Latest California Healthline Stories
State Moving Toward Licensing Home Health Workers
Two bills have been proposed to regulate an estimated one million unlicensed home health workers in California. The big questions are, how much regulation is needed, and how much that type of program will cost. One of the bills, AB 899 by Mariko Yamada (D-Davis), has looser requirements and is currently stuck in the Assembly appropriations committee.
The one more likely to make it to the floor is SB 411 by Curren Price (D-Inglewood), which would require background checks and care instruction for all home health care workers. It is expected to be taken up for a floor vote as soon as the end of January.
SB 411 is the one up for debate and possible amendment, according to Jordan Lindsey, director of policy and public affairs for CAHSAH, the California Association for Health Services at Home.
‘Road Map’ Lays Out Details for Building Exchange
The Children’s Partnership “blueprint for reform” released this week marks an important milestone in the formation of California’s Health Benefit Exchange, according to Kristen Golden Testa, health director of the Children’s Partnership.
“The [Health Benefit] Exchange board did a lot of work on the visioning process, figuring out what they wanted the exchange to be like,” Golden Testa said. “This offers a road map to get to a lot of the visioning pieces.”
The report was released in draft form to the exchange board in December, and some of the detail laid out in the report may have helped board staff develop that RFP, Golden Testa said.
Medical Transport Lawsuit Gets Federal Injunction
A federal judge issued a preliminary injunction Wednesday to halt a 10% Medi-Cal provider reimbursement cut to medical transportation services.
It was the third time the state has lost in court on this issue. State officials said the state will appeal. Preliminary injunction rulings at the end of December halted cuts in hospital and pharmacy services. Another lawsuit, brought by the California Medical Association and other providers, is still pending.
Marat Sheynkman, executive director of the California Medical Transportation Association, which filed the suit that triggered Wednesday’s ruling, said the 10% Medi-Cal reimbursement cut would have hit medical transport providers particularly hard.
Controversy Surfaces Over Ombudsman Plan
Legislative committees started back up with a bang yesterday, when a seemingly benign measure to beef up the state’s Long-Term Care Ombudsman Program was almost scuttled by its director.
Yesterday, during the first meeting in months of the Senate Committee on Human Services, Senate member Lois Wolk (D-Davis) introduced SB 345, which is designed to increase the advocacy power of the long-term care ombudsman’s office.
“The idea is to strengthen the ability to advocate residents’ rights,” Wolk said. “There is warranted concern that the ombudsman’s office has not been adequately representing residents. The ultimate goal is that the ombudsman’s office will aggressively pursue advocacy for the residents of long-term care facilities.”
Legislation Would Require On-Time Medicaid Payments
Sarane Baker-Collins remembers the time well. “We went for months without a [Medi-Cal] payment. We kept doing our work, and the state didn’t pay us for months. It’s almost criminal what the state did to us.”
Baker-Collins runs three small homes for residents with developmental disabilities in Santa Rosa. In the wake of the budget impasse of 2008, California had to shut off payments to Baker-Collins and other health care providers until a budget could be agreed upon.
Some Medi-Cal providers went as long as 60 days without reimbursement. For a small not-for-profit on a thin margin like the one run by Baker-Collins, that’s a cost hard to bear.
Could New Not-for-Profit Requirement Limit Patient Access?
State health officials recently outlined new requirements for the transition of adult day health care centers into the nascent Community Based Adult Services program. They include the stipulation that centers must be not-for-profit to qualify for Medi-Cal funding.
Many centers are for-profit, particularly in Los Angeles County where the bulk of day care beneficiaries live. Advocates worry the change could decrease access to care if for-profits are unwilling or unable to make the conversion to not-for-profit status.
Elissa Gershon, a senior attorney for Disability Rights California, said the new not-for-profit requirement could make it difficult for some beneficiaries to find care.
Communities of Color Hit Hardest by Health Cuts, Advocates Say
Health care officials and advocates expressed serious concern over Democratic Gov. Jerry Brown’s latest round of budget proposals that include reductions to community clinics, hospitals, and programs such as Healthy Families and CalWORKs.
“We have much more need than resources to provide for it,” Diana Dooley, secretary of California’s Health and Human Services Agency, said in a conference call with stakeholders. “I fully understand your concern. These are consequential reductions. All of these cuts have consequences.”
Both health officials and advocates seem a little weary of the constant and continued reductions. According to Ellen Wu of the California Pan-Ethnic Health Network, acknowledging that the reductions are hard is getting a little harder to hear.
Exchange Board Has One Meeting To Consider HHS List
Just before the most recent California Health Benefit Exchange board meeting, the federal Health and Human Services agency released its list of proposed essential health benefits. Aimed at ensuring that health plans in individual and small group markets offer a minimum of coverage — both inside and outside of health benefit exchanges — the HHS proposed list is scheduled to take effect in 2014.
Board members got a quick briefing on the proposed requirements, since comments on them are due at the end of January. That leaves the board with one more meeting — on Jan. 17 — to approve comments on those benefit requirements, according to Peter Lee, executive director of the board.
“It’s something we didn’t expect to see,” Lee said. “We didn’t know it was coming.”
Federal Court Halts Some Medi-Cal Cuts
A federal judge last month blocked California’s plan to cut Medi-Cal provider reimbursement rates to skilled nursing facilities and pharmacies. State officials said they will appeal the decisions.
The two lawsuits were brought by Managed Pharmacy Care and the California Hospital Association.
“We’re pleased by the court decision,” Jan Emerson-Shea of CHA said. “We believe it is the right thing to put the interests of patients first.”
State Says IHSS Court Order Kept Counties in Dark
There are three levels of exemption for some Californians from the 20% trigger cuts to In-Home Supportive Services, according to officials from the Department of Social Services.
Counties, which administer IHSS programs through county welfare departments, haven’t heard about any of these exemptions because a federal temporary restraining order halted the implementation of those cuts, according to Michael Weston of DSS.
Basically, he said, implementation of changes and communication about IHSS with the counties halted when the court issued its temporary restraining order. Meanwhile, the exemption process continued to be developed within the department, Weston said.