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CHA has compiled a comprehensive list of FAQs related to general employment, labor relations, and furlough and layoff issues; the American Hospital Association has prepared a summary of federal legislation employers should know about. Other commonly asked questions are below. ​

What are the requirements of AB 2537, the PPE stockpile bill? 

CHA has developed these frequently asked questions to assist hospitals with implementation. (12/29)

Are there any resources to assist hospitals in implementing AB 685, the law that requires employers to provide notice to employees about possible exposure to COVID-19 in the workplace?

CHA has two resources: a toolkit developed that includes a sample employee notice, and an on-demand educational video that provides an overview of the new law. (12/18)

Some hospital employees want to stay at a hotel, concerned about exposing their family members to the virus. Are there any resources for that?

Yes. These resources offer free or discounted rooms for exposed or COVID-19-positive health care workers: (12/11)

The Non-Congregate Sheltering for California Healthcare Workers Program provides hotel rooms to front-line health care workers who are exposed to or test positive for COVID-19 and do not have the ability to self-isolate or quarantine at home. The cost is covered by the federal or state government. 

For an employee to qualify for the program, the employing hospital must have a certification letter on file with the Office of Emergency Services (OES). The certification letter is referenced in the April 20 California Department of Public Health All Facilities Letter. If a hospital has not yet submitted a certification letter, it may do so at any time. Once that letter is on file, the hospital does not need to submit another one. The letter should be sent by email to the California Department of General Services at covid19lodging@dgs.ca.gov, in addition to sending to OES at HealthcareNCS@caloes.ca.gov. 
Effective January 12, 2021, the program is making a major change to the reservation process. To meet the criteria established by the Hotels for Healthcare Workers (HFHCW) program, all certified health care facilities are required to assign a designated point of contact to assist and oversee the reservation process; to serve as the approver for all lodging reservations, and to submit and/or approve all hotel reservation requests. As of January 12, the points of contact are the only individuals who can submit and approve reservation requests. The facility point of contact is expected to respond promptly, preferably within 24 hours, to approve or reject each hotel reservation request if contacted by CalTravelStore or Department of General Services staff. Failure to do so may result in delays and/or a lapse in the reservation.
Health care facilities can identify as many points of contact as they deem necessary. Additional details are here. Please submit the name, job title, email address and telephone number for your facility point(s) of contact to COVID19Lodging@dgs.ca.gov no later than December 31, 2020, using the subject line “FACILITY POC for (enter facility name).” Health systems are encouraged to designate multiple individuals as points of contact.
While employees will still be able to call CalTravelStore to request a hotel reservation, the facility point of contact will be contacted by email and/or telephone to approve or reject each reservation request.
Finally, current hospital contracts expire at the end of 2020. The state is in the process of renewing contracts and has indicated that several hotels are electing not to renew the contract. If a hospital has a relationship with a hotel that is interested in participating in the statewide travel program, the hotel should contact Kelly Bouchard, statewide program manager, at Kelly.Bouchard@dgs.ca.gov or (916) 376-399. The state’s sourcing team will follow up by sending to the hotel a Request for Proposal (RFP). Upon review and acceptance of the hotel’s proposal by the state, the hotel may participate in the program and will be reimbursed by the state according to the terms and conditions of the RFP.

The program is authorized on a monthly basis, and authorization for the following month may not occur until the last day of the preceding month — making it difficult to determine how long the program will continue. If you have any questions about the program, contact Hospital Association of Southern California Regional Vice President Teri Hollingsworth.

2.  The American Hospital Association has provided this list of hotels, airlines, and food service companies that are offering discounts or complementary services for health care workers. Note, however, that not all hotels within a group are participating in the discount program.

Our staff needs help with childcare. What resources are available?

The California Childcare Resource and Referral Center California Child Care Resource & Referral Network has created a list of available resources and contacts. Additionally, all levels of government are working on childcare solutions for health care workers, with several available resources. Read more  (7/15)

On May 6, the Governor issued an Executive Order creating a rebuttable presumption in the workers’ compensation system for COVID-19 claims. That order expired on July 5. What does that mean for my hospital’s workers compensation program?

The Governor’s Executive Order N-62-20 implemented a presumption in the workers’ compensation system that expired on July 5. On September 17, the Governor signed Senate Bill  (SB) 1159, which creates several different presumptions based on job roles or worksites.

The law, which took effect immediately, adopts a COVID-19 specific presumption in the workers’ compensation system for employees that test positive for COVID-19. It is retroactive to July 6, 2020 and expires on January 1, 2023.  

The Division of Workers Compensation has issued FAQs, and CHA believes will be issuing emergency regulations as well. CHA has developed an on-demand educational video that reviews the law.

The law does four things:

Codifies the Governor’s Executive Order that created a presumption in the workers’ compensation system, from March 19 – July 5 for employees who were required to leave their home for work during the stay-at-home order
Creates a presumption in the workers’ compensation system for fire, police, and hospital employees
Creates a presumption in the workers’ compensation system for employees working in other workplaces that experience an “outbreak”
Requires the Commission on Health and Safety and Workers’ Compensation to evaluate the impact of these presumptions on the workers’ compensation system.   (9/22)

I am concerned about the emotional well-being of my staff. Are there resources beyond my Employee Assistance Program benefits?​

The Hospital Quality Institute’s “Care for the Caregiver” webinar is now available as an on-demand recording. The webinar includes practical and necessary tools to assist hospitals and their employees in creating a peer support model for adverse events such as the COVID-19 pandemic. Additionally, the training offers information on how to engage in empathic conversation with both patients and families. More information and the recording are available here.

Various associations representing California’s licensed mental health professionals have joined together to provide support to health professionals, first responders, and essential workers on the front lines fighting the COVID pandemic. On this website, health care workers can locate licensed providers who are offering services for free during the crisis.

In addition, behavioral health professionals in the Bay Area have created a pro bono project for Bay Area front-line health care workers. The COVID-19 Pro Bono Counseling Project is a project devoted to helping health care workers locate free convenient short-term psychotherapy during the COVID19 crisis. For more information, email therapy4frontlinescovid19@gmail.com. A short video on the program is also available. (7/14)

Are there any resources to help hospitals understand the Paycheck Protection Program in the CARES Act?

The American Hospital Association hosted a webinar to explain this new law, which provides forgivable loans when the funds are used for payroll and other allowable costs.

In March, the federal government passed the Families First Coronavirus Response Act, which contains two leave provisions. Does this law apply in California since we have our own leave laws and, if so, what am I required to provide?  

Yes, the act applies to California employers with fewer than 500 employees and all public employers. It went into effect on April 1.  However, the law contains an optional exemption for health care providers. The Department of Labor originally adopted emergency regulations that created a very broad definition of “health care provider” to include anyone who works in a hospital or other facility related to health care. However, on August 3, a federal judge concluded the department exceeded its authority in applying such a broad definition and invalidated that portion of the regulations.  Read more (9/16)

Has there been any change to the California meal and rest period rules?

Not specifically. However, with the waiver of the nurse-to-patient ratios in CDPH AFL 20-26, the ratios, including the “at all times” requirement is no longer in place, so hospitals have a bit more flexibility with regard to meal and rest period coverage. Hospitals with represented employees, however, should review their collective bargaining agreements to determine if they address this issue. (4/9)

Many counties have been issuing shelter-in-place orders over the past few weeks and on March 19, the Governor issued an Executive Order that required most people in California to shelter in place. Does this apply to hospital and other health care workers? Can I require them to come to work?

The Governor’s Executive Order allowed individuals needed to maintain continuity of operations of critical infrastructure to be able to travel to work. Health care is a critical infrastructure, but the Executive Order did not address whether some individuals were deemed essential to support health care while others may be non-essential. The following day, the Governor issued a list of “essential critical infrastructure workers.” In the health care sector, the definition of “essential” workers is broad. We understand that some hospital staff are being stopped by law enforcement on their way to work and that their hospital badge may not be sufficient to demonstrate that they are critical infrastructure staff.  CHA is working with the CalChamber to find a solution that will allow all essential critical infrastructure employees to travel easily to work.  (4/9)  

I understand some cities and counties are developing expanded sick leave ordinances. Do they apply to hospitals and health systems?

There are a number of proposals across the state, and each has its own provisions related to health care workers. Current local ordinances include the cities of Los Angeles, San Jose, San Francisco, Oakland, Long Beach, Sacramento, San Mateo, Santa Rosa, and Emeryville, as well as Los Angeles County. (7/16)

Complying with all aspects of California Labor law is challenging during the best of times. Am I expected to comply right now as my hospital is faced with preparing and responding to the COVID-19 pandemic?

To date, the Governor’s Executive Orders have not relaxed any provisions of California Labor Code or the wage orders. CHA, along with CalChamber, appreciates the operational realities of complying with California’s hundreds of employment laws and are strategizing on ways to limit liability. We will keep hospitals posted about any developments. ​(4/9)

I may have to lay off staff. Does California’s Worker Adjustment and Retraining Notification (WARN) Act still apply?

Only parts of the California WARN Act apply.  On March 17, the Governor issued an Executive Order suspending many aspects of the California WARN Act. The executive order suspends, starting March 4, 2020, Labor Code Sections 1402(a), 1402, and 1403 for an employer that orders a mass layoff, relocation, or termination at a covered establishment. Certain conditions apply: Read more (4/9)

This post has been archived and contains information that may be out of date.CHA’s Coronavirus Response newsletter provides news and updates on state and federal guidance, recommendations, and advocacy on behalf of hospitals and their patients.  News for January 26 CDPH Issues AFLs on COVID-19 Staffing Flexibilities, State Cost-Sharing Program In a positive development for hospitals, […]

Can a hospital provide telehealth services using out-of-state physicians who are not licensed in California?

Yes, during the COVID-19 emergency the state Emergency Medical Services Authority has set up a quick process for hospitals to be able to use health care practitioners licensed in other states. For details, go to https://emsa.ca.gov/covid19/ . (4/10)

Can hospitals bill Medicare for telehealth or other virtual services when provided to patients in their own homes?

CMS’s COVID-19 FAQs on Medicare Fee-for Service Billing provide responses to questions on when hospitals can bill Medicare for services provided to a patient in their home when the patient’s home has been made a provider based department of the hospital. (7/22)

Is there any federal guidance on how we can utilize telehealth services during this emergency?

Yes, the Centers for Medicare & Medicaid Services (CMS) has issued a fact sheet and frequently asked questions that provide guidance on how hospitals can use telehealth services under the Medicare program as a result of recently enacted legislation. In addition, CMS has prepared an FAQ on the use of telehealth by private health insurance plans. (4/10)

Where can I find information about telehealth services covered by health plans and insurers?

Both the Department of Managed Health Care and the Department of Insurance have issued guidance directing health plans and insurers to provide increased access to telehealth services during the COVID-19 emergency. (4/10)

Can hospitals use popular applications such as FaceTime, Skype, or Google Hangouts to provide telehealth services?

Yes, the federal Health and Human Services Office of Civil Rights has issued a notice of enforcement discretion announcing it will not impose penalties for noncompliance with HIPAA rules in connection with the good faith provision of telehealth using such non-public facing audio or video communication products during the COVID-19 nationwide public health emergency. However, public facing platforms such as Facebook Live, Twitch, TikTok, and similar video communication applications should not be used in the provision of telehealth by covered health care providers. (4/10)

Can providers from other states provide telehealth services to patients in California?

The federal government has waived requirements that physicians or other health care professionals hold licenses in the state in which they provide services for Medicare payment purposes — including for telehealth services — however, state law on licensure still applies. California’s Emergency Medical Services Authority has established a quick process for telehealth agencies and other entities, including hospitals, to obtain approval to use out-of-state personnel. (4/10) 

Can Medicare telehealth services only be provided to patients that have been seen within the past three years?

No, the Coronavirus Aid, Relief, and Economic Security (CARES) Act removed the restriction that telehealth services only be provided to established patients who have been seen by the clinician within the past three years. CMS had previously announced it would not enforce this requirement. (4/10)

Can providers in rural health clinics (RHCs) and federally qualified health clinics (FQHCs) provide Medicare telehealth services to patients outside of their clinics during this emergency?

Yes, the CARES Act removed “distant site” restrictions, allowing RHCs and FQHCs to receive Medicare payment for telehealth services delivered by a provider in their clinics to a patient outside of their clinic, including in their home. CMS guidance provides more information on payment and billing for telehealth services provided by RHCs and RQHCs. (4/20)

Can providers use telehealth to meet “face-to-face” encounter requirements?

For Medicare beneficiaries with end-stage renal disease who receive home dialysis, telehealth can be used for the monthly clinical assessment without first receiving the initial face-to-face clinical assessment and ongoing face-to-face assessments that would typically be required. In addition, telehealth visits with a physician or nurse practitioner can be used to satisfy face-to-face encounter requirements to recertify hospice care eligibility. (4/10)

This post has been archived and contains information that may be out of date.

How can a hospital get a waiver of nurse-staffing ratios?

The California Department of Public Health (CDPH) is now offering an expedited option for hospitals to flex the nurse staffing ratios. This process, which took effect immediately with the release of All-Facilities Letter 20-26.4, means hospitals can use certain alternative measures as soon as they submit the waiver request form.