CEO Messages

AI and APOT: Two Complex Issues Worthy of Ongoing Conversation

The 2024 Hospital Quality Institute and Hospital Council Annual Conference in Lake Tahoe has come to a close. On Oct. 20-21, hospital and health care system leaders gathered to learn about a variety of topics — including how open and transparent communication is valued and actively encouraged, and how to effectively engage executives and board members in working toward zero harm. Also discussed were the not-yet-finalized California Hospital Association (CHA) regulatory and legislative agenda, which Hospital Council fully supports, and two significant issues worth emphasizing: artificial intelligence (AI) and ambulance patient offload times (APOTs).

Collaboration Is Key to Building More Capacity for Patients

In August, mold contamination in the air ducts at Sonoma County’s crisis stabilization unit (CSU) forced the CSU’s closure, as mentioned previously, and the necessary repairs could take several months, extending into the new year. This valuable facility’s closure is not only significantly impacting patients who need immediate mental health care, but also placing strain on local emergency departments.  

Workforce Issues Are Impacting Rural Hospitals

Hospitals in California are facing multiple challenges that impact patients’ ability to access quality care. One of the most significant is a shortage of health care workers, with 22% of Californians living in areas without enough primary care providers. Shortages are particularly prevalent in rural areas, where patients struggle to access care because there aren’t enough nurses, physicians, pharmacists, and other health care workers to keep up with demand. 

Protecting Our Rural Hospitals

Hospital Council works to support the advocacy agenda of the California Hospital Association (CHA), and one of the top advocacy priorities for both our organizations is rural health care. About 2 million people live in and visit California’s rural communities, and the lifesaving and life-changing hospital care they rely on is at risk of being lost due to financial instability. California has roughly five dozen rural and critical access hospitals (CAHs), but many of these hospitals are on the financial brink, reducing services just to stay open or facing the possibility of closure.

Putting Our Community First as Fire Season Continues

This fire season — especially last month — has been exceptionally challenging for our hospitals and the communities they support. From July 2023 to July 2024, Cal Fire’s number of reported fires spanning more than 20 acres increased from 38 to 174. In many Hospital Council sections, particularly in rural areas impacted by previous fires, the numbers have been even more dramatic as fires continue to grow. The Park Fire alone has spread to more than 429,000 acres, affecting Butte, Tehama, Shasta, and Plumas counties. Combined with other fires in the Hospital Council region — such as the Borel Fire, the Blue Fire, and the Crozier Fire — the number of acres affected in a short time frame is inconceivable. 

Upcoming Board Meeting to Highlight Key Issues

The California Legislature is back in Sacramento working to wrap up the 2024 session by the end of August. Lawmakers are considering several bills of significance to hospitals, including ones related to 2030 seismic requirements and financial sustainability for rural hospitals. In addition to state legislative items, several local ballot initiatives and issues impact Hospital Council members. These will be discussed at the Hospital Council Board of Directors meeting next week. 

Critical Deadline Approaches on Ambulance Patient Offload Times

On Sept. 1, hospitals must submit an ambulance patient offload time (APOT) reduction protocol under Assembly Bill 40. This bill requires hospitals to include mechanisms that will improve internal operations and reduce APOT. The standard is 30 minutes, 90% of the time for general acute care hospitals with emergency departments.  

Protecting Hospitals During Fire Season

The Fourth of July weekend marks a time of celebration in the lives of Americans and is often spent enjoying time with loved ones. July also brings higher temperatures, which increases the risk of fire. Although the precise causes are yet to be determined, the Hospital Council region experienced multiple fires and public safety power shutoffs (PSPS) during the holiday weekend.  

Regional Behavioral Health Event Emphasizes Collaboration Across Sectors

A behavioral health crisis has long existed in California. Almost one quarter of adults with a mental illness are unable to receive the treatment they need — a number that has not improved since 2011. To discuss this crisis, the Sonoma County Department of Health Services hosted the Regional Behavioral Health Collaborative at the end of May in Santa Rosa. The event drew attendees from various community sectors in and outside of Sonoma County and was held in collaboration with Hospital Council and the Master of Health Care Delivery Science program at Dartmouth College.  

Embracing Individuality and Health Care Access During LGBTQ+ Pride Month

June marks Pride Month, a time to honor the LGBTQ+ community and embrace individuality. Although much work has been done in health care to build more inclusive environments, the LGBTQ+ community experiences worse health outcomes than heterosexual individuals. Stigmatization, hate, violence, and discrimination are still significant barriers to the health and well-being of LGBTQ+ individuals.