Tuesday, March 23, 2004

HEALTH ACCESS UPDATE
Tuesday, March 23rd, 2004


NEW HEALTH POLICYMAKERS SET IN LEGISLATURE, ADMINISTRATION
* Cohn Chairs Smaller Assembly Health Committee
* Dymally Heads New Budget Subcommittee on Health
* Shewry Returns as DHS Director
* Ehnes Named DMHC Director


COHN CHAIRS ASSEMBLY HEALTH COMMITTEE

Chair Rebecca Cohn and Vice-Chair Todd Spitzer head the new list of the
Assembly Health Committee, with seven less Assemblymembers serving on the
policy committee that reviews many of the bills of interest to health care
advocates. As promised by Assembly Speaker Fabian Nunez, the committee is
smaller, with 18, rather than 25, members. Cohn replaces Assemblyman Dario
Frommer, who now serves as Majority Leader, and is maintaining his seat on
the committee.


Assembly Health Committee
Regular meetings normally Tuesdays, 1:30pm, Room 4202, Capitol

Rebecca Cohn (D-24: Saratoga, Campbell), Chair
Wilma Chan (D-16: Oakland)
Edward Chavez (D-57: La Puente, Industry)
Mervyn Dymally (D-52: Compton)
Dario Frommer (D-43: Los Angeles, Glendale)
Paul Koretz (D-42: West Hollywood)
Sally Lieber (D-22: Mountain View, San Jose)
Cindy Montanez (D-39: San Fernando, Mission Hills)
George Nakano (D-53: Torrance)
Gloria Negrete McLeod (D-61: Chino, Montclair)
Mark Ridley-Thomas (D-48: Los Angeles)
Simon Salinas (D-28: Salinas, Hollister)
Lois Wolk (D-8: Davis, Vacaville)
Todd Spitzer (R-71: Orange), Vice-Chair
Robert Dutton (R-63: Rancho Cucamonga)
Alan Nakanishi (R-10: Lodi)
George Plescia (R-75: San Diego)
Keith Richman (R-38: Northridge, Granada Hills)


DYMALLY CHAIRS ASSEMBLY BUDGET SUBCOMMITTEE ON HEALTH

Assemblyman Mervyn Dymally now chairs the Assembly Budget Subcommittee on
Health and Human Services, which will review all of the proposed budget cuts
on health care. He replaces Assemblywoman Judy Chu, who now is Chair of the
Assembly Appropriations Committee, and will be a leader in budget
negotiations for the Democratic Caucus along with Assemblyman Darrell
Steinberg, the Chair of the full Assembly Budget Committee. Taking Chu's
place on the committee is Assemblyman John Laird.


Assembly Budget Subcommittee #1 on Health and Human Services
Regular meetings normally Mondays, 4:00pm, Room 127, Capitol

Mervyn Dymally (D-52: Compton), Chair
Loni Hancock (D-14: Berkeley, El Cerrito)
John Laird (D-27: Santa Cruz, Monterey)
Ray Haynes (R-66: Murrieta, Temecula)
Robert Pacheco (R-60: Walnut, City of Industry)
Alternates:
Darrell Steinberg (D-9: Sacramento), Chair, Budget Committee
Rick Keene (R-3: Chico), Vice-Chair, Budget Committee


---
GOVERNOR APPOINTS DIRECTORS FOR DHS, DMHC

Last week, after months of speculation, Governor Arnold Schwarzenegger
announced the appointment of two directors of critical departments
responsible for health policy. Below are biographies of the two directors,
from the Governor's press releases announcing the appointment, from his web
site at www.governor.ca.gov.

Sandra Shewry will start soon as director of the California Department of
Health Services, which among other reponsibilities oversees the Medi-Cal
program that serves over 6.7 million children, families, seniors, and people
with disabilities.

Lucinda "Cindy" Ann Ehnes will return to the Department of Managed Health
Care as the Director. The department is the main regulator of HMOs, PPOs,
and other managed care plans, with a specific mission to protect the
interest of the millions of Californians enrolled in such health coverage.


SANDRA SHEWRY, Director, Department of Health Services (DHS)

For over 20 years, Sandra Shewry has worked in the health care field, a
majority of which was in California state government. She most recently
served as the director of the Health Division for the National Governor's
Association (NGA) Center for Best Practices in Washington, D.C. Before
joining the NGA, she held several senior health-related positions within
state government. Shewry was a deputy director and then executive director
of the California Managed Risk Medical Insurance Board, which runs the
Healthy Families Program. From 1985 to 1990, she served as an assistant
secretary at the California Health and Welfare Agency (now the California
Health and Human Services Agency). Shewry was a health planning and policy
analyst for the Department of Health Services from 1982 to 1984.

Shewry, 48, earned a Master's degree in Public Health and a Master's degree
in Social Welfare from the University of California, Berkeley and her
Bachelor's degree from the University of California, Santa Cruz. She is a
native of Ferndale, CA, and registered as decline-to-state. This position
requires Senate confirmation and the statutory salary is $123,255.

Shewry will oversee the over 5,000 employees working in its Sacramento
headquarters and the over 60 field offices throughout the state. As part of
its mandate to protect and improve the health of all Californians, the
Department administers a broad range of public and clinical health programs
that provide health care services, including the Medi-Cal Program. The
Department operates under the aegis of the California Health and Human
Services Agency.


CINDY EHNES, Director, Department of Managed Health Care (DMHC)

Since December 2003, Ehnes has served as the division manager of Self-Funded
Health Plans at the California Public Employees Retirement System (CalPERS).
Prior to that, she was the deputy director of plan and provider relations at
the Department of Managed Health Care and the interim executive officer for
the California Board of Optometry. Ehnes also served as the legislative
affairs director for the Commission on Family Medicine in Colorado for two
years and from 1997 to 2000 as the director of enforcement for the Colorado
Division of Insurance. From 1978 to 1984 and again from 1988 to 1996, she
was an attorney in private practice. She served as the vice president of
development for the National Sports Center for the Disabled from 1984 to
1988 and was the chairwoman of the board and consumer representative for
CoverColorado Health Plan from 1990 to 1997.

Ehnes, 53, of Fair Oaks, CA, has a Juris Doctorate from Catholic University
Law School and a Bachelor of Arts degree from George Washington University.
She is a registered Democrat. The statutory salary for this position is
$123,255 and it requires Senate confirmation.

The California Department of Managed Health Care was launched on July 1,
2000 to ensure high quality prevention and health care for Californians
enrolled in managed health care plans. The Department is responsible for the
licensing and accountability of managed care plans through the enforcement
of prevention and care laws, providing an annual report card on quality care
under managed care, developing a public education campaign so consumers know
their rights under managed care plans, and for the development of a
third-party grievance system for consumers. The Department is under the
jurisdiction of the Business, Transportation and Housing Agency.

--
Anthony E. Wright
Executive Director
Health Access
1127 11th St., #234, Sacramento, CA 95814
Ph: 916-442-2308, Fx: 916-497-0921
awright@health-access.org

Labels: Updates

posted by Anthony Wright | Permalink | 11:16 AM


 

Tuesday, March 16, 2004

HEALTH ACCESS UPDATE
Monday, March 15th, 2004

* Federal Budget Update: Senate Actions; Medicaid Cuts Threatened in House
* Anti-SB2 Campaign Fined $25K for 10 Counts of Disclosure Law Violations
* Updated Calendar of Health and Budget Events (http://www.health-access.org/calendar.htm)


FEDERAL BUDGET UPDATE: MEDICAID CUTS THREATENED

GOOD VOTE IN THE SENATE: In a victory for national health care advocates
last week, the Senate voted to NOT require severe Medicaid cuts over the
next several years. Several Republican Senators joined the Democratic caucus
in voting for an amendment by Senator Baucus to take the section requiring
cuts out of the main budget resolution by Senator Nickles. (An attempt by
Senator Rockefeller to include an extension of federal assistance to states
through continued enhanced Medicaid matching funds was not pursued at this
time, but will be made later as the budget process continues.)

BAD VOTE UPCOMING IN THE HOUSE: The House of Representatives is now
considering their budget resolution, and once again, there is a significant
threat to Medicaid. The House Budget Committee plans to complete meet its
work by this Wednesday, March 17th, and have the full House consider the
resolution the week after.

The House budget resolution will require at least $2 billion in Medicaid
cuts, as well as caps on discretionary spending (such as education and other
health programs). It would also include budget rules that are likely to make
it easier to make all the President’s tax cuts permanent, placing further
pressure to cut health programs. A full analysis of the House budget, and
all its problems, is available by the Center for Budget and Policy
Priorities at http://www.cbpp.org/3-12-04bud.htm.

Already, 29 House Republicans have signed a letter opposing cuts to
Medicaid, including California Congressmen George Radanovich of Fresno, Ed
Royce of Fullerton, and Randy "Duke" Cunningham of Escondido. The letter
states, in part "As the Budget Committee prepares the House budget
resolution we are troubled by proposals that could weaken coverage and
access to services for millions of Americans, including our nation's seniors
and disabled, by making reductions to the Medicaid program.... The state and
federal governments have ensured that more than 50 million people have
access to health care services through the Medicaid program. This includes
25 million children - more than one in four in the U.S... Proposing
reductions without ensuring the preservation of coverage for those in need
simply transfers the burden to states. We urge the Budget Committee to
refrain from proposing cuts to Medicaid spending. Any cuts would add
millions to the ranks of the uninsured at a time when Congress is working to
reduce those ranks."

ACTION: Please call your Congressional representatives to tell them, as part
of the budget resolution:
1. Oppose the caps on discretionary programs.
2. Oppose making the president's tax cuts permanent.
3. Oppose provisions that force cuts to Medicaid.
All Representatives should be contacted. National advocates have
specifically asked for calls and faxes to go to California Representatives
Mary Bono of Palm Springs, Jerry Lewis of Redlands, and Doug Ose of
Sacramento. Also, thanks should go to Radanovich, Royce, and Cunningham for
signing the Medicaid letter.


ANTI-SB 2 CAMPAIGN FINED FOR DISCLOSURE VIOLATIONS

This morning, Monday, March 15th, the California Fair Political Practices
Commission (FPPC) imposed an administrative penalty of $25,000 on the
campaign seeking to repeal SB 2, the bill to protect and expand
employer-based health coverage for millions of Californians. The campaign
was found on 10 counts of failing to report contributions totalling over $1
million, from companies including Nordstrom's, Target, Sears, and Yum!
Brands
(owner of KFC and Taco Bell).

By disclosing their contributions two months late, these large corporations
didn't seem enthusiastic to let the public know about their work to repeal
this law protecting health coverage for workers. Advocates for SB 2 will
make sure the public knows who the employers are who seek to scale back
health coverage or drop it altogether, not only for their workers, but their
customers as well.

--
Anthony E. Wright
Executive Director
Health Access
1127 11th St., #234, Sacramento, CA 95814
Ph: 916-442-2308, Fx: 916-497-0921
awright@health-access.org

Labels: Updates

posted by Anthony Wright | Permalink | 12:23 PM


 

Monday, March 08, 2004

HEALTH ACCESS ALERT
Monday, March 8th, 2004

BUDGET BLUES
* California Senate Budget Subcommittee Considers Various Health Cuts
* U.S. Senate to Consider Budget Resolution With Health Cuts


SENATE BUDGET SUBCOMMITTEE HEARS HEALTH CUTS, REJECTS ENROLLMENT CAPS

The Senate Budget Subcommittee #3 on Health and Human Services, chaired by
Senator Wes Chesbro, met this afternoon for over four hours considering a
range of cuts proposed by Governor Arnold Schwarzenegger. Dozens of
advocates, organization representatives, and people directly affected by the
proposed cuts came and testified about the severe impact of the cuts.

CAPS REJECTED: The Subcommittee, namely Democratic Senators Chesbro, Ortiz,
and Cedillo, voted to reject many of the "enrollment caps" proposed by the
Governor. These programs would have, in the first year, 2004-05, denied:
* care to over 114,000 children applying to get Healthy Families coverage;
* coverage to over 1,250 children with disabilities applying to get into
California Children's Services (CCS);
* prescription drug coverage to over 1,392 AIDS patients applying to get
covered by the AIDS Drug Assistance Program (ADAP);
* coverage to over 11,430 recent legal immigrants applying to get Medi-Cal;
* prenatal care to over 65,900 undocumented pregnant women and infants, as
well as long-term care to undocumented seniors, applying to get Medi-Cal;
* treatment to 525 immigrants with cancer applying to get into the Breast
and Cervical Cancer Treatment Program in Medi-Cal;
* services to over 35 hemophelia patients and others applying to get into
the Genetically Handicapped Persons Program.

LAO ANALYSIS: The Legislative Analyst's Office recommended to be reject
these caps, largely on concerns that the caps were difficult to administer,
raise issues of inequity between those on the program versus those on the
waiting list, and may ultimately cost more to the state.

HEATED DEBATE: The debate got emotional at times, especially regarding
testimony about the impact of AIDS patients not getting the life-saving
drugs they need. The discussion among committee members was particularly
heated in an exchange between Senator Tom McClintock and Senator Deborah
Ortiz regarding the enrollment caps to specific Medi-Cal services for both
legal and undocumental immgrants.

CUTS TO PROVIDERS CONSIDERED: The committee also rejected the proposal to
eliminate the "alternative rate method" of paying community clinics, which
would result in a significant cut to those clinics and their ability to
provide for their patients. The committee held open the issue of the
proposed 10% provider rate reductions to all Medi-Cal providers, especially
as court cases are pending on that issue.

DISCUSSION ON DRUG COSTS: There was significant discussion on the issue of
drug rebates, and why the Administration has not done more to raise more
revenue from negotiating with pharmaceutical companies. This was an ongoing
theme throughout the many discussions in a number of programs and areas.

ATTACHED is a UPDATED Health Care Budget Cuts Scorecard. The actions that
the Subcommittee took were a good signal that legislators will not blindly
approve Governor Schwarzenegger's budget and cut proposals. Yet this is the
beginning, not the end of the debate. Health advocates should continue to
oppose these cuts, as no decision is final until the budget is complete.


U.S. SENATE TO DEBATE FEDERAL BUDGET AND POSSIBLE SEVERE MEDICAID CUTS

U.S. Senate Budget Committee Chairman Don Nickles (R-OK) sponsored a budget
resolution that seeks to cut Medicaid by over $11 billion in the next five
years, along with cuts in other areas. Yet it would increase the budget
deficit, by accelerating repeal of the estate tax and making other tax cuts
permanent. The Center for Budget and Policy Priorities have an analysis at
http://www.cbpp.org/3-4-04bud.htm

Health advocates need to urge our U.S. Senators to vote AGAINST the Nickles
budget resolution and FOR key health amendments that will be proposed in
floor debate later this week, most likely on Wednesday, March 10th, or
Thursday, March 11th. Two amendments of note are:
* an amendment to “strike the ‘reconciliation instruction’” that will force
an estimated $11 billion in Medicaid cuts over five years;
* an amendment that will allow Congress to consider legislation later this
year providing extra help to the states for Medicaid. (This legislation
would continue last year’s increase in the Federal Medical Assistance
Percentage or FMAP. It will continue the temporary aid that California and
other states got last year to help prevent health care cuts.)

CALL CALIFORNIA'S SENATORS TO PREVENT HEALTH CARE CUTS:
Senator Barbara Boxer: 202-224-3553
Senator Diane Feinstein: 202-224-3841

--
Anthony E. Wright
Executive Director
Health Access
1127 11th St., #234, Sacramento, CA 95814
Ph: 916-442-2308, Fx: 916-497-0921
awright@health-access.org

Labels: Updates

posted by Anthony Wright | Permalink | 8:52 PM


 

Wednesday, March 03, 2004

HEALTH ACCESS UPDATE
Wednesday, March 10th, 2004


ELECTION RESULTS SET STAGE FOR NEW PHASE OF BUDGET DEBATE
* Election Message: No Mandate for Cuts, Ground Rules for the Budget Debate
* Next Two Months Critical to Demonstrate Impact of Cuts


While health care was not on the ballot, this past election has significant impact on health care, and the shape of the budget debate moving forward. Propositions 57 & 58 passed by a wide margin, while Proposition 56 failed.

SETBACK ON 56: The defeat of Proposition 56, to be clear, was a setback for health care advocates. The reforms were needed to stop the ongoing cycle of late and irresponsible budgets, and to change the dynamic of the budget process that has gotten us into our current crisis. Advocates will have to find different ways to keep legislators accountable to budget decisions, including decisions to cut health programs. In the long term, the lack of reform continues to make it difficult to win the broad reforms needed to meet the health care needs of all Californians, and the ultimate goal of quality, affordable health care for all.

ELECTION ANALYSIS: A combination of factors conspired against Proposition 56. With no real contest in the presidential primary contest, it was a remarkably low turnout election, with an electorate seemingly exhausted from the historic recall election just a few months ago. The recall and change in Administrations also changed the dynamic of the race: much of the voter demand for change had dissipated. The reform agenda in the Budget Accountability Act was overwhelmed by the focus on Propositions 57 & 58, which were similar sounding and were also billed as the solution to the state’s budget crisis. Among the choices, Proposition 56 was the only initiative that had a funded opposition, which was successful in raising questions about the provisions. When voters are confused about an issue, they tend to vote “no." And in this case, they felt they did their part to address the budget problem by supporting 57 & 58, something that was supported by most political leaders.

NO MANDATE FOR CUTS: That said, health advocates should also be clear about what this election did not state about the budget. There was no mandate in this election for additional cuts to health or other vital services. If anything, some of the support for Proposition 57 was a desire to avoid more cuts, which were threatened without passage of 57 & 58. In several local elections around the state, voters approved tax increases to prevent cuts, including Measure A in Alameda County (see below) around health issues.

NEW RULES FOR NEW PHASE OF BUDGET DEBATE: What the election does is set the ground rules for a new phase in the budget debate. Proposition 56 would have changed the dynamic for the better, but its defeat still leaves us with the same budget process that advocates have had some success in preventing the worst of the cuts in the past several years. The passage of the bond in Proposition 57 does not erase the deficit, but defines its size—around $14 million. It prevents the need for drastic cuts immediately, and otherwise re-affirms that timetable for the budget debate.

With the election in the past, we now mark a new beginning for budget debate. March and April are traditionally the times that legislative budget committees review proposed cuts, and study the impact of those cuts. Starting with a Monday, March 8th hearing by the Senate Budget Subcommittee on Health, there will be a series of hearings, as well as advocacy activities, rallies, lobby days, and events through the announcement of the May Revision of the budget. Advocates will need to put significant emphasis to demonstrate the severe impact of the proposed cuts, and to indicate that there are other choices.

SIGNS OF HOPE AT HIGHLAND: Under that theme, Alameda County voters gave their support (by 70.9%) for Measure A, a property tax increase in order to fund health care services, especially to keep open Highland Hospital and the Alameda County Medical Center, the key safety net health care institution in Oakland. They followed the lead of Los Angeles voters over a year ago, and this victory indicates once again that voters support health care, are against cuts and the closure of health care institutions--even if it means they must share in the solution with additional revenues.

ACTIONS NEEDED IN NEXT TWO MONTHS: Numerous organizations are sponsoring and planning hearings, activities, lobby days, and rallies over the next three months to make the case to voters, and ultimately, to Governor Schwarzenegger to prevent these cuts, and choose another solution. Events include a range of town hall meetings and actions in local districts around the state, and mobilizations in Sacramento of hundreds of community leaders. This includes a major combined action in Sacramento of thousands on May 12th, sponsored by groups representing seniors, children, hunger, and health care advocates. More information will be available in the Health and Budget Advocacy Calendar. If your organization is planning your own event or activity, please let us know so that we may include it.

--
Anthony E. Wright
Executive Director
Health Access
1127 11th St., #234, Sacramento, CA 95814
Ph: 916-442-2308, Fx: 916-497-0921
awright@health-access.org

Labels: Updates

posted by Anthony Wright | Permalink | 6:52 PM


 

Tuesday, March 02, 2004

HEALTH ACCESS UPDATE
Tuesday, March 2, 2004
(Election Day--Please Vote!)

LEGISLATORS AUTHOR OVER A DOZEN BILLS TO
LOWER COST & INCREASE ACCESS TO PRESCRIPTION DRUGS

Many consumer organizations, including Health Access California and others
representating seniors, labor, communities of color, people with
disabilties, and California families, are supporting a broad range of
legislation aimed at controlling the price of prescription drugs and
improving consumer information about drugs.

More than a dozen bills on controlling prescription drug prices have been
introduced. Additional bills or resolutions may also appear. ATTACHED and
BELOW is a list.

Hearing dates are not yet firm for these bills. Support letters for
individual bills should be sent as soon as possible: hearing dates may be as
early as March 10th in the Senate.

There will be press conferences, sponsored by numerous consumer
organizations, next WEDNESDAY, MARCH 10th, in both Sacramento and Los
Angeles to announce the kick-off for "OURx Bill of Rights," a California
campaign for safe and affordable prescription drugs. More information on
this campaign, and how to support it, will be forthcoming. ATTACHED is a
flyer on the March 10th Sacramento event.


BILLS TO CONSIDER

Health Access Recommends Support:

SB1144 (Burton) would allow the Department of General Services to contract
with Canadian sources to purchase drugs for Corrections, state hospitals,
and other state agencies (not including Medi-Cal or PERS). SENATE HEALTH.

SB1170 (Ortiz) would require DHS to establish a Maximum Allowable Ingredient
Cost lists within a year. SENATE HEALTH.

SB1149 (Ortiz) would require a website listing sources for purchasing
Canadian drugs that were not safe. SENATE BUSINESS AND PROFESSIONS.

SB1333 (Perata) would require Medi-Cal to seek further rebates. SENATE
HEALTH.

SB???? (Escutia) would require drug companies to offer prices to community
clinics that do not exceed the price ceiling for the federal 340B program.
Bill number to follow later this year. Assembly Health

SB1765 (Sher) would codify the voluntary guidelines issued by Pharmaceutical
Research and Manufacturers of America (PHARMA) regarding gifts, meals, and
other inducements offered to physicians and other prescribers. SENATE
HEALTH.

SJR 24 (Ortiz) is a resolution asking the President and Congress to regulate
or ban direct-to-consumer advertising of prescription drugs.

AB1957 (Frommer) would require the Board of Pharmacy to establish a website
with links to certified Canadian pharmacies so individual Californians could
safely purchase drugs. ASSEMBLY BUSINESS AND PROFESSIONS; ASSEMBLY HEALTH

AB1959 (Chu) would require legislative oversight of DHS Medi-Cal rebates:
the Office of the Inspector General recently found that California is owed
almost $1.3 billion for unpaid rebates. ASSEMBLY HEALTH

AB1960 (Pavley) would impose on pharmacy benefit managers (PBMs) a fiduciary
duty to the purchaser (rather than the drug company that sells to them) and
would require disclosure to the purchaser of rebates, discounts, and other
price cuts received by the PBM. ASSEMBLY BUSINESS AND PROFESSIONS.

AB262 (Chan) prohibits sale of a physician’s prescribing data unless the
physician consents. Patient privacy is protected by various state and
federal laws but physician prescribing patterns are not protected by those
laws. SENATE APPROPRIATIONS

AB2326 (Corbett) requires the creation of evidence-based drug lists for use
by consumers and purchasers. ASSEMBLY HEALTH

AJR 61 (Ridley-Thomas) calls on the federal government to certify that the
importation of drugs from Canada is safe. ASSEMBLY HEALTH

AJR 62 (Ridley-Thomas) calls on the federal government to repeal the
provisions of the Medicare drug bill that prohibit the federal government
from negotiating Medicare drug prices. ASSEMBLY HEALTH


Watch Bills:

Health Access recommends WATCH on these bills until more information can be
obtained about what the authors and the sponsors intend to accomplish with
them.

AB1958 (Frommer) would create a drug purchasing pool for public and private
purchasers, including businesses, HMOs, and individuals. ASSEMBLY HEALTH

AB2679 (Wolk) makes technical changes to Medi-Cal drug program.

AB2682 (Negrete McLeod) limits out of state wholesalers and may impede
importation from Canada and elsewhere.

--
Anthony E. Wright
Executive Director
Health Access
1127 11th St., #234, Sacramento, CA 95814
Ph: 916-442-2308, Fx: 916-497-0921
awright@health-access.org

Labels: Updates

posted by Anthony Wright | Permalink | 6:51 PM


 

Digging a bigger whole for reform...

 

Scoring at home...

 

We are hiring, to make a difference...

 

Field Poll: strong opposition to the health cuts.....

 

An Unhealthy Trend

 

Dressing up the Individual (Market)

 

A great debate on the great divide...

 

Jones to be chair of Health Committee...

 

Bass on the budget...

 

Pretty soon, the insureable will be a pretty exclu...