State Flex Conference 2011

Ideas to Implementation:The Development of the

California Critical Access Hospital Network

Peggy Broussard WheelerVice President, Rural Health Care and Governance

California Hospital AssociationSacramento, California

California’s Rural Hospitals

Rural Hospital Definition in accordance with: Chapter 67/88 (AB 2148) of the California Health and Safety Code and SB 1458, Section 12480 of the California Health and

Safety Code, 1987

California’s Critical Access HospitalsCritical Access Hospital (CAH) – Hospital that is certified to receive cost-based

reimbursement from Medicare. The reimbursement that CAHs receive is intended to improve their financial performance and thereby reduce hospital closures.

CAHs are certified under a different set of Medicare Conditions of Participation (CoP) that are more flexible than the acute care hospital CoPs.

California Rural Hospitals and Critical Access Hospitals

By the Numbers

352 California Community Hospitals (1)

69 Rural Hospitals (19% of all CA Hospitals) (2)

31 Critical Access Hospitals (Included with Rural Hospitals) (3)

(1) American Hospital Association AHA Hospital Statistics 2010 Edition(2) California OSHPD ALIRTS 2008(3) California State Office of Rural Health 2010

Rural Hospitals and Critical Access Hospitals

Key Issues in 2011 Physician Recruitment and EmploymentAccess to Specialists/ Telemedicine

Seismic Relief The State Budget/ Medi-Cal and Medicare

Funding Health Information Technology

Implementation National Health Reform

Formation of the California Critical Access Hospital Network

The first certified CAH in California was Eastern Plumas District Hospital in Portola, California. Certified in 2000.

The program began to grow in 2001 as 7 more CAHs were certified in 2001.

Today - there are now 31 CAHs in California

Formation of the California Critical Access Hospital Network December 2007, a California Flex Program planning session was held.

We determined: Little networking and sharing of best practices was occurring between CAHs A CAH network and website should be developed Flex Program funds should be directed to support network planning

February 2008 in conjunction with the annual California Hospital Association Rural Health Care Symposium, a meeting of the California CAHs was held as a CAH Colloquium. 5 Objectives were agreed upon:

Increase CAH participation in CHART (California Hospital Assessment and Reporting Taskforce)

Challenge CAHs to identify a viability index Establish a CAH Network Webpage Identify and Improve CAH Financial Indicators Develop a CCAHN model

Formation of the California Critical Access Hospital Network

August 2008 - a group of 5 CAHs, with Mendocino Coast District Hospital as the lead, applied for a Federal HRSA Network Planning Grant worth $85,000.

March 2009 - awarded a HRSA grant.

Formation of the California Critical Access Hospital Network

So How Have We Done?

Formation of the California Critical Access Hospital Network

√ Create CCAHN Webpage

Program participation began in March 2010

21 CAHs enrolled 15 CAHs with data

back to June 2010 Semi-monthly QHi

User Group Meetings Lean initiative

Formation of the California Critical Access Hospital Network

√ Convene Regular Meetings of Network Participants

Formation of the California Critical Access Hospital Network

√ Develop a CCAHN Model√ Conduct a Comprehensive

Strategic Planning Process

Formation of the California Critical Access Hospital Network

So How Do We Pay For It?

Formation of the California Critical Access Hospital Network

Funding Flex Program funding HRSA Network Planning Grant Member Dues Programs and Services Other Grants

Formation of the California Critical Access Hospital Network

Structure and Operations CCAHN Board and Members California Health Foundation and Trust Executive Leadership

CCAHN Advisory Board

Executive DirectorYear 1

Administrative Assistant

Year 2

CA Health Foundation &

Trust/ CA Hospital Assoc.

CCAHN General

Membership (31 CAHs)

Chair

Vice Chair

Secretary/Treasurer

4 other Hospital CEO

Representatives

CCAHN Organizational Chart