David Gorn

Health IT Building Blocks Are Building Up


Health information technology is going to be crucial in successfully revamping California’s health care system. In two short years, California hopes to have most physicians across the state using electronic health records — and to have those records linked through a health information exchange system, using a provider directory services database.

California took a big step toward realizing those goals, when Cal eConnect announced yesterday that it’s ready to start taking bids from vendors that would design that provider directory services system.

That RFP, or Request for Proposals, will be a central topic of conversation when Cal eConnect convenes today (Wednesday) for a membership meeting.

More Money Could Go to Work Force Training, Report Says

The California Senate Office of Research released a report yesterday that looks at where federal funding for work force investment is going. And, apparently, it’s not to work force training.

“In California, most Local Workforce Investment Boards have reported investing little of their federal funds into work force training and instead have spent a substantial amount on other employment services,” the report stated.

There are hundreds of millions of dollars allocated to California each year under the federal Workforce Investment Act of 1998, according to the report. Most of that money is spent at the local level, in local investment boards.

Round One Goes to Services for Developmental Disabilities

California facilities for residents with developmental disabilities have been squeezed by state budget cuts — including a Medi-Cal freeze on some reimbursement rates. But just because California is low on cash, that doesn’t give the state the right to freeze those rates, U.S. District Court judge Christina Snyder said. She issued a preliminary injunction on Friday that halted some budget-cutting measures that don’t follow the law.

“Judge Snyder’s ruling is that the rate freeze was applied unlawfully,” Mark Reagan, attorney for the California Association of Health Facilities, said.

“This is just one round,” Reagan said, adding, “There will certainly be more rounds to come. But at least this piece has been achieved.”

Senate Health Committee Moves Single-Payer Bill

Many dozens of single-payer supporters crammed the Senate Committee on Health chambers on Wednesday for hearing on a bill that would set up a single-payer health system in California.

The supporters were respectful and emphatic as they all stepped, one by one, up to the microphone to voice their support for such a model. After all of the advocates took their turn and returned to their seats, Senate Health Committee Chair Ed Hernandez (D-West Covina) wanted to know if there were any more speakers, so he politely asked if there was anyone else in the audience who was in favor of the bill.

And a sea of hands went up, as nearly everyone in the audience spontaneously and quietly raised their hands.

Intermediate Care Facilities Catch a Break

A U.S. District Court judge this week issued a ruling that temporarily prohibits California from freezing Medi-Cal reimbursement rates for intermediate care facilities that care for residents with developmental disabilities. Medi-Cal is California’s Medicaid program.

A permanent ruling is expected soon, possibly by the end of the week. However, even the temporary stay is a big victory for developmental services providers and their patients, according to Deborah Pacyna of the California Association of Health Facilities.

“These providers are required to provide quality care 24 hours a day, and yet they’re having to pay out of their own pockets to do that, to the point of possibly closing,” Pacyna said, adding, “They’re paying for patient assessments, staffing, fuel, food, in spite of being faced with this rate freeze, so we hope the judge recognizes this financial hardship.”

Obesity, Diabetes Lead Latino Health Agenda

Greg Talavera said he’s never seen anything like it.

Talavera, vice president of clinical affairs at the San Ysidro Health Center in Southern California, was in Sacramento last week for a forum on health risks in the Latino community.

“From a public health perspective, I am alarmed,” Talavera said. “Child obesity is an epidemic. This is the biggest epidemic since the AIDS epidemic.”

Physicians Scarce for Latinos in California

There are two main hurdles to getting quality health care among the Latino population, according to David Hayes-Bautista, founding director of UCLA medical school’s Center for the Study of Latino Health and Culture.

Access is the No. 1 issue and linguistic competency is No. 2, Hayes-Bautista said.

Hayes-Bautista was part of a forum convened last week in Sacramento by the Latino Community Development Foundation — a forum that included Health and Human Services Secretary Diana Dooley and a number of state Senate and Assembly members.

Joint Ventures on Table for County-Run Plans

A number of county-run health insurance plans, such as the San Francisco Health Plan or the Santa Clara Family Health Plan, could find themselves at a disadvantage when the state’s health benefits exchange goes into operation in 2014.

A new bill, SB 222 by state Sen. Elaine Alquist (D-Santa Clara), is aimed at addressing the problem before it arises.

“In 2014 people will be required to obtain health insurance,” Alquist said at a Senate health committee hearing this week. “Local health plans and county-run health plans have the potential to provide coverage, but they lack the clear statutory authority to form joint ventures or to initiate joint coverage agreements on a regional basis. This bill provides authority for local health plans to provide health insurance coverage to individuals and groups on a regional basis.”

Clearing a Path Through the Smog

The thumbnail summary of California’s air quality is abysmal. Los Angeles and Bakersfield have the worst air quality in the nation, according to the annual State of the Air report by the American Lung Association. On the county grading scale, 37 of California’s 58 counties get an F in air quality.

“California is unique,” Bonnie Holmes-Gen of the American Lung Association of California said, in explaining why air pollution is so bad in this state.

“Our large population, combined with our sunny days,” help foul the air, she said.  “Plus you see a lot of diesel emissions at our ports, and a lot of diesel because of our agriculture. There are geographic elements, where the San Joaquin Valley is like a big bowl that holds the smog. And of course, there has been a large increase in vehicle miles traveled. People do love their cars in California.”