Latest California Healthline Stories
The Exchange by Any Other Name
Now there are four.
At yesterday’s meeting of the state’s Health Benefit Exchange board, Chris Kelly, the exchange’s senior advisor for marketing and outreach, presented the four finalists in the project to pick a new name for the exchange — the name that will be used to market the exchange’s choices and services.
“We brought forward about 13 names last time [at the Aug. 23 board meeting],” Kelly said, “including Wellquest and, of course, Avocado — that is still a crowd favorite.”
Kelly prefaced his presentation by reiterating that each proposed name includes a marketing package with a unique logo and tagline — “a voice of its own,” as Kelly put it.
Motion Could Delay Implementation
A court motion filed Saturday challenging the state’s implementation of a new program for adult day services raises a number of concerns about how the new legal hurdle may affect timing and appeals in the new Community Based Adult Services program.
One of the main issues revolves around the fate of approximately 2,400 former Medi-Cal beneficiaries of Adult Day Health Care services. Those frail, elderly and disabled people had been denied eligibility to the replacement CBAS program. Many of them had been denied eligibility after earlier being approved for it.
According to Elissa Gershon, attorney for Disability Rights California which filed the motion Saturday in U.S. District Court in San Francisco, there are approximately 2,200 appeals of eligibility still outstanding, and roughly another 200 who have had a hearing but are still awaiting a decision.
October Start for New Adult Day Program Could Be Halted
Disability Rights California on Saturday filed a motion in U.S. District Court to stop the Department of Health Care Services’ implementation of portions of the Community Based Adult Services program, saying the department violated terms of a previous settlement agreement.
The motion noted that a federal court twice prohibited cutbacks to Adult Day Health Care benefits because “the loss or interruption of necessary ADHC services would irreparably harm ADHC recipients and place them at serious risk of institutionalization.”
That led to a December lawsuit settlement agreement that established the CBAS program to replace ADHC services.
Uninsured Number Dips — But Why?
Census results released Wednesday show a drop in the number of people without health insurance nationally, from 16.3% of Americans in 2010 down to 15.7% in 2011, about 1.4 million fewer uninsured across the country.
Given the weak economy, that was a welcome development to Kiwon Yoo, policy director of the Insure the Uninsured Project, based in Santa Monica.
“The biggest reason for that is the dependent coverage that kicked in,” Yoo said. “The numbers declined by about 2.2% in that age group, and that’s 3 million people nationally. That’s a big chunk of it.”
Legislative Help for Long-Term Care?
The SCAN Foundation today released results of a survey on long-term care readiness in California. It wasn’t pretty:
• Roughly half of the poll respondents said they will need long-term care for a close family member within the next five years.
• About half of the poll respondents said they cannot afford even one month of nursing home care.
• Almost two-thirds of the registered voters in the poll said they’re worried about being able to afford long-term care.
• A whopping 88% of those polled said legislators should make affordable long-term care a high or moderate priority.
Promise, Peril of Duals Program
Advocates see potential for improvement but also are concerned about consumer protections in the transition of roughly 1.1 million Californians into Medi-Cal managed care. The state is launching a managed care pilot project for beneficiaries who are dually eligible for Medicare and Medi-Cal, California’s Medicaid program.
“This is really a critical moment in time for dual-eligibles and represents an amazing time to improve care for duals,” said Kevin Prindiville, deputy director of the National Senior Citizens Law Center office in Oakland. “But it’s also a time to be very careful and cautious about how we proceed to move forward.”
Prindiville, one of several speakers at an informational forum last month, said California is still negotiating with CMS officials, so some of the details of the plan are still uncertain.
Oversight Commission: ‘Descriptions Incomplete’
A state oversight commission found little to no substance in reports of programmatic misconduct in its initial report released yesterday on concerns raised over compliance with Mental Health Services Act program in California.
“Basically, in the programs that were mentioned, the descriptions of those programs were incomplete,” said Jennifer Whitney, chief of communications for the Mental Health Services Oversight and Accountability Commission. “And that painted a very different picture of the programs.”
Several recent news reports questioned 13 different programmatic elements that supposedly used MHSA funds for such things as yoga classes and a sweat lodge.
Tuberculosis Added to Screening List
Legislators have worked on a number of bills this session related to immunizations. On Friday, Gov. Jerry Brown (D) signed one of them into law.
SB 659 by state Sen. Gloria Negrete McLeod (D-Chino) requires tuberculosis screening to be included on the state’s immunization registry. That will help health officials coordinate TB immunization efforts, Negrete McLeod said, because parents now won’t need to prove immunization with their yellow-card record.
“By allowing these results to be included in the state registry,” she said, “parents will have an easier time demonstrating compliance with the requirements of local school districts.”
$4.6 Million Grant for Consumer Assistance
The Department of Managed Health Care recently received a $4.6 million federal grant to fund its consumer assistance program to help answer questions from California consumers about health coverage.
“This will enable us to reach and assist more Californians who are struggling with health coverage questions,” said Marta Green, deputy director for communications and planning at DMHC.
“The focus of the grant is on consumer assistance for Californians,” Green said, “and in particular to help seniors and people with disabilities, who have more specific needs.”
To get an idea of why health care reform is so important, said Pam Kehaly, president of Anthem Blue Cross, you have to understand how much it costs.
“The issue today is how to restrain the rising cost of health care while delivering high-quality care,” Kehaly said at a policy roundtable discussion in Sacramento yesterday. “Last year, that was a $2.7 trillion expenditure. We throw these numbers around, but it’s hard to understand the magnitude of what we’re talking about. But if you sat at your dining room table tomorrow morning and turned over dollar bills, one after the other, it would take you 92 years to reach $2.7 trillion.”
Or put another way, Kehaly said, the cost of health care is about $8,400 for every American every year. “That means, for a family of four, it’s pretty much like buying a new car every year,” Kehaly said. “The amount of the economy of France — that is, how much France and the French people spend on everything — that’s how much we spend on health care.”