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PROPOSED TRAINING PROJECT DETAILS

Training Proposal for Alta Los Angeles Hospitals, Inc. 17-0833 of 5

TRAINING PROPOSAL FOR

Alta Los Angeles Hospitals, Inc.

17- 0833

Panel Meeting Date: 09/22/2017

Regional Office: North Hollywood Regional Office

Analyst Name: Jela Romero

Type of Proposal: Single Employer Contract (SE)

Funding Source: Special Employment Training (SET), Priority

FUNDING OVERVIEW

Provided here is a summary of the funding for the proposed Training Project.

TOTAL ETP FUNDING: $737,236.00

Program & Admin Cost Support Cost Substantial Contribution

($ / %) Total In-Kind

$749,484.00 N/A $12,248 (15%) $875,000.00

APPLICANT PROFILE

Company Summary Alta Hospitals System, LLC (ALTA) owns and operates a network of acute care

hospitals in Los Angeles, Hollywood, Van Nuys, Norwalk, Culver City, Tustin and Bellflower. The acute care hospitals provide short-term inpatient and outpatient care for brief illnesses and quasi-residential cares for sub-acute patients on ventilators that are unable to transition to nursing homes or long-term care facilities. They also offer pediatric care, gynecology, general surgery, orthopedic surgery, cardiology, rehabilitation and detoxification services, and acute psychiatric services.

Industry Sector(s) Healthcare

Priority Industry Yes

No. of Employees (Applicant) State: 2,800 US: 4,400 World Wide: 4,400

Turnover Rate (Applicant) 0.00%.



Repeat Contractor Yes

High Unemployment Area No

Unions

No

TRAINING PROFILE

Training Objective

Alta Hospitals are continuing to work on methodologies to increase the quality of care, lower costs, improve program integrity and make its health care system more effective, simple and accessible.

Training is summarized below. Additional details are provided in Attachment 1 - Group and Job Title Details of this Panel Proposal.

# Group Characteristics # of Trainees

Reimbursement Rate

Avg. Hours

Cost Per Trainee

Min – Max Hour

1 S-RET 499 $18.00 42 $756.00 8 - 200

2 S-RET- JOB CREATION 198 $20.00 94 $1,880.00 8 - 200

TOTAL: 697



1. Company Background

Founded in 1998, Alta is a division of Prospect Medical Holdings, Inc. that also operates Prospect Medical Systems in Santa Ana, CA; ProMed Health Care Administrators in Ontario, CA; and the Nix Hospitals System, LLC in San Antonio, Texas. There are five Alta hospitals that will participate in this training proposal (Los Angeles, Van Nuys, Hollywood, Norwalk and Bellflower) wherein Los Angeles will be the lead hospital in facilitating training and administration for this ETP proposal. The Alta hospitals that are the subject of this training proposal serve ethnically diverse communities; patients are 95% Medicare/Medi-Cal with a large number of underinsured and uninsured.

2. Current Training Project Details

Purpose of Training

This will be Alta’s third ETP Agreement. In this ETP proposal, Alta plans to hire and train 150 employees (net new hires) for the planned expansion of the Bellflower facility, and another 30 nurses at other facilities to fill available positions so Alta can refrain from using registry-contract nurses. Training in this proposal will also include significant training on updates and new standards of Alta's EMR system, which is a valuable tool for organizing patient and medical care provider communication. Additionally, the Hospital will be training on new quality training initiatives designed to improve HCAHPS national survey ratings and patient satisfaction. This training is based on Value Based Purchasing initiatives focusing on the Five Fundamentals of Communication – AIDET (Acknowledge, Introduce, Duration, Explanation and Thank You). The Hospital will also train health care providers on required Workplace Violence programs to prevent bed-side care violence between patients and healthcare providers.

Training Infrastructure and Administrative Plan

Alta has retained the services of National Training Systems, Inc. for administration of the ETP project. Alta’s Chief Nursing Officer and Hospital Administrator at the Los Angeles facility will oversee all other aspects including scheduling training and ensuring training completion is documented for ETP reimbursement. Training will be delivered by a combination of in-house staff and vendors.

Marketing Plan

(MEC Only)

N/A

Support Cost Description

(MEC Only)

N/A

Substantial Contribution Description

Alta is repeat contractor with payment earned in excess of $250,000 within the past five years in one of its locations (Los Angeles facility - See Prior Project Table.) Accordingly, reimbursement for trainees will be reduced by 15% to reflect the Company’s $12,248 Substantial Contribution to the cost of training. No substantial contribution was assessed to the Job Creation group.

3. Sample Curriculum

Each of the Trainee groups will be able to take courses under the various delivery methods.

Delivery Method/Level Classroom/Simulated Laboratory

Training Type/Level Sample Classes

Medical Skills – Didactic Dysrhythmia Recognition and Interpretation



Code Blue Response & Procedures

Care of the Geriatric Patient

Chest Tube Care & Management

Computer Skills Electronic Medical Records Application Skills

ICD-10 (International Classification of Disease)

Microsoft Office Skills (Intermediate & Advanced)

Continuous Improvement AIDET Training

Critical Thinking Skills

Management of Assaultive Behavior

Frontline Leadership Skills

Delivery Method/Level Productive Lab (PL)

Training Type/Level Sample Classes

Medical Skills – Clinical with Preceptor

Intravenous (IV) Therapy

Pre and Post-Operative Care

4. Additional Company or Training Project Details

4.1 Program Waivers

The next table lists the various waivers and supporting justifications for training that apply to this proposed Training Project.

Waivers/Justification Type Summary

SET Wage Modification/ Multiple Barriers

Approximately 55 trainees in Group 1 have two or more barriers to employment (e.g. mental or physical disability, limited English proficiency, limited Math skills). These trainees are either a Certified Nursing Assistant (CNA) or a Certified Mental Health Worker (CMHW). Under the Multiple Barriers program, they qualify for the standard ETP Minimum Wage ($16.96) rather than the SET Priority Statewide wage ($22.04).

These trainees were recruited by Alta from a hard-to-serve population with language and educational barriers, through the hospital’s outreach program (e.g. job fairs). These occupational titles do not require high academic degrees. However, they must be able to communicate and receive instructions in English and need basic math skills. These trainees are eligible to take up to 100% of training in Literacy Skills such as Vocational English as a Second Language. However, the Hospital is only requesting 16-20 hours per-trainee.



4.2 Subcontractor Summary

The applicant has retained the services of the following Subcontractor(s).

Subcontractor Type Subcontractor Name City Service Cost

Development National Training Systems, Inc. Ladera Ranch $20,000.00

Administrative National Training Systems, Inc. Ladera Ranch 13%

Training To Be Determined $0.00

4.3 Previous ETP Project Summary

The table below summarizes the active performance under the ETP contract.

Active Contract(s) Elements

Summary

Agreement Number ET16-0290

Purpose of Training Training provided standardized skill sets for nurses and allied medical workers in various skills training in MS Didactic, MS-Clinical with Preceptor, Computers Skills and Continuous Improvement.

Location(s) Los Angeles, Van Nuys, Hollywood, Norwalk and Bellflower

Term 12/14/15 – 12/13/17

Approved Amount $664,240.00

Projected Earnings $604,803.00

Performance Percentage 91%

Other Notes The ETP Online System shows $380,289 Earned-In Process (57% of approved amount) and $224,514 Earned–Approved (34% of approved amount). Alta anticipates 95% earnings based on 30,812 hours tracked online to date.

This table summarizes Contractor's performance under prior contract(s) completed within the last five years.

Past Contract Activity

Agreement Number

Location(s) Term Approved Amount

Project Earnings Performance %

Et14-0231 Los Angeles, Van Nuys, Hollywood and Norwalk

12/23/13-12/22/15

$679,080 $506,159 75%

Notes

4.4 Supporting Panel Proposal Documentation

Attachments 1, 2, and 3 provide additional application details on the intended training population, the detailed curriculum, and associated program characteristics that are related to this proposed Training Project.

Attachment 1 – Group and Job Title Details

Training Proposal for Alta Los Angeles Hospitals, Inc.: 17-0833 Attachment 1: Page 1 of 2

The proposed Training Project includes training for the following Trainees, organized by training group.

Group #: 1 – <Retrainees, Multiple Barriers>

County ETP Minimum Wage

Los Angeles County $16.96

Los Angeles County (SET) $22.04

Job Title Estimated Number of Trainees

Base Wage Range Health Benefits Applied

Post-Retention Wage

Los Angeles County - 4081 E Olympic Blvd, Los Angeles

Certified Nursing Assistant 15 $14.46 - $16.50 $2.50 $16.96

Licensed Vocational Nurse 2 $20.04 - $24.00 $2.00 $22.04

Registered Nurse 76 $30.00 - $59.00 $0.00 $30.00

Technician 8 $22.00 - $39.00 $0.04 $22.04

Therapist 2 $34.00 - $62.00 $0.00 $34.00

Los Angeles County - 13222 Bloomfield Ave, Norwalk

Case Manager 4 $22.55 - $52.12 $0.00 $22.04

Certified Nursing Assistant 10 $14.46 - $16.00 $2.50 $16.96


Therapist 2 $22.04 - $51.00 $0.00 $22.04

Los Angeles County - 10250 Artesia Blvd, Bellflower

Case Manager 10 $22.55 - $52.12 $0.00 $22.55



Social Worker 3 $26.16 - $37.00 $0.00 $26.16

Attachment 1 – Group and Job Title Details

Training Proposal for Alta Los Angeles Hospitals, Inc.: 17-0833 Attachment 1: Page 2 of 2



Post-Retention Wage

Los Angeles County - 14433 Emelita Street, Van Nuys

Case Manager 4 $22.55 - $51.00 $0.00 $22.55

Certified Mental health 3 $14.50 - $19.00 $2.46 $16.96


Los Angeles County - 6245 Delongpre Ave, Los Angeles



Technician 8 $21.00 - $42.00 $1.04 $22.04

Group #: 2 – <Job Creation>

County ETP Minimum Wage

Los Angeles County $14.13



Post-Retention Wage

Los Angeles County- 13222 Bloomfield Ave, Norwalk


Los Angeles County - 10250 Artesia Blvd, Bellflower


Los Angeles County - 14433 Emelita Street, Van Nuys


Los Angeles County - 6245 Delongpre Ave, Los Angeles

Certified Nurse Assistant 5 $14.00 - $18.00 $0.13 $14.13


Attachment 2 – Training Delivery and Curriculum Listing

Training Proposal Alta Los Angeles Hospitals, Inc.: 17-0833 Attachment 2: Page 1 of 4

Provided below are details on the types of training planned for this proposed Training Project.


Training Type/Level Planned Course Offerings

Computer Skills

Electronic Medical Records Application Skills

Excel (Intermediate & Advanced)

ICD-10

Microsoft Office Skills (Intermediate & Advanced

Literacy Skills

Basic Math

Vocational English

Continous Improvement Skills

AIDET Training

Charge Nursing Training

Communication Skills

CORE Measures

Crisis Prevention Intervention (CPI)

Critical Thinking Skills

Culturally Appropriate Care

Customer Service Skills

Documentation Skills

Frontline Leadership Skills

Improving Observation and Reporting Skills

Management of Assaultive behavior

Performance & Quality Improvement

Preceptor Skills

Preventing Hospital Readmissions

Preventing Workplace Violence

Relationship Building

Medical Skills (didactic)

Activities of Daily Living

Acute Myocardial Infarction

Advanced Cardiac Life Support (ACLS)

Ambulating a Patient with Ambulatory Device

Arterial Blood Gas (ABG) Interpretation

Arterial Lines

Aspects of Aging

Assessment





Basic Life Support (BLS)

Bladder and Bowel Management

Body Mechanics

Care of the Bariatric Patient

Care of the Cardiac Patient

Care of the Geriatric Patient

Care of the Neurosurgical Patient

Care of the Stroke Patient

Care of the Transplant Patient

Care Planning

Central Lines Management

Chest Tube Care & Management

Code Blue Response & Procedures

Critical Care Nursing Skills

Decontamination Procedures

Dementia and Alzheimers Disease

Diabetes Care & Management

Dysrhythmia Recognition & Interpretation

Educating the Patient & Family

EKG & Cardiac Monitoring

Elder Abuse/Prevention and Reporting

Emergency Room Nursing Skills

End of Life

Equipment Skills (IV, Cardiac Telemetry, etc.)

Gastrointestinal (GI) Assessment & Management

Gender Confirmation

Hemodynamic Monitoring

Hoyer Lift and Sally Slide Use

Infection Control

Informed Consent

Intra-Aortic Balloon Pump (IABP) Therapy

Intra-Cranial Pressure Monitoring

Intravenous (IV) Insertion & Therapy

Intubation

Isolation and precautions

Management of Nephostomy Tubes

Medical/Surgical Nursing Skills





Medication Administration & Management

Moderate Sedation

Never Events

New Graduate Nursing Skills

Newborn Assessment

Nurse Sensitive Indicators

Nursing Care of the Vegitative Patient

Nutrition

Oral Care

Orthopedic Nursing Skills

Outpatient Cardiac Rehabilitation

Oxygenation

Pacemaker and AICD

Pain Management (Acute & Chronic)

Pallative Care

Paracentisis Patient Care and Drainage

Parantoneal Dialysis

Parenteral feeding

Patient Assessment & Care

Patient Fall Prevention

Pediatric Advanced Life Support (PALS)

Pediatric Patients (Acute Care, Intensive Care)

Pharmacology;Critical Care drips

PICC Line Insertion

Positioning the Patient

Pre and Post Operative Care

Pressure Ulcers

Rapid Response Skills

Renal Assessment & Management

Respiratory Assessment & Care

Restraints/Restraint Free Environment

Sepsis; Recognition and Treatment

Sheath Pull

Surgical Nursing Skills

Telemetry Nursing Skills

Thoracentesis Patient Care

Transfer Techniques





Transuretheral Resection of the Prostate

Trauma Nursing Skills

Triage Nursing Skills

Ventilator & Tracheotomy Care

Wound & Skin Care

Delivery Method/Level Productive Lab (PL)


Medical Skills (Preceptor)

Care of Trauma Patient

Cath Lab Nursing Dialysis Intravenous (IV) Therapy

Critical Care Nursing Skills Intravenous (IV) Therapy

EKG & Cardiac Monitoring Dysrhythmia Interpretation

Hemodynamic Monitoring

Intravenous (IV) Therapy

Management of the Renal Transplant Patient

Medical/Surgical Nursing Skills

Orthopedic Nursing Skills

Orthopedic Nursing Skills Ventilator and Tracheotomy Care

Patient Assessment & Care

Pre and Post Operative Care

Telemetry Nursing Skills Intravenous (IV)

Therapy Oncology Nursing Skills

Total Parenteral Nutrition Care of the Cardiac Patient

Trauma Nursing Skills

PL Justification and Details

Explain the need for productive laboratory (PL) training.

There is no productive laboratory training. There is clinical training only.

Describe the Equipment/Processes to be used in delivering PL training

There are no productive lab hours

Describe Trainer Qualifications:

there are no productive lab hours

Attachment 3 - Training Project Characteristics Details

Training Proposal for Alta Los Angeles Hospitals, Inc: 17-0833 Attachment 3: Page 1 of 1

Provided in the table are details on the training characteristics.

Characteristic Program Summary

Retrainee - Job Creation Retrainee Program

The Panel incentivizes job creation. Training for newly-hired employees is reimbursed at a higher rate, and trainees are subject to a lower post-retention wage. The date of hire for trainees is within the three-month period before contract approval, or within the term of the contract. Trainees are hired into “net new jobs” as a condition of contract. Substantial Contribution and Turnover Rate penalty requirements do not apply.

Employer must demonstrate expanded or new facilities, new equipment or machinery, expanded business capacity or other measureable investment in hiring workers and expanding their California workforce.

SET Wage Waiver The participating employer is in an industry sector designated for “priority funding” by the panel. These trainees qualify for a wage modification of up to 25% below the SET wage.

SET Multiple Barriers Some trainees in Job Group 1 have two or more barriers to employment (e.g., mental or physical disability, limited English proficiency, limited math skills). These trainees may receive the ETP Minimum Wage post-retention. (Title 22, CCR, Section 4409(a)(7).)

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