Roundup: Tough to get on Calif.'s new adult day care

Jul 11 2012

A selection of health policy stories from California, Massachusetts, Georgia, Pennsylvania and Indiana.

San Francisco Chronicle: Many Ineligible For New Adult Day Care
Community-Based Adult Services began March 1 as part of a legal settlement between the state and advocates that sued over Gov. Jerry Brown's plan to eliminate Adult Day Health Care entirely. Under the agreement, the state is supposed to accept adults who qualified for Adult Day Health Care and are additionally considered at risk of institutionalization. ... But Disability Rights California attorney Elissa Gershon, who helped negotiate the settlement, said state officials have been rejecting many people who they agree are at risk of institutionalization by saying they do not meet the Adult Day Health Care requirements (Lagos, 7/9).

Reuters: Massachusetts Governor Signs $32.5 Billion Budget
Massachusetts Governor Deval Patrick on Sunday signed a $32.5 billion state budget for fiscal 2013 that boosted funds for education, including community colleges, and projected savings in health care costs. … The budget assumes savings of about $700 million in health care costs through changes to payment and delivery models used by MassHealth, the state's version of Medicaid, and "competitive procurement strategies" by the Health Connector Authority, the agency which oversees the state's universal health care program (Krasny, 7/9).

Boston Globe: In Letter To Governor Patrick, Hospital Group Calls Medicaid Cuts 'Unsound Public Policy'
The Massachusetts Hospital Association sent a letter to Governor Patrick last week asking him to stop proposed administrative changes the group says would result in cuts of about $40 million to Medicaid payments for hospitals. The changes, effective Oct. 1, "represent the continued practice of shifting of government costs onto providers," President Lynn Nicholas wrote to Patrick in a letter dated July 3. "This cost shifting practice is unsound public policy and stands as a direct barrier to the reform effort in Massachusetts" (Conaboy, 7/9).

KQED: Children's Advocates Divided On Healthy Families Transition
As the Legislature debated -- and ultimately approved -- a budget-cutting plan to transfer nearly 900,000 California children on the Healthy Families program into Medi-Cal next year, dozens of groups joined in opposition. They ranged from the California Medical Association, a professional organization that represents the state's doctors, to the California Primary Care Association, which represents community clinics. Mostly, they were groups that focus on children and families, such as Children Now and United Ways of California (Bazar, 7/9).

HealthyCal: Dental Clinic Provides Much Needed Care To Kids With Special Needs
(Oakland's) Children's Hospital opened the dental clinic nearly thirty years ago to address the oral health of hospital patients who had special behavioral or medical needs, such as hemophilia, cancer or heart problems. … More than 80 percent of their nearly 6,000 patients are on Medi-Cal, which very few pediatric dentists serving special needs patients will accept (Shanafelt, 7/10).

Georgia Health News: Some With Pre-Existing Conditions See Hope In Insurance Changes
Liz Johnson and Robert Irby have diabetes and other medical conditions, so having insurance has been crucial to them. ... Early this year, their monthly premiums jumped by about $100, reaching $628 for him and $677 for her. The couple had automatic payment online through their bank. But they did not immediately adjust the amount paid to reflect the new premiums. When they realized their mistake, they say, they sent in the extra money. But Blue Cross and Blue Shield of Georgia, their health insurer, sent the money back and canceled them. ... The problem of pre-existing conditions, though, has remained an enormous barrier for people getting affordable coverage. It has adversely affected millions of Americans, keeping them from changing jobs due to fear of losing insurance, and leading to insurers routinely rejecting applicants for individual coverage, or setting sky-high premiums (Miller, 7/9).

Philadelphia Inquirer: Pa. Eliminating Easy Stopgap Health Coverage For Poor
If you are poor in Pennsylvania and temporarily disabled, a health-care worker can fill out a one-page form that qualifies you to receive medical care paid for by the state. But that is changing under a new policy, requiring more paperwork, that Gov. (Tom) Corbett is implementing, arguing that it will save taxpayers money without denying significant numbers of people medical care. Health care workers and advocates for the poor, however, say the new policy could leave thousands of people without needed care and drive up medical costs in the long run (Hill, 6/9).

CNN: Indiana Abortion Law Ruled Illegal
A controversial Indiana law that would keep low-income women from using federal Medicaid benefits to receive any kind of reproductive medical care from Planned Parenthood is unacceptable because it denies women the freedom to choose their health care providers, according to a federal hearing officer (Boyette, 7/9).

California Healthline: Residency Program May Help Doctor Shortage in Central Valley
How do you address a shortage of physicians in an underserved rural county in the Central Valley? If you have a thriving regional medical district that operates the main referral hospital and the only trauma emergency department between Bakersfield and Fresno, you establish a medical residency program. That's just what Visalia's Kaweah Delta Health Care District is doing (Daniel, 7/9).