State Highlights: Calif. prop 45 ad truth check; Medi-Cal autism coverage

Sep 16 2014

A selection of health policy stories from Florida, California, Kansas, Illinois, Washington state and Minnesota.

San Jose Mercury News: New Anti-Prop. 45 Ad Is Partiallly Misleading
Proposition 45 would give California's elected insurance commissioner the authority to reject excessive health insurance rate hikes, a power the commissioner already wields for auto and homeowners insurance rates. The campaign against it -- for which the insurance industry has so far put up $37.3 million -- is now airing a 60-second radio ad narrated by a nurse named Candy Campbell. What does the ad say? Campbell says voters have a choice between letting the state's "new independent commission" negotiate rates and reject expensive plans, or handing that power over to "one politician" who can "take millions in campaign contributions from special interests." Is it true? The "commission" Campbell is referring to is the board of Covered California, the state's new health insurance exchange created by the Affordable Care Act, commonly called "Obamacare." Covered California is indeed an independent part of state government. But it's somewhat misleading to describe the board as "independent." The board members are appointed by politicians -- the governor and the Legislature (Richman, 9/13).

Kansas Health Institute News Service: Specialists In South Dakota Use Telehealth System To Give ER Care In Kansas
A new nurse was on duty a few weeks ago in the emergency room at the Phillips County Hospital when paramedics arrived with a critically injured patient. She immediately pushed the red button on some newly installed equipment. Seconds later, a seasoned ER nurse and board-certified doctor sitting at a bank of monitors 380 miles away in Sioux Falls, S.D., were using a high-definition camera and other diagnostic equipment to monitor the patient, give advice and document everything the on-site nurse was doing to save the patient's life. The Phillipsburg hospital is the first in the state to sign up for a 24/7 telemedicine program operated by Avera Health, a Catholic health care system based in Sioux Falls. For a flat fee of about $65,000 a year, it and the other hospitals in the network can make unlimited use of the eEmergency system (McLean, 9/15).

Kaiser Health News: California To Broaden Autism Coverage For Kids Through Medicaid
A new initiative seeks to help level the playing field. Starting Monday, September 15, thousands of children from low-income families who are on the autism spectrum will be eligible for behavioral therapy under Medi-Cal, the state's health plan for the poor. California is among the first states to respond to a recent rule by the U.S. Centers for Medicare & Medicaid Services that requires the therapy to be covered, when deemed medically necessary, as part of a "comprehensive array of preventive, diagnostic and treatment services" for low-income people 21 and under (Hernandez, 9/15).

Miami Herald: Health Care Prices: Many Moving Parts Veiled By Confidentiality Agreements
Private commercial insurers do not publish their payments like Medicare does, but health care experts say the prices they pay hospitals for the same procedure can vary just as much -- and the reason often depends on more than just the hospital where the knee replacement was performed. For most insured Americans, the reasons for such variance in health care prices also can include the medical condition of the patient, complications that may arise, physicians' fees, market competition, and even who's paying for the procedure and how. That's a lot of moving parts for anyone to nail down a firm price, said Frank Sacco, chief executive of Memorial Healthcare System, the public hospital network for South Broward County (Chang, 9/14).

Chicago Sun Times: Emanuel Socks City Retirees With 40 Percent Health Insurance Hike
Mayor Rahm Emanuel on Friday dropped another financial bombshell on Chicago's 25,000 retired city workers and their dependents: their monthly health insurance premiums will be going up by a whopping 40 percent -- in spite of a pending lawsuit and a precedent-setting Illinois Supreme Court ruling. Last year, Emanuel announced plans to save $108.7 million a year by phasing out the city's 55 percent subsidy for retiree health care and forcing retirees to make the switch to Obamacare. For the city, the Year One savings was $25 million. For retirees, that translated into an increase in monthly health insurance premiums in the 20 percent and 30 percent-range. On Friday, city retirees and their dependents got hit again -- only this time, even harder. The city notified them of a 30-percent to 40-percent increase that will cost most of the retirees between another $300 to $400 a month (Spielman, 9/12).

Los Angeles Times: Medi-Cal Official To Leave Health Care Post In January
The official who led California's giant public health care services department through a tumultuous implementation of Obamacare reforms -- including a months-long period during which hundreds of thousands of Medicaid applications have languished, waiting to be processed -- will depart his position in January, state officials have announced. Toby Douglas directed the state's $91-billion Department of Health Care Services for four years (Brown, 9/12).

California Healthline: Douglas Resigns as DHCS Director
Toby Douglas announced his resignation Friday as director of California's embattled Department of Health Care Services. Appointed director by Gov. Jerry Brown (D) in 2011, Douglas oversaw tumultuous change in the growing department as the state expanded its Medicaid program and launched several initiatives as part of California's response to the Affordable Care Act (Lauer, 9/12).

The Associated Press: WSU Regents Approve Plan For New Medical School 
Washington State University's board of regents on Friday unanimously approved the administration's controversial effort to start a new medical school in Spokane, citing the "dire need" for more doctors in the state. ... WSU's plan is opposed by the University of Washington, which operates the state's only publicly funded medical school. While approving WSU President Elson S. Floyd's pursuit of the independent medical school, the regents said the university should continue its partnership with the University of Washington's WWAMI program, which trains doctors for the states of Washington, Wyoming, Alaska, Montana and Idaho (Geranios, 9/12). 

The Associated Press: Kids Go To Adult Trauma Centers, Treatment Delayed
Florida state guidelines require children with traumatic injuries to be taken to a trauma center specializing in pediatric care. Yet, in recent years, dozens of Florida kids have instead gone to adult centers that weren't able to treat them, according to an investigation by the Tampa Bay Times. The Times reported Sunday that in years past, children went to adult centers only when those facilities were significantly closer than ones designated for pediatric care, or because paramedics believed the child wouldn't survive a longer journey. Experts say 50 miles is considered a reasonable distance to fly an injured patient for proper care. Since 2009, though, the state has approved six new Hospital Corporation of America trauma centers. And at least 100 children have been taken to those facilities instead of pediatric centers even though in most cases they were not more than 50 miles away. Of that group, than 60 children then had to be transferred to pediatric trauma centers (9/14).

Minneapolis Star Tribune: New Minnesota Law Pushes Mental Health System To A Crisis Point
Hundreds of people with severe mental illnesses are languishing for weeks or even months without proper medical treatment, in part because of a law that requires state psychiatric facilities to admit some jail inmates ahead of hospital patients, regardless of clinical need or cost. The longer waits for mental health beds are an unintended consequence of 2013 legislation that was designed to shrink the swelling population of mentally ill people housed in county jails. The law, known as the "48-hour rule," required inmates to be transferred to a state psychiatric facility within 48 hours after being committed by a state judge. Though the rule was hailed by law enforcement officials, it has raised safety concerns in hospitals (Serres, 9/14).

Sacramento Bee: Think Sacramento Is All About State Workers? Health Care Sector Is Surging
Sacramento has long been known as a state worker town. These days, it's just as accurate to call it a health worker town. The health care sector in the four-county Sacramento region has grown steadily and significantly for more than a decade, according to the California Employment Development Department. While most other sectors shed jobs during the recession, hospitals, doctor's offices and nursing homes held strong, adding 10,000 workers between 2008 and 2014 (Reese, 9/15).