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september 19, 2017



Action Needed to Reject Harmful ACA Repeal Bill

Senators Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV) and Ron Johnson (R-WI) unveiled a proposal last week to repeal and replace the Affordable Care Act (ACA). The bill contains provisions that closely match those of other failed repeal and replace legislation. Under the proposal, rural states and those that did not expand their Medicaid programs would receive more funding, but states that have been most successful in enrolling individuals (e.g., California) would lose billions in federal funding. Similar to previous bills, the new proposal would change Medicaid to a block grant program, allow for the elimination of Essential Health Benefits and put patients at risk. The nonpartisan Congressional Budget Office has yet to analyze the costs of the bill and how it would affect health insurance enrollment, but as with previous efforts, it is anticipated it will reduce coverage for tens of millions of consumers. If you know anyone in Alaska, Arizona or Maine, please urge them to call their Senators and demand that they reject this partisan approach and, instead, support the bipartisan work currently underway in the Senate.



Dynamic Team Takes on the AAFP Congress of Delegates

An energetic and highly motivated team of California delegates, alternates and others advocated for chapter-authored, -sponsored and -supported resolutions at the AAFP Congress of Delegates in San Antonio, TX last week. Delegates Jeff Luther and Jay W. Lee and Alternate Delegates Lee Ralph and Michelle Quiogue were supported by President-elect Lisa Ward, 2018 National Conference of Constituency Leaders (NCCL) Convener Shani Muhammad, NCCL Delegate Brent Sugimoto, National Conference Resident Chair Alex M. McDonald and interested members Jerry Abraham, Parker Duncan, Emily Guh and Sarah McNeil in offering testimony and working the room.


The results: CAFP-authored resolutions: 1) a resolution calling on AAFP to repeal the Hyde Amendment was affirmed as current policy; 2) resolutions seeking to end the use of antibiotics in livestock and change language in AAFP policy on end-of-life care from “assisted suicide” to “medical aid in dying” were referred to the Board of Directors.


Co-sponsored resolutions: 1) a resolution asking AAFP to include a state political action check-off on its dues statement was not adopted; 2) resolutions calling on AAFP to recognize health care as a human right were adopted as amended to recognize health as a human right.



Exciting Changes at 2018 Family Medicine Clinical Forum

Mark April 13-15, 2018 on your calendar now! We’d like you and your team members to join CAFP and more than 250 colleagues as we celebrate CAFP’s 70th birthday. Here’s a peek at what’s in store:

  • The 2018 Forum will be in Monterey! The beautiful California Coast is calling our name and the Monterey Marriott Downtown will be the new site of Forum festivities (and great education).
  • We’re starting a little earlier – the afternoon of Friday, April 13 – and providing the option to spend time with family and friends Saturday late afternoon/evening before concluding on Sunday afternoon.
  • We’re all learning together (no concurrent tracks next year).
  • An excellent optional Pain Management Workshop will be offered on Sunday afternoon.
  • Three KSAs including one brand new KSA on Palliative Care.
  • The same practical, engaging sessions on a variety of relevant topics; we’re giving Dr. Hoby Lee more time for his popular “Family Medicine Update” session!


Registration opens by the end of the month but you can reserve your room now at the Monterey Marriott for our negotiated $209 rate. Questions? Contact CAFP at



California-born and -Educated FP Chosen as AAFP President-elect

John Cullen, MD of Valdez, Alaska was elected as AAFP President-elect at the recent Congress of Delegates in San Antonio, TX. Dr. Cullen was born and raised in San Diego and completed his residency in Modesto, CA. CAFP congratulates Dr. Cullen and the Alaska AFP Executive Marilyn Dodd on both his win and her retirement after 21 years.




CAFP Statement on Threat to DACA

President Trump has threatened to end the Deferred Action for Childhood Arrivals (DACA) program in six months unless Congress can find a legislative solution. DACA provides deportation protection to roughly 800,000 young undocumented people who entered the country as children. One in four of them live in California. Under DACA, they have the right to work legally in the United States and must meet several requirements: they must have been 30 or younger in 2012; been brought to the U.S. before age 16; currently be in school, have graduated from high school, have obtained a GED or have been honorably discharged from the Coast Guard or armed forces; and not have been convicted of a felony, a significant misdemeanor or pose a threat to national security or public safety. The application cost is nearly $500 and permits must be renewed every two years. DACA does not give beneficiaries legal U.S. residency; they simply are given a reprieve from deportation while being allowed to work legally.


“These young people and children are our neighbors, friends, classmates and patients. They are outstanding members of our communities, actively supporting and contributing to our lives, including the medical arena,” said CAFP President Michelle Quiogue, MD. “DACA has provided certainty and stability to their lives; the threat to end DACA hangs over their heads now, potentially deterring many from obtaining needed health services and, in all likelihood, creating stress, anxiety, depression and other conditions that may contribute to ill health,” she added.


Some DACA participants and those eligible for the program are medical students and residents in California. According to the Association of American Medical Colleges, 34 students with DACA status matriculated to U.S. medical schools in 2016 and about 70 students with DACA status were enrolled last year. Although the number of medical students with DACA status is relatively small, the U.S. health care system can ill afford to lose any source of future physicians. Congress’s previous attempts at a legislative solution (2007, 2009, 2010 and 2011) all failed. If Congress fails to act again, some DACA participants could face deportation as early as March.


DACA primary care physician residents are well-poised to deliver high quality, culturally competent care to California’s population, which is 40 percent Latino compared to a physician population that is only five percent Latino. CAFP also is a strong supporter of the University of California Los Angeles’s International Medical Graduate program, which helps non-citizen physicians qualify for medical residencies by preparing them for the U.S. Medical Licensing Exam. They must compete for residency spots and, upon graduation, work in medically underserved areas for a minimum of two years.


CAFP urges Congress to take quick action to renew the DACA program.



Online Membership Renewal Available This Week!

When family physicians work together, great things can be accomplished. Just this past year, CAFP helped improve physician payment under Medi-Cal, protected patient access to care and championed several initiatives to improve community health. None of this would have been possible without strong support from you, our amazing members. Renew your CAFP and AAFP membership online beginning Thursday, September 21. You may also sign up for auto-renewal and/or the installment plan at any time. Contact the AAFP Member Resource Center at (800) 274-2237 for one-on-one assistance. Thank you for your past and continued support. We look forward to sharing more victories like these with you in the year ahead.




NILC Releases Immigration Toolkit for Health Care Providers

The National Immigration Law Center (NILC) is dedicated to defending and advancing the rights of immigrants with low income. To aid in the provision of care to these populations, the organization has created an immigration toolkit designed to clarify providers’ and patients’ rights and create safe spaces for patients and staff. The toolkit includes sample materials that can be adapted for health care facilities. Please note that you will be asked to register in order to access the toolkit and registrations are approved in approximately three business days.



CAFP’s Practice Management News Library

Every month, CAFP publishes an article related to either practice management, legal or coding and billing issues in the Practice Management Newsletter (PMN) for our members. These articles are communicated directly through email and are hosted on our website for the month. CAFP would like to welcome all members to view past PMN articles on the website through our newly created PMN library. The library offers three categories ordered by date. CAFP staff will monitor the relevance of the articles and ensure they contain the most up-to-date information.



2017-2018 Influenza Vaccination Recommendations

The 2017-2018 Advisory Committee on Immunization Practices (ACIP) recommendations for the prevention and control of seasonal influenza with vaccines have been published here. The report focuses on the recommendations for use of vaccines for the prevention and control of influenza during the 2017-18 season in the United States.


To help our members save money on vaccine purchases, CAFP has developed a relationship with Atlantic Health Partners, a group purchasing program for physicians to obtain the most favorable pricing and purchasing terms on a wide variety of flu and travel vaccines. For more information, please contact Cindy Berenson or Jeff Winokur at 800-741-2044 or