Latest California Healthline Stories
Physicians, Nurse Practitioners at Odds Over New Roles
It’s a time of celebration and indignation for Beth Haney, president of the California Association of Nurse Practitioners.
Last week, Gov. Jerry Brown (D) signed into law a bill that will remove a six-month waiting period for new NP graduates to write prescriptions.
However, earlier last week, the American Academy of Family Physicians came out with a policy paper that raised questions about the wisdom of expanding the scope of practice for nurse practitioners.
Governor Nixes Long List of Health Bills
Gov. Jerry Brown (D) vetoed a number of health care bills over the weekend. They ranged from a program designed to improve flu vaccinations among health care workers, to a proposal to define and promote patient-centered medical homes, to a regulation on hospital-nurse staffing ratios.
The governor had a variety of reasons he gave for the different vetoes, but at least one of those explanations didn’t make much sense, according Assembly member Henry Perea (D-Fresno). Perea is the author of AB 1000, a measure designed to make oral chemotherapy more affordable and accessible for Californians.
“While I support the author’s efforts to make oral chemotherapy treatments more affordable for the insured, this bill doesn’t distinguish between health plans and insurers who make these drugs available at a reasonable cost and those who do not,” Brown wrote in his veto message.
Access, Capacity Concerns for CBAS
California’s Community Based Adult Services program officially launches today, the culmination of a long and contentious effort to first eliminate and then replace the Adult Day Health Care program.
There were roughly 36,000 recipients of ADHC services when the governor first proposed eliminating it as a Medi-Cal benefit in January, 2011. After a long budget fight, the Legislature voted to end ADHC in May, 2011, with the proviso that a stripped-down replacement program would take its place. That plan was vetoed by the governor in June 2011, prompting a legal challenge by Disability Rights California. The settlement of that lawsuit in December 2011 led to creation of the new CBAS program.
According to Department of Health Care Services officials, about 80% of former ADHC beneficiaries now can receive CBAS benefits, which mirror ADHC services. The remaining 20% are eligible for enhanced case management services.
New Attention on End-of-Life Care
Partnership HealthPlan of California, a health insurer covering roughly 200,000 Medi-Cal beneficiaries in six Northern California counties, has decided to offer the optional benefit of palliative care to its members.
“It’s part of health care, and part of life,” said Richard Fleming, the regional medical director for PHP. “That’s why we’re arranging for greater availability of palliative care. It’s an enhanced benefit, for people before they’re in hospice.”
People in palliative care are severely ill, but don’t fall specifically into the definition of being within six months of dying. “They need a lot more medication management, and there are social issues they need help with,” Fleming said.
Is Quality Key to Cutting Long-Term Cost?
National health care reform presents an opportunity to improve the way California delivers and measures the quality of long-term care and save money along the way, according to organizers of a long-term care conference last week in Sacramento.
The long-term care population — often elders with multiple chronic conditions, multiple providers and sometimes dozens of medications — is an expensive one to treat. According to Lisa Shugarman, director of policy at the SCAN Foundation, which sponsored the conference, national reform gives California a chance to change the way it handles long-term issues.
“We are hoping to improve, not just the quality of long-term supports and services,” Shugarman said, “but also the quality of the system as a whole.”
Oversight Hearing Examines CBAS Concerns
A member of the Assembly Committee for Aging and Long-Term Care asked that the state Legislative Counsel look into variation in eligibility approvals for the state’s new adult day care program.
That was one of many concerns raised during an Assembly oversight hearing yesterday examining the state’s pending Oct. 1 implementation of much of its Community Based Adult Services program.
Toby Douglas, director of the Department of Health Care Services, which is overseeing implementation of the CBAS program, answered a number of questions from legislators about the state’s new program designed as part of a settlement of a lawsuit challenging the state’s plans following elimination of the Adult Day Health Care program.
Assembly Hearing Raises Questions About Adult Day Care Transition
An Assembly hearing today will examine the state’s planned Oct. 1 transition from Adult Day Health Care to the Community Based Adult Services program.
A growing chorus of concerns has been raised about the new program for seniors and disabled so it’s important to examine plans closely before the transition begins, said Assembly member Mariko Yamada (D-Davis).
“Eliminating ADHC was a painful 2011 budget action taken with the understanding that strategic replacement services for some of our state’s most vulnerable adults would continue,” Yamada said. “Despite a legal agreement establishing a standard for these replacement services, many of our constituents report continued problems in timely adjudication of appeals and access to care.”
Exchange Considers Community Grants for Outreach
Stakeholders and board members mapped out marketing strategies focusing on community outreach for California’s new Health Benefit Exchange at a board meeting this week in Sacramento.
Board members realize new rules and opportunities coming into play in 2014 as part of national health reform may be confusing for many Californians and they hope to make the process as simple and straightforward as possible.
The exchange’s staff is planning ways to use community-based grants to educate Californians on how and where to sign up for health care. The exchange is paying particular attention to communicating with populations it considers hard to reach, including rural and lower income Californians, according to Juli Baker, chief technology officer for the exchange.
MRMIB Balks at Oct. 1 Deadline to Start HF Notices
Managed Risk Medical Insurance Board officials yesterday expressed reluctance and worry over the state’s plan to move 415,000 children out of the Healthy Families program and into Medi-Cal managed care plans on a single day — Jan. 1, 2013.
Because notices of the change would need to be sent 90 days prior to the big shift, letters would need to be mailed to beneficiaries in a little more than a week, by Oct. 1.
That plan moves too many children too quickly, said board member Richard Figueroa.
DHCS Says State Is Ready for Adult Day Care Transition
Advocates for seniors and the disabled filed a motion on Saturday asking a U.S. District Court judge in San Francisco to intervene in some implementation details of the settlement agreement it signed eight months ago with the Department of Health Care Services.
State officials yesterday answered some of the questions about the Oct. 1 implementation of the Community Based Adult Services program.
Some advocates worried about confusion around the launch of the CBAS program since the state is holding training sessions for the CBAS changeover in October for both health plans and physicians.