Latest California Healthline Stories
Will Ending Adult Day Health Care Services Save State Money?
The state has said its decision to eliminate adult day health care services as a Medi-Cal benefit — essentially shuttering ADHC centers and moving beneficiaries into managed care — is a cost-saving move. But there are questions about how much money it actually will save.
Committee Chair Asks for Four-Month Delay of ADHC Elimination
Assembly member Mariko Yamada (D-Davis) called yesterday for a temporary delay of the scheduled Dec. 1 elimination date for adult day services as a Medi-Cal benefit. She wants that date to be extended to Mar. 31.
Yamada, chair of the Assembly Committee on Aging and Long-Term Care, said the state’s transition plan moves too quickly for the large scope of the changes it’s undertaking involving a vulnerable population. She and other legislators have serious concerns about the rapid time frame, and a number of them have signed the request for delay, according to Yamada.
The state Department of Health Care Services is trying to shift services for 36,000 elderly and disabled ADHC patients by Dec. 1. That includes an effort to move most of those recipients into managed care programs by Oct. 1, so those managed care plans can conduct assessments on many of those patients and make sure their services are in place before the Dec. 1 benefit cut-off date.
Bundled Payments and the Scars of Capitation
Health care organizations are grappling with a new CMS plan to realign payment along episodes of care. California’s experience with capitation and other payment models will give state providers a unique vantage point on the initiative.
Sacramento Event, Physician Highlight CCS Program
Assembly member Richard Pan (D-Natomas), a primary care physician, has been advocating pretty strongly for specialists and for the state’s children who benefit from their care.
Last week, physicians and patients gathered at a clinic in Sacramento to promote Pan’s AB 301, which would extend the deadline for funding the California Children’s Services program (CCS) by about four years.
The CCS program ensures access to specialists for about 185,000 children with severe and chronic health conditions in California.
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.
Building Public Trust in Electronic Health Information Exchange
The privacy and security “Tiger Team” has been prolific in its issuance of recommendations on everything from patient consent to authentication. The group’s recommendations are likely to factor strongly into the Office of the National Coordinator for Health Information Technology’s privacy- and security-related policymaking.
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.
Smokers, Politicians Struggle With Tobacco Habit
Smoking among adults is dropping in California, according to a recent report. Another kind of tobacco habit — money spent to influence California politicians and policy — could be on the rise in coming months in response to a statewide ballot initiative to increase the tobacco tax.
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.