Latest California Healthline Stories
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.”
Study Looks at Language Barriers to Exchange Coverage
Communities of color are expected to make up a large portion of the California Health Benefit Exchange population. Many potential enrollees have limited English skills, which could get in the way of obtaining coverage.
That’s according to a report due to be released today as a joint project of the UCLA Center for Health Policy Research, the California Pan-Ethnic Health Network and the UC Berkeley Center for Labor Research and Education.
“We estimate that about 2.65 million nonelderly adults will be eligible for the exchange. Of that 2.65 million, about 67% of them are people of color,” UCLA researcher Daphna Gans said. “That’s mostly Latino, followed by African American, then Asian.”
Dental Problems Showing Up as Emergencies
A study being released today by the Pew Foundation found that 83,000 emergency department visits in California in 2007 were due to preventable dental problems. That rate of dental emergencies is likely growing quickly, according to Shelly Gehshan, director of the national Pew Children’s Dental Campaign.
“It is the wrong service, in the wrong setting, at the wrong time,” Gehshan said.
“These are people who come in with dental pain, and they’re desperate. The emergency room can’t cure that, so they don’t really get the problem taken care of.”
Exemption Granted for Pediatric Day Health
For months, Terry Racciato has been trying to get the state to reverse its imposition of a 10% Medi-Cal provider rate cut on the 14 pediatric day health care centers in California.
Racciato, who runs two PDHC centers in the San Diego area, has been arguing with the Department of Health Care Services that pediatric day health care services should be exempted from that 10% rate cut, as home health agencies were.
On Friday, the state agreed.
Hearing Examines States’ Behavioral Health Restructuring
The state has big plans for restructuring the behavioral health system in California. State legislators held a rare four-committee joint hearing this week to hear about the details of that reorganization, and to raise concerns about it.
“We understand the need to streamline and cut costs,” Sen. Ed Hernandez (D-West Covina) said, “but at what cost?”
Assembly member Holly Mitchell (D-Los Angeles) said California’s consumers must be at the center of all discussion about changing health care policies and programs.
“I think it is critical to pause, as a body,” Mitchell said, “to make sure consumers aren’t harmed by this streamlining of our departments.”
From Supreme Court to Appeals Court
Yesterday’s decision by the U.S. Supreme Court had a ripple effect in California, influencing a number of lawsuits in the state over health care cuts.
Four lawsuits have been filed over the 10% Medi-Cal provider rate cuts, and in all four cases, a federal judge has issued a temporary injunction blocking those cuts. In another court case, an injunction halted 20% trigger cuts to Californians receiving In-Home Supportive Services.
All of those cases were waiting to see what the Supreme Court would decide in Douglas v. Independent Living Center of Southern California. Yesterday’s decision to send that case back to the Ninth Circuit Court of Appeals was a huge victory for patient rights’ groups, according to Melinda Bird, a Disability Rights California attorney.
Working Out the Details of the Exchange
James Robinson can sum up the ultimate ideal and goal of the health benefit exchange in California:
“We want to cover all services, for everyone, without prior authorization,” he said. “And without having to pay for it.”
Robinson, director of the UC Berkeley Center for Health Technology, was part of a panel discussion at yesterday’s California Health Benefit Exchange board meeting. Health experts chimed in on a series of panel discussions designed to help the board make sense of the complexity of the new exchange.
Adult Day Care Transition Gets Another Month
The state’s move on Friday to shift the transition date for Adult Day Health Care elimination by a month was borne of a request by CMS, according to officials from the Department of Health Care Services.
Advocates say the delay may be due to the scattered nature of the state’s transition so far.
“It’s been a royal mess,” Corinne Jan of the Family Bridges ADHC in Oakland said. “Lots of duplications on the lists. Some people got a notice they were eligible [for the alternate program], then another saying they’re not. Lots of confusion.”
More Uninsured Could Put Pressure on State
A UCLA Center for Health Policy Research report showed that 670,000 Californians lost employer-based health insurance in 2008 and 2009. That is a far cry from the earlier estimate of 2 million newly uninsured in the state. But what’s interesting about the new number, according to the report’s lead author Shana Lavarreda, is that it indicates that a new class of uninsured has been rising.
“The uninsured here is less and less an undocumented [worker] problem, and now it’s more of a Main Street problem,” Lavarreda said.
A majority — if not all — of those working-age Californians who lost coverage over that two-year period could have been considered residents of “Main Street.”
Can Health Equity Be a Moneymaker?
Sometimes the right thing might also be the financially beneficial thing.
Physician groups are gathering today in Sacramento for a conference on disparities in health care related to race, language and geography. This time, the debate is not just about the moral imperative to promote equity in health care, but also about the clinical and financial impetus to make that move.
“The thing that has changed, as more people are brought into systems of care with accountability, health organizations are going to be looking at avoidable cost as well as avoidable risk,” according to Wells Shoemaker, medical director of the California Association of Physician Groups, which organized the conference.”It’s sort of the low-hanging fruit when you’re looking for avoidable costs.”