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Doing What is Right is Not Always Easy

Grief, anger, exhaustion, frustration — COVID-19 has been about so many different things for so many people. For hospitals — and their front-line workers — as many are well aware, it’s been about saving lives. Put simply, it’s been about “doing the right thing.”

At the first Hospital Council board meeting of the year, that was the clear consensus among board members. But as many of you have discovered throughout the course of the past year, often it’s been “so hard to do the right thing.”

No doubt. It’s not easy to do the right thing when the rules are hard to follow and the guidance is constantly changing. Now, more than a year into this pandemic, we’ve seen guidance at the local, state, and federal levels switch more than a few times. If you’ve lost count, no one would blame you.

It seems as though no sooner have hospitals settled into a routine that the rules change again. And while few would agree that the state’s rollout of the COVID-19 vaccine was seamless, now, just two months in — as counties, hospitals, and other vaccinators are finally finding their footing — the state has decided to shift gears once again. Although relying on a patchwork county-by-county system may not have been the most efficient method of distribution and left many hospitals struggling to get shots in arms while not knowing if they were doing the right thing, vaccinators have been making it work.

However, as has regularly been the case the past 12 months, it’s time for a set change again. While much is still unknown, and the details of the contract with Blue Shield, the third-party administrator chosen to take over distribution of the vaccine, won’t be disclosed until next week, shifting to a single statewide standard for eligibility should help take some of the strain off your hospitals, which are laser-focused on caring for COVID-19 patients. As hospitals have been doing for months now, they will adapt.

But, it seems, just as the load is lightened, another package is heaped upon you.

That weight came in the form of last week’s All Facilities Letter from the California Department of Public Health, which reinstated the state’s nurse staffing ratios. While the ability to care for all patients has always had to be delicately balanced with staffing needs, existing nursing shortages have only been exacerbated by the COVID-19 pandemic. But pivot you must and pivot you will. If hospitals have shown nothing else this past year, it’s that they have the ability to adapt on the fly and switch gears in no time.

At the same time, much-needed COVID-19 relief at the federal level remains elusive. For months now, as hospitals have been struggling under the weight of the pandemic and endured crushing financial losses in the process, they’ve been there — 24/7/365. But critical action is needed to support patient care and workforce sustainability and to preserve our health care infrastructure.

There are no hospital-specific proposals in President Biden’s current COVID-19 proposal, which is why CHA is asking for Congress to do to the right thing and include these advocacy priorities in the COVID-19 relief package:

  • Expand and improve the Provider Relief Fund
  • Forgive from repayment the Medicare Accelerated and Advance Payment Program loans 
  • Extend the delay in sequestration cuts for the duration of the public health emergency

It’s safe to say that, as the pandemic drags on, new variants of COVID-19 lurk just around the corner, and the potential for yet another surge remains, there will likely be more changes in guidance at all levels of government. But what won’t change is hospitals’ commitment to doing the right thing and continuing to care for all Californians in all ways. Because it’s the right thing to do.