David Gorn

Medi-Cal Crunch Looms for Community Clinics

The budget is about seven weeks late now. Without a budget, the state can’t keep writing Medi-Cal checks to health care providers. And that budget crunch begins today, when the last Medi-Cal checks go out to community clinics throughout California.

Without that $43 million every two weeks, those clinics will be in big trouble, according to Carmela Castellano-Garcia, president and CEO of the California Primary Care Association (CPCA).

“That means clinics are not going to receive 50% to 80% of their revenue, so they’ll be in a challenging financial situation,” Castellano-Garcia said. “This budget stalemate is going to have significant impact on them.”

Let the Tele-Doctoring Continue, Expand

From a health policy point of view, the star power was out in force at yesterday’s official inauguration of the California Telehealth Network.

Aneesh Chopra, national chief technology officer, was chatting with Gov. Arnold Schwarzenegger. The head of health sciences and services for the UC system, Jack Stobo, was nodding at something said by Sharon Gillette, bureau chief for the FCC.

They were all out to announce the success and expansion of a telemedicine pilot project that has been running since 2007. With the help of $22 million from the FCC’s broadband initiative — one of the largest grants awarded by the agency — and another $3.6 million of corporate money pitched in by the California Emerging Technology Fund, the state officially launched its CTN agency yesterday.

Recruiting, Training More Health Care Workers

There is a dearth of health care providers in California, and the demand for more highly skilled health workers will only increase when national health care reform goes into effect. That’s the word from Tom Riley, legislative advocate for the California Academy of Family Physicians, speaking at a Senate Health Committee hearing last week.

“We think the time has come for this to be front and center in the health care debate, the workforce issue,” Riley said. “This is a terribly important thing for us to be addressing.”

The proposed law, AB 2551 by Assembly member Ed Hernandez (D-West Covina), would establish the Health Workforce Development Council, a task force charged with tackling how to recruit and train a new segment of the health care workforce.

How To Make Evidence-Based Medicine Work

No one seems to understand just what evidence-based medicine is, and right now that is its biggest problem.

That was the consensus at Thursday’s conference in the Capitol Building — “Right Care, Right Time, Right Place” — put on by the New America Foundation and sponsored by the Assembly and Senate health committees.

“Clearly, over time, physicians need to learn to embrace evidence-based medicine. But more importantly, consumers need to embrace it, and understand it.” That’s according to Richard Baker, chair of the Council of Scientific Affairs for the California Medical Association and dean of the College of Medicine for Charles Drew University of Medicine and Science in Los Angeles.

Committees Move Health Bills Forward

It is sausage-making time in Sacramento.

It’s the time where intense behind-the-scenes lobbying is going on over the many dozens of bills being held in suspense in the Assembly and Senate appropriations committees.

These are bills that require a certain amount of funding, so they can’t all go on to a floor vote in the state legislature. As one staffer put it, critical decisions have to be made here, because the state has more bills than money.

ED Crunch Not Necessarily Medicaid, Uninsured Issue

A study released yesterday by UC San Francisco showed a 23% increase in the number of people visiting U.S. hospital emergency departments over the past decade. Those numbers match a CDC report that came out a week ago.

The commonly held view is that rising numbers of uninsured patients and declining Medicaid reimbursements account for the spike in emergency room visits.

Not so fast, Angela Gardner of the American College of Emergency Physicians said.

When is a state tax not a state tax?

In California, when the going gets tough, the tough come up with a complicated, arcane funding solution.

To put it in the simplest terms possible, the state doesn’t have enough dollars in its budget, so it wants more federal dollars. And to get more federal matching dollars for the In-Home Supportive Services program, the state is planning to levy a 6% sales tax.

On itself. Which it will pay — to itself.

Law Takes Aim at Crowded Emergency Departments

California’s emergency departments are packed. As the ranks of the uninsured and underinsured across the state have grown, and their health problems have tended to fester and grow more acute, patients have been heading to emergency rooms in record numbers.

That means wait times have become much longer in emergency departments, and patient care is more likely to be compromised under the crush of increased demand.

A bill to address that problem — AB 2153 by Assembly member Ted Lieu (D-Torrance) — is one Senate floor vote away from going to the governor’s desk.

Ombudsman Program Tries to Follow Money

California’s long-term ombudsman program, a volunteer network governed by a state agency, is designed to represent and advocate for people in nursing homes and senior housing. In many cases, it’s the only forum seniors have to voice complaints and concerns about their living situations — which makes it an extremely popular program among seniors.

Right now, the state’s ombudsman program may be beloved, but it’s a beloved orphan.

Last year, the $3.8 million program was cut, and then lawmakers later restored almost half of it — $1.6 million. But now, even that temporary funding is gone, and officials have been scrounging to come up with enough money to keep the Long-Term Care Ombudsman Program going.