Latest California Healthline Stories
Assembly Passes Mental Health, Addiction Coverage Bill
To Assembly member Jim Beall (D-San Jose), it just makes sense. When private insurers fail to cover addiction and mental health services, he said, the cost of those illnesses fall on the state.
“If you don’t treat it, it gets worse. If it gets worse, it gets shoved over to the public sector,” Beall said. “And then, if it gets shoved into the public sector, it gets worse. Then they end up in prison, with a substance abuse or mental health problem in prison, and this is costing the state way too much money. We need to stop the cycle.”
Beall is the author of AB 154, a bill requiring insurers to cover mental health and addiction services, which passed the Assembly floor late last week.
Personal Stories Highlight Oral Chemotherapy Bill
New legislation proposed by Assembly member Henry Perea (D-Fresno) would require health plans to provide chemotherapy in pill form, in some cases.
“This bill will provide greater access for oral chemotherapy treatment,” Perea said on the Assembly floor late last week. “This is the right thing to do, to allow people access to lifesaving drugs.”
Perea introduced the measure with his personal account of caring for his mother, who he said was diagnosed with stage 2 lung cancer just over a year ago. During the long, eight-hour chemo infusion in the hospital, he learned quite a lot about cancer and chemo from patients and professionals.
Single Payer 2 Votes Short in Senate
The idea of a single-payer health care system in California stalled on the Senate floor yesterday, falling two votes short of passage.
Reconsideration of the bill was granted, though, so proponents of SB 810 by Mark Leno (D-San Francisco) have until Tuesday to reintroduce the bill. First they will have to come up with two big votes. The bill failed on a 19-15 vote.
“We don’t want to follow the path of Europe, where the economy is in trouble, where the Euro is failing,” Sen. Ted Gaines (R-Roseville) said. “It’s not the example we should follow. We don’t have the money. I don’t know where the money’s going to come from.”
Court Agrees to New Mental Health Plan for Sacramento County
A federal district judge yesterday approved the final settlement of a lawsuit that challenged a plan by Sacramento County to restructure and downsize its mental health system. Yesterday’s settlement means mental health services will remain at their current levels in the county — and, in fact, may even improve, given a number of proposals the county still hopes to adopt.
The county hopes to save money by consolidating two county-operated clinics into one, according to Mary Ann Bennett, director of the county’s Division of Mental Health.
“One of them is in a leased facility,” Bennett said. “So we want to get out of the leased facility, and we will get some savings there.”
Judge Calls ADHC Settlement a Win-Win
A federal judge yesterday gave her official stamp of approval to last month’s settlement of a lawsuit challenging the state’s transition plan for adult day health care services.
“It’s a good result in a challenging time,” according to attorney Elissa Gerson of Disability Rights California, which brought the lawsuit.
During yesterday’s hearing, U.S. District Judge Saundra Brown Armstrong said the settlement outcome was actually better than it would have been if the case went to trial and DRC eventually won it.
Senate Sends Ombudsman Bill to Assembly
The state Senate yesterday passed SB 345 by Lois Wolk (D-Davis), a bill designed to give more independence and power to the Long-Term Care Ombudsman program. It now heads to the Assembly for committee and floor approval.
“Most of the provisions in this law simply clarify state and federal law,” bill author Wolk said. “What has happened in this ombudsman program is the office is not effectively being an advocate for people in long-term care and local [ombudsman] offices.”
State ombudsman Joseph Rodrigues begs to differ, and has testified against the bill in committee hearings, saying that the proposed law is duplicative and establishes additional requirements without additional funding.
Appropriations Committee Moves Single Payer Toward Floor
After all the drama, controversy and heated debate over legislation to set up a single-payer health care system in years past, last week’s appropriations committee approval of the measure was strikingly brief and uneventful.
Like several other bills up for approval at last week’s hearing, there was no presentation on single payer — only a vote, followed by an eight-word pronouncement from Senate Committee on Appropriations Chair Christine Kehoe (D-San Diego):
“OK,” Kehoe said, “6 to 2, that measure is out.”
Trigger Cuts to IHSS Care Put on Hold
Federal judge Claudia Wilken did not mince words yesterday when an attorney representing California asked her if she would issue a stay, to grant the state the right to start implementation of a proposed 20% cut in In-Home Supportive Services.
“No, I won’t stay it,” Wilken said of the temporary restraining order she issued last month. “The TRO is now the permanent injunction, … but it will be modified. It is appealable, as of now. But no, I’m not going to lift it.”
The injunction means that 370,000 Californians, mostly seniors, will continue to receive IHSS care, while the state appeals the decision.
Cuts, Policy Changes at Healthy Families Program
The most recent state budget proposal includes a variety of cost-saving measures in the Healthy Families program — reduced reimbursement rates, higher premium prices, higher copays and a transition of its 877,859 children into managed care plans by the end of June 2013.
At yesterday’s monthly meeting of the Managed Risk Medical Insurance Board, chief deputy director Terresa Krum broached the bad news.
“There are a number of significant budget assumptions,” Krum said. “So first, the budget proposes to reduce the per-member, per-month rates paid to health plans in Healthy Families to the average Medi-Cal rate.”
Lots To Do With Less Than Two Years To Go
It is an eventful month for the California Health Benefit Exchange board.
Tomorrow, it releases its final solicitation for technology to help run the exchange. Proposals are due at the end of this month for the communication, outreach, assisters and health plan management components of the exchange.
Meanwhile, Executive Director Peter Lee said at yesterday’s board meeting, the exchange has continued to hire new personnel and is now negotiating for office space to lease in Sacramento to accommodate all of those new hires.