Latest California Healthline Stories
Trying To Provide Solutions to Patient Access
California is in a bit of a fix, according to Senate member Ed Hernandez (D-West Covina), chair of the Senate Committee on Health.
The state doesn’t have enough physicians and other primary care providers now, according to some estimates. That shortage will become more acute in 2014 when the Affordable Care Act brings up to four million newly insured Californians into the system, looking for providers to care for them.
“2014 is essentially here,” Hernandez said yesterday at a Senate health committee hearing on primary care workforce issues. “We have had a historic piece of legislation pass at the federal level, the most historic health legislation since the Lyndon Johnson administration, when the Medicare Act was passed. But there are a lot of unknowns still, including how to implement it.”
Caregivers make up a sizable volunteer workforce in California — people who put in about 1.7 billion hours of care last year and didn’t get paid for it. If they did, all of that work is valued at more than $20 billion. In California, where more than 10,000 people turn 65 every day, the need for that workforce will only grow.
That’s according to a raft of testimony yesterday at the Capitol Building in Sacramento, before a joint hearing of two committees: Human Services and Aging and Long-Term Care.
The state doesn’t do much for this vast and contributing population, and is about to do even less, according to Michelle Pope, executive director for Alzheimer’s Services of the East Bay, who testified yesterday before the joint committee.
Health Insurers, Physician Group Oppose Ballot Initiative
It’s not even a ballot measure yet, but it’s certainly getting ballot-measure treatment.
Yesterday, a coalition of health insurance organizations, the California Medical Association, the California Hospital Association and other groups announced they were joining forces to fight a ballot measure designed to regulate health insurance rate increases.
“This initiative does nothing to address the cost drivers in the health care system,” according to Paul Phinney, president-elect of the CMA. “I just think this initiative is the wrong idea.”
Legislature Examines Duals Transition
Toby Douglas took a good amount of heat last Wednesday at an Assembly joint hearing of the committee on Aging and Long-Term Care and the Budget subcommittee on Health and Human Services.
Douglas — director of the state Department of Health Care Services — with a full array of budget cuts, program transitions and agency reorganization on his plate, has been making presentations and fielding questions at a number of legislative hearings recently. None of them has been a cakewalk, but this hearing was a little more barbed than most.
Complaints and concerns ranged from a perceived lack of choice to worry over rapid-fire changes.
California Mandates 48 Specific Areas of Coverage
An analysis released yesterday by the California Health Benefits Review Program shows that a large cross-section of Californians — about 32 million people — will be covered by health care mandates passed by the Legislature. There are now 48 of those mandates that either require coverage or require an offer of coverage, and another five mandates that deal with more general terms and conditions of coverage.
That is not the final word on the number of mandates. CHBRP was asked to evaluate three more legislative bills recently that deal with mandated coverage of tobacco cessation, prescription drugs and children’s immunizations. In addition, some of the 16 bills the agency analyzed last year are up for approval this year. They include mandates ranging from mental health coverage to oral chemotherapy treatment.
State-passed mandates could have a financial impact on the health plans that need to cover those conditions and also may affect the list of essential health benefits offered by the California health benefit exchange.
More People May Be Eligible for Adult Day Services
There was a glimmer of good news for the 35,000 adult day health care Medi-Cal patients in California. It looks like a much higher percentage of them than previously estimated will be eligible to receive the new benefit called Community Based Adult Services.
Department of Health Care Services Director Toby Douglas originally said he expected about 50% of current ADHC patients to qualify for the new program. ADHC will be eliminated as a Medi-Cal benefit on Mar. 31 and the CBAS program starts Apr. 1.
Now it looks like 70% to 80% of those receiving the ADHC benefit will qualify for CBAS, according to Catherine Blakemore, executive director of Disability Rights California, which is monitoring the state’s assessment and placement of ADHC patients.
Survey: Californians Concur on Need for Prevention
At a joint Assembly and Senate health hearing yesterday, results of a Field Poll unveiled a few days shy of the official release indicate that an overwhelming majority of Californians (about 80% of those surveyed) believe government and schools need to pitch in to fight childhood obesity and that preventive health programs pay for themselves in reduced health care costs to the state.
That tied in nicely with the intent of the hearing, which was convened by the two legislative health committees to look at ways to focus health policy toward prevention of chronic conditions such as obesity, heart disease and diabetes.
“When we look at the fact that individual [health] behavior and people’s environment contribute to about 70% of our health care costs, it should really be addressed,” according to Larry Cohen, founder and executive director of the Prevention Institute and a panelist at the hearing. “But our health care investment is only about 4% in prevention.”
Central Valley Residency May Stay Open
Paul Hensler, CEO of Kern Medical Center in Bakersfield, said yesterday he plans to keep the family practice residency program intact.
Two weeks ago, the hospital announced it was closing that residency program to the incoming class of six residents, though the program itself would continue. Yesterday, Hensler said he and community members have been working hard to come up with a solution to keep the program.
“There are two scenarios,” Hensler said, “to either make the [Family Practice] department more cost-effective, or to develop a collaborative program with the community here.”
Welfare to Work Seen As Health Issue
Phil Ansell, director of the Los Angeles County Department of Social Services, has watched funding for the CalWORKs program diminish over recent years. At an Assembly hearing late last week, Ansell held both hands apart, as if measuring a decent-sized fish in the air.
“If this balloon is our welfare-to-work program,” he said, then moved his hands closer together, “we have managed to shrink it without tearing it.”
If the governor’s recently proposed cuts to CalWORKs go through, though, Ansell said it’s likely that balloon will pop.
Organizing the Mental Health of California
Assembly member Wesley Chesbro (D-Arcata) is nothing if not optimistic.
But at last week’s Assembly hearing on mental health issues, even he was having a little trouble trying to make lemonade of the budget cuts to mental health services.
“We have gotten to the point where we’re cutting things that were originally designed to save costs,” Chesbro said of one particular mental health-related program, the caregiver resource centers.
“At this point,” Chesbro said, “we’re like the farmer eating his seed corn.”