Here’s a look at some of the work that Hospital Council RVPs have been involved in over the past few weeks.
On Nov. 18, the state announced that the rollout of the Medi-Cal Managed Care Pharmacy program with Magellan has been delayed until April 1, 2021. This move by the state to the new pharmacy program remains unpopular with many, including providers concerned about negative impacts on patient care. One clinic network reports this will result in a $2 million loss of 340B dollars, plus a loss of investment in time, software, dollars, and staff administering 340B. That clinic network is joining with others to sue the state to carve them out of the program.
For more information, contact T Abraham at tabraham@hospitalcouncil.org.
Shasta County’s Whole Person Care effort to provide medical respite is under way. A clinic and local hospitals are standing up medical respite in the hopes that, in time, California Advancing and Innovating Medi-Cal or some other funding mechanism will be in place to make it sustainable.
For more information, contact T Abraham at tabraham@hospitalcouncil.org.
In September, the Sierra-Sacramento Valley Emergency Medical Services Agency (S-SVEMSA) put forth a proposal to fine hospitals for missing ambulance patient offload time (APOT) targets. As is the case with other local emergency medical services agencies (LEMSAs), emergency medical services providers have complained about APOT at certain facilities. In this case, the facilities that would be most affected by the proposal were those in the most densely populated portion of the 10-county jurisdiction. On Nov. 17, S-SVEMSA officially postponed any further consideration of the policy until late spring 2021.
Hospitals within the S-SVEMSA territory have worked diligently since September to redirect the focus on APOT management from a punitive system of fines to a collaborative approach of operational improvement. The change in tone from the September Regional Medical Control Committee (RMCC) meeting to last week’s RMCC meeting was remarkable. Rather than emphasizing the symptom (high offload times), the conversation shifted to causes (drivers of EMS volume, drags on through-put, and inaccurate times).
S-SVEMSA staff explained that the decision to postpone any further consideration of fines resulted from:
- Recent APOT improvement at facilities with the highest times
- Current inconsistencies and inaccuracies in measuring APOT by EMS providers
- The resurgence of COVID-19
- Hesitance to be the first LEMSA in California to institute fines on hospitals
- The fact that greater attention and collaboration are now being directed at the problem
S-SVEMSA will lead an effort to ensure that all ambulance crews record APOT properly and consistently. It will try to confirm the accuracy of the data and will now review APOT data at every RMCC and board meeting to bring about a more concerted and consistent focus on measurement and improvement.
Tremendous credit goes to Placer County Supervisor Jim Holmes, chair of the Board of Directors. Following conversations with local hospital leaders and other health officials, he asked to postpone the consideration of fines until late next spring to allow for more cooperation between staff and the most-affected hospitals. Coupled with the advocacy of hospital leaders and clinicians with other board members and S-SVEMSA staff, the coordinated efforts have prevented the setting of a negative statewide precedent.
For more information, contact Brian Jensen at bjensen@hospitalcouncil.org.
SacValley MedShare (SVMS), the largest health information exchange (HIE) in the north state, recently completed an eHealth eXchange connection to Sutter. Sutter providers can view patient information from many participating providers already connected to the HIE, including Dignity, UC San Francisco, and UC Davis. This information will be especially useful in emergency situations when up-to-date patient information is most critical. The Hospital Council has held a board position on SVMS since its inception.
For more information, contact T Abraham at tabraham@hospitalcouncil.org.
On Nov. 13, the Fresno/Madera & Tulare/Kings 5150 Workgroup held its final meeting of 2020. Deryk Van Brunt gave a presentation on CredibleMind, a website focused on population-based mental health. This website consists of 80% self-help options on over 200 topics and 20% connection to local resources. Deryk discussed how counties are easily able to use Coronavirus Aid, Recovery, and Economic Stimulus (CARES) Act funding to enter into contract with CredibleMind. Representatives from the Department of Behavioral Health in Fresno and Tulare County gave updates, including the monitoring of access and utilization rates and the desire to provide more local capacity. A common concern among hospitals was the uptick of minors on 5150 holds throughout September and October.
For more information, contact David Bacci at dbacci@hospitalcouncil.org.
On Nov. 12, RVP David Bacci attended the Kern County Emergency Medical Care Advisory Board meeting. The meeting largely focused on the expected COVID-19 surge this winter. The group also discussed the formation of an Ambulance Patient Offload Time (APOT) task force to seek ways to reduce APOT. The group will consist of ambulance providers, hospital CEOs, and the Hospital Council.
For more information, contact David Bacci at dbacci@hospitalcouncil.org.
Also on Nov. 12, RVP David Bacci and CHA’s state legislative team met with Assemblyman Joaquin Arambula (D-Fresno) and leaders from Madera Community Hospital, Community Medical Centers, and Kaweah Delta Healthcare District. The meeting focused on the impacts of COVID-19 on hospital finances and workforce. The coming seismic mandate, and the ways that the pandemic inhibits a hospital’s ability to comply were also discussed. The assemblymember voiced his concern and support for the hospitals and reiterated his commitment to trying to help remedy these issues in the coming legislative year.
For more information, contact David Bacci at dbacci@hospitalcouncil.org.
On Nov. 11, the East Bay Section held its last membership meeting of the year. Robert Imhoff, Hospital Quality Institute president, introduced the new Hospital Quality Improvement Platform, and members discussed using it for future census data collection and reporting. East Bay hospitals also received an update on the latest COVID-19 developments, reviewed local election results for key races and ballot measures, and provided direction on the section’s policy priorities for next year.
For more information, contact Rebecca Rozen at rrozen@hospitalcouncil.org.
During the spring and early summer, the Hospital Council facilitated the creation of a Mobile COVID-19 Testing Program in Sacramento County. The three-month pilot, which was funded by existing budgets of three fire/EMS providers, took paramedics into congregant living settings to perform testing among the most vulnerable populations and the staff who cared for them. Skilled nursing, memory care, assisted living, and behavioral health facilities benefitted from having on-site testing that prevented the unnecessary transport of fragile individuals. The county health officer credited this front-line response with helping keep a lid on viral spread in the capital region during the early stages of the pandemic.
Due to the success of the program, the Board of Supervisors allocated CARES Act dollars to resurrect the program beginning on Oct. 1. Since that time, the number of provider agencies operating mobile testing units has expanded from three to five. During the first six weeks of the renewed effort, paramedics performed 15,000 swabs in these congregant living settings. Because of its importance, the county is extending the program through June 2021.
For more information, contact Brian Jensen at bjensen@hospitalcouncil.org.