Latest California Healthline Stories
Immunization Procedure Passes Committee
Richard Pan is a pediatrician as well as an Assembly member, so the bills he authors on children’s health care carry a little more weight with his fellow legislators.
But Pan (D-Sacramento) had his hands full yesterday in the Assembly Committee on Health, as he introduced AB 2109, a bill that would require licensed providers to educate parents about the risks of skipping immunizations — for their children as well as others in the community. The bill would require providers to sign an exemption form specifying that parents had been educated about the risks but still chose against vaccinations.
“We want to make sure parents or guardians have an opportunity to talk to a licensed health care professional,” Pan said. “And the reason for that is, that decision doesn’t just impact that child. It impacts the larger community.”
State Wins Case to Cut Adult Day Provider Rates
After four similar cases went against the state in the past few months, the Department of Health Care Services won in court late Friday, when a federal judge refused to issue a preliminary injunction against Medi-Cal cutbacks.
The lawsuit, brought by the Adult Day Health Care Association, challenged the department’s plan to cut Medi-Cal provider rates by 10%. Judges in four other cases issued preliminary injunctions halting those cuts, including suits brought by the California Medical Association and the California Hospital Association.
The difference in this case, according to DHCS spokesman Norman Williams, lies in a previous settlement of another case over the state’s adult day health services. That settlement prompted the creation of a replacement program, Community-Based Adult Services, and included an agreement that covered the lower rates.
Bill Would Expand Clinics’ Hiring Options for Mental Health Care Providers
Palm Springs has a problem that is shared in rural communities across California, according to J.M. Evosevich, a marriage and family therapist from Palm Springs who is a past president of the California Association of Marriage and Family Therapists. Evosevich said at a recent Assembly hearing that clinics throughout rural California have a problem: They can’t find enough social workers to take care of people’s mental health needs.
“There’s a waiting list for people that need mental health care, and they can’t provide it because they don’t have the [mental health] providers,” Evosevich said. “We are uniquely qualified to deal with marriage and family therapies. And those services are lacking in our area.”
AB 1785 by Bonnie Lowenthal (D-Long Beach) aims to change. The bill came before the Assembly Committee on Health last week.
Health Committee Approves Additions to Medical Review Plan
The independent medical review process in California needs an update according to Senate member Ed Hernandez (D-West Covina) who introduced SB 1410 at Wednesday’s Senate Committee on Health hearing.
“This bill deals with the Independent Medical Review program as an important safeguard for consumers of health care in California,” Hernandez said. “Collectively these changes will improve the effectiveness and transparency of the IMR program.”
Hernandez said the bill adds three improvements to the current IMR process in the state.
‘It Can Be Costly to Treat CCS Kids’
Assembly member Cathleen Galgiani (D-Tracy) is well aware of the budget crisis in California. But she’s also aware of another crisis in children’s hospitals, she said.
“It can be costly to treat CCS (California Children’s Services) kids,” Galgiani said. “The Department was considering reimbursing hospitals at their negotiated California Medical Assistance Commission or otherwise known as CMAC rate. This bill would clarify [that] reimbursement.”
The CMAC rate is a hospital rate of reimbursement negotiated by the California Medical Assistance Commission. The state Department of Health Care Services would like to switch to that rate. Galgiani’s AB 1728 instead would maintain the current reimbursement rate, which is a hospital’s interim rate. The CMAC rate would go into effect unless this bill is passed.
Essential Health Benefit Bill Clears Committee
Bill Monning, chair of the Assembly Committee on Health, knew the moment was a big one.
“We are serving as policymakers in extraordinary times,” Monning (D-Carmel) said yesterday at the health committee hearing. “For up to 5 million Californians, we have the opportunity before us to set essential health benefits.”
Monning introduced AB 1453, which laid out a plan for what essential benefits will be covered in California under the Affordable Care Act. The proposed set of benefits is modeled on the Kaiser small group HMO plan.
The Department of Health Care Services may need an abacus to keep track of all of the lawsuits being levied against it.
A ruling is expected as early as today in a lawsuit brought against DHCS by the California Primary Care Association and several other providers.
The CPCA hopes a federal judge will grant a temporary restraining order to halt a lower reimbursement rate for adult day health services in the recently launched Community Based Adult Services program.
Medi-Cal Cuts Face Another Preliminary Injunction
The Department of Health Care Services has been on the losing end so far of four court cases over the 10% cut in Medi-Cal provider rates. In each of the four cases, preliminary injunctions were granted to halt the cuts from specific provider groups, such as emergency transport, hospitals, pharmacies, physicians and dentists.
Now it’s adult day service providers’ turn for a judicial ruling.
A decision is expected today from federal judge Christina Snyder on a request for another preliminary injunction. This one is from adult day health providers who worked under the Adult Day Health Care program before it was terminated and replaced by the Community Based Adult Services program, or CBAS.
Food Distribution Inequity a Target of Talks
Paula Daniels is the senior advisor on food policy in Los Angeles County, but a lot of people don’t really understand what she’s working on.
“People don’t always get it,” Daniels said. “There’s an enormous amount of policy that’s related to the food system. When you think about the whole system, the kind of food, how it’s grown, how you get it, where it’s distributed, there’s regulatory policy, there’s economic policy. And from an environmental justice point of view, it cuts across every line.”
Daniels spoke yesterday in Los Angeles at an event called “An Appetite for Equity: Ensuring Access to Healthy Foods.” It’s the first of three meetings across the state sponsored by the California Pan-Ethnic Health Network. The next event is Apr. 11 in Fresno; the final one is Apr. 19 in Oakland.
State Names Four Counties for Duals Project
California took a big step yesterday, officially unveiling the four counties that will kick off the three-year project to eventually shift 1.1 million dual eligibles — Californians eligible for both Medi-Cal and Medicare — to a Medi-Cal managed care program.
The first four participants in the Coordinated Care Initiative are Los Angeles, Orange, San Diego and San Mateo counties. The Department of Health Care Services currently has authority to start the program in those counties, but legislation is pending in Sacramento that would expand authority for the number of participating counties — up to 10 of them by 2013.
The trailer bill language for that legislation has been finalized. The trailer bill is expected to be included in the budget package in June, DHCS officials said.