Latest California Healthline Stories
Appropriations Committee Moves Single Payer Toward Floor
After all the drama, controversy and heated debate over legislation to set up a single-payer health care system in years past, last week’s appropriations committee approval of the measure was strikingly brief and uneventful.
Like several other bills up for approval at last week’s hearing, there was no presentation on single payer — only a vote, followed by an eight-word pronouncement from Senate Committee on Appropriations Chair Christine Kehoe (D-San Diego):
“OK,” Kehoe said, “6 to 2, that measure is out.”
Trigger Cuts to IHSS Care Put on Hold
Federal judge Claudia Wilken did not mince words yesterday when an attorney representing California asked her if she would issue a stay, to grant the state the right to start implementation of a proposed 20% cut in In-Home Supportive Services.
“No, I won’t stay it,” Wilken said of the temporary restraining order she issued last month. “The TRO is now the permanent injunction, … but it will be modified. It is appealable, as of now. But no, I’m not going to lift it.”
The injunction means that 370,000 Californians, mostly seniors, will continue to receive IHSS care, while the state appeals the decision.
Cuts, Policy Changes at Healthy Families Program
The most recent state budget proposal includes a variety of cost-saving measures in the Healthy Families program — reduced reimbursement rates, higher premium prices, higher copays and a transition of its 877,859 children into managed care plans by the end of June 2013.
At yesterday’s monthly meeting of the Managed Risk Medical Insurance Board, chief deputy director Terresa Krum broached the bad news.
“There are a number of significant budget assumptions,” Krum said. “So first, the budget proposes to reduce the per-member, per-month rates paid to health plans in Healthy Families to the average Medi-Cal rate.”
Lots To Do With Less Than Two Years To Go
It is an eventful month for the California Health Benefit Exchange board.
Tomorrow, it releases its final solicitation for technology to help run the exchange. Proposals are due at the end of this month for the communication, outreach, assisters and health plan management components of the exchange.
Meanwhile, Executive Director Peter Lee said at yesterday’s board meeting, the exchange has continued to hire new personnel and is now negotiating for office space to lease in Sacramento to accommodate all of those new hires.
State Moving Toward Licensing Home Health Workers
Two bills have been proposed to regulate an estimated one million unlicensed home health workers in California. The big questions are, how much regulation is needed, and how much that type of program will cost. One of the bills, AB 899 by Mariko Yamada (D-Davis), has looser requirements and is currently stuck in the Assembly appropriations committee.
The one more likely to make it to the floor is SB 411 by Curren Price (D-Inglewood), which would require background checks and care instruction for all home health care workers. It is expected to be taken up for a floor vote as soon as the end of January.
SB 411 is the one up for debate and possible amendment, according to Jordan Lindsey, director of policy and public affairs for CAHSAH, the California Association for Health Services at Home.
‘Road Map’ Lays Out Details for Building Exchange
The Children’s Partnership “blueprint for reform” released this week marks an important milestone in the formation of California’s Health Benefit Exchange, according to Kristen Golden Testa, health director of the Children’s Partnership.
“The [Health Benefit] Exchange board did a lot of work on the visioning process, figuring out what they wanted the exchange to be like,” Golden Testa said. “This offers a road map to get to a lot of the visioning pieces.”
The report was released in draft form to the exchange board in December, and some of the detail laid out in the report may have helped board staff develop that RFP, Golden Testa said.
Medical Transport Lawsuit Gets Federal Injunction
A federal judge issued a preliminary injunction Wednesday to halt a 10% Medi-Cal provider reimbursement cut to medical transportation services.
It was the third time the state has lost in court on this issue. State officials said the state will appeal. Preliminary injunction rulings at the end of December halted cuts in hospital and pharmacy services. Another lawsuit, brought by the California Medical Association and other providers, is still pending.
Marat Sheynkman, executive director of the California Medical Transportation Association, which filed the suit that triggered Wednesday’s ruling, said the 10% Medi-Cal reimbursement cut would have hit medical transport providers particularly hard.
Controversy Surfaces Over Ombudsman Plan
Legislative committees started back up with a bang yesterday, when a seemingly benign measure to beef up the state’s Long-Term Care Ombudsman Program was almost scuttled by its director.
Yesterday, during the first meeting in months of the Senate Committee on Human Services, Senate member Lois Wolk (D-Davis) introduced SB 345, which is designed to increase the advocacy power of the long-term care ombudsman’s office.
“The idea is to strengthen the ability to advocate residents’ rights,” Wolk said. “There is warranted concern that the ombudsman’s office has not been adequately representing residents. The ultimate goal is that the ombudsman’s office will aggressively pursue advocacy for the residents of long-term care facilities.”
Legislation Would Require On-Time Medicaid Payments
Sarane Baker-Collins remembers the time well. “We went for months without a [Medi-Cal] payment. We kept doing our work, and the state didn’t pay us for months. It’s almost criminal what the state did to us.”
Baker-Collins runs three small homes for residents with developmental disabilities in Santa Rosa. In the wake of the budget impasse of 2008, California had to shut off payments to Baker-Collins and other health care providers until a budget could be agreed upon.
Some Medi-Cal providers went as long as 60 days without reimbursement. For a small not-for-profit on a thin margin like the one run by Baker-Collins, that’s a cost hard to bear.
Could New Not-for-Profit Requirement Limit Patient Access?
State health officials recently outlined new requirements for the transition of adult day health care centers into the nascent Community Based Adult Services program. They include the stipulation that centers must be not-for-profit to qualify for Medi-Cal funding.
Many centers are for-profit, particularly in Los Angeles County where the bulk of day care beneficiaries live. Advocates worry the change could decrease access to care if for-profits are unwilling or unable to make the conversion to not-for-profit status.
Elissa Gershon, a senior attorney for Disability Rights California, said the new not-for-profit requirement could make it difficult for some beneficiaries to find care.