Latest California Healthline Stories
Assembly Hearing Raises Questions About Adult Day Care Transition
An Assembly hearing today will examine the state’s planned Oct. 1 transition from Adult Day Health Care to the Community Based Adult Services program.
A growing chorus of concerns has been raised about the new program for seniors and disabled so it’s important to examine plans closely before the transition begins, said Assembly member Mariko Yamada (D-Davis).
“Eliminating ADHC was a painful 2011 budget action taken with the understanding that strategic replacement services for some of our state’s most vulnerable adults would continue,” Yamada said. “Despite a legal agreement establishing a standard for these replacement services, many of our constituents report continued problems in timely adjudication of appeals and access to care.”
Exchange Considers Community Grants for Outreach
Stakeholders and board members mapped out marketing strategies focusing on community outreach for California’s new Health Benefit Exchange at a board meeting this week in Sacramento.
Board members realize new rules and opportunities coming into play in 2014 as part of national health reform may be confusing for many Californians and they hope to make the process as simple and straightforward as possible.
The exchange’s staff is planning ways to use community-based grants to educate Californians on how and where to sign up for health care. The exchange is paying particular attention to communicating with populations it considers hard to reach, including rural and lower income Californians, according to Juli Baker, chief technology officer for the exchange.
MRMIB Balks at Oct. 1 Deadline to Start HF Notices
Managed Risk Medical Insurance Board officials yesterday expressed reluctance and worry over the state’s plan to move 415,000 children out of the Healthy Families program and into Medi-Cal managed care plans on a single day — Jan. 1, 2013.
Because notices of the change would need to be sent 90 days prior to the big shift, letters would need to be mailed to beneficiaries in a little more than a week, by Oct. 1.
That plan moves too many children too quickly, said board member Richard Figueroa.
DHCS Says State Is Ready for Adult Day Care Transition
Advocates for seniors and the disabled filed a motion on Saturday asking a U.S. District Court judge in San Francisco to intervene in some implementation details of the settlement agreement it signed eight months ago with the Department of Health Care Services.
State officials yesterday answered some of the questions about the Oct. 1 implementation of the Community Based Adult Services program.
Some advocates worried about confusion around the launch of the CBAS program since the state is holding training sessions for the CBAS changeover in October for both health plans and physicians.
The Exchange by Any Other Name
Now there are four.
At yesterday’s meeting of the state’s Health Benefit Exchange board, Chris Kelly, the exchange’s senior advisor for marketing and outreach, presented the four finalists in the project to pick a new name for the exchange — the name that will be used to market the exchange’s choices and services.
“We brought forward about 13 names last time [at the Aug. 23 board meeting],” Kelly said, “including Wellquest and, of course, Avocado — that is still a crowd favorite.”
Kelly prefaced his presentation by reiterating that each proposed name includes a marketing package with a unique logo and tagline — “a voice of its own,” as Kelly put it.
Motion Could Delay Implementation
A court motion filed Saturday challenging the state’s implementation of a new program for adult day services raises a number of concerns about how the new legal hurdle may affect timing and appeals in the new Community Based Adult Services program.
One of the main issues revolves around the fate of approximately 2,400 former Medi-Cal beneficiaries of Adult Day Health Care services. Those frail, elderly and disabled people had been denied eligibility to the replacement CBAS program. Many of them had been denied eligibility after earlier being approved for it.
According to Elissa Gershon, attorney for Disability Rights California which filed the motion Saturday in U.S. District Court in San Francisco, there are approximately 2,200 appeals of eligibility still outstanding, and roughly another 200 who have had a hearing but are still awaiting a decision.
October Start for New Adult Day Program Could Be Halted
Disability Rights California on Saturday filed a motion in U.S. District Court to stop the Department of Health Care Services’ implementation of portions of the Community Based Adult Services program, saying the department violated terms of a previous settlement agreement.
The motion noted that a federal court twice prohibited cutbacks to Adult Day Health Care benefits because “the loss or interruption of necessary ADHC services would irreparably harm ADHC recipients and place them at serious risk of institutionalization.”
That led to a December lawsuit settlement agreement that established the CBAS program to replace ADHC services.
Uninsured Number Dips — But Why?
Census results released Wednesday show a drop in the number of people without health insurance nationally, from 16.3% of Americans in 2010 down to 15.7% in 2011, about 1.4 million fewer uninsured across the country.
Given the weak economy, that was a welcome development to Kiwon Yoo, policy director of the Insure the Uninsured Project, based in Santa Monica.
“The biggest reason for that is the dependent coverage that kicked in,” Yoo said. “The numbers declined by about 2.2% in that age group, and that’s 3 million people nationally. That’s a big chunk of it.”
Legislative Help for Long-Term Care?
The SCAN Foundation today released results of a survey on long-term care readiness in California. It wasn’t pretty:
• Roughly half of the poll respondents said they will need long-term care for a close family member within the next five years.
• About half of the poll respondents said they cannot afford even one month of nursing home care.
• Almost two-thirds of the registered voters in the poll said they’re worried about being able to afford long-term care.
• A whopping 88% of those polled said legislators should make affordable long-term care a high or moderate priority.
Promise, Peril of Duals Program
Advocates see potential for improvement but also are concerned about consumer protections in the transition of roughly 1.1 million Californians into Medi-Cal managed care. The state is launching a managed care pilot project for beneficiaries who are dually eligible for Medicare and Medi-Cal, California’s Medicaid program.
“This is really a critical moment in time for dual-eligibles and represents an amazing time to improve care for duals,” said Kevin Prindiville, deputy director of the National Senior Citizens Law Center office in Oakland. “But it’s also a time to be very careful and cautious about how we proceed to move forward.”
Prindiville, one of several speakers at an informational forum last month, said California is still negotiating with CMS officials, so some of the details of the plan are still uncertain.