Posts Tagged ‘Licensing’

Wildfire Season Kicks Off

May 23rd, 2014

fireThe first big fire of the season started this week in Oak Creek Canyon- called the Slide fire.  Smoke is usually the first public health impact from wildland fires.  The air quality in Flagstaff and Sedona has been generally OK- but poor at times depending on the winds (smoke levels in Sedona have been high during the early morning hours the last couple of nights).  Here’s a link to the data for the ADEQ’s portable air quality monitors in the area.  The website includes hourly air quality data for East and West Flagstaff, Fort Tuthill, Camp Verde, Prescott, Sedona, Show Low, Springerville, and Payson.

We play a significant role in response where there are wildfires in Arizona.  Our licensing folks monitor the need for evacuation of hospitals, assisted living and behavioral health facilities.  Our environmental health folks work with the local health departments and the ADEQ to make decisions about health advisories related to smoke.  Our emergency preparedness staff supports local public health for any support we can give to protect the health of people who need to be evacuated and in surrounding areas.  You can read more in our Wildfire Smoke and Your Health brochure and in our ADHS Wildfire Plan.

 

Healthcare Associated Infections Progress Report

April 8th, 2014

haiprogressreportHealthcare-Associated infections are a major (often preventable) threat to patient safety. Last week the National and State Healthcare Associated Infections Progress Report expanded on previous reports- detailing progress toward the eliminating healthcare-associated infections.  The HAI Progress Report found significant reductions for nearly all infections- including in AZ. Central line-associated bloodstream infections and surgical site infections continued to approach the 5-year goals set in the National Action Plan to Prevent Health Care-Associated Infections.

Arizona’s public health system takes a layered approach to preventing HAI’s in our state.  It starts with our Licensing team- who regulates the healthcare institutions where the care happens.  Our Medical Facilities Licensing team and our HAI Program collaborate to ensure the safety of patients in Arizona by jointly providing technical assistance and guidance to licensed healthcare facilities in response to identified infection control breaches.  The next layer is our network of public health disease detectives.  Our Healthcare-Associated Infections Program and the counties conduct epidemiologic investigations when we get reports of unsafe injection practices affecting multiple patients.

Our HAI Program and Advisory Committee also generate guidance documents for healthcare facilities and provide best practices for infection control and injection safety like materials produced through the CDC’s One and Only Campaign and Arizona’s Stakeholder-driven No Place Like Home initiative- which partners with the national Partnership for Patients: Better Care, Lower Costs project.

Regulatory Reform Revolution Continues

November 7th, 2013

One of the things I’m most proud of over the last 5 years has been the way we successfully overhauled our regulation licensed healthcare institutions in AZ.  Very few government entities could have accomplished such an all-encompassing regulatory reform effort that creates a new outcome-based system that will improve public health- while maintaining support from the vast majority of our Stakeholders.

Now we’re in the implementation phase. Our Licensing team has been attending association meetings and conducting and provider trainings for each of the new rule sets.  Licensing has also partnered with our Web and New Media team to make the most of our limited resources.  For example, our trainings have been “live-streamed” during the training so providers didn’t have to come all the way down to our building.  They’re also recorded so they can be viewed whenever the providers have time.   You can see some of the trainings our staff provided by visiting our implementation page and selecting provider trainings. There are still many more to come!

Our team is also improving some of the rule packages. For example, we’re still hard at work on improving rules for Adult Therapeutic and Behavioral Health Respite Homes. Since October 1st, we’ve continued to meet with stakeholders and the most recent drafts of these articles should be posted this week. Providers can give feedback and comments about the rules through our online survey. We’ll also have the surveyors working with providers and giving us their own feedback on issues they find in the field or rules that could be improved.

No Place Like Home

October 18th, 2013

Over the last 18 months, our licensing team in collaboration with trade organizations from every sphere of healthcare delivery, partnered with Health Services Advisory Group (HSAG), Arizona’s Medicare Quality Improvement Organization, in its statewide initiative designed to reduce by 4000 the number of preventable hospital readmissions. Aptly named the No Place Like Home Campaign, because there really is no place like home when it comes to patient healing, the campaign not only met their 18 month goal, but exceeded it by a large margin. Under the skilled leadership of Barbara Averyt, BSHA, Catherine Price, MSEd and the Care Transitions team of HSAG, the coalition partners were able to prevent 5,872 Medicare readmissions, an improvement of almost 20% from the 2010 baseline data. These results propelled Arizona to the #1 position in the nation for highest relative improvement rate in reducing Medicare hospital readmissions and became a model for many other states to replicate in their own campaigns to reduce readmissions. These stellar results are a tribute to the close collaboration and responsive partnerships between ADHS, HSAG and the multiple stakeholder organizations in the campaign. For information on the NPLH campaign, please visit their website at www.noplacelikehomeaz.com.

Licensing Collaborative Established as an Evidence-Based Best Practice

August 26th, 2013

Our Licensing team routinely analyzes the most frequent and important deficiencies that we observe when we conduct inspections at our licensed facilities.  We use the data to help educate the folks that we license… and to identify topics for provider training and technical assistance (public health interventions). For example, our medical facilities licensing team has found that infection control had become increasingly troublesome among some dialysis providers.  

That info led our medical facilities licensing team to join with our Office of Infectious Disease Services and our Healthcare Associated Infections Advisory Committee to conduct a day-long collaboration for our licensed dialysis providers and public health professionals. We conducted the collaborative a few months ago- providing tools for dialysis providers to improve their infection control performance by building relationships with public health, renal associations, federal partners and other stakeholders.  The event was very well attended; participants spent the day sharing best practices, identifying new ways to promote infection control, and developing a strategic plan for future activities. Best of all- we’ve seen a decrease in deficient practices since the event.  

Our ADVICE Collaborative has been identified by the federal government as a Best Practice Pilot and will be featured at the upcoming Roadmap to Eliminate HAI: 2013 Action Plan Conference. Kathy McCanna, our branch chief of Healthcare Institution Licensing will be presenting at the conference about our collaborative.  You’ll find more about the collaborative by visiting our website. This is just one of our many examples of how we’re leveraging licensing to improve public health outcomes.

Regulatory Reform Finish Line

June 28th, 2013

We owe a big round of applause to our Licensing & Rulemaking teams- who’ve spent the better part of 2 years working with hundreds of folks from numerous associations and licensed facilities as part of our regulatory reform initiative. 

This afternoon we filed an overhaul of 20 Articles of regulations for healthcare institutions and behavioral health service agencies including hospitals, skilled nursing facilities, outpatient surgery and treatment centers, recovery care, adult therapeutic foster homes, assisted living, home health agencies, hospice facilities, DUI services; residential treatment centers and midwives.  A big thanks to the entire Licensing, Rulemaking, and Behavioral Health teams for making this effort a success.  These new rules will be driving Arizona toward better public health outcomes for years to come. 

All the rules have an October 1 implementation date, although most of the midwifery regulations kick in right away.  The delayed implementation date gives: 1) our licensees a chance to learn the new rules before they’re expected to comply with them; 2) our surveyors time to learn the new rules so we can survey to them properly; and 3) AHCCCS the time they need to figure out some reimbursement issues.  

The next step is to prepare for implementation of the new rules.  Check out our implementation website for the nuts and bolts of the upcoming implementation activities.  The state budget gave us extended “exempt” rulemaking authority through April of 2014…  meaning that we’ll be able to make additional revisions as we implement the new regulations and find areas that can use tweaking.

 

Regulatory Reform in the Home-Stretch

June 21st, 2013

Our Licensing & Rulemaking teams have spent the better part of 18 months working with hundreds of folks from numerous associations and licensed facilities as part of our regulatory reform initiative.  We’ve been overhauling 18 Articles of regulations for Healthcare Institutions and Behavioral Health Service Agencies including hospitals, skilled nursing facilities, outpatient surgery and treatment centers, recovery care, adult therapeutic foster homes, assisted living, home health agencies, hospice facilities, DUI services; residential treatment centers and midwives.  It’s been a long road- and we’re in the final-stretch now. 

Our teams are busy going through some final revisions to the 600 pages of new Rules, which we’ll be filing next week.  We’ll have an October 1 implementation date on each of the packages.  That’ll give our licensees a chance to learn the new rules before they’re expected to comply with them; it’ll give our surveyors time to learn the new rules so we can survey to them properly; and it’ll give AHCCCS the time that they need to figure out some reimbursement issues. 

As an added bonus- the state budget that was signed by the Governor on Monday gives us extended “exempt” rulemaking authority through April of 2014…  meaning that we’ll be able to make additional revisions as we implement the new regulations and find areas that can use tweaking.

Rulemaking Stuff

May 10th, 2013

Our Licensing and Rulemaking teams spent the last week of April with hundreds of Stakeholders from numerous associations and licensees about our ongoing regulatory reform effort.  In addition, we’ve received hundreds of comments regarding our draft rules for Healthcare Institutions and Behavioral Health Service Agencies on our website (the comment period ended on May 5).  Our teams are now busy going through the written comments and our notes from the meetings as we prepare the final regulations, which are due by the end of June. 

We also have another Midwifery Scope of Practice Advisory Committee meeting on Wednesday, May 15 from 4-6 pm in the Lab.  We’ll be discussing the newest edition of the draft rules.  The latest draft still includes Vaginal Birth After Cesarean (VBAC) and Breech Delivery as within scope for Certified Professional Midwives under certain prescribed circumstances, although this latest version would not allow for the delivery of twins by a midwife.  We’ve also clarified monitoring reporting requirements regarding labor progression.  The final midwifery rules are also due at the end of June.

 

Licensing’s Stakeholder Cornucopia

April 29th, 2013

Our Licensing and Rulemaking teams spent virtually all week hearing from hundreds of Stakeholders from numerous associations and licensees about our ongoing regulatory reform effort.  Our team met with representatives from:  Adult Day Health Care Facilities;  Assisted Living FacilitiesHome Health Agencies; Hospices; Hospitals; Nursing Care Institutions; Outpatient Surgical Centers; Outpatient Treatment Centers; Recovery Care Centers; Adult Therapeutic Foster Homes; DUI Services; Level 1 Residential Treatment CentersLevel 1 Sub-Acute Facilities; Level 3 BH Residential Agencies; Level 4 Transitional Agencies; and Rural Substance Abuse Transitional Agencies

Most of the meetings went fairly well, with representatives providing us with specific and mostly constructive feedback which we’ll use to help construct better regulations.  Some meetings were more helpful than others.  The meetings in which folks gave us specific and targeted feedback regarding discrete parts of our draft rules were, of course, the most productive. 

We’ve posted our draft rules for Healthcare Institutions and Behavioral Health Service Agencies on our website.  Folks can continue to provide written comments and feedback via the respective on-line surveys on the Healthcare Institutions and Behavioral Health Service Agencies websites through May 5.

 

Licensing Changes Near

April 9th, 2013

We’re getting near the end of the long journey of our licensing regulatory reform.  Last Wednesday we posted the revised draft rules for Chapter 10 (Health Care Institutions – Licensing) and Chapter 20 (Non-licensing approval).  Our goals is to simplify and streamline our rules so they align with our strategic plan and map to improve public health outcomes.  We’ve been working with representatives from the medical community, the behavioral health system, advocates and other affected folks to help reform our regulations.  We still need your help. Please provide comments for Chapter 10 using online surveys . Please provide comments for Chapter 20 using online survey .

The comment period will end on May 5th. The Department will revise the drafts and the final rules will take effect on July 1st of this year.  Please visit our Licensing webpage  to learn more about our integrated licensing rules implementation.

Thanks to all who have helped to advance the licensing of integrated health in Arizona!