA News Article

Homeless Patient Discharge Planning Guidebook Now Available for Free Download
Print copies also available

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 News Article

Court of Appeal Grants CHA Request for Published Opinion
Court ruled in favor of hospital, physicians in wrongful death suit

The California Court of Appeal last week granted CHA’s request to publish its opinion in Alexander v. Scripps Memorial Hospital La Jolla et al. CHA requested that the court publish the decision because of the important legal issues it addresses, and because having it published allows attorneys in future cases to rely on it.

In the case, a patient with incurable stage four pancreatic cancer was transferred to a hospital from a skilled-nursing facility (SNF) for evaluation. The transferring physician did not believe she would return to the SNF, as he believed her death was imminent. The patient had completed an advance directive and a Physician Orders for Life Sustaining Treatment (POLST) form electing to have all measures taken to prolong her life, including full resuscitation if necessary. All physicians caring for the patient agreed that cardiac compression would be futile and cause harm and suffering. The family said they understood her condition was terminal, but still wanted full resuscitation.

CHA News Article

CHA Requests Published Opinion From California Court of Appeal
Court ruled in favor of hospital, physicians in wrongful death suit

CHA filed a request yesterday with the California Court of Appeal to publish its opinion in Alexander v. Scripps Memorial Hospital La Jolla et al. In that case, a patient with incurable stage four pancreatic cancer was transferred to a hospital from a skilled-nursing facility (SNF) for evaluation. The transferring physician did not believe she would return to the SNF, as he believed her death was imminent. The patient had completed an advance directive and a Physician Orders for Life Sustaining Treatment form electing to have all measures taken to prolong her life, including full resuscitation if necessary. All physicians caring for the patient agreed that cardiac compression would be futile and cause harm and suffering. The family said they understood her condition was terminal, but still wanted full resuscitation.

The physicians consulted the hospital’s Appropriate Care Committee, which met at the patient’s bedside, reviewed her medical records and spoke with her physicians. The committee explained to the family that doctors could not embark on ineffective care. The patient died three days after admission, having received palliative care and pain control, but without receiving cardiac compression. She died about an hour before she was scheduled to be transferred to another facility that the family believed would comply with its directions. The family sued, alleging 16 different causes of action, including malpractice, wrongful death, elder abuse, misrepresentation, infliction of emotional distress and violations of state law regarding advance directives.

Overview

Quality & Patient Safety

CHA is committed to helping hospitals improve quality, reduce medical errors and adverse events, and maximize patient safety. To further those efforts, CHA and the Regional Associations established the Hospital Quality Institute (HQI) in 2013 to realize statewide impact of improving patient safety and quality care for all Californians, to accelerate the rate of improvement and to advance California as a national leader in quality performance. HQI’s broad scope of work includes reducing patient harm, reducing health care-associated infections, reducing hospital readmissions, improving patient experience and improving maternal/child outcomes. Hospitals and health systems that belong to HQI — a voluntary organization — use it as an excellent source of performance data and analytics to focus improvement opportunities and take best practices to scale. In addition, CHPSO, the nation’s largest and longest operating patient safety organization, is a division of HQI.

CHA also regularly tracks and reports on important developments in the public reporting of hospital quality data, including OSHPD and Hospital Compare website data, and keeps members informed of regulations related to pay for quality reporting and performance.

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Registration Open for Disaster Planning for California Hospitals Conference
Sept. 10-11 in Pasadena, livestreaming available

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. 

CHA News Article

CMS Updates Hospital Star Ratings, Seeks Comments on Proposed Changes to Methodology
Comments due March 29, national provider call to be held tomorrow

Last week, the Centers for Medicare & Medicaid Services (CMS) updated its overall hospital quality star ratings on Hospital Compare, which were last updated in December 2017.

CHA News Article

HQI Accepting Applications for 2019 C. Duane Dauner Quality Award
Applications due April 30

Applications are now open for the Hospital Quality Institute’s (HQI) 2019 C. Duane Dauner Quality Award, which recognizes outstanding achievement in the areas of patient safety, quality improvement and patient experience.

CHA News Article Allison Bradley

EMSA Proposes Updated Stroke, STEMI and EMSC Regulations

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.

CHA News Article

HQI Leader Honored for Work on Hospital Quality Transparency

Last week, Hospital Quality Institute (HQI) President & CEO Julie Morath was honored by the Patient Safety Movement Foundation with its Beau Biden Humanitarian Award. The award recognizes California hospitals’ participation in an effort, led by HQI, to provide consumers with easily accessible, meaningful information about hospital quality.

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 validated 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 and other necessary partners.

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

CHA News Article

CHA Supports Resident Physician Shortage Act of 2019
Urges California delegation to cosponsor

CHA sent a letter to the California congressional delegation this week, urging support of the Resident Physician Shortage Act of 2019 (H.R. 1763), which takes steps to reduce nationwide physician shortages by increasing the number of Medicare-supported residency positions.

CHA News Article Brianna Nathan

Report Provides Educational Solutions, Regional Forecasts for California RN Workforce

A new report identifies the clinical capacity of and training needs for the state’s nursing workforce, particularly RN surpluses and shortages by region. The report is the culmination of a landmark initiative to identify innovative solutions for the most challenging nursing education issues facing California.

CHA News Article

CHA Supports Commission’s Recommendations to Grow, Diversify California’s Health Care Workforce

A new report, “Meeting the Demand for Health,” outlines the need for a statewide infrastructure designed to produce a steady pipeline of professionals who can care for California’s growing and aging population.

CHA News Article

CalMedForce Awards $38 Million in Proposition 56 Graduate Medical Education Funding

This week, Physicians for a Healthy California announced 73 awards totaling $38 million in the inaugural cycle of its CalMedForce Program, which provides funding for graduate medical education programs in California.

CHA News Article

Applications Open for $40M GME Grant Program
Deadline is Jan. 15

Applications are now being accepted for the $40 million CalMedForce graduate medical education (GME) grant program. The deadline for applications is Jan. 15, 2019.

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