Legislative News

CAFP Achieves Key Legislative Wins in Sacramento
CAFP and other organizations testified against, and were successful in defeating, SB 1427 by Senator Ronald Calderon (D - Montebello), a bill that would have, as originally drafted, allowed psychologists to prescribe medication with little or no physician oversight. CAFP worked with the sponsors, who showed a willingness to amend the bill to resolve significant concerns we had about training, supervision, liability, and other patient safety issues. These changes, however, were not made soon enough, nor were they sufficient to remove our opposition. CAFP also testified on our co-sponsored bill SB 1440 by Senator Sheila Kuehl (D-Los Angeles) which would create an 85 percent medical-loss ratio; meaning that medical insurance companies would be required to spend at least 85 cents of each premium dollar directly on patient health care. The bill passed out of the Senate Health Committee, and will next be heard in the Senate Appropriations Committee.

Other Key CAFP-Supported Legislative Successes:

(click on the name of the bill for more information)
AB 1945 Asm. De La Torre (D - Los Angeles) Postclaims underwriting
Requires a health care service plan or disability insurer that sells health insurance to obtain regulatory approval prior to rescinding a contract or policy.
Passed unanimously out of Assembly Health Committee.

SB 1379 Sen. Ducheny (D - San Diego) Physician loan repayment.
Requires DMHC fines and administrative penalties on health plans and insurers to be used to fund the Steve Thompson Physician Corps Loan Repayment Program which largely benefits future workforce in family medicine.
Passed unanimously out of Senate Health Committee.

AB 2580 Asm. Arambula (D - Fresno) Health: immunizations.
Adds the pertussis (whooping cough) booster vaccine to the list of vaccinations required for pupils before entering the seventh grade.
Passed unanimously out of Assembly Health Committee.

SB 1349 Sen. Cox (R - Fair Oaks) Medi-Cal funding: mental health services.
Requires the State Controller to reimburse cities and counties for certain mental health services within 90 days after the Department of Mental Health (DMH) receives a claim for reimbursement. Provides that interest shall be paid from the DMH budget if the claim is not paid on time.
Passed unanimously out of Senate Health Committee.

CAFP Integral in the Passage of Health Workforce Bill
CAFP advocated strongly during the Assembly Labor and Employment Committee hearing this week for a bill sponsored by a key ally in health care reform efforts. AB 2375, authored Assemblymember Ed Hernandez (D - Baldwin Park) and sponsored by the Latino Coalition for a Health California, would create a health care workforce master plan to address the critical shortage of primary care providers throughout the state. CAFP Legislative Advocate, Tom Riley, pointing out to the Committee that prior to 1980's, California collected data that included information on primary care workforce, and that this information is critical for any decision making made by the state. The bill was approved by the Committee, and is on its way to the Assembly Appropriations Committee.

CAFP Advocates for Physician Network Transparency at Medi-Cal Meeting
Recently, CAFP participated in a California Health Care Foundation-sponsored event called the Medi-Cal Performance Dashboard Meeting. Participants included the Department of Health Care Services, the Office of the Patient Advocate, Stan Rosenstein (the senior health care advisor to Governor on Medi-Cal), and many others. The purpose of the meeting was to identify measures to provide better transparency to quality, cost, and access within the Medi-Cal system. CAFP has continually advocated for a proper count of primary care physicians practicing in California and treating Medi-Cal patients, and did so at this meeting. We believe that this data could help consumers associate how insufficient pay can lead to poor access. CAFP hopes the dashboard project will be an avenue to affect change, and we will keep you posted on any future developments.

MRMIB Announces Regulatory Changes to the Health Families Program
The Managed Risk Medical Insurance Board, also known as MRMIB, operates the Healthy Families Program (HFP) and has called for public comment on two new sets of regulations. The first regulatory proposal is beneficial to the state and would be relatively benign to family physicians. AB 203 (signed in 2006), directs the HFP to discontinue "Bridge" benefits to children enrolled in HFP when it is determined that the child's family income is below HFP eligibility requirements and appears to be eligible for no-cost Medi-Cal insurance instead. In lieu of the Bridge benefits provided by HFP, benefits will be provided by Medi-Cal through the Presumptive Eligibility program until Medi-Cal makes an eligibility determination. This allows a better funding mechanism for the state, with a higher federal match. CAFP's only concern, as expressed in our letter to the Board, is that the regulations do not stipulate that the patient's provider be notified of the switch from HFP to Medi-Cal. http://www.mrmib.ca.gov/MRMIB/HFP_Proposed_Regulations_Medi-Cal_Bridge_Deletion.pdf

The second set of regulatory changes would set forth that, in current or future unforeseen fiscal situations in which insufficient funds are available for the Healthy Family Program, enrollment would be restricted and a waiting list for new applicants would be established to help control costs. If the waiting list does not sufficiently limit expenditures, disenrollment of subscriber children at their Annual Eligibility Review would be enacted. CAFP is greatly concerned that this would significantly disrupt continuity of care for some of California's most vulnerable patients. CAFP has been in contact with MRMIB and will be attending the public hearing on Monday to address this point and urge the Board to revise the regulations to fix this potentially serious problem, before the regulations go into effect.
http://www.mrmib.ca.gov/MRMIB/HFP_Proposed_Regulations_Disenrollment_Waiting_List.pdf

CAFP Advocates for Physician Network Transparency at Medi-Cal Meeting
This past Thursday, CAFP participated in a California Health Care Foundation-sponsored event called the Medi-Cal Performance Dashboard Meeting. Participants included the Department of Health Care Services, the Office of the Patient Advocate, Stan Rosenstein (the senior health care advisor to Governor on Medi-cal), and many others. The purpose of the meeting was to identify measures to provide better transparency to quality, cost, and access within the Medi-Cal system. CAFP has continually advocated for a proper count of primary care physicians practicing in California and treating Medi-Cal patients, and did so at this meeting. We believe that this data could help consumers associate how insufficient pay can lead to poor access. CAFP hopes the dashboard project will be an avenue to affect change, and we will keep you posted on any future developments.

CAFP-Opposed Bill on Optometry Scope Expansion Continues to Move
CAFP testified before the Senate Business, Professions and Economic Development Committee this past Monday, to oppose SB 1406 by Senator Lou Correa (D - Santa Ana), which would allow optometrists to independently diagnose and treat patients suffering from such chronic eye diseases like glaucoma, perform any minor surgical procedure not requiring general anesthesia, and allow the California State Board of Optometry and not the Medical Board of California to determine the appropriate education, training and certification criteria for optometrists to essentially practice medicine. Many CAFP members and Key Contacts took action and emailed members of the committee with their opposition. While CAFP still remains strongly opposed, we have been working with the sponsors of the bill to find common ground and a safer way to incorporate optometrists within the primary care patient-centered medical home. The bill passed out of the Committee and will next be heard in the Senate Appropriations Committee.

CAFP Achieves Key Legislative Wins in Sacramento
CAFP and other organizations testified against, and were successful in defeating, SB 1427 by Senator Ronald Calderon (D – Montebello), a bill that would have, as originally drafted, allowed psychologists to prescribe drugs with little or no physician oversight. CAFP worked with the sponsors, who showed a willingness to amend the bill to resolve significant concerns we had about training, supervision, liability, and other patient safety issues. These changes, however, were not made soon enough, nor were they sufficiently extensive to remove our and others opposition. CAFP also testified on our co-sponsored bill SB 1440 by Senator Sheila Kuehl (D-Los Angeles) which, if signed into law, will create an 85 percent medical-loss ratio; meaning that medical insurance companies will be required to spend at least 85 percent of premium dollars directly on patient health care. The bill passed out of the Senate Health Committee, and will next be heard in the Senate Appropriations Committee.

CAFP Leader Gives Healthcare Disparities Presentation at the Capitol
Michael Rodriguez, MD, MPH, Professor at the David Geffen School of Medicine – UCLA, presented Confronting Healthcare Disparities in Medi-Cal Managed Care: The Role of Ethnicity, Race and Primary Language. As part of the California Program on Access to Care, Dr. Rodriguez urged the state to improve and standardize data collection on race, ethnicity, and primary language in order to better address health care disparities through evidenced-based solutions.

Decisions on Health Care Legislation and Budget Looming
CAFP staff is actively engaged in efforts to amend, support, and oppose key components of the budget and significant pieces of legislation. Next week will see several hearings for both the budget and health policy committees in the Senate and Assembly that will include decisions on such issues as required pertussis immunization, revenue sources for the Steven Thompson Loan Repayment Program, and timely reimbursements for mental health services, among others.

Family Physicians Storm the Capitol
More than 30 CAFP members from throughout state stormed the State Capitol last Monday to meet with legislators and their staffs to express concerns over the proposed health care budget cuts.

A smaller group met with one of the Governor’s senior health care advisors, Richard Figueroa, to discuss health care reform and the budget. For those who were unable to attend, there will be other opportunities later this year to make your voice heard. Please contact CAFP to find out how.

CAFP President Stands Up for Her Patients, Her Practice and Family Medicine
Last week, CAFP President Carla Kakutani, MD, testified before the Assembly Budget Subcommittee on Health and Human Services at the Capitol. The Committee reviewed opposition to the proposed 10 percent Medi-Cal cuts because of its potential to greatly limit access to care for patients. “I don’t think of these people as the ‘Medi-Cal population,’ I think of them as patients I’ve known for 15 years,” testified Dr. Kakutani. “I think of them as people my kids go to school with, and people that I see in the store.”

CAFP Advocates for Strong Medicine
CAFP’s latest advocacy effort has resulted in an easy-to-use monograph exploring how physician supply, payment and safety net issues contribute to the dwindling sustainability of primary care. “Strong Medicine: Family Medicine’s Fix for California’s Fractured Health Care System,” combines Census, Medi-Cal, Medicare and other data sources to ensure policymakers and legislators have the facts on the future of family medicine. A series of recommendations to address California’s primary care shortage is also included.

Ensure Your Views on Medicare Cuts Are Heard!
AAFP’s Family Medicine Congressional Conference will be held May 19 – 20 in Washington, DC. The two-day meeting offers training in advocacy, provides more detail on the issues being debated in the halls of Congress, and offers an opportunity to visit Congressional offices so your representatives are aware of your concerns. The early registration deadline ($245) is March 21. Conference details are available on AAFP’s Web site.

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