Disability Rights Withdraws Contempt Filing — For Now
A contempt-of-court motion filed against the Department of Health Care Services was recently withdrawn by Disability Rights California, though adult day health care advocates said they might re-file later.
“We still think we’re right and the department is wrong,” said Elissa Gershon, a senior attorney at Disability Rights California. “But once we began having discussions, it became clear it wasn’t something that was as appropriate to bring before a federal judge.”
There were two main sticking points in the contempt filing, one of which has been worked out, Gershon said.
Will FQHCs Get Lower Adult Health Rate?
A federal judge last week heard arguments for and against issuing a temporary restraining order against the state’s plan to reduce payments for adult day health services. The California Primary Care Association filed suit on behalf of federally qualified health centers.
U.S. District Court judge James Ware heard the case last week. He has 30 days to issue a ruling.
In a similar case last month filed by the Adult Day Health Care Association, a federal judge declined to issue a preliminary injunction against the state and upheld the Department of Health Care Services’ plan to set new rates for day service providers in the recently launched Community Based Adult Services program.
Newborn Test Takes Baby Step Forward
A bill to require hospitals to screen all newborns for congenital heart conditions recently was presented to the Assembly Committee on Appropriations — where it was expected to get a rough reception. Instead, AB 1731 (Marty Block, D-San Diego) was moved to the suspense file, where it will await next month’s budget discussions.
“The test … only costs $3 per baby,” Block said at last week’s hearing. “If undetected, congenital heart disease can require subsequent emergency room visits, and additional medical costs are much higher than the treatment cost if the baby’s condition had been caught earlier.”
Block was addressing fiscal concerns first raised in the Assembly Committee on Health. In addition to California hospitals’ cost of administering the screening test to newborns, the Assembly analysis estimates additional cost to the Department of Health Care Services to launch and run the program — up to $1 million annually, as well as start-up costs of $300,000.
Opposition to Ombudsman Bill Evaporates
Joe Rodrigues, the State Long-Term Care Ombudsman, has removed his opposition to SB 345 by Lois Wolk (D-Davis), a Senate bill designed to reform the ombudsman’s office.
Rodrigues said the bill authors made a number of amendments to the measure. He now supports the bill presented at a legislative committee hearing earlier this week.
“We were able to work with them on coming to some agreements that will benefit the program and strengthen the [ombudsman’s] office,” Rodrigues said. “It made some of the good things to do in the bill less burdensome, such as the advisory council and the annual report. The bill looks very different today than it was a year and a half ago when it was first introduced.”
Health Plans’ Quality for Duals in Question
Seven of the eight health plans in California’s pilot project to shift dual eligibles into managed Medi-Cal have inferior quality ratings for treating Medi-Cal beneficiaries, according to a report released yesterday.
The ambitious plan for 1.1 million Californians eligible for both Medicare and Medi-Cal benefits will start with a pilot program in four counties — Los Angeles, Orange, San Diego and San Mateo. The state hopes to expand the pilot project to as many as 10 counties, pending legislative approval.
The report from National Senior Citizens Law Center, citing the state Department of Health Care Services’ own quality assessment, shows seven plans earned a rating of 1 out of 5 stars in overall Medi-Cal performance.
Health Facilities Get Improvement Boost
The federal government yesterday issued $722 million in renovation and construction grants to community health centers, including $122 million in grants to California facilities.
Dean Germano, CEO of Shasta Community Health Center in Redding, said his center’s $5 million capital grant announced yesterday will pay for about half of a planned $10 million building addition.
“The plans are completed, and we were waiting on a decision from HHS to see if we could do this,” Germano said.
Subcommittee Approves Change for Sacramento County Dental Program
Recent controversy over dental services in Sacramento County came to a head at an Assembly budget subcommittee hearing yesterday. The root of the problem is the county’s children’s dental care program, organized as a managed care pilot project that has been plagued with access problems over its 18-year history.
In fiscal year 2010-11, about 31% of the children eligible for dental care in Sacramento County actually saw a dentist (compared to a statewide average of about 50%). It is the only county in the state with a mandatory managed care dental program, which pays a per-person, capitated rate, whether beneficiaries receive dental care or not.
State legislators are considering changing that system to allow a voluntary option for beneficiaries to switch to fee-for-service. State health care officials are asking to keep the current system, with some major reforms to boost those low utilization rates.
Mixed Reviews at Basic Health Program Briefing
The state Legislature is considering a bill to create a Basic Health Program in California. If adopted, SB 703 by Ed Hernandez (D-West Covina) would create low-cost health care insurance for as many as one million low-income Californians.
One of the options offered states in the Affordable Care Act, the Basic Health Program shares some goals with the Health Benefit Exchange, though the cost of insurance is expected to be significantly lower under the BHP.
That prospect would seem to be a slam-dunk proposition for patient advocates, but it’s not as simple as that.
Expansion of Safety Net Sparks Debate
The 17 health care clinics run by the Molina Medical Group, which care for many low-income patients, should qualify as safety net providers in California, according to the group’s owners. AB 2002 by Gil Cedillo (D-Los Angeles) would redefine the state’s process for establishing Medi-Cal safety net providers to allow centers like Molina’s to be included.
“This bill would create a fair definition of a safety net provider,” according to Gilbert Simon, a physician at Sacramento Family Medical Center who testified at an Assembly Committee on Health hearing earlier this week. Sacramento Family Medical Center is a Molina Healthcare partner. Molina Healthcare is a for-profit company operating in 16 states and headquartered in Long Beach.
“Physician groups across the state are preparing and building sustainable networks to provide medical homes to patients [for the expansion of health care enrollment in 2014], and it is imperative that we acknowledge the true nature of the safety net,” Simon said, “and take steps to acknowledge its expanding role.”
Senate Committee Approves New Type of Nursing Home
A new idea elbowed its way into the familiar pile of health care legislation in the Senate Committee on Health yesterday. A nursing home model — the “Green House Project” — bucks the cold, institutional feel of many long-term care facilities.
“SB 1228 is a transformative bill that will eliminate red tape and save money. It is a revolutionary model of care,” Senate member Elaine Alquist (D-San Jose) said, presenting her bill to the committee yesterday.
“It puts the ‘home’ back into nursing home,” Alquist said.