CEO Message

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Last month, Tom Insel, MD, Gov. Newsom’s new special advisor on mental health care, shared with the Behavioral Health Action coalition some early ideas to change the trajectory of behavioral health care delivery in California. That Dr. Insel recognized coalition members as important to the process of transforming behavioral health is testament to the group’s hard and excellent work over the past year.

CHA co-founded Behavioral Health Action in 2018 with the National Alliance for Mental Illness, California, as an alliance of more than 50 organizations from health care, education, labor, law enforcement, local government, and business. Our first-of-its-kind coalition is focused on eliminating stigma and engaging lawmakers to develop solutions to the behavioral health challenges that so many Californians experience — for example:

More than 6 million Californians suffer from a mental illness.
Only one in three gets the help they need.
The number of adolescents suffering from depressive illnesses statewide continues to outpace the national rate.
Half of us will care for someone living with a mental health issue at some point in our lives.

The statistics are daunting, so the coalition hit the ground running last year with its mission to elevate the prominence of behavioral health so it gets the attention it needs, educate decision makers, and innovate the way we treat and support Californians in need — which includes getting the right care, in the right setting, at the right time.

In October, we held a one-on-one conversation with then-candidate Newsom, who pledged his commitment to turn California into a leader in improving the lives of people experiencing behavioral health challenges. When Dr. Insel spoke to the coalition last month, he continued to advance that conversation, explaining his view that we need both a shared understanding of the current problems and shared goals for tackling them.

Behavioral Health Action is working on just such a shared vision — an updated statewide model for behavioral health that will serve as a roadmap for the administration to use. As the model progresses, we’ll keep you updated.

In the meantime, we continue our work on many fronts: educating lawmakers about the importance of change, advocating for a budget that ensures everyone can get care when they need it, and strengthening our ties with the administration through a common sense of purpose.

CARMELA

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Surprise billing continues to garner attention from both federal and state lawmakers — and it’s a vitally important conversation. Patients should not be caught off guard by unexpected bills for out-of-network emergency care. Hospitals have said all along that when patients need emergency care, we support protecting them from surprise bills by limiting their out-of-network cost sharing to no more than the amount for in-network patients.

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Last week, this message highlighted that hospitals and their staff would be available to all who might need them while the rest of us took a break for the long holiday weekend. And, of course, that’s exactly what happened when two major earthquakes struck the town of Ridgecrest in the span of just two days.

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While much of the nation prepares this week for the July 4 summer holiday, hospitals and their dedicated employees will continue their 24/7 work to care for any and all who need them, at any moment.

In California, the Independence Day weekend isn’t just a beginning-of-summer holiday — it also marks a few days of heightened risk at the start of a perilous fire season. One thing Californians have learned over the past several years of wildfires: hospitals and the people who work in them are ready, willing, and able to do what’s needed when disaster strikes.

Yes, there are the hospital emergency operations plans; the standards, regulations, and statutes; the staff training and education; and everything else hospitals do in case of an emergency. But there are also the people who dedicate themselves to their communities and their neighbors in need, no matter the strained circumstances or personal difficulty. 

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In a little more than a month, the Centers for Medicare & Medicaid Services (CMS) will issue a final rule of significant importance for California’s hospitals: a decision that could alter the way Medicare adjusts hospital payments for geographic differences in labor costs (known as the Area Wage Index).

Their proposal? Take money from hospitals in California with high wages to give to hospitals in states with lower wages. CMS suggests this is an effort to address longstanding inequities in the wage index and to help rural hospitals.  

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California’s nine-month legislative session will take its summer recess in mid-July and rev back up in mid-August for what will be a frenetic final four weeks to send bills to the Governor’s desk. CHA has been tracking hundreds of health care-related bills, and actively working on dozens on behalf of hospitals and health systems.

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On Thursday, the Legislature approved the first budget under this new Governor — a nearly $214 billion spending plan that makes significant investments in the new Governor’s top priorities, including health care (we anticipate the trailer bill related to health care will be approved later in the month).

One of the key takeaways from Newsom’s first budget negotiation effort is that he is clearly disposed to use the budget — his most powerful tool as Governor — in a proactive and impactful way to advance his health care goals.

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I’d like to add my voice today to the national chorus that has united to call for an end to violence in our communities and workplaces.

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This year marks the 15th anniversary of the implementation of nurse staffing ratios in California. Unsurprisingly, coordinated and cohesive labor interests are pushing to enhance the penalties for infractions and expand oversight for staffing ratio compliance.

Their claim is that increased penalties — an additional $30,000 for the first infraction (even with zero threat of patient harm) and $60,000 (again, with zero threat of patient harm) for subsequent infractions — will improve patient safety.

You all know better.

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California’s $213 billion annual budget is something of a litmus test. Its value hinges greatly on one’s point of view, and depending on how you look at things, you can find plenty to be pleased with and plenty to be upset about.

In the latest iteration of Gov. Newsom’s spending plan, released earlier this month, health care leaders should find much to be happy about. Newsom makes significant new investments in care — hundreds of millions of dollars for priorities shared by hospitals. Among his noteworthy allocations: