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2016 HASD&IC REGIONAL PRIORITIES

HASD&ICís 2016 Priorities are driven by a shared vision with CHA and the Regional Associations of an optimally healthy society and goal that all Californians have equitable, safe, high quality, medically necessary, patient-centered health care.

The primary focus of the Hospital Association of San Diego & Imperial Counties (HASD&IC) is to provide advocacy on behalf our members at the local and regional levels, while supporting CHA at the state and federal levels. During 2016, HASD&IC will continue to:

  • Enhance HASD&ICís capability for effective advocacy with local and regional governmental entities.
  • Serve as a unified voice representing and advocating for members at the local and regional levels.
  • Represent and promote the value of community hospitals to elected officials, health care stakeholders, and to the communities they serve through effective public advocacy outreach.
  • Provide appropriate media responses to inquiries regarding hospital policies and practices.
  • Promote member participation in CHA boards, committees, and educational events.
  • Engage members and educate key stakeholders, opinion leaders, legislators, and their district staff on hospital issues and efforts in support of CHAís Digital Advocacy goals.
  • Support CHAís federal & state legislative and regulatory advocacy efforts.
  • Respond to CHA Advocacy Alerts and organize regional teams to attend CHAís Health Policy Legislative Day and the California Congressional Action Program.
  • Support the California Hospital Association Political Action Committee (CHPAC) to ensure a strong voice for hospitals and health systems when decisions are made that affect hospitalsí ability to fulfill their missions.

Financial Viability

For hospitals to be able to provide great patient care and to provide a positive economic impact within their communities, they need to be financially healthy. Public policy priorities, including changes to healthcare and growing social needs of our communities, has the potential to impact a hospitalís financial viability.

Issues of significant concern to the members:

  • Reimbursement rates, including a growing Medi-Cal population and a decreasing commercial insurance market.
  • Changing payment and healthcare delivery models.

To support member concerns, HASD&IC will:

  1. Advocate for health care policies and practices to support efficient and effective operations of programs hospitals implement locally to meet legislative and regulatory requirements, such as expansions to the dual eligible program, behavioral health services, post-acute care services, emergency medical services, and disaster planning.
  2. Provide hospital representation and advocacy on policy issues related to local Medi-Cal geographic and Covered California managed care programs and the Medi-Cal Section 1115 Waiver.
  3. Advocate for effective outreach and enrollment services to support work performed by hospitals, including the Hospital Outstation Services Program (HOS), as well as county agencies and community-based organizations.

Behavioral Health

Hospital emergency departments (EDs) have become the location that many patients with significant behavioral health issues access necessary care. This is due in part to a lack of adequate public and private sector resources available to serve our community. There have been significant gaps in the behavioral health continuum of care due to the patientís payer source, as well as unavailable services necessary to meet the needs of patients in our community.

Issues of significant concern to the members:

  • Insufficient system of services to meet the needs of patients, thus creating challenges to transfer patients to the appropriate services.
  • Increased need and utilization in the community.
  • Increasing impact on ED volume and throughput.
  • County policies on 5150 holds and releases (specifically in Imperial County).
  • Need for improving the integration of physical and behavioral health at State policy level to increase consistency among counties in administration of Medi-Cal behavioral health benefits.

To support member concerns, HASD&IC will:

  1. Continue collaborative efforts with the stakeholders in San Diego County; including the Health and Human Services Agency, Public Safety, Law Enforcement, clinics, physicians, and other key groups to identify and implement solutions to improve the behavioral health continuum of care in San Diego County.
  2. Include behavioral health needs and services as part of population health and Community Health Needs Assessment (CHNA) activities.
  3. Advocate for additional alternative treatment, placement, and care delivery options for patients; e.g. sobering centers, mobile crisis units, crisis residential centers, and the use of tele-health for care management of 5150 holds and releases and for court-ordered hearings.
  4. Develop and implement local solutions to increase access to behavioral health services and share those experiences as part of the development of statewide policy.

Community Benefit

Hospitals and healthcare systems in San Diego County have a long history of responding to health needs in the communities they serve. This commitment extends beyond traditional hospital care to community health programs that provide services to the regionís most vulnerable populations.

In 2013, HASD&IC began facilitation of a hospital-focused triennial Community Health Needs Assessment (CHNA) that identifies and prioritizes the most critical health-related needs of San Diego County residents. Participating hospitals use the findings to guide their community programs and to meet IRS regulatory requirements. Four conditions emerged clearly as the top community health needs in San Diego County: Behavioral Health, Cardiovascular Disease, Diabetes (Type 2), and Obesity. HASD&IC and the participating hospitals shared their process and results with community in 2014 and found a high level of support for both. A board-appointed CHNA Committee now directs the CHNA process and provides guidance to HASD&IC on community benefit related issues.

Issues of significant concern/interest to the members:

  • Regional, focused collaboration to impact the health of the community.
  • Access to health care and services for vulnerable residents.
  • Innovative partnerships and models of care management and care coordination, especially for patients with chronic health conditions.
  • Barriers that make hospital programs inaccessible for residents in high need communities.
  • Promotion of the value and diversity of hospital programs to the broader community.
  • Community-wide knowledge and support for the HASD&IC facilitated CHNA process.

To support member concerns, HASD&IC will:

  1. Build on the findings and experiences from 2013 to facilitate a 2016 CHNA process that utilizes national best practices and develops innovative strategies to collect and analyze information about the identified priority health conditions.
  2. Expand and continue engagement with community leaders, clinical experts, community based organizations, and residents through the 2016 Community Health Needs Assessment process in order to develop meaningful partnerships and a deeper understanding of the health needs of vulnerable San Diegans.
  3. Encourage hospitals and other community/public partners to align their needs assessments where appropriate and share results to strengthen regional findings and reduce the burden on vulnerable communities who are being assessed by multiple efforts.
  4. Leverage and create social and traditional media opportunities to emphasize the impact of hospital community benefit programs and how the CHNA process is utilized to develop community benefit programs and implementation strategies.
  5. Include the CHNA process/findings and hospital community benefit contributions in conversations with local, state, and federal elected officials and their staff whenever possible.

Engage Members in Quality and Patient Safety Activities

HASD&IC is committed to helping hospitals improve quality, reduce medical errors and adverse events, and maximize patient safety. To support those efforts, HASD&IC, along with CHA and the other regional associations, created the Hospital Quality Institute (HQI) in 2013. HQI was established to realize the 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.

Issues of significant concern to members include:

  • More quality measures tied to reimbursement and/or penalties now and into the future.
  • Redundancy with reporting requirements to different organizations.

To support member engagement, HASD&IC will:

  1. Support Hospital Quality Instituteís core activities, programs, and partnerships, including Patient Safety FirstÖA California Partnership for Health and the California Maternal Quality Care Collaborative (CMQCC).
  2. Improve quality of care through initiatives aimed to reduce sepsis mortality, decrease NTSV Cesarean Section rate, reduce obstetrical postpartum hemorrhage, and improve maternal and perinatal safety.
  3. Support individual hospitals and HASD&ICís work in quality and patient safety efforts to reduce medical errors and adverse events, including:
    • Increase participation in CHPSO Safe Table.
  4. Convene specialty area(s) as extensions of CHA / HQI committees in quality & patient safety, including:
    • Medication Safety
    • Regional Quality and Senior Leaders
  5. Promote, educate, and support an accountable culture of safety.
  6. Support efforts towards hospitals and health systems moving towards becoming High Reliability Organizations (HROs).
  7. Strive for collaboration, cooperation, and coordination of allied stakeholders to reduce redundancies in data collection and measured improvements.

Strengthen our Health Care Infrastructure with a Workforce to Meet Regional Needs.

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 been completed that validate the need to address critical health professional shortages in nursing and the allied health occupations.

Issues of significant concern to members include:

  • Lack of primary care providers.
  • Significant shortages and an aging workforce in the allied health professions

To support member concerns, HASD&IC will:

  1. Continue to heighten awareness of workforce shortages in the region, especially to meet health care reform requirements.
  2. Work with local and statewide collaboratives and educational institutions to develop and implement strategies to address workforce needs and supportive curriculum.

Support Collaboration among Regional Health Care Providers and the Community.

  • Strengthen working relationships and a common agenda with community health centers, long-term care providers, physician groups, and medical societies in the region on care transitions for improved population health.
  • Advocate for responsive policies for regional emergency medical services that strengthen the hospital safety net in partnership with community clinics and physicians.
  • Support the continued expansion of our regionís health information exchange.
  • Expand partnerships with the business, academic, social services, and public health communities.
  • Engage with community groups and professional organizations to share issues/concerns, positively position hospitals, and identify common advocacy agendas.
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