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CEO Message

Taking Stock and Looking Forward

In just a few hours, the state Legislature will officially wrap up its 2019 session. This was a particularly challenging year for our work to protect your ability to care for patients, as a new Democratic supermajority opened the door for several brazen policy proposals detrimental to hospitals. And the session saw a record number of bills (more than 3,000) introduced, so the pace was fast and furious. Factor in the uncertainty about how a new governor would respond to this environment, and you’ve got a volatile legislative mix for the past nine months.

Despite these dynamics, significant progress was made on several goals that support your work. This includes:

Expanding Coverage and Access

  • Through the state budget, advanced several board-approved priorities, including Medi-Cal coverage to undocumented adults age 19-25; insurance subsidies for families earning between 400 and 600% of the federal poverty level; and a state-level individual mandate for coverage.
  • Advanced a bill that codifies current training and data reporting practices to support reducing racial disparities in maternal health.
  • Secured passage of a bill that ensures insurance companies reimburse providers for care rendered during and after natural disasters.

Protection From Onerous Regulations

  • Halted momentum on a bill that, in an effort to ban surprise billing, would have set rates for insurance companies to pay hospitals for out-of-network emergency care. The bill will resurface in 2020, and CHA will continue to oppose rate regulation while supporting patient billing protections.
  • Sponsored a bill to offer relief from the state’s outdated 2030 hospital seismic standards. At our request, the bill has been extended into 2020 to help ensure uninterrupted care following a disaster.
  • Defeated a bill to give workers’ compensation benefits to hospital employees with certain illnesses and injuries unless the hospital could provide evidence the employee did not contract the illness or injury at work.
  • On a community benefits reporting bill, secured amendments so the bill no longer includes a percentage of Medicare reimbursement for the definition of charity care, limits reportable community benefits programs, or requires new regulations. 

Investments in Behavioral Health

  • Leveraging the behavioral health awareness work of Behavioral Health Action, a CHA co-led coalition, we helped secure hundreds of millions in investments in mental health and substance use disorder treatment.

A smaller number of bills didn’t go our way, but we’ll regroup heading into 2020 and try to resolve anything that hinders your ability to provide care. Here’s how they ended up:

  • Nurse staffing ratio penalties: Excessive penalties for noncompliance remain, but we secured amendments creating significant flexibility to meet ratios when encountering “unpredictable” and “uncontrollable” circumstances, and removing a prescriptive mandate on how hospitals should attempt to fill vacant spots.
  • Independent contractors: Fought but failed to defeat a bill that would prohibit hospitals from contracting with many health care professionals. This sweeping legislation affects dozens of employment sectors, and we plan join with them to consider future legislative and legal remedies.
  • Supplier diversity reporting: Secured important amendments that delay implementation until July 2021 and permit systems to report at the systemwide level. The bill remains problematic because it ignores the purchasing patterns of multi-state systems and hospitals that work with national group purchasing organizations.

Your phone calls, emails, and face-to-face visits with legislators were integral to our advocacy success this year. Thank you for your partnership and commitment. Gov. Newsom now has until Oct. 13 to sign or veto any bills — we’ll keep you apprised of those outcomes as they unfold.

— Carmela