Latest California Healthline Stories
Letter Out, Senate ADHC Hearing Set for Thursday
The Department of Health Care Services has sent 26,000 notification letters to adult day health care program participants in California, notifying them that ADHC no longer will be a Medi-Cal benefit as of Dec. 1.
Beneficiaries have until Oct. 1 to choose a managed care plan or opt to remain in a fee-for-service day center. Those who choose a managed care plan, according to DHCS, will be assessed and then receive services similar to what they get in ADHC centers.
Those who don’t make a choice by Oct. 1 will be automatically enrolled in a managed care plan, according to DHCS officials.
Budget Trailer Bills Might Rescue Healthy Families Program
When faced with running a large children’s program on about $390 million less than you had before, how many beneficiaries will you be forced to drop?
That’s the question facing the Healthy Families program, which is considering a substantial disenrollment of the 870,000 children currently in the program.
The answer, according to Senate member Mark Leno (D-San Francisco), lies in two bills — ABX1 21 and SBX1 9, budget trailer bills left over from the previous session.
Massive ‘Disenrollment’ of Children Considered
The mood at the start of yesterday’s Managed Risk Medical Insurance Board meeting was somber.
The chair of MRMIB, Cliff Allenby, said a letter had recently arrived from the Department of Finance, saying that $130 million in state general fund money would need to be cut from the Healthy Families program, which is administered by MRMIB.
Since the federal government matches state money 2 to 1, that means a grand total of $390 million was suddenly gone from Healthy Families, a low-cost insurance program that covers about 870,000 children in California.
Legislators, Advocates, State Officials Attend ADHC Hearing
A legislative hearing yesterday took on the task of unraveling the legal, administrative and medical tangles generated by the elimination of adult day health care as a Medi-Cal benefit in California.
The likely closure of up to 300 ADHC centers across the state on Dec. 1 — and what will happen to the medically fragile population of roughly 35,000 seniors and the disabled in California who use those centers — has produced a swell of deep worry and frustration in the ADHC community and in Sacramento.
Advocates have charged the Department of Health Care Services with ignoring the needs of the ADHC population and shunning the advice and input of center directors and experts associated with that program.
Assembly ADHC Hearing Offers All Sides
Anyone who has been on vacation since the start of the year and missed Sacramento’s debate over the fate of the adult day health care program gets a chance to hear every part of it, all at once, today.
The Assembly Committee on Aging and Long-Term Care is holding a hearing today on ADHC — its importance to Californians, the reasons for its elimination as a Medi-Cal benefit, the details of transition for about 35,000 ADHC patients and the pending legal decision that could either approve or reject that state transition plan.
Department of Health Care Services Director Toby Douglas will attend the hearing and outline the state’s plan. ADHC advocates will make an appearance, as well, as will a representative of the legal team that is suing the state over its elimination of the ADHC benefit.
Rate Regulation, Basic Health Headed to Floor?
The state Legislature reconvenes today, starting with a Senate Committee on Appropriations hearing with 167 items on the agenda. The Assembly’s Appropriations Committee meets Wednesday, with 184 items to consider.
Those numbers will be whittled down for this week’s hearings, but generally Appropriations is the final destination before an actual floor vote for any bill that might spend money. That’s why the two committees will have so many menu items from which to choose.
Among the bills that still need to clear the Appropriations hurdle is AB 52 — by Assembly members Mike Feuer (D-Los Angeles) and Jared Huffman (D-San Rafael) — which is the health insurance rate regulation bill. Also up is the bill to create a Basic Health Program, SB 703, by Sen. Ed Hernandez (D-West Covina).
American Indian Providers Get Help With EHRs
Christine Schmoeckel of the state’s Office of Health Information Integrity was pretty happy yesterday.
“Our newest news is that we have a fourth regional extension center in California,” she said. “This is great news, that we now have four centers.”
Schmoeckel was hosting yesterday’s California health information technology stakeholders’ meeting, in part because many health IT leaders are in Southern California this week, meeting with the Office of the National Coordinator for Health IT.
Uninsured Healthier Than Current Medi-Cal Beneficiaries
Helen Lee was surprised by a few of the findings in a study released last week by the Public Policy Institute of California.
“We find a relatively young population among the uninsured,” the PPIC policy fellow said. “In fact, more than half were in the 19 to 40 group.”
Up to three million Californians will join the ranks of the insured under the expansion of coverage in 2014 mandated by the federal Affordable Care Act. So it’s important to know the demographic makeup of all of those potential enrollees, Lee said.
State Lambasted Over Transition Plan, Lack of Communication
Jill Yungling was trying to hold in her exasperation yesterday, but it just kept spilling over.
“It is appalling to me how they can sit up there and say all of these things, and it’s all so full of holes,” Yungling said, “and we’re just supposed to sit down here and believe them.”
Yungling came from Carmichael to attend yesterday’s adult day health care stakeholder meeting in Sacramento. The California Department of Health Care Services convened the session to discuss the elimination of ADHC as a Medi-Cal benefit, a move that is likely to shutter most of the 300 ADHC centers across the state.
New Transition Plan, New ADHC Options
There’s an interesting phrase in the state’s new transition plan for the adult day health care program: “ADHC-like services.”
It’s one of the care options listed in the state’s recently released transition plan, and it will be part of the discussion today in Sacramento, when the Department of Health Care Services holds an ADHC stakeholder meeting.
“Current ADHC [centers] could provide ADHC-like services under the waiver,” according to Toby Douglas, the director of DHCS. “There are ways we can do that as part of the transition plan.”