Latest California Healthline Stories
DHCS Request To Delay ADHC Case Granted
The day in court for adult day health care will have to wait.
A U.S. District Court judge on Friday approved a request by the California Department of Health Care Services to put off the hearing that challenges the department’s elimination of the ADHC program.
The hearing on a suit by Disability Rights California was set for tomorrow. ADHC centers across the state were watching that date to gauge whether or not they’ll be able to remain open much longer. The new hearing is scheduled for Nov. 1, 30 days before the state’s scheduled elimination of the program at roughly 300 ADHC centers across California.
ADHC Saga About to Take a Pivotal Turn
The state Department of Health Care Services is moving to cancel its July 26 court hearing over the legality of eliminating the ADHC program.
DHCS also sent a letter this week to CMS asking for a three-month extension to the original Sept. 1 elimination date. That request was approved by CMS and that approval is being used as the basis for canceling the upcoming court date, according to Lydia Missaelides of the California Association of Adult Day Services.
On top of all of that, the word in the Dome is Gov. Jerry Brown (D) is set to veto the KAFI program as soon as today, or possibly over the weekend.
Incentive Plan Working for Public Hospitals
A big component of the federal Medicaid waiver California officials negotiated last year was the provision to set up an incentive program to redesign systems and improve quality in public hospitals.
It’s going well, apparently.
Melissa Stafford Jones of the California Association of Public Hospitals said all the state’s public hospitals “met their milestones.”
Children’s Programs Slowly Moving Forward at MRMIB
Reports of the demise of the Managed Risk Medical Insurance Board were a little premature. There it was, alive and well at its monthly meeting last week, discussing expansion of existing programs and establishment of new ones.
MRMIB runs four programs: Healthy Families, Access for Infants and Mothers (AIM), the Pre-Existing Condition Insurance Plan (PCIP) and the Major Risk Medical Insurance Program (MRMIP).
The agency was slated for elimination under the governor’s May budget revision. The current plan still is to phase out MRMIB’s activities by 2014, when much of its mission will be taken over by the new federal health care reform law. But when the Gov. Jerry Brown (D) announced in May that he wanted to move 900,000 children from the Healthy Families program to a Medi-Cal managed care plan, Brown also proposed the quick elimination of MRMIB, since Healthy Families is such a large part of what MRMIB does.
Adult Day Health Care Waits for the Governor
First of all, Assembly member Bob Blumenfield (D-Woodland Hills) wants to make it clear there is reason to be hopeful.
“We have had multiple meetings with the governor’s office, making it clear what the legislative intent is,” Blumenfield said. “There is light at the end of the tunnel.”
The Legislature passed Blumenfield’s bill, AB 96, which would set up the Keeping Adults Free from Institutions program, at about half the cost of the previous adult day health care program. If Gov. Jerry Brown (D) signs it this week, $85 million would be spent trying to keep a good number of the 300 ADHC centers across the state open, and could keep thousands of seniors out of nursing homes.
Non-Contracted Services at Heart of Two Court Cases
A woman named Fucino, who is eligible for the County Medically Indigent Services Program (CMISP) and gets her care in Sacramento County, one day traveled to Monterey County to visit family. While in Monterey, she had a health issue that landed her in the emergency department in that county.
Does Sacramento County have to pay for that out-of-county ED visit? And more important, what does all of that have to do with a multimillion-dollar lawsuit filed against the county by UC-Davis?
The answer to the latter question is: non-contracted services. It’s the same principle at the core of both cases, where the court has to decide whether or not the county should pay for non-contracted services.
Is the State Shifting its No-ADHC Stance?
The state has been fighting a long battle to eliminate the adult day health care program in California — including arguing the case to eliminate it this month in district court.
That’s why yesterday’s announcement from the Department of Health Care Services was such a surprise. The department said it would delay the planned Sept. 1 elimination date for ADHC.
“The director [of DHCS] has the authority to extend the ADHC deadline, and that’s what he’s doing,” Tony Cava of DHCS said.
ADHC Lawsuit Gets Federal Support
It’s a little like the Monty Python skit where the guy keeps hopping out of the wheelbarrow during the Black Plague, saying, “I’m not dead yet.”
Well, adult day health care isn’t quite dead yet in California.
The elimination date to end the program is Sept. 1, but a lawsuit to halt that elimination just got a big boost from the federal Department of Justice, which filed an amicus brief in support of the ADHC program.
Federal Officials Take Non-Stance on Rate Regulation
This year, few bills have stirred as much vitriolic rhetoric as the proposed health insurance rate regulation law, AB 52 by Assembly members Mike Feuer (D-Los Angeles) and Jared Huffman (D-San Rafael).
Now the statewide spat threatens to draw in federal officials, and they’re having none of it.
It all revolves around a recent report from HHS, which concluded that California’s current health insurance rate review is “effective.”
Lofty Expansion Plan for Children’s Health Initiative
They’ve added a “C.” But that’s not the only change.
The successful not-for-profit Children’s Health Initiative (CHI) has changed its name and has now become California Coverage & Health Initiatives. The shift is an ambitious one.
“Originally the CHIs were local efforts to reach universal coverage for kids in a county or group of counties,” CCHI executive director Suzie Shupe said. “And we do have a pretty good track record of helping families access care, and keep them retained.”