California Hospital Association outlines strained hospital landscape, urges board to separate hospital practice issues

The California Hospital Association (CHA) presented a wide‑ranging overview of hospital operations and urged the California State Board of Pharmacy to treat hospital pharmacy practice as distinct from retail practice and to create a hospital pharmacy advisory track.

Sherry Lowe, CHA vice president for policy, told the board that hospitals are under sustained operational strain. “If you’ve seen 1 hospital, you’ve seen 1 hospital,” Lowe said, arguing that hospitals vary widely but share common pressures: high occupancy, much higher acuity, workforce shortages and rising contract‑labor costs. She described emergency departments filled with patients awaiting discharge placements and warned that delayed hospital throughput is affecting ambulance response and community care.

Lowe identified new financial and regulatory headwinds: rising labor costs (wages up roughly 35 percent over five years, she said), a county and state health‑affordability initiative (the Office of Healthcare Affordability, OCA) setting sector spending targets and a 2030 seismic retrofit requirement for hospitals estimated to cost the sector many billions of dollars.

CHA asked the board to “bifurcate” data and enforcement reporting so hospital pharmacies are considered separately from retail pharmacies in inspections, reporting and guidance, and to consider forming a hospital pharmacy committee that would advise the board on hospital‑specific practices and inspection protocols. The CHA also asked the board to involve hospital clinical pharmacists in policy development and to tailor rules to account for distinct hospital workflows — including clinical decision support built into hospital electronic health records and interdisciplinary rounds.

Board members welcomed the briefing and asked clarifying questions about OCA spending targets, the impacts of rising staffing costs and hospital workforce pressures. Board member Maria Serpa urged the board to ensure the oversight committees and public materials reflect hospital contexts, noting that certain specialty costs (for example, high‑cost pediatric drugs) and hospital capital needs do not translate easily into flat affordability targets.

The CHA presentation position paper and public comments underscored the point that a “one‑size‑fits‑all” regulatory approach can create operational and safety risks if inspection and reporting do not account for hospital‑specific procedures. Lowe closed by offering CHA’s pharmacy working group and the association’s regional staff as resources for future board work. The board did not vote on rules or establish a committee at the meeting but indicated interest in more detailed discussion at future meetings.