Latest California Healthline Stories
Access, Clinic Finances, ED Overuse All Major Concerns for CMA
With health care reform and the state’s cutbacks and reorganization of its health care system, the practice of medicine in California is about to undergo major changes. California Medical Association officials have serious concerns about some of those changes.
“Yes, we are in a budget crunch, and yes, money is tight,” said Doug Brosnan, an emergency department physician and a member of the CMA’s board of trustees. “But there is suffering. Patients are suffering because they lack access to basic services.”
Brosnan was part of a group of CMA officials who met with reporters on Friday in Sacramento to talk about California’s recent spate of budget cuts to health programs and the outlook for reform after the Supreme Court’s decision to uphold most of the Affordable Care Act. CMA officials said they are concerned about the state’s efforts to reorganize existing services — such as the duals demonstration project, or the shift of 873,000 children from the Healthy Families program to Medi-Cal managed care.
Governor Signs Veteran-Benefit Bill
It was a bill that had no organized opposition, and passed through every committee without a single “nay” vote.
The governor added his approval Tuesday to that overwhelming support, signing AB 1869 by Assembly Speaker John Pérez (D-Los Angeles) into law.
The legislation affects approximately 130,000 veterans who remain uninsured despite possibly being eligible for federal Veterans Affairs health benefits, according to a Senate analysis of California Health Interview Survey data compiled by UCLA.
‘Where You Live Matters’ to Your Health
Health care numbers are interesting to Angela Russell but they only become important when you remember what they represent, Russell said.
“Data rankings are a starting point, not an endpoint, and the key is using that information to take action,” Russell said. “You have to remember, this data is alive. It represents families and individuals and communities.”
Russell is the engagement lead for the County Health Rankings and Roadmaps program at the University of Wisconsin Population Health Institute. Yesterday, she was in the Capitol Building to talk about using federal and state health care data to make policy changes at the local level. The event was part of a California Health Policy Forum briefing called: “Health Rankings for Communities Across California: Using Data To Improve Population Health.” The event was funded in part by California HealthCare Foundation, which publishes California Healthline.
Two Yamada Bills Signed into Law
Gov. Jerry Brown (D) yesterday signed a bill to protect seniors in county-run nursing homes during state emergencies. One day earlier, he signed another senior-protection bill, this one to make sure veterans get clearer updates on the cost of their care.
Assembly member Mariko Yamada (D-Davis) authored both bills.
“Our commitment to all issues relating to aging and the long-term care population continues,” Yamada said. “We thank the governor for helping make sure greater transparency is available for veterans, and ensuring that nursing home facilities are included in emergency response plans. And at no cost to the state.”
Timeline Delineates Duals Project Tasks
The state Department of Health Care Services has released a timeline of deadlines and target dates for its Coordinated Care Initiative, also known as the duals demonstration project.
Eventually, the duals project hopes to move about one million Californians dually eligible for Medi-Cal and Medicare benefits into Medi-Cal managed care plans. The idea, state officials have said, is to provide better, more integrated care by pooling the funding sources from two disparate programs. Coordinated care could provide stronger case management, offer needed services and save state and federal dollars.
The pilot program in eight counties, beginning in March, 2013, will serve about 700,000 of the state’s dual eligibles.
DHCS Rejects Judge’s Opinion on Adult Services Eligibility
An administrative law judge from the Department of Social Services issued an opinion that the Department of Health Care Services does not have the legal authority in two cases to deny eligibility for the Community Based Adult Services program. That opinion was rejected in an alternate decision issued Wednesday by DHCS director Toby Douglas.
The appeals process, contained at this point within the state Health and Human Services Agency, is overseen by DSS, which submits its findings to Douglas, who has final word on appeals decisions.
One of the two potential beneficiaries whose coverage was denied by the state provided California Healthline with the 10-page document containing the judge’s ruling and the state’s overruling of it.
Future of Health IT on Display at Gathering
The future of health care depends on the present of health information technology.
That was the take-home message yesterday, during the first day of a two-day conference on the progress and promise of health IT in California. The gathering is called “Connecting California to Improve Patient Care in 2012: Practical Solutions for Health Information Exchange and Quality Analytics.” That mouthful was nothing compared to the arcane and complex conversation during the first of a two-day conference in Rohnert Park. The conference concludes today.
“We are using data to improve people’s health care,” said Linette Scott, chief medical information officer for the state Department of Health Care Services. Scott said the success of state health care projects, like the duals demonstration project (also known as the Coordinated Care Initiative), for instance, depends on the successful development of information technology.
Moving ‘Almost a Million Children’ to Medi-Cal
The Managed Risk Medical Insurance Board, which oversees the state’s Healthy Families program, yesterday took a long look at the first outline of a plan to facilitate the state-ordered shift of an estimated 873,000 children enrolled in the HF program to Medi-Cal managed care.
The conclusion was, the current time frame to make such a big change is too tight, said Janette Casillas, executive director of MRMIB.
“In this transition, it is not just an administrative process to move almost a million children,” Casillas told the board yesterday. “Whenever a child is disenrolled [in the Healthy Families program], there are seven different IT transactions to make, for example. There are three separate transactions to update meds.”
Task Force Starts with Population Health
When you’re trying to take on reformation of the complex and arcane system of health care in California, where do you even begin?
At population health, apparently.
The state’s recently formed “Let’s Get Healthy California” task force convened yesterday for the first of four scheduled webinars. The meetings are part of the task force’s plan to eventually organize the unruly health care system in California by creating a priority list and action plan for what needs to be done, according to Diana Dooley, Secretary of Health and Human Services.
Appeal Decisions Due From DHCS
The Department of Health Care Services will issue a decision this week on the first “test case” appeal hearings to decide eligibility for the new Community-Based Adult Services program, according to DHCS officials.
The first appeal hearings were held May 30. After judges submit rulings to the state, the DHCS director has 30 days to decide whether or not the department accepts those rulings.
“We have received under 20 decisions [from judges] so far,” said Norman Williams, deputy director of public affairs for DHCS. “The first one was on or around June 18, and they’ve been on a flow basis since then.”