CCAHN History

On February 27, 2008, in conjunction with the Rural Health Care Symposium, a meeting of California’s Critical Access Hospitals (CAHs) convened as the CAH Colloquium. The meeting was attended by 19 of the 25 CAHs. From this meeting, an interim working group of CAH CEOs was formed and was charged with developing a process for formalizing a California CAH Network and establishing preliminary objectives for the network. This working group named the network – California’s Critical Access Hospital Network (CCAHN).

The initial objectives outlined were:

  • Objective 1: Increase CAH participation in CHART (California Hospital Assessment Reporting Taskforce)
  • Objective 2: Challenge CAHs to identify a viability index
  • Objective 3: Establish a California Critical Access Hospital Network webpage
  • Objective 4: Identify and Improve CAH financial indicators
  • Objective 5: Develop a CCAHN model 

In April 2008, CHA launched a webpage for Critical Access Hospitals on the CHA website. With the recent launch of CHA’s new website, approval was received to work with Digital Deployment to extend the California Hospital Association website content management system to create a new zone of the website for a Critical Access Hospital community with its own look and feel. 

In the summer of 2008, Mendocino Coast District Hospital (MCDH), in partnership with four other California critical access hospitals (CAHs), applied for and received a Health Resources and Services Administration (HRSA) Rural Health Network Development Planning Grant.

The other partner hospitals included:

  • Catalina Island Medical Center, Avalon
  • Frank R. Howard Memorial Hospital, Willits
  • Redwood Memorial Hospital, Fortuna
  • Mayers Memorial Hospital, Fall River Mills 

These five hospitals applied on behalf of 28 CAHs participating in the critical access hospital network (CCAHN) formed in February 2008. This Network was created for the purpose of providing a forum for discussing critical issues affecting the viability of some of California’s most remote hospitals as well as opportunities to leverage the knowledge and experience of participants to address common issues facing all CAHs in California. 

The proposed project was focused on laying the foundation for establishment of a formal horizontal CAH network to be accomplished through:

  • Convening meetings of network participants
  • Completing a targeted needs assessment
  • Conducting a comprehensive strategic planning process
  • Developing a framework for a business/operations plan aimed at achieving a sustainable network
  • Taking steps toward tackling common issues of network participants (in particular those related to HIT, quality and performance improvement, and work force recruitment and retention
  • Leveraging the resources of other grant programs
  • Examining the experience of established and successful critical access hospital networks in other states

The grant made it possible: to hire part time staff to coordinate a series of CCAHN meetings (face to face, teleconference, and webcam); to engage consulting assistance to develop a formal CCAHN strategic plan and to carry out other network development activities.

Initial steps in development of a formal CCAHN strategic plan included interviewing California critical access hospital CEOs, convening an Exploratory Group focused on discussion of key network formation issues, and conducting a series of meetings leading up to a formal CCAHN Strategic Planning Retreat held in Napa CA on October 1, 2009. Retreat attendees identified through a nominal group approach their prioritization of benefits and services they expect to receive through a CAH network.

Consistent with the Network Development Grant requirements, the Napa retreat included presentations by the executive directors of two successful out of state networks: 

  • Carolyn Bruce, Western Healthcare Alliance, Grand Junction CO
  • Pat Schou, Illinois Critical Access Hospital Network, Princeton IL 

Members of this CCAHN Advisory Committee are Ray Hino, Woody Laughnan, Kevin Erich, Robert Schapper, Lee Barron, Chuck Bill, David Yarbrough, Katharine Anne Campbell, Richard Hathaway, Charles Harrison, and Bryan Ballard. Specific items this group was asked to address included: 

  • CCAHN Mission Statement
  • Organizational structure and dues
  • Quality improvement software decision, Kansas, Stroudwater, ICAHN
  • Priorities January to March, 2010 (e.g. hiring an executive director)
  • Collaboration on information technology
  • Inventory of expertise/services per hospital (perhaps added to CAH master list)
  • Network benefits and services:
    • Staffing standards
    • Financial performance, technical assistance
    • Education and sharing 

At the November 2009 Advisory Committee meeting the Committee recommended to the CCAHN membership that CCAHN be an independent entity within the California Health Foundation and Trust (CHFT) and that administrative overhead (e.g. budget, accounting, payroll, etc.) be provided through CHFT. 

CAH CEOs at the CCAHN General Membership Meeting on January 29, 2010 voted affirmatively and unanimously to accept an affiliation with CHFT. In addition, the following seven member Board was ratified: 

  • Raymond Hino, CEO
    Mendocino Coast District Hospital
  • Chuck Bill, CEO
    John C. Fremont Hospital, Mariposa, CA
  • Gary Boyd, CEO
    Mammoth Hospital, Mammoth Lakes, CA
  • Kevin Erich, CEO
    Frank R. Howard Memorial Hospital, Willits, CA
  • Richard Hathaway, CEO
    Plumas District Hospital, Quincy, CA
  • Siri Nelson, Chief Administrative Officer
    Sutter Lakeside Hospital, Lakeport, CA
  • David Yarbrough, Administrator
    Biggs-Gridley Memorial Hospital, Gridley, CA

Western Healthcare Alliance (WHA) provided administrative management for CCAHN under this model until December 2019. The California Hospital Association (CHA), Rural Healthcare Center, then assumed full responsibility for the management and implementation of activities for CCAHN. The Advisory Committee model was archived and a newfound focus on frequent networking of various CAH roles emerged. Current peer networks include Chief Executive Officers (CEO), Chief Financial Officers (CFO), Materials Managers, Information Technology, Human Resources, Revenue Cycle, and plans to add an Infection Preventionists Peer Network.

There are currently 36 CAHS in California, CCAHN membership is available to each of them.


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