Originally published in the California Family Physician, Spring 2021
by Carla Kakutani, MD
As chair of CAFP’s Legislative Affairs Committee (LAC), I know firsthand how important it is that family physicians be involved in the legislative process. Each year, the LAC has no bigger responsibility than to prioritize roughly 50 bills for CAFP action out of the thousands of bills the State Legislature will consider. From bills we oppose or try to amend, to bills we work tirelessly to pass, each one will have a large impact on your practice, your patients or both. The LAC will meet at the end of March to select those bills and make position recommendations to the CAFP Board. The LAC uses CAFP policy to guide those positions, and its strategic plan to guide its prioritization.
Here are just a few of the hundreds of bills the LAC will review and consider recommending a Support or Oppose position:
- AB 864 (Low) would move the Controlled Substance Utilization Review and Evaluation System (CURES) database out from under the Department of Justice and into the Department of Public Health. CAFP for years has called for this change as the database should be used as a clinical tool to improve care, not as a prosecutorial weapon against health care professionals.
- SB 428 (Hurtado) would require health plans and insurers to provide coverage and payment for adverse childhood experience (ACE) screenings. CAFP has been a strong supporter of efforts to screen and treat patients affected by ACEs in the Medi-Cal program, including through our education efforts[i].
- AB 97 (Nazarian) would prohibit health plans and insurers from imposing a deductible on an insulin prescription drug. Insulin cost is a big reason the average annual per-patient spending on treatment for type 1 diabetes increased from $12,467 in 2012 to $18,494 in 2016. During that time, the price of insulin doubled, according to the Health Care Cost Institute. The price of one insulin product, Lantus, saw a 49 percent price increase in 2014 alone even though it had been on the market for decades. Another insulin brand, NovoLog, increased in list price by 353 percent from 2001 to 2016.
- SB 48 (Limón) would require all general internists and family physicians to complete at least four hours of mandatory continuing education on the special care needs of patients with dementia. As part of a family physician’s residency training, they must complete, at a minimum, 100 hours or 125 encounters with geriatric patients across a continuum of sites. Evidence does not show that family physicians are providing inadequate care and that four additional hours of continuing medical education in this area will improve health outcomes.
- SB 316 (Eggman) would allow federally qualified health centers and rural health clinics to bill for a patient who has two visits in the same day at a single location, if after the first visit the patient suffers illness or injury requiring additional diagnosis or treatment, or if the patient has a medical visit and a mental health visit or dental visit. This measure could greatly improve efficiency and access to care.
- SB 742 (Pan) would make it unlawful, except upon private property, for a person to engage in physical obstruction, intimidation, or picketing within 300 feet of a vaccination site during vaccination services. The site includes, but is not limited to, a hospital, physician’s office, clinic, or any retail space or pop-up location made available for large-scale vaccination services. This issue has garnered significant attention as the large-scale effort to administer the COVID-19 vaccines has generated disruptive activity by vaccination opponents.
If you would like to get more involved in the legislative process, I encourage to attend CAFP’s All Member Advocacy Meeting[ii], which will be held virtually this year on May 15-16, 2021.