Latest California Healthline Stories
Tulare County Hospitals Want to Form LIHP
Senate member Jean Fuller (R-Bakersfield) is not interested in leaving federal health care dollars on the table.
That’s why she introduced a bill last week in the Senate Committee on Health that would enable local hospital districts in Tulare County to gain access to about $4.5 million in federal money over the next 18 months for a local Low Income Health Program (LIHP).
“Under current law, the county’s non-participation [in LIHP] precludes hospitals from leveraging the federal dollars that are available under the Medicaid waiver,” Fuller said last week in a Senate health hearing. “We can improve health care access with this, particularly in rural areas.”
New Adult Program Launches With a Few Issues Still To Be Resolved
It was January 2011 when the governor first red-lined the Adult Day Health Care program for elimination as a Medi-Cal benefit. Since then, it has been rescued, cut in half, eliminated altogether, reinstated and replaced.
Yesterday the replacement program, Community Based Adult Services, went into effect. For about 32,000 former beneficiaries of ADHC, the changeover will go relatively unnoticed. Most of the currently open centers are expected to remain open, and CBAS benefits are similar to those in the now extinct ADHC program.
“It’s a culmination of months of hard work, developing a program that’s appropriate and useful for former ADHC participants,” Norman Williams of the Department of Health Care Services said. “We had a goal of a program that would allow people to remain independent and living in the community.”
The CBAS era has officially begun.
Late Friday night, CMS approved implementation of the Community Based Adult Services program. That means the state has successfully eliminated adult day health care as a Medi-Cal benefit, and is replacing it with CBAS, starting today.
According to officials from the Department of Health Care Services, almost 32,000 of the nearly 40,000 ADHC beneficiaries have been deemed eligible for CBAS. That’s more than 80% of the ADHC population.
State: DHCS Contempt Motion Won’t Delay New Program Launch
Attorneys gathered in U.S. District Court yesterday morning to argue whether or not the state Department of Health Care Services should be found in contempt of court for its handling of the adult day health transition.
That argument will wait a week, at least. After meeting two hours yesterday, the two sides agreed to delay court proceedings.
“At this point the parties have been working on a possible solution. We hope to have a decision by next Friday,” Disability Rights California attorney Elissa Gershon told the federal magistrate hearing the case.
Ironing Out Details of Duals Conversion
State officials met with stakeholders in Sacramento yesterday to answer questions and work out the final details of the duals demonstration project — an ambitious plan to enroll an estimated 700,000 dual-eligible Californians in 10 counties into Medi-Cal managed care.
Enrollment will be mandatory for beneficiaries eligible for both Medi-Cal and Medicare. Jane Ogle, deputy director of health care delivery systems at the Department of Health Care Services, was quick to point out that beneficiaries would keep their own physician, even if that physician is not in the Medi-Cal network, and that beneficiaries have the power to opt out of the demonstration project, if they want.
“There is no need to assign a new doctor to people,” Ogle said. “There just is no need to do that.”
Changes Intended to Smooth MRMIP Operation
Assembly member Bill Monning (D-Carmel) is chair of the Assembly Committee on Health, but at yesterday’s meeting he went to the other side of the dais to present a piece of new legislation.
Monning’s AB 1526 would eliminate the annual and lifetime limits on coverage in the Major Risk Medical Insurance Program, popularly known as MRMIP.
“This bill is related to two goals I’ve had since I started in the Assembly. And number one is to make MRMIP more affordable for people who are in dire need of it,” Monning said. “And the other goal was, to actually meet Mister Mip.”
Pediatric Centers Must Pay Retroactively
If you were running a business on a shoestring budget, how hard would it be to pay off a lump sum payment equal to 10% of costs for the past 10 months?
That’s the question Terry Racciato would like to ask officials at the Department of Health Care Services.
Racciato, president of two Together We Grow pediatric day health centers in San Diego, is facing the prospect of paying the state $200,000 or more for what she considers to be a state administrative mistake.
Advocates File Contempt Motion Against State
The settlement now is officially unsettled.
Disability Rights California, which filed and then settled a lawsuit challenging the transition of adult day health care by the Department of Health Care Services, now has filed a contempt motion saying that DHCS officials have not been following the terms of the agreement.
That settlement prompted the state’s creation of the Community Based Adult Services program, due to launch Sunday, the day after ADHC is eliminated as a Medi-Cal benefit.
Legislative Hearing Looks at Transition Plans
During a Senate subcommittee review of a number of state health care proposals yesterday, one theme seemed to stand out: People are unhappy with them.
The budget subcommittee on Health and Human Services heard proposals by the Department of Health Care Services to cut health plan rate reimbursement for Healthy Families’ children by 25%. In addition, DHCS intends to move 900,000 children from that program into Medi-Cal managed care. The committee also heard from a long parade of people who opposed those proposals.
After all the testimony and acrimony, subcommittee chair Mark DeSaulnier (D-Concord) didn’t quite know what to say.
Solution to Physician Shortage May Lie in Mid-Level Practitioners
Ed Hernandez, an optometrist, can see it coming.
The Democrat Senate member from West Covina yesterday helped convene the second hearing in a week to explore the looming shortage of primary care providers in California. The addition of millions of newly insured along with a likely decline in the number of physicians in California is an equation that worries Hernandez. He said the gap is unlikely to be filled in traditional ways.
“Last week we looked at the shortage of providers in California, a shortage that will not lessen,” Hernandez said yesterday at a joint meeting of the Senate Committee on Health and the Senate Committee on Business, Professions and Economic Development.