ETP 130 - Single (05/02/16) 1 of 6

RETRAINEE - JOB CREATION

Training Proposal for:

AHMC Garfield Medical Center, LP dba Garfield Medical

Center

Agreement Number: ET17-0331

Panel Meeting of: December 16, 2016

ETP Regional Office: North Hollywood Analyst: M. Reeves

PROJECT PROFILE

Contract

Attributes:

Retrainee

SET

Medical Skills Training

Job Creation Initiative

Priority Rate

Industry

Sector(s):

Healthcare

Priority Industry: Yes No

Counties

Served:

Los Angeles Repeat

Contractor:

Yes No

Union(s): Yes No SEIU United Health Workers West, and SEIU Local 121RN

Number of Employees in: CA: 979 U.S.: 979 Worldwide: 979

Turnover Rate: 11%

Managers/Supervisors: (% of total trainees)

N/A

FUNDING DETAIL

Program Costs - (Substantial Contribution)

(High Earner Reduction)

= Total ETP Funding

$749,300

$187,650

50%

$0

$561,650

In-Kind Contribution: 100% of Total ETP Funding Required $1,301,880

AHMC Garfield Medical Center, LP December 16, 2016 ET17-0331 dba Garfield Medical Center

ETP 130 - Single (05/02/16) 2 of 6

TRAINING PLAN TABLE

2 Retrainee

SET

Job Creation Initiative

Medical Skills Training

Priority Rate

MS Preceptor, MS Didactic,

Computer Skills, Continuous Imp.

100 8-200 0 $3,740 **$13.73

Weighted Avg: 187

*Reflects Substantial Contribution

**It will be made a condition of contract that the trainees in this Job Number will never be paid less than the State or local minimum wage rate as in effect at the end of retention regardless of the wage expressed in this table. The highest minimum wage rate will prevail.

Minimum Wage by County: Job Number 1: $21.28 per hour Statewide Average Hourly Wage (Priority Industry). Job Number 2: $13.73 per hour for Los Angeles County (Job Creation).

Health Benefits: Yes No This is employer share of cost for healthcare premiums –

medical, dental, vision.

Used to meet the Post-Retention Wage?: Yes No Maybe

Up to $4.17 per hour for Job Number 1 and $1.42 per hour for Job Number 2 may be used to

meet the Post-Retention Wage.

Wage Range by Occupation

Occupation Titles Wage Range Estimated # of

Trainees

Job Number 1

Registered Nurse 442

Licensed Vocational Nurse 19

Therapist 28

Technician I 59

Technician II 72

Phlebotomist 9

Dietician 1

Social Worker 5

Pharmacist 10

Medical Coder 2

Job

No. Job Description Type of Training

Estimated

No. of

Trainees

Range of

Hours Average

Cost per

Trainee

Post-

Retention

Wage Class /

Lab CBT

1 Retrainee

SET

Medical Skills Training

Priority Rate

MS Preceptor, MS Didactic,

Computer Skills, Continuous Imp.

695 8-200 0 *$270 $21.28

Weighted Avg: 30

AHMC Garfield Medical Center, LP December 16, 2016 ET17-0331 dba Garfield Medical Center

ETP 130 - Single (05/02/16) 3 of 6

Coordinator I 33

Coordinator II 5

Medical Transcriptionist 10

Job Number 2

Registered Nurse 60

Licensed Vocational Nurse 6

Certified Nurse Assistant 10

Ancillary Support Staff 24

INTRODUCTION AHMC Garfield Medical Center, LP dba Garfield Medical Center (Garfield Medical), located in Monterey Park, is a 210-bed acute care facility that has been serving the needs of the San Gabriel Valley since 1933. Garfield Medical (www.garfieldmedicalcenter.com) is a for-profit hospital accredited by The Joint Commission for specialized medical services. The Hospital is eligible for ETP funding under Special Employment Training (SET) for frontline workers, and qualifies for priority industry reimbursement as a healthcare employer. The Hospital’s services include medical/surgical, 24-hour emergency care, pediatric, cardiology, obstetrics, general surgery, radiology, neonatal intensive care, rehabilitation, and a stroke center. The Hospital is also a recognized American Heart Association CPR training center. The Hospital is eligible for ETP funding under Special Employment Training (SET) for frontline workers.

PROJECT DETAILS

Retrainee - Job Creation The Panel offers incentives to companies that commit to hiring new employees. Training for newly-hired employees will be reimbursed at a higher rate, and trainees will be subject to a lower post-retention wage. Garfield Medical has committed to hiring and training 100 new employees, including 60 RNs, (Job Number 2). These new workers are needed for the Hospital to maintain adequate staffing ratios and increase capacity to meet growing patient care requirements. The date-of-hire for all trainees will be within the three-month period before contract approval or within the term-of-contract. These trainees will be hired into “net new jobs” as a condition of contract. The Hospital has identified the following changes in programs and services that are driving the current need for training:

Obstetrics Complications and Emergencies – Training will focus on several conditions that can complicate a pregnancy and threaten the well-being of mother and child. This training will prepare nurses for high-risk cases such as obstetrics hemorrhage, shoulder dystocia, prolapsed cord, and pregnancy-induced hypertension.

AHMC Garfield Medical Center, LP December 16, 2016 ET17-0331 dba Garfield Medical Center

ETP 130 - Single (05/02/16) 4 of 6

Electronic Medical Record (EMR) Utilization –The Hospital has converted to an electronic documentation system and must continue to provide training to staff on proper and effective utilization of the EMR system.

Sepsis Bundle – The Hospital has developed a Sepsis program to establish detection and treatment protocols. Training is necessary to ensure employees remain competent regarding this life-threatening condition that can result in death if treatment is not administered quickly.

Neurosurgery – This highly specialized area involves caring for patients with nervous system disorders including the brain, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system. Comprehensive training is needed to equip staff with the skills to care for patients requiring neurosurgery.

Safe Patient Handling Program – Proper utilization of patient handling equipment ensures safe patient transfer and lifting. Extensive training is necessary to maintain proper and safe operation of equipment.

Open Heart Care Training – Care of the post heart surgery patient is accomplished through both classroom and hands-on training. Trainees will accompany the patient during pre-operation, intra-operation, and post-operation periods. Standard treatment plans and goals of therapy will be covered extensively.

Training Plan Training will take place at the Hospital’s facility in Monterey Park and possibly at off-site vendor locations in California. Training will be delivered by in-house subject matter experts and vendors (to be identified during the contract term). Medical Skills Training (80%) – Approximately 500 RNs and 25 LVNs will participate in Clinical Preceptor and Didactic training classes. This training will ensure trainees are competent in advanced medical procedures. Technicians, Therapists, and other allied-health staff may receive limited medical skills training based on their respective job duties. This training excludes non-nursing Ancillary Support Staff. Computer Skills (10%) - Training will be offered to all occupations. Training will cover software applications to support the Hospital’s continued electronic medical records conversion efforts. Continuous Improvement (10%) - Training will be offered to all occupations. These courses will focus on performance and quality of care improvements. Training will include case management, communication, leadership, and team building skills. SET/Wage Modification Under SET, employers are not required to demonstrate out-of-state competition. To qualify under SET, trainees must be earning at least the statewide average hourly wage at the end of the retention period. However, trainees employed in a Priority Industry qualify for a wage modification up to 25% below the statewide average hourly wage. The Hospital is requesting the wage modification from $28.37 to $21.28 for trainees in Job Number 1.

AHMC Garfield Medical Center, LP December 16, 2016 ET17-0331 dba Garfield Medical Center

ETP 130 - Single (05/02/16) 5 of 6

Substantial Contribution Garfield Medical is a repeat contractor with payment earned in excess of $250,000 and a former Substantial Contribution at the 30% level within the past five years. Reimbursement for trainees in Job Number 1 will be reduced by 50% to reflect the Hospital’s $187,650 Substantial Contribution to the cost of training. The Substantial Contribution requirement does not apply to Retrainee – Job Creation trainees (Job Number 2). Prior Projects This will be Garfield Medical’s fourth ETP Agreement and the third within the past five years (See Prior Projects Table). Training in this new proposal differs from and/or expands on training delivered in the past. In addition to improved programs, the proposed project also features training on several new pieces of equipment/technology including a Philips Vital Sign Machine, Physio-contol LifePak 20 Defibrillator, GE Giraffe Incubator, Echo Cardiac System, GE Giraffe Omnibed, and a Spinal Table System. This proposal includes employees who may have participated in a previous contract. Several Curriculum topics are repeated from prior agreements; however, the subject matter has been updated, so there will be no duplication of training. Garfield Medical is a wholly-owned subsidiary of AHMC Healthcare, Inc. It operates as a Limited Partnership autonomous from other AHMC hospitals in the state. For FY2016/17, the Panel has approved other AHMC wholly-owned and operated subsidiaries. AHMC San Gabriel and AHMC Whittier were approved at the August Panel meeting, and AHMC Monterey Park was approved at the October Panel meeting. Commitment to Training

Garfield Medical spends approximately $2 million annually on training. The Hospital’s ongoing training includes new employee orientation, Annual Skills Day, management training, life support certification and recertification, and in-service training to disseminate new information. Safety training is, and will continue to be, provided in accordance with all pertinent requirements under state and federal law. RECOMMENDATION

Staff recommends approval of this proposal.

PRIOR PROJECTS

The following table summarizes performance by Garfield Medical under ETP Agreements that were completed within the last five years:

Agreement No. Location (City) Term Approved Amount

Payment Earned $ %

ET14-0310 Monterey Park 02/24/14 – 02/23/16

$375,959 $375,959 (100%)

ET12-0336 Monterey Park 03/26/12 – 03/25/14

$179,690 $179,690 (100%)

AHMC Garfield Medical Center, LP December 16, 2016 ET17-0331 dba Garfield Medical Center

ETP 130 - Single (05/02/16) 6 of 6

DEVELOPMENT SERVICES

Training Funding Source in Seal Beach assisted with development for a flat fee of $8,500.

ADMINISTRATIVE SERVICES

Training Funding Source will also perform administrative services for a fee not to exceed 13% of payment earned.

TRAINING VENDORS

To Be Determined

AHMC Garfield Medical Center, LP ET17-0331 dba Garfield Medical Center

ETP 100 Exhibit B Menu Curriculum (07/07/14) 1 of 4

Exhibit B: Menu Curriculum

Class/Lab Hours 8 - 200 Trainees may receive any of the following:

MEDICAL SKILLS TRAINING – DIDACTIC

Acute Myocardial Infarction

Advanced Cardiac Life Support (ACLS)

Arterial Blood Gas (ABG) Interpretation

Basic Life Support (BLS)

Body Mechanics and Safe Patient Handling

Care of the Cardiac Patient

Care of Pediatric Patients (Acute Care, Intensive Care)

Care of the Stroke Patient

Central Lines Management

Chest Tube Care & Management

Code Blue Response & Procedures

Critical Care Nursing Skills

Decontamination Procedures

Diabetes Care & Management

Dysrhythmia Recognition & Interpretation

Educating the Patient & Family

EKG & Cardiac Monitoring

Electronic Fetal Monitoring (Beginning & Advanced)

Emergency Care of the Burn Patient

Emergency Room Nursing Skills

Equipment Skills (IV pumps, cardiac telemetry, vital signs, pulse-oximeter, ventilators, specialty beds and mattresses)

Gastrointestinal Assessment and Management

Infection Control

Intravenous (IV) Insertion & Therapy

Labor, Delivery and Postpartum Nursing Skills

Medical/Surgical Nursing Skills

Medication Administration & Management

Moderate Sedation

Neonatal Advanced Life Support (NALS)

Neonatal Nursing Skills

Neonatal Resuscitation Provider (NRP)

Nurse Orientation Training (for New Grads only)

Ostomy & Continence Care

Pain Management (Acute & Chronic)

Patient Assessment & Care

Patient Fall Prevention

Pediatric Advanced Life Support (PALS)

PICC Line Insertion

Pre and Post-Operative Care

Rapid Response Skills

Renal Assessment & Management

Respiratory Assessment & Care

AHMC Garfield Medical Center, LP ET17-0331 dba Garfield Medical Center

ETP 100 Exhibit B Menu Curriculum (07/07/14) 2 of 4

Restraints

Surgical Nursing Skills

S.T.A.B.L.E.

Telemetry Nursing Skills

Total Parenteral Nutrition (TPN)

Transfer Techniques

Triage Nursing Skills

Ventilator and Tracheotomy Care

New Graduate Program Skills Wound & Skin Care

Defibrillator Training

MEDICAL SKILLS TRAINING – CLINICAL PRECEPTOR

Emergency Department Training o Emergency Room Nursing Skills o Emergency Care of the Burn Patient o OB Trauma o Trauma Nursing Skills o Triage Nursing Skills o Care of Pediatric patients

Intensive Care Unit/Critical Care Unit Training o Critical Care Nursing Skills o Patient Assessment & Care o Pre and Post-Operative Care o Ventilator & Tracheotomy Care o Hemodynamics Training

Long Term Care Unit (Subacute, Skilled Nursing, Transitional Care & Hospice)

o Patient Assessment & Care o Geriatric Nursing Skills o Med/Surg Nursing Skills o Hospice Nursing Skills

Medical/Surgical Unit Training o Patient Assessment & Care o Medical/Surgical Nursing Skills o Pre and Post-Operative Care

Obstetrics Unit Training o Patient Assessment & Care o Antepartum, Labor, Delivery and Postpartum Skills o Neonatal Nursing Skills o S.T.A.B.L.E. o Advanced & Electronic Fetal Monitoring o Neonatal Resuscitation Provider (NRP)

AHMC Garfield Medical Center, LP ET17-0331 dba Garfield Medical Center

ETP 100 Exhibit B Menu Curriculum (07/07/14) 3 of 4

Operating Room and Post-Anesthesia Care Unit (PACU) Training o Patient Assessment & Care o Care of the Burn Patient o Peri-Operative Nursing Skills o Pre and Post-Operative Care

Pediatric Services Unit o Care of Pediatric Patients (Acute Care, Intensive Care) o Patient Assessment & Care o Pre and Post-Operative Care

Surgical Services Unit Training o Patient Assessment & Care o Surgical Nursing Skills o Pre and Post-Operative Care

Telemetry Unit Training o Care of the Cardiac Patient o EKG & Cardiac Monitoring o Dysrhythmia Interpretation o Telemetry Nursing Skills o Pre and Post-Operative Care o Intravenous (IV) Therapy

CONTINUOUS IMPROVEMENT

Case Management/Discharge Planning

Charge Nurse Training/Frontline Leadership Skills

Communications Skills

Conflict Resolution Skills

CORE Measures

Crisis Prevention Intervention (CPI)

Critical Thinking Skills

Culturally Appropriate Care

Patient Satisfaction (HCAPHS) Training

Value-Based Purchasing

Documentation Skills

Organization and Time Management Skills

Patient and Family Centered Care Skills

Preceptor Skills (train-the-trainer)

Performance and Quality Improvement and Procedures Skills

Team Building Skills

Utilization Review

ED Assaultive Training

Meaningful Use COMPUTER SKILLS

Electronic Medical Records Application Skills

AHMC Garfield Medical Center, LP ET17-0331 dba Garfield Medical Center

ETP 100 Exhibit B Menu Curriculum (07/07/14) 4 of 4

Note: Reimbursement for retraining is capped at 200 total training hours per trainee, regardless of the method of delivery.