CHA WORKFORCE COMMITTEE MEETING

Transcription

1 CHA WORKFORCE COMMITTEE MEETING Thursday, September 18, :00 am 2:30 pm California Hospital Association 1215 K Street, #800 Sacramento, CA 95814

2 CHA WORKFORCE COMMITTEE MEETING Thursday, September 18, :00 a.m. - 2:30 p.m. In Person California Hospital Association 1215 K Street, #800 Sacramento, CA Call-In Information Chorus Call: (800) Pass Code: # AGENDA ITEM TIME SUBJECT REPORTING PAGE I. 10:00-10:10 Welcome and Introductions II. 10:10-10:15 *Minutes From Previous Meeting A. Approval of CHA Workforce Committee Minutes from July 23, 2014 conference call Laura Long 3 Laura Long 9 III. 10:15-11:00 Landscape Update: A. Evolving and emerging issue discussion generated by members B. HSI Study C. Attorney General s Recidivism Reduction Imitative Laura Long Cathy Martin Anette Smith- Dohring 13 1

3 CHA Workforce Committee Meeting Thursday, September 18, 2014 IV. 11:00-11:45 Health Workforce Development: California Health Workforce Development Council Discussion A. The role of the CHA Workforce Committee in informing the Council s work. Laura Long Anette Smith- Dohring 29 V. 11:45-12:00 Integrated Workforce Survey Tool Update A. Review final set of supplemental questions B. Point of contacts for the HASC survey included for your reference per the supplemental hand- out Teri Hollingsworth 31 VI. 12:00-12:30 Lunch All VII. 12:30-1:15 Community Paramedicine Pilot Project A. Overview and current status VIII. 1:15-1:30 James Irvine Foundation Grant A. Update IX. 1:30-2:00 Legislative update A session outcomes B session X. 2:00-2:15 Other business A. Next meeting: December 4, 2014, in Sacramento in the Hospital Council Board Room, 7 th Floor BJ Bartleson 39 Cathy Martin 41 Cathy Martin 47 Laura Long 51 XI. 2:15-2:30 Final Comments All XII. 2:30 Adjourn Laura Long 2

4 September 18, 2014 TO: FROM: SUBJECT: CHA Workforce Committee Cathy Martin, Vice President, Workforce Welcome and Introductions CHA Workforce Committee Roster I. ACTION REQUESTED Review contact information and titles contained in the roster on the following pages. II. SUMMARY AND BACKGROUND Attached please find the most recent CHA Workforce Committee Roster. Please review your contact information for accuracy. Forward all corrections to Michele Coughlin at 3

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6 CHA Workforce Committee ROSTER CHAIR LAURA LONG Director National Workforce Planning and Development/Strategic Workforce Initiatives Kaiser Permanente 1800 Harrison Street, 15 th Floor Oakland, CA Office: VICE CHAIR MICHAEL PETERSON Director Workforce Development & Recruitment Strategies Sharp HealthCare 8695 Spectrum Center Blvd. San Diego, CA Office: IMMEDIATE PAST CHAIR ANETTE SMITH-DOHRING Workforce Development Manager Sutter Health Sacramento Sierra Region 2700 Gateway Oaks Drive, Suite 1100 Sacramento, CA Office: Fax: MEMBERS GLENDA ADACHI Talent Planning & Performance Management Compensation Sutter Health 2700 Gateway Oaks Drive, Suite 2600 Sacramento, CA Office: CORINNE BOULANGER Talent Planning Consultant Sutter Health 2700 Gateway Oaks Drive, Suite 2600 Sacramento, CA Office: JANICE BUEHLER Director Recruitment & Workforce Planning Cedars-Sinai Health System 8700 Beverly Blvd., SSB-110 Los Angeles, CA Office: Fax: MARY CONTRERAS, RN Chief Nursing Officer Community Medical Centers 789 N. Medical Center Drive, East Clovis, CA Office: Fax: SHARI DE ANDA Senior Talent Acquisition Consultant Sutter Health 2700 Gateway Oaks Drive, Suite 2500 Sacramento, CA Office: Fax: RITA ESSAIAN Director, HR/Human Capital Huntington Hospital 100 West California Blvd. Pasadena, CA l Office: Fax: Updated: September 12,

7 CHA Workforce Committee Roster MYRA GREGORIAN Vice President Human Resources Long Beach Memorial Miller Children s Hospital Long Beach 2801 Atlantic Avenue Long Beach, CA Office: Fax: mgregorian@memorialcare.org ROBERT HAMILTON Manager, Workforce Planning and Talent Acquisition Huntington Hospital 100 W. California Boulevard Pasadena, California Office: Fax: Robert.hamilton@huntingtonhospital.com JENNIFER HERMANN Director, Human Resources UCSF Medical Center 3360 Geary Blvd., Suite 301 San Francisco, CA Office: Fax: jennifer.hermann@ucsfmedctr.org TERRY JAQUA, MBA Director, Human Resources Shasta Regional Medical Center 1100 Butte Street Redding, CA Office: Fax: tjaqua@primehealthcare.com SHAWN KANG Director, Human Resources Long Beach Memorial Miller Children s Hospital 2801 Atlantic Avenue Long Beach, CA Office: skang@memorialcare.org HEATHER KENWARD Workforce Development John Muir Health 2540 East Street Concord, CA Office: Fax: heather.kenward@johnmuirhealth.com LISA KLEIN Talent Manager UC San Diego Health System 1450 Frazee Road San Diego, CA, Office: Cell: lcklein@ucsd.edu SARA LAUTENBACH Diversity & Talent Acquisition Director Sutter Health 2700 Gateway Oaks Drive, Suite 2600 Sacramento, CA Office: lautens1@sutterhealth.org STEPHANIE E. LEACH National Nursing Policy Consultant National Patient Care Services Kaiser Permanente 1800 Harrison Street, 17th Floor Oakland, CA Office: Fax: stephanie.e.leach@kp.org Page 2 ANN MILLER Director, Talent Management and Workforce Planning Department of Human Resources City of Hope 1500 East Duarte Road Duarte, CA Office: ext Fax: annmiller@coh.org Updated: September 12,

8 CHA Workforce Committee Roster Page 3 MICHELLE MIRANDA Senior Talent Acquisition Consultant Sutter Health Sacramento Sierra Region 2700 Gateway Oaks Drive, Suite 2500 Sacramento, CA Office: mirandam@sutterhealth.org MONICA MORRIS Workforce Planning Consultant National Workforce Planning & Development Kaiser Permanente 1800 Harrison Street, 15 th Floor Oakland, CA Office: monica.m.morris@kp.org JENNIFER MORROW, M.A., PHR Director Regional Human Resources Vibra Healthcare 7173 N. Sharon Fresno, CA Office: Fax: jmorrow@vibrahealthcare.com SCOTT MUMBERT Manager, Recruitment Cottage Health System P.O. Box 689 Santa Barbara, CA Office: Fax: smumbert@sbch.org ANDREA PERRY (Alternate for Janice Buehler) Workforce Planning Specialist Cedars-Sinai Health System 8700 Beverly Blvd., PACT 700 Los Angeles, CA Office: Fax: andrea.perry@cshs.org JENNIFER RANGEL Executive Recruiter UC Davis 2730 Stockton Blvd. Sacramento, CA Office: Fax: jennifer.rangel@ucdmc.ucdavis.edu BOB REDLO Vice President Doctors Medical Center 2000 Vale Road San Pablo, CA Office: Fax: bredlo@dmc-sp.org PATRICE RYAN Vice President Human Resources Cottage Health System P.O. Box 689 Santa Barbara, CA Office: Fax: pryan@sbch.org GREGORY SMORZEWSKI Human Resources Director Community Hospital of the Monterey Peninsula Holman Highway Monterey, CA Office: Gregory.smorzewski@chomp.org RACHELLE WENGER, MPA Director, Public Policy & Community Advocacy Dignity Health 251 S. Lake Avenue, Suite 800 Pasadena, CA Office: Fax: rachelle.wenger@dignityhealth.org Updated: September 12,

9 CHA Workforce Committee Roster Page 4 DENNIS YEE, CHCR Recruitment Consultant Children's Hospital Central California 9300 Valley Children's Place Madera, CA Office: Fax: dyee@childrenscentralcal.org REGIONAL ASSOCIATION REPRESENTATIVES: DIMITRIOS ALEXIOU VP Inland Office Hospital Association of Southern California 3993 Jurupa Avenue, Suite 105 Riverside, CA Office: Fax: dalexiou@hasc.org TERI HOLLINGSWORTH Vice President Human Resources Hospital Association of Southern California 515 S. Figueroa Street, Suite 1300 Los Angeles, CA Office: thollingsworth@hasc.org CHA STAFF: GAIL BLANCHARD-SAIGER Vice President Labor & Employment California Hospital Association 1215 K Street, Suite 800 Sacramento, CA Office: Fax: gblanchard@calhospital.org MICHELE COUGHLIN Administrative Assistant California Hospital Association 1215 K Street, Suite 800 Sacramento, CA Office: Fax: mcoughlin@calhospital.org CATHY MARTIN Vice President, Workforce California Hospital Association 1215 K Street, Suite 800 Sacramento, CA Office: Fax: camartin@calhospital.org REBECCA ROZEN Regional Vice President Hospital Council, East Bay Section 3840 Buskirk Avenue, Suite 205 Pleasant Hill, CA Office: Fax: rrozen@hospitalcouncil.net JUDITH YATES Senior Vice President/COO Hospital Association of San Diego & Imperial Counties 5575 Ruffin Road, Suite 225 San Diego, CA Office: Fax: jyates@hasdic.org Updated: September 12,

10 September 18, 2014 TO: FROM: SUBJECT: CHA Workforce Committee Cathy Martin, Vice President, Workforce Draft July 23, 2014 Meeting Minutes I. ACTION REQUESTED Review and approve the minutes of the July 23, 2014 conference call of the CHA Workforce Committee. 9

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12 CALIFORNIA HOSPITAL ASSOCIATION WORKFORCE COMMITTEE DRAFT MEETING MINUTES Wednesday, July 23, :00 p.m. 4:30 p.m. Via Conference Call Members Present: CHA Staff: Regional Association Staff: Guests: Corinne Boulanger, Heather Kenward, Sara Lautenbach, Laura Long, Roberto Martinez, Ann Miller, Michelle Miranda, Monica Morris, Jennifer Morrow, Michael Peterson, Anette Smith-Dohring Cathy Martin Teri Hollingsworth, Rebecca Rozen Ben Teichman Future Sense I. Call to Order/Introductions Laura Long called the meeting to order at 3:05 pm. Introductions were made. II. Minutes from the Previous Meeting It was moved, seconded, and the minutes from the May 21, 2014 meeting were unanimously approved. III. Background for this Call Cathy Martin provided a background for the call stating that at the beginning of the year, Laura Long led the committee through a discussion about creating, through this group, a community of practice. Laura, as well as the other members present, recognized that there is tremendous knowledge and expertise around the table and that we should be leveraging those assets to elevate the conversation around workforce planning and development within our respective institutions and also with regard to outside stakeholders and policy makers. This call is the first in our effort to bring back intelligence to this group as we set out to create a community of practice. Laura Long agreed to kick off this endeavor by sharing a preliminary vision of a maturity model that Kaiser is developing. IV. Learning Community Discussion Laura Long provided a background for Kaiser s interest in creating a maturity model, stating that it is important to position your operational strategies with your human capital. The maturity model is a way to map where you are and to identify gaps and design strategies to get to 100% performance. She presented a graphic of a maturity model in development and explained the thinking and goals behind this construct. The goal is to access how each quadrant (Strategic DENOTES ACTION ITEM 11

13 CHA Workforce Committee Meeting DRAFT MINUTES Wednesday, July 23, 2014 Workforce Planning, Alignment with Recruitment and Retention, Career Development, and Training and Education) is performing and to aim for 100% performance. Q/A followed. As a follow up to this discussion, we will further examine this model, along with others being developed by members such as Sutter Health, in an effort to develop some common language and definitions for this work, recognizing that each hospital will approach things in the most appropriate way for their facility. It is possible that if a common vision/model is developed by the committee it could attract resources to actually do the work. V. Integrated Workforce Survey Tool Update Ben Teichman from FutureSense presented a set of previously developed survey questions to the committee for their feedback to inform the fourth quarter 2014 questions. The committee weighed in on the wording and relevancy of the questions. Ben will present the final set to the September 18 th meeting for final approval. It was also mentioned that some of the hospitals are not sure if the right person to answer these questions is receiving the survey. It was suggested that if the committee members know who the recipient of the survey is, they might be able to assist with responses to some of the supplemental questions being asked in the fourth quarter of each year. Members also asked if making the supplemental survey separate from the fourth quarter vacancy and turnover survey might be more effective. Cathy agreed to discuss this suggestion with Teri Hollingsworth in order to better assess the viability of a separate survey. Ben will provide a point of contact reference sheet for members of the committee. VI. James Irvine Foundation Project Cathy Martin updated the committee on the progress of the James Irvine Foundation grant progress stating that the first meeting of this project occurred on July 22 and was very engaging. Hospitals, educators, the state, as well as intermediaries where present to discuss barriers to increasing opportunities for secondary work-based learning in health care. The group of experts contributed greatly to the success of the meeting and the Irvine Foundation is very pleased with the work thus far. VII. CHA s Digital Advocacy Program Committee members who have stories, pictures and/or videos they would like included on Our Health California, should send them to Cathy, who will compile them for submission. Please obtain your organization s approval prior to sending. The digital advocacy campaign focused on workforce has been postponed until the fall, so there is still time to collect content for Tracy Campbell. VIII. Other Business A. Next Meeting The next Workforce Committee meeting will be Thursday, September 18, 2014 from 10:00am-2:30pm at the CHA offices in Sacramento. IX. Adjourn The meeting was adjourned at 4:11 pm. DENOTES ACTION ITEM 12

14 September 18, 2014 TO: FROM: SUBJECT: CHA Workforce Committee Cathy Martin, Vice President, Workforce Landscape Update I. ACTION REQUESTED None required. Discussion item. II. SUMMARY AND BACKGROUND On the following pages, please find a description of a potential project under consideration in which CHA would partner with the California Community Colleges Health Workforce Initiative, UCSF, and the Education Fund of SEIU-UHW Labor Management Trust. This document is in reference to Agenda Item B, under the Landscape Update. Also, on the following pages, please find a summary of Attorney General Kamala Harris Recidivism Reduction Initiative. This item is reference to Agenda Item C, under the Landscape Update. 13

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16 HSI Network LLC Wayzata, MN Voice: Fax: April 24, 2014 Elizabeth Toups Executive Director nd Street, Suite 200 Oakland, CA Dear Elizabeth, Thank you for this opportunity to submit our proposal for Phase II: An expanded analysis of how the Affordable Care Act (ACA) impacts the California labor force. The following letter reflects our sense of what you are trying to achieve, and hopefully conveys a useful outline of how we might proceed in helping you in this endeavor. Let s discuss after your review to determine if we are in the correct scope and process, and we can refine as needed. BACKGROUND AND PROJECT OBJECTIVES The objective of our Phase I work was to assess how the ACA would impact the labor force in California. Given that the first wave of the ACA is focused on coverage reform, it is estimated that up to 2.7 million Californians will gain health insurance. Basic economics suggests that more coverage will lead to increased demand for services and a corresponding need for greater supply of services and the professionals who provide them. The results from our study indicated a need for 48,112 new health care jobs by And, these new positions are not restricted to one health care sector or occupation, but cover the spectrum of positions from entry level to highly trained individuals. Industries most in need of jobs include hospitals, other health care services (e.g., mental health, occupational therapists, and audiologists among others), dentist offices and physician offices. The top five occupations estimated to have most job growth included RNs, Nursing, Psychiatric and Home Health Aides, Dental Assistants, Medical Assistants, and Managers of health care services. We also found that job growth varied by region. The fastest growth rate was estimated in the San Joaquin Valley. The largest numeric growth in jobs was in Los Angeles and Other Southern California regions, with approximately 13,000 to 14,000 new jobs in each region. While Phase I was informative, it was just a starting point to understand the workforce needed in the future. As the next wave of the ACA continues to unfold, there will be a heightened focus on payment changes that encourage efficiency, such as ACOs, value-based purchasing, and readmission penalties. It is anticipated that there will be reduced hospital payments, as well as new payment and delivery models resulting from the Center for Medicare & Medicaid Innovation Center (CMMI). In response to these changes, it is expected that there will be more emphasis on care coordination, cost minimization and quality improvement. The objectives of Phase II are, therefore, to expand the analysis from Phase I to factor in the potential impact of the next wave of the ACA on the California workforce. 15

17 Types of questions to be addressed during Phase II include: Will the newly insured seek health care services in the same way as those previously insured? How will emerging care delivery models change the composition of labor force needed? Based on these emerging models of care, what educational and regulatory reforms will be needed? What new skill sets should the incumbent workforce acquire to compete in this new environment? How will technology change the composition of the workforce needed? What types of regional differences and modalities (e.g. telehealth) can we anticipate and how will these impact the workforce? Where are the most significant gaps between the required skills and competencies and the preparedness of new graduates? In what areas of the state are there dramatic differences in educational capacity & preparedness of new graduates? What are some successful models of addressing gaps between employer skill needs and new graduate competencies? How can we best plan for a future workforce when occupational turnover is high and job descriptions are continuously in flux? PROJECT APPROACH Our proposed process represents a comprehensive, highly participative approach, focused on understanding the potential implications of health care reform on the California workforce. Our work will involve two tightly-linked approaches to learn how health workforce needs will change. We will use qualitative approaches to understand the changes currently underway and anticipated over the next decade, focusing on the perspectives of external experts. We will use quantitative data to model 3 to 6 scenarios on the potential demand for different types of health professionals. The work tasks are summarized into five work steps. Details around each work step follows. Step 1: Confirm scope of work, participants and schedule Upon award of the engagement, we will immediately begin working with you to confirm the scope of work and overall timeline. We will then identify participants to be included in the core team, subgroups, steering committee, and potential interviewees for external expertise. Step 2: Information gathering, subgroup brainstorming session and interviews In step 2 we will gather quantitative data and qualitative information from industry experts to learn how changes in health care financing and delivery are affecting specific organizations and the workforce they need. We will meet with the Steering Committee to outline key areas of change in health care delivery that may impact future need for health workers. Some key scenarios are described below. We will develop a semi-structured interview guide, based on specific scenarios, so that each interview can be focused on specific areas and generate meaningful information. Interviews will solicit information about how organizations are 16

18 responding to changes in their environment, what they anticipate for the next 5-10 years, and specifically how they are addressing the workforce challenges listed above. Step 3: Develop quantitative models of 3 to 6 specific scenarios In Step 3, we will use the qualitative information gathered in Step 2 to develop 3-6 specific scenarios that can be modeled, using the forecasting model developed in Phase I of our work. The interviews will help us identify the changes most likely to occur, and the rapidity with which they will occur. These changes will be translated into 3-6 specific scenarios of change, which will be used to understand how changes in technology and care delivery might impact estimated demand for workers. For example, consider if the interviews suggest that 25% of primary care services will be delivered in medical homes within 10 years. If this were to be the case, the historic staffing patterns of primary care offices would be different for 25% of offices, with fewer physicians, more nurse practitioners and physician assistants, more RNs, and more medical assistants. Such a change could be numerically incorporated into the quantitative model to estimate the total change in demand for each of these types of health professionals. The models to be estimated will be determined in collaboration with the full project team and steering committee, and will be finalized after Step 2 is complete. Step 4: Submit initial findings An initial report will present the key findings from the interviews (Step 2) and the models (Step 3). The report will provide information about the changes leaders are observing and expecting, the scenarios they view as most likely, the training needs they face, and the quantitative estimates from the models. The report will then be shared first with the subgroups to validate the findings and/or modify the scenarios as needed. The report and a draft presentation will then be shared with the Steering Committee for final oversight and adjustments. Step 5: Summarize findings and implications in a final report Based on feedback from the subgroups and steering committee, we will make any adjustments to the scenarios and summarize the findings and implications in a final report and a PowerPoint for broader communication. Pending the level of changes, we may need to reconvene the Steering Committee to confirm the final results. Preliminary Scenario Areas to be confirmed by Steering Committee The scenarios will cover three of the four major areas along the care continuum: Primary Care, Ambulatory Care, and Acute Care. Long-term care, while a major component of our health care system, will be assessed at a later time. PRIMARY CARE AMBULATORY CARE ACUTE CARE LONG-TERM CARE Preventative Clinic Visit Urgent Care Specialist Visit PATIENT CARE CONTINUUM Ancillary (e.g., Imaging,Surgery) Emergency Care Inpatient Stay Rehab SNF End-of-life Care Home Care PHASE II Focus Areas PHASE III 17

19 One cannot address any of these areas independent from the other areas. As our health care system becomes more integrated in how services are provided, these three areas will become even more interconnected and must be analyzed as a group. In addition, five primary factors demographics, technology, models of care, reimbursement and regulator will influence the demand for services and the workforce needed to support that demand. These factors will be considered in each of the scenarios and are depicted in the graphic below. Quantitative FACTORS IMPACTING WORKFORCE Qualitative Demographics Technology Models of Care Reimbursement Regulatory Below are our preliminary thoughts on the types of scenarios to develop. We will work with the steering committee at the start of the engagement to modify and revise before getting started. Primary Care Primary care medical offices, Preventative care, Medical Homes, Community Health Centers The situation Unfavorable reimbursement low reimbursement and high patient numbers drive minute visits, which are often inadequate to deliver effective prevention and counseling services. Traditional insurance has not historically paid for e-visits, , and phone calls; high-level service in these areas is typically limited concierge-type practices. Lack of coordination while large groups are starting to provide more coordinated care, practices with 1-2 providers do not have the resources to deliver care coordination services. Geography and access urban areas with a large primary care base still struggle with workloads; the situation is often worse in rural locations Demographics As population ages, the need for chronic disease management will likely increase. Also a greater need for preventative services and general primary care is anticipated for low income insured individuals, whose numbers will increase with the expansion of Medi-Cal. Technology both large and small provider groups have difficulty financing electronic medical records, let alone e-alerts for medications or other business support systems needed to assess, maintain or improve quality, safety and patient centered care Current workforce shortage the increase in workload combined with lower compensation drives primary care providers to early retirement; shortages of many other health professionals have been reported including skilled medical assistants. 18

20 Impact of ACA Increase in reimbursement Medicare to increase by 10%, Medi-Cal to increase to at least Medicare levels Grants and pilots for new care delivery models (medical homes, community health centers) Scholarships, loan repayments, training programs for physicians, midlevel providers and community providers Preliminary questions to address 1. How rapidly are new care delivery models, such as medical homes, likely to be implemented? 2. What future workforce is needed to support new primary care models? 3. What capabilities do these individuals need to be successful in the future? 4. How will regional variation and demographics change the workforce need? 5. What impact will emergency technology have on the primary care workforce? Ambulatory Care Specialist Physician offices, laboratory and radiology services, ambulatory surgery, physical and occupational therapy, home health, oral health The situation Continued shift of inpatients to outpatient services Current workforce is highly specialized (e.g., dieticians, RNs, technicians) Impact of ACA With the increased focus on value (quality and service at a lower cost), clinical effectiveness, and care coordination, both within an institution and across institutions, there is a greater need for coordination. Ambulatory care will likely provide a major connector between primary care and acute care. The move to greater coordination will have significant technology implications (e.g., greater need to understand the robust analytics from both clinical and claims data, including how to follow track a patient across the continuum). Preliminary questions to address 1. How rapidly will new payment models drive greater ambulatory services, such as home health care? 2. How will the ambulatory care workforce change? If at all? 3. What will be the role of aides, medical assistants and other technicians and assistants such as physical therapy assistants and dental assistants? How might they change to accommodate new payment and delivery models? What regulatory and educational changes need to be made to support this workforce? Acute care Hospitals, ACOs 19

21 The situation The shift from inpatient to outpatient care has left many hospitals with sicker patients, and hospitals often compete for more affluent patients to ensure a positive bottom line. Performance-based payment programs are being expanded, providing explicit financial penalties for low-quality care and financial incentives for high-quality care. There has been an increase in mergers/acquisitions in some cases to develop ACOs and in other cases to achieve economies of scale and align with the provisions of the ACA. Impact of ACA Need to demonstrate reduced readmission rates and hospital acquired conditions or at risk for penalties Need to show that community needs are being met or at risk of losing 501c3 status Need to demonstrate value quality and service at a lower cost to break even or receive financial reward. Questions to address 1. How are the financial structures of ACOs changing approaches to care delivery? 2. How will changes in technology (e.g., information technology, medical technology, business and decision support software, etc.)? 3. How is performance-based payment affecting hospital staffing and care delivery approaches? 4. How rapidly will new care delivery approaches be implemented? PARTICIPANTS Given our experience with similar projects, and in an effort to efficiently and effectively complete these tasks, we recommend constituting the following groups/individuals throughout this process: Steering Committee: The Steering Committee will be responsible for confirming scenarios, validating findings and approving recommendations to be shared with a broader constituency. Based on the proposed approach, this committee will likely meet 2 to 3 times over the course of the engagement although this may change pending the outcomes from each work step. We recommend that this group include representatives from each major funder. Core Team: We also recommend constituting a Core Team consisting of the leading researchers from the HSI team, and a subset of the Steering Committee. This team will bear responsibility for previewing and refining Steering Committee documents and coordinating planning logistics (data collection, schedules, interview participants, etc.). We will also utilize the Core Team to discuss and resolve potential obstacles and keep the overall effort on-track. Subgroups: We anticipate engaging three subgroups. These groups will be topic-specific focusing on the following areas: Skills and Competencies, Models of Care, and Regionalization. These groups will meet two times over the course of the engagement. The first meeting will be a brainstorming session to gather all qualitative insights and issues to consider. The second meeting will be to review implications and recommendations. 20

22 Given that not all participants will be available to meet and the need to take a deeper dive in the topic areas listed above or other topics, we envision up to 10 one-on-one interviews. Upon award of the engagement, we will work with you to identify committee membership and potential interviewees. HSI TEAM HSI is in the unique position of providing a team with knowledge and experience across all major health care sectors insurers, providers, pharma/biotech, and policymakers. Joanne Spetz, Ph.D., Academic Consultant, HSI, will serve as our project leader and will be responsible for the overall quality of our work and final outcomes. Joanne is a Professor at the Philip R. Lee Institute for Health Policy Studies and in the Department of Family and Community Medicine and the School of Nursing at the University of California, San Francisco. She is the Associate Director for Research Strategy at the UCSF Center for the Health Professions and the Director of the UCSF Health Workforce Research Center. Her fields of specialty are labor economics, public finance, and econometrics. Joanne has led research on the health care workforce, organization of the hospital industry, impact of health information technology, effect of medical marijuana policy on youth substance use, and quality of patient care. Joanne's teaching is in the areas of quantitative research methods, health care financial management, and health economics. Susan Chapman, RN, PhD, Academic Consultant, HSI, will serve as our subject matter expert on work force and models of care. She is an Associate Professor and Director of the Health Policy Nursing Specialty in the UCSF Department of Social and Behavioral Sciences, School of Nursing, and Affiliated Faculty at Center for the Health Professions. For the past 12 years, Susan has focused her research on health workforce policy including nursing, allied health, behavioral health, and entry-level occupations. Using mixed methods approaches, she studies supply and demand for health care labor, health care education and career development, workforce diversity, and regulation. Her recent work is focused on new and shifting roles for health care workers in new models of care. Shelley Oberlin, M.S., M.H.A, M.B.A, Senior Manager, HSI, will serve as our project manager, organizing the process and assisting will the development of all work products and deliverables. She will serve as our primary contact throughout this engagement. Shelley has more than 15 years of experience in the provider sector helping clients think strategically about health related topics including health reform, ACO development, payment system changes and the continuum of care. She was recently the lead author of Health Care Payment in Transition: A California Perspective funded by the California HealthCare Foundation. Additional programmers and analysts will be utilized on an as-needed basis. These individuals will have access to Stata, base SAS software; SAS/IML, which is an interactive matrix language for advanced mathematical and statistical applications; SAS/ETS for econometric and time series analysis; and SAS/STAT for in-depth statistical analyses. 21

23 TIMELINE AND BUDGET To complete this scope of work, we propose a 4 to 5 month process starting on June 1 st and ending end of September or end of October pending availability of participants (i.e., we know many people go on vacation during the summer months). The graphic below illustrates our proposed time line by major work step. A more detailed schedule will be developed upon award of the engagement. DRAFT Work Plan Month June July August September October Major Work Steps Step 1: Confirm scope of work, participants, schedule Step 2: Information gathering, subgroup brainstorming session and interviews Step 3: Develop quantitative models of 3 to 6 specific scenarios Step 4: Submit initial findings Step 5: Summarize findings and implications in a final report MEETINGS/INTERVIEWS Core Team (frequent calls) X X X X X Steering Committee (2 to 3 meetings) X X X Subgroup Meetings (2 meetings) X X Interviews X X Our estimated total project budget covering all fees and expenses for Phase II is $100,000. This covers all deliverables and participation for three months of work. We propose this be invoiced in monthly installments of $20,000, with the final invoice sent at the end of the project. Thank you again for this opportunity, and please let us know if we can provide more detail or clarification in any area of our proposal. Best Regards, Joanne Spetz Academic Consultant, HSI Professor at UCSF Shelley Oberlin Senior Manager, HSI 22

24 WHO WE ARE HSI Network, LLC brings together leading academic and health care professionals to provide advisory services to insurers, universities, government agencies, and health care providers. Since its incorporation in 1998, HSI now has offices in Minnesota, Connecticut and Virginia with network affiliates and associate principals throughout the United States. WHAT WE DO HSI assists clients in solving complex problems and transforming data into information of strategic value. WHAT MAKES US DIFFERENT We value our relationships: We only work with organizations where we can add value by generating innovative and timely applied research to answer core business questions. We are seasoned professionals: Most of our associates have 15 to 20+ years of health care experience. We see the big picture: We recognize the value of taking a holistic approach to solving health care issues considering all major stakeholders (e.g., patients, providers, insurers, policymakers, etc.). We were the first non-insurer consulting group to have completed mixed insurer and electronic medical record data analytics. We are reputable: We have one of the highest per capita publication track records in the industry, greater non-aligned access to policy makers than other firm, and are engaged by organizations that are considered industry leaders in their respective fields. REPRESENTATIVE CLIENTS Government/ Foundations Providers Private Insurers Technology/ Pharmaceutical Universities Centers for Medicare and Medicaid California Healthcare Foundation California Endowment Delmarva Foundation UCSF UCLA St. Anthony s Medical Center All Alaska Pediatric Partnership Common Wealth of the Bahamas Blue Cross Blue Shield United Health Care Cigna HealthNet Medtronic Merck Optum Pfizer John s Hopkins Harvard Univ. of Chicago NORC Univ. of PENN 23

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26 Attorney General Kamala D. Harris Launches Initiative to Reduce Recidivism in California Wednesday, November 20, 2013 LOS ANGELES -- Attorney General Kamala D. Harris today launched a new initiative designed to curb recidivism in California through partnerships between the California Department of Justice s new Division of Recidivism Reduction and Re-Entry and the state s counties and District Attorneys. The Division will support counties and District Attorneys by partnering on best practices and policy initiatives, such as the development of a statewide definition of recidivism, identifying grants to fund the creation and expansion of innovative anti-recidivism programs and using technology to facilitate more effective data analysis and recidivism metrics. California s District Attorneys bring vital experience to the challenge of reducing recidivism, and it is important their perspective is incorporated, said Attorney General Harris. This new division will support innovative, evidence-based approaches to recidivism solutions in California. San Diego County has been a statewide leader in working to reduce recidivism through innovative prisoner re-entry programs, said San Diego County District Attorney Bonnie Dumanis. We welcome the Attorney General s leadership and commitment of resources in this area as our County continues to protect public safety while dealing with the ongoing challenges brought on by prisoner realignment. "The Attorney General's initiative will provide local prosecutors with the accurate data we need to determine realignment's real impact on public safety," Los Angeles County District Attorney Jackie Lacey said. "I look forward to working with other prosecutors in developing effective diversion programs for nonviolent offenders and seeking funds to expand alternative sentencing courts." Any successful crime reduction effort must include a strategic and well planned approach to combatting recidivism, said Alameda County District Attorney Nancy E. O Malley. Both low level criminals as well violent offenders will eventually return to our communities when released 25

27 from jail or prison, and I welcome the opportunity to work closely with Attorney General Harris office on putting into place the best possible strategies to reduce crime and recidivism rates. The decision to implement a new strategic plan that would ultimately help reduce crime and recidivism in our state is a powerful step forward, and I commend Attorney General Harris for her leadership in this area, San Bernardino County District Attorney Michael Ramos said. It is a data-driven methodology that will not only better equip local DAs with resources and technical assistance, but one that will make our streets safer. As we continue to address the ever changing needs brought about by prison reform, this initiative is a much-needed, collaborative approach to tackling crime more effectively at the state and local levels. I appreciate the leadership of Attorney General Harris in focusing our collective attention to best practices to reduce recidivism and crime in our communities, Los Angeles County Sheriff Lee Baca said. The Los Angeles County Sheriff s Department has been a national leader in rehabilitating jail inmates while incarcerated, and those efforts will only be enhanced with proven re-entry strategies focusing on helping offenders be successful upon release from jails and prisons. As the California Criminal Justice System continues to recalibrate itself with the implementation of Realignment, the California Police Chiefs Association is encouraged by the Attorney General s announcement that the Department of Justice will partner with counties to identify and implement successful reentry programs, California Police Chiefs Association President Kim Raney said. Ensuring public safety in our communities is the primary mission for Police Chiefs, and we welcome the Attorney General s commitment to work with counties to ensure the safety of cities statewide. The Division of Recidivism Reduction and Re-Entry will consist of three subdivisions focused on program development, evaluation and grants. It will be funded through existing California Department of Justice resources. The Division will use innovative technology, such as the Department s recently created California SmartJustice system, to analyze offender populations and recidivism risk factors. SmartJustice, a new database and analytical tool created by the California Department of Justice, can track repeat offenders and offense trends to provide counties with more effective options in developing anti-recidivism initiatives. 26

28 In 2005, then San Francisco District Attorney Harris created a reentry initiative called Back on Track, which aimed to reduce recidivism among certain low-level, non-violent drug offenders. Over a two-year period, the program reduced recidivism among its graduates to less than 10 percent. Back on Track was designated as a model for law enforcement by the US Department of Justice. # # # 27

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30 September 18, 2014 TO: FROM: SUBJECT: CHA Workforce Committee Cathy Martin, Vice President, Workforce Workforce Development, Health Workforce Development Council I. ACTION REQUESTED None required. Discussion item. II. SUMMARY AND BACKGROUND Laura Long and Anette Smith-Dohring will be leading a discussion relative to the California Health Workforce Development Council, a special committee to the California Workforce Investment Board. Members will develop strategies for informing the work of the Council. 29

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32 September 18, 2014 TO: FROM: SUBJECT: CHA Workforce Committee Cathy Martin, Vice President, Workforce Integrated Data Collection Tool Update I. ACTION REQUESTED Approve the final version of the fourth quarter supplemental questions to be used in the Quarterly Vacancy and Turnover Survey. II. SUMMARY AND BACKGROUND Teri Hollingsworth of the Hospital Association of Southern California will be will be updating the committee on the integrated survey tool and progress to date in Point of contact information is also provided so that members know who within their organization will be receiving the survey. 31

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34 Workforce Impact Questions A.) For each position, indicate the negative impact on patient care (i.e. services rendered by members of the healthcare community for the benefit of the patient) when a vacancy exists. Indicate the impact for each position on a scale from 1 - No Impact to 7 - Extremely Negative Impact for each position. Nursing Registered Nurse - Staff (Not New Graduated) Direct Care Registered Nurse - Other RN - New Graduate (less than 6 months experience) Certified Registered Nurse Anesthetists (CRNAs) Certified Nursing Assistant Clinical Nurse Specialists (CNSs) Home Health Aide Licensed Vocational Nurse Nurse Midwives (CNMs) Nurse Practioners (NPs) Physician Assistant Unlicensed Nursing Aide/Assistant Allied Health Coder Clinical Laboratory Scientist CT Technologist CVIR Technologist Medical Assistant Medical Laboratory Technician MRI Technologist Occupational Therapy Assistant Pharmacist Physical Therapist Radiological Technologist Respiratory Therapist Social Worker (LCSW) Ultrasound Technologist Impact Score B.) For each position, indicate the impact on hospital efficiencies (i.e. increased labor costs due to staff overtime, scheduling/staffing efficiencies, supply/equipment efficiencies) when a vacancy exists. Indicate the impact for each position on a scale from 1 - No Impact to 7 - Extremely Impact for each position. Nursing Registered Nurse - Staff (Not New Graduated) Direct Care Registered Nurse - Other RN - New Graduate (less than 6 months experience) Certified Registered Nurse Anesthetists (CRNAs) Certified Nursing Assistant Clinical Nurse Specialists (CNSs) Home Health Aide Licensed Vocational Nurse Nurse Midwives (CNMs) Nurse Practioners (NPs) Physician Assistant Unlicensed Nursing Aide/Assistant Allied Health Coder Clinical Laboratory Scientist CT Technologist CVIR Technologist Medical Assistant Medical Laboratory Technician MRI Technologist Occupational Therapy Assistant Pharmacist Physical Therapist Radiological Technologist Respiratory Therapist Social Worker (LCSW) Ultrasound Technologist Impact Score C.) How much has your hospital spent in the last 12 months on workforce development initiatives (I.e. Pipeline development work based learning for high school students; staff time to supervise interns, clinical training (pre-or post-licensure) or other activities like sponsoring a HOSA program) Initiative 1 Initiative 2 Initiative 3 Name of Initiative Description of Initiative Amount $ In kind estimated $ value 33

35 D.) In the past 12 months, have you limited services due to vacancies in these professions? If yes, please explain. Examples include sending out lab test due to lab personnel capacities, limiting special imaging services or surgeries, etc. (Please mark a "X" for Yes or NO for each position) Yes No Explanation Nursing Registered Nurse - Staff (Not New Graduated) Direct Care Registered Nurse - Other RN - New Graduate (less than 6 months experience) Certified Registered Nurse Anesthetists (CRNAs) Certified Nursing Assistant Clinical Nurse Specialists (CNSs) Home Health Aide Licensed Vocational Nurse Nurse Midwives (CNMs) Nurse Practioners (NPs) Physician Assistant Unlicensed Nursing Aide/Assistant Allied Health Coder Clinical Laboratory Scientist CT Technologist CVIR Technologist Medical Assistant Medical Laboratory Technician MRI Technologist Occupational Therapy Assistant Pharmacist Physical Therapist Radiological Technologist Respiratory Therapist Social Worker (LCSW) Ultrasound Technologist E.) For each of the following, please indicate how concerned you are regarding its impact on your hospital's workforce supply. Indicate the impact for each position on a scale from 1 - No Concern to 7 - Extremely Concerned for each scenario. Impact Score a. Aging healthcare workforce within hospital b. Population growth in region c. Population aging in region d. Cultural diversity and linguistic capabilities e. Impact of health reform f. Impact of CA state budget cuts on healthcare professional educatio g. Leave of absences h. Disability accommodations and/or physical limitations due to aging workforce F.) Please indicate the number of employees in the following occupations who fall within the stated age brackets Over 65 Nursing Registered Nurse - Staff (Not New Graduated) Direct Care Registered Nurse - Other RN - New Graduate (less than 6 months experience) Certified Nursing Assistant Home Health Aide Licensed Vocational Nurse Unlicensed Nursing Aide/Assistant Allied Health Coder Clinical Laboratory Scientist CT Technologist CVIR Technologist Medical Assistant Medical Laboratory Technician MRI Technologist Occupational Therapy Assistant Pharmacist 34

36 Physical Therapist Physician Assistant Radiological Technologist Respiratory Therapist Social Worker (LCSW) Ultrasound Technologist G.) How difficult is it to find qualified applicants for the following occupations? (Please mark a "X" for each position) Certified Nursing Assistant Clinical Laboratory Scientist Coder Licensed Vocational Nurse Medical Assistant Medical Laboratory Technician Radiological Technologist Ultrasound Technologist Not Difficult Moderately Difficult Extremely Difficult Don't Know/Not Applicable H.) Does your organization provide professional development (such as in-house or sponsored training) to employees for the following occupations? (Please mark a "X" for Yes or No or Don't Know/Not Applicable for each position and if Yes, please provide the topics of training) Yes No Don't Know/Not Applicable If Yes, topics of training provided include: Certified Nursing Assistant Clinical Laboratory Scientist Coder Licensed Vocational Nurse Medical Assistant Medical Laboratory Technician Radiological Technologist Ultrasound Technologist 35

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38 Organization Phone Number Alt Contact Alt Alt Phone Kaiser Permanente Monica Morris Marjorie Kleerup Sharp Healthcare Susan Johnson Sutter Health Ashley Hammam Miller Children's Hospital Long Beach Megan Hoang Huntington Hospital Yolanda Munoz (626) UCSF Medical Center Jeffrey Chiu (415) Shasta Regional Medical Center Diana Cancel Long Beach Memorial Megan Hoang City of Hope John Freudenberg N/A Vibra Healthcare N/A N/A N/A Cottage Health System Deb Patelzick Dignity Health Daniel Paleg Children's Hospital Central California Jose Canas Cedars-Sinai Health System Jennifer Freeman Kevin Mounce Community Medical Centers Nicholas Aquino (559) John Muir Health Robin Van der Bij (925) UC San Diego Health System Ross Dammann Banner Lassen Medical Center Roberto Martinez UC Davis Doctors Medical Center Marielle Calara Community Hospital of the Monterey Peninsula Rachel Stuhler