California Code of Regulations
Title 4 - Business Regulations
Division 10 - California Health Facilities Financing Authority
Chapter 1 - The Children's Hospital Program of 2018
Section 7007.1 - Evaluation Criteria for Eligible Hospitals

Universal Citation: 4 CA Code of Regs 7007.1

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

The following evaluation criteria applies to Eligible Hospitals. Applications shall be scored on the following criteria:

(a) How well the Project contributes to both of the following: (Maximum 60 points)

(1) Expansion of Health Care Access or Improvement of Health Care Access by children eligible for Governmental Health Insurance Programs and Indigent, Underserved, and Uninsured children. (Maximum 30 points)
(A) Application includes a narrative description and statistics of how the Project contributes towards Expansion of Health Care Access or Improvement of Health Care Access to children eligible for Governmental Health Insurance Programs and Indigent, Underserved, and Uninsured children. The narrative and statistics shall include:
(i) The hospital's current capacity and/or quantity and scope of Pediatric Services provided, including but not limited to, the number and type/usage of pediatric beds, space (e.g. square feet, rooms, etc.) for outpatient/other services, and/or equipment, as applicable;

(ii) The total number of pediatric patients as well as those who are eligible for Governmental Health Insurance Programs and Indigent, Underserved, and Uninsured children served in the last fiscal/calendar year;

(iii) How the Project will contribute towards the expansion or improvement and the anticipated capacity and/or quantity and scope of services provided after Project implementation, including but not limited to, the number and type/usage of pediatric beds, space, and/or equipment added, as applicable;

(iv) The total number and percentage of additional pediatric patients as well as those that are eligible for Governmental Health Insurance Programs and Indigent, Underserved, and Uninsured children that are projected to be served as a result of the implementation of the Project in a given fiscal/calendar year; and

(v) Any cultural, language, geographical or other barriers that the Project addresses to improve accessibility for children.

(2) Improvement of Child Health Care or Improvement of Pediatric Patient Outcomes. (Maximum 30 points)
(A) Application includes a narrative description, specifics, and statistics of the ways the Project contributes towards the Improvement of Child Health Care or Improvement of Pediatric Patient Outcomes.
(i) If the Project improves upon targeted evidence-based measures that focus on quality improvement, including, but not limited to, the Centers for Medicare and Medicaid Services (CMS) Core Set of Children's Health Care Quality Measures, National Committee for Quality Assurance (NCQA) measures, Centers for Disease Control and Prevention (CDC) measures, include the specific quality measure(s), source of measure(s), and how the Project would improve upon the measure(s).

(B) Application provides a narrative description of how the Project improves the reliability and sustainability of the Pediatric Services through the update of equipment or facility(ies).

(b) How well the Applicant does any or all of the following (Maximum 40 points):

(1) Provides Uncompensated Care or Undercompensated Care to Indigent or public pediatric patients. (Maximum 20 points)
(A) Application includes data and accompanying narrative description on the following:
(i) The uncompensated care costs and the percent of uncompensated care costs to total operating expenses extracted from the most recent annual Hospital Disclosure Report filed with OSHPD pursuant to the "Accounting and Reporting Manual for California Hospitals", title 22, Section 97018.

(ii) The uncompensated care costs and the percent of uncompensated care costs to total operating expenses for Indigent children or public pediatric patients receiving health insurance coverage from, including but not limited to, Governmental Health Insurance Programs.

(B) Application includes a narrative description of the infrastructure that currently exists to assist the families of pediatric patients in finding alternative sources of health care coverage. For example, hospital patient financial workers providing hospital presumptive eligibility for Medi-Cal, county eligibility staff operating onsite to provide assistance to families of pediatric patients, etc.

(2) Provides services to Vulnerable Pediatric Populations. (Maximum 15 points)
(A) Application provides:
(i) The gross patient revenue (by payor) extracted from the most recent annual Hospital Disclosure Report filed with OSHPD pursuant to the "Accounting and Reporting Manual for California Hospitals", title 22, Section 97018.

(ii) The gross pediatric patient revenue or gross revenue for pediatric services (by payor).

(iii) Number of pediatric patients, pediatric patient days or pediatric patient visits (by payor), as available.

(iv) The number and type(s) of Special Care Center(s).

(v) The percent (%) of the pediatric population the hospital is serving, who have special health care needs, during the timeframe of the most recent annual Hospital Disclosure Report filed with OSHPD pursuant to the "Accounting and Reporting Manual for California Hospitals", title 22, Section 97018.

(vi) The percent (%) of hospital resources allocated to the pediatric population identified in (v) above.

(3) Promotes Pediatric Teaching Programs or Pediatric Research Programs. (Maximum 5 points)
(A) Application includes a description of the following:
(i) The study area(s) of the Pediatric Research Program(s).

(ii) The specific area(s) of the Pediatric Teaching Program(s).

(iii) The number of individuals currently participating in the Pediatric Teaching Program(s) and the maximum capacity of the Pediatric Teaching Program(s).

(iv) How the Applicant promotes the Pediatric Teaching Program(s) or Pediatric Research Program(s) and, if applicable, how the Project improves or sustains the Pediatric Teaching Program(s) or Pediatric Research Program(s).

(c) How well the Applicant demonstrates Project readiness and feasibility based upon the following: (Maximum 30 points)

(1) A Project timeline that includes the following:
(A) An expected start date (e.g. construction start date(s) and/or equipment purchase date(s)).

(B) An expected completion date (e.g. construction completion date(s), and/or equipment installation date(s)).

(C) Potential challenges anticipated in implementing the Project and how these challenges will be managed to ensure timely completion.

(2) Whether the Project is ready and feasible after review of all of the following:
(A) For all Projects with the exception of equipment acquisition Projects, the Applicant shall submit estimates of Project costs and evidence of property ownership or, if the property is leased to an Eligible Hospital, or a California nonprofit corporation of which the Eligible Hospital is an operating entity, a copy of a lease agreement that satisfies the requirements of Section 7014.

(B) For all Projects with the exception of equipment acquisition Projects, the Applicant shall provide building permits and/or executed architect, design, engineering, and construction contracts, if available. When applicable, the Applicant shall submit evidence that it is in compliance with CEQA. The Applicant shall also be in compliance with all other applicable laws.
(i) An Applicant with a Project that does not yet have building permits, and/or executed architect, design, engineering, and construction contracts, and/or evidence of compliance with CEQA shall provide a detailed statement that explains the status of obtaining the missing items within twelve (12) months of Final Allocation.

(C) For equipment acquisition Projects, the Applicant shall submit a specific list of items and cost estimates of equipment (or copies of purchase orders and invoices), and if applicable, cost estimates of installation of such equipment.

(D) If funding sources other than the Grant are required to complete the Project, the Applicant shall provide proof of the other funding sources, including but not limited to, commitment letters and board approved capital campaign plans. Such documentation shall be in accordance with the Project timeline and budget.

(3) The sources and uses of funds:
(A) The Applicant shall detail all sources of funds required to complete the proposed Project. Sources may include, but are not limited to, the total Grant request, borrowed funds, internal assets, and other sources. If the Project, or a portion of the Project, has been or will be submitted to other lenders or grantors for funding, the Applicant shall list them and the status of their consideration.

(B) The Applicant shall detail the uses of all funds required to complete the proposed Project. The total uses shall not exceed the total of all available fund sources. In some instances, funds from sources other than the Grant may be used for portions of a proposed Project that would otherwise be ineligible for this Grant. In those instances, the Applicant shall describe specifically how the Grant funds, as well as other grants, loans, or internal funds, will be used to ensure Grant funds will not subsidize Project elements not eligible for such funds.

(C) If a proposed Project will benefit both pediatric and non-pediatric patients, the total Grant for that Project cannot exceed the proportionate share use of the pediatric population.
(i) The Authority staff shall evaluate the methodology used to determine the proportionate share use of the pediatric population and may alter the amount of Grant funds to be awarded based on this or an alternate methodology and any other factors related to improvement of pediatric population care.

(4) Whether on-going operation of the Project is feasible:
(A) The Applicant shall demonstrate the feasibility of the Project to generate sufficient revenues to support on-going operation of new or expanded services and/or research programs through one of the following:
(i) A third-party feasibility study (including but not limited to the scope of the services to be provided with the new Project, financing plan of the Project, forecasted revenues and expenses of the Project operations, market share/service area demand analysis and observations on market positioning).

(ii) Funding letters or other documentation.

(B) If revenues generated by the Project will be insufficient to support the on-going operation of new or expanded services and/or research programs the Applicant's revenues shall be sufficient to support the on-going operation.

(5) The financial capacity of the Eligible Hospital based upon a review of the Most Recent Audited Financial Statements provided pursuant to Section 7001, subdivision (b)(2).

(d) In addition to the points attainable in subdivisions (a), (b), and (c) above, an Eligible Hospital meeting the definition of a Small and Rural Hospital as defined in Health and Safety Code Section 124840 shall receive five (5) additional points.

1. New section filed 4-12-2019 as an emergency; operative 4-12-2019 (Register 2019, No. 15). A Certificate of Compliance must be transmitted to OAL by 10-9-2019 or emergency language will be repealed by operation of law on the following day.
2. New section, including amendments, refiled 10-7-2019 as an emergency; operative 10-10-2019 (Register 2019, No. 41). A Certificate of Compliance must be transmitted to OAL by 1-8-2020 or emergency language will be repealed by operation of law on the following day.
3. New section, including 10-7-2019 amendments, refiled 1-8-2020 as an emergency; operative 1-9-2020 (Register 2020, No. 2). A Certificate of Compliance must be transmitted to OAL by 4-8-2020 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 1-8-2020 order transmitted to OAL 12-3-2019 and filed 1-16-2020 (Register 2020, No. 3).

Note: Authority cited: Sections 1179.82, 1179.85 and 1179.87, Health and Safety Code. Reference: Sections 1179.85, 1179.87 and 1179.88, Health and Safety Code.

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