As we step into 2021, we hold hope for the return to a new “normal,” but we know difficult times are not yet behind us. Since the beginning, California’s public health care systems have been on the front lines of the COVID-19 response, caring for those most vulnerable, increasing access to testing, rapidly redesigning care to meet surges, and partnering with community organizations to provide food assistance, among other activities. And now, public health care systems are taking on vaccine distribution. As systems continue to battle the pandemic, we offer a special thank you below to the many courageous health care workers for their commitment to protect and serve their patients every day.
This past year, telehealth emerged as an essential way to ensure ongoing care for patients. The more widespread use of phone and video visits has broken down longstanding barriers, facilitating greater and more equitable access to care. In this version of the SNIForward, we highlight how telehealth significantly impacted the lives of two patients cared for by public health care systems.
Lastly, we are thrilled to recognize the 2020 Quality Leaders Awards (QLA) winners. The QLAs showcase innovative approaches to advance care and population health. This year, we added a new category to recognize those systems that made outstanding contributions to their community’s COVID-19 response. Please check out the QLA winners below to learn more about their inspiring success stories.
SNI has been honored to support members’ tireless COVID-19 efforts and will continue to do so in the year ahead. SNI will establish and strengthen support for members in several areas, including advancing virtual care and anti-racism initiatives, and supporting implementation of a new design of the Quality Incentive Program (QIP). Also, with the one-year extension of the 1115 waiver, SNI’s support for Whole Person Care and the Global Payment Program will continue.
Giovanna Giuliani
Executive Director
California Health Care Safety Net Institute
Celebrating Health Care Heroes
The health care workers on the front lines of the pandemic have truly shown us what it means to serve with compassion. Every day, across California’s public health care systems, thousands of providers are caring for those most at risk for COVID, including essential workers and individuals who are low-income and/or homeless. To honor the strength, determination, and courage of these health care heroes, we compiled a slideshow to recognize their contributions to the fight against COVID and commitment to care for those in their community.
Patient Stories of Telehealth Improving Access
Last week, CAPH/SNI released its first blog in a new series funded by the California Health Care Foundation titled, “Can the nutritionist call me during my lunch break?” and other patient stories of telehealth improving access. This blog highlights the critical role of telehealth, especially for those who need these services the most.
For example, an undocumented single mother describes how video visits with Dr. Daniele Levy, supervising psychologist for behavioral health integration at San Mateo Medical Center (SMMC), turned her life around when she was struggling with depression and stress.
Dr. Rakhi Singh, a family medicine practitioner at SMMC’s Fair Oaks Health Center Adult Clinic, further describes how telehealth, particularly phone visits, has been critical for her low-income patients who often face obstacles when seeking care, such as child care, travel, and time off from work.
Lastly, Dr. Stanley Patterson, a family medicine practitioner at Ventura County Health Care Agency’s Magnolia Family Medical Clinic, shares a story about an 85-year-old diabetic patient who averted a below-the-knee amputation due to a video visit. These patient stories underscore the importance of telehealth as a doorway to more accessible and equitable care, both during the pandemic and beyond.
Listen to physicians describe why telehealth is so important for their patients
2020 Quality Leaders Awards (QLAs)
In December, we were pleased to continue the tradition of the QLAs at the virtual CAPH/SNI Annual Conference, thanks to funding from Kaiser Permanente. The QLAs highlight innovative approaches to improve care and advance population health in California’s public health care systems. This year, in addition to the four standard QLA award categories, we added a new category called, COVID-19 Response. This category recognizes those systems that made outstanding contributions to the community with their COVID response. Learn more about our 2020 winners below.
Top Honor – Laguna Honda Hospital and Rehabilitation Center
Caring for seniors and adults with disabilities, Laguna Honda Hospital and Rehabilitation Center in San Francisco is the largest publicly run skilled nursing facility in the country. Through a COVID-19 response and outbreak management plan driven by early, decisive action, and scientific expertise, Laguna Honda effectively managed and slowed the spread of COVID-19 on campus.
Performance Excellence – LAC+USC Medical Center COVID-19 has resulted in the delay of crucial immunizations for children, as well as a doubling of the prevalence of food insecurity. To address these gaps, the Pediatric Primary Care Clinic at LAC+USC Medical Center partnered with the Los Angeles Regional Food Bank to implement a drive-up model of care, where children received routine vaccinations and their families received a trunkful of fresh and non-perishable food.
Data-Driven Organization – Contra Costa Health Services
When COVID-19 struck, leaders at Contra Costa Health Services (CCHS) knew that their most high-risk patients would need extra support to safely shelter-in-place. To identify those individuals, CCHS leveraged their data warehouse to design a COVID Vulnerability Index that predicts patients’ likelihood of hospitalization from COVID-19. This model has allowed CCHS to target their interventions to those most in need.
Ambulatory Care Redesign – San Mateo Medical Center When COVID-19 hit, San Mateo Medical Center (SMMC) had days to implement telehealth across their organization. They quickly assembled an interdisciplinary team to adapt their in-person visit workflows to a new telehealth model and developed standard work processes. The thoughtful formation of this team-based approach allowed SMMC to continue to deliver high quality care during the pandemic.
Special Recognition, COVID-19 Response – Arrowhead Regional Medical Center As COVID-19 emerged, Arrowhead Regional Medical Center proactively formed a multidisciplinary and multi-stakeholder Skilled Nursing Facility Outreach and Support (SO+S) Team to provide targeted interventions to sites experiencing outbreaks. By providing in-the-field assessments and expertise around infection control protocols, staffing, and supply chain issues, the SO+S Team controlled outbreaks at 48 facilities.
Special Recognition, COVID-19 Response – Natividad Medical Center At the beginning of the pandemic, there was an abundance of urgent information about the outbreak that was inaccessible to non-English speakers. Natividad quickly realized the need to address this gap and responded with a large-scale communications campaign to share science-based information about COVID-19 in multiple indigenous languages.
Special Recognition, COVID-19 Response – Santa Clara Valley Medical Center In February, the County of Santa Clara emerged as an epicenter of COVID-19, with up to 25% of the nation’s cases. Santa Clara Valley Medical Center conducted early rapid surveillance research to guide public health decisions and established novel methodologies to increase testing capacity. These efforts resulted in a 15-fold increase in testing capacity and bolstered Santa Clara’s ability to provide wraparound medical and social services to those most in need.
Learn More
You can follow CAPH/SNI program and advocacy news on Twitter @CAPHSystems
CAPH/SNI members can access program materials through SNI Link– our members’ only program portal
QIP PY4Reporting Manual User Agreement AMAPQA CMS v20210125
End User Agreement
LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION (“CPT®”)
CPT only copyright 2019 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.
You, your employees and agents are authorized to use CPT only as contained in QIP PY4 Reporting Manual solely for your own personal use and only for participating in state governmental healthcare related programs supported by and/or administered by SNI. You acknowledge that the American Medical Association (“AMA”) holds all copyright, trademark and other rights in CPT.
Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this Agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the American Medical Association, Intellectual Property Services, AMA Plaza, 330 North Wabash Avenue, Suite 39300, Chicago, Illinois 60611-5885. Applications are available at the American Medical Association Web site (http://info.commerce.ama-assn.org/ama-data-file-request-0).
LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION (“CPT®”)
CPT only copyright 2019 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.
You, your employees and agents are authorized to use CPT only as contained in QIP PY4 Reporting Manual solely for your own personal use and only for participating in state governmental healthcare related programs supported by and/or administered by SNI. You acknowledge that the American Medical Association (“AMA”) holds all copyright, trademark and other rights in CPT.
Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this Agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the American Medical Association, Intellectual Property Services, AMA Plaza, 330 North Wabash Avenue, Suite 39300, Chicago, Illinois 60611-5885. Applications are available at the American Medical Association Web site (http://info.commerce.ama-assn.org/ama-data-file-request-0).
U.S. Government Rights
This product includes CPT which is commercial technical data, which was developed exclusively at private expense by the American Medical Association (AMA), 330 North Wabash Avenue, Chicago, Illinois 60611. The AMA does not agree to license CPT to the Federal Government based on the license in FAR 52.227-14 (Data Rights - General) and DFARS 252.227-7015 (Technical Data - Commercial Items) or any other license provision. The AMA reserves all rights to approve any license with any Federal agency.
Disclaimer of Warranties and Liabilities.
CPT is provided “as is” without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this product is with SNI, and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product.
This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.
Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled “I agree”.
Pharmacy Quality Alliance Copyright Statement
By agreeing to this policy, user accepts the following limitations of the QIP use of the Pharmacy Quality Alliance (PQA) Opioid measures and code sets: To accurately calculate the measure rates, the PQA NDC files are required. User acknowledges that the PQA measures and NDC files will only be used for the sole purpose of evaluating and improving opioid use for populations being served by Public Health Care Systems (PHS) and by District and Municipal Hospitals (DMPH) and will not be used for other purposes within user. Except for the purpose indicated above, the measures and NDC file will not be used in any other commercial product, service or value-added benefit. User also acknowledges that the information and lists will not be forwarded or provided to anyone outside of SNI, the California Department of Health Care Services DHCS, the PHS or the DMPH.
CMS MEDICAID ADULT AND CHILD CORE SET
License Agreements
Please review the licensing information below and indicate your agreement and acceptance.
LICENSE FOR USE OF PHYSICIANS' CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION (CPT)
End User Point and Click Agreement:
CPT codes, descriptions and other data only are copyright 2019 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).
You, your employees and agents are authorized to use CPT only as contained in the following authorized materials of Centers for Medicare and Medicaid Services (CMS) internally within your organization within the United States for the sole use by yourself, employees and agents. Use is limited to use in Medicare, Medicaid or other programs administered by CMS. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.
Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60654. Applications are available at the AMA Web site, http://www.ama-assn.org/go/cpt.
Applicable FARS\DFARS Restrictions Apply to Government Use. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60654. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
AMA Disclaimer of Warranties and Liabilities.
CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this agreement.
CMS Disclaimer
The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT should be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.
Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled "Accept".
LICENSE FOR USE OF CURRENT DENTAL TERMINOLOGY (CDT™)
THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. BY CLICKING BELOW ON THE BUTTON LABELED “ACCEPT”, YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT.
IF YOU DO NOT AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK BELOW ON THE BUTTON LABELED “DO NOT ACCEPT” AND EXIT FROM THIS COMPUTER SCREEN.
IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THIS AGREEMENT CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. AS USED HEREIN, “YOU” AND “YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING.
1. Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.
2. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the American Dental Association web site, http://www.ADA.org/ .
3. Applicable Federal Acquisition Regulation Clauses (FARS)\Department of restrictions apply to Government Use. Please click here to see all U.S. Government Rights Provisions.
4. ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. CDT IS PROVIDED “AS IS” WITHOUT WARRANTY OF ANY KIND, EITHER EXPRESSED OR IMPLIED, INCLUDING BUT NOT LIMITED TO, THE IMPLIED WARRANTIES O F MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. NO FEE SCHEDULES, BASIC UNIT, RELATIVE VALUES OR RELATED LISTINGS ARE INCLUDED IN CDT. THE ADA DOES NOT DIRECTLY OR INDIRECTLY PRACTICE MEDICINE OR DISPENSE DENTAL SERVICES. THE SOLE RESPONSIBILITY FOR THE SOFTWARE, INCLUDING ANY CDT AND OTHER CONTENT CONTAINED THEREIN, IS WITH (INSERT NAME OF APPLICABLE ENTITY) OR THE CMS; AND NO ENDORSEMENT BY THE ADA IS INTENDED OR IMPLIED. THE ADA EXPRESSLY DISCLAIMS RESPONSIBILITY FOR ANY CONSEQUENCES OR LIABILITY ATTRIBUTABLE TO OR RELATED TO ANY USE, NON-USE, OR INTERPRETATION OF INFORMATION CONTAINED OR NOT CONTAINED IN THIS FILE/PRODUCT. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. The ADA is a third party beneficiary to this Agreement.
5. CMS DISCLAIMER. The scope of this license is determined by the ADA, the copyright holder. Any questions pertaining to the license or use of the CDT should be addressed to the ADA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. IN NO EVENT SHALL CMS BE LIABLE FOR DIRECT, INDIRECT, SPECIAL, INCIDENTAL, OR CONSEQUENTIAL DAMAGES ARISING OUT OF THE USE OF SUCH INFORMATION OR MATERIAL.
LICENSE FOR NATIONAL UNIFORM BILLING COMMITTEE (NUBC)
These materials contain NUBC Official UB-04 Specifications (UB-04 Data), which is copyrighted by the American Hospital Association (AHA).
THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. BY CLICKING BELOW ON THE BUTTON LABELED "ACCEPT", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT.
IF YOU DO NOT AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK BELOW ON THE BUTTON LABELED "DO NOT ACCEPT" AND EXIT FROM THIS COMPUTER SCREEN.
IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THIS AGREEMENT CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING.
Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use UB-04 Data only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of UB-04 Data is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this Agreement. You acknowledge that the AHA holds all copyright, trademark and other rights in UB-04 Data. You shall not remove, alter, or obscure any AHA copyright notices or other proprietary rights notices included in the materials.
Any use not authorized herein is prohibited, including, by way of illustration and not by way of limitation, making copies of UB-04 Data for resale and/or license, transferring copies of UB-04 Data to any party not bound by this agreement, creating any modified or derivative work of UB-04 Data, or making any commercial use of UB-04 Data. License to use UB-04 Data for any use not authorized herein must be obtained through the American Hospital Association, 155 N. Wacker Drive, Suite 400, Chicago, Illinois, 60606. Applications are available at the NUBC website, http://www.nubc.org/.
The UB-04 Data included in this product is commercial technical data and/or computer databases and/or commercial computer software and/or commercial computer software documentation, as applicable, which was developed exclusively at private expense by the American Hospital Association, 155 N. Wacker Drive, Suite 400, Chicago, Illinois 60606. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (December 2007) and FAR 52.227-19 (December 2007), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
AHA DISCLAIMER OF WARRANTIES AND LIABILITIES. UB-04 Data is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. The sole responsibility for the software, including any UB-04 Data and other content contained therein, is with the Medicare/Medicaid Contractor or the CMS; and no endorsement by the AHA is intended or implied. The AHA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. The AHA is a third-party beneficiary to this Agreement.
CMS DISCLAIMER. The scope of this license is determined by the AHA, the copyright holder. Any questions pertaining to the license or use of the UB-04 Data should be addressed to the AHA. End users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE UB-04 DATA. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.
