In 2001, Network member Devon Dabbs and colleague Lori Butterworth were on a mission. They were determined to change public insurance rules that required families of children with a life-threatening illness to make the agonizing decision to abandon medical efforts to cure their child in order to qualify for hospice/palliative care. By 2006, the duo had succeeded. A federal waiver was in place so that California children could receive both curative treatment and palliative care. But the waiver was only the beginning. Learn more.
Looking Toward 2014: Key Facts about the Medi-Cal Expansion is a recently released publication based on a webinar by Network member Scott Graves, senior policy analyst at the California Budget Project. The report addresses upcoming coverage changes, and highlights such key issues as a potential payment cut for Medi-Cal providers. View the report (PDF).
The Department of Health Care Services has announced the schedule for implementing its plan to reduce payments to Medi-Cal health care providers by 10 percent. These reductions were proposed in 2011, but were not completed pending a lawsuit. In June of this year, the Ninth Circuit Court of Appeals allowed the state to proceed with the reductions, which Medi-Cal recipients and providers say will have a devastating effect on children with special health care needs, among others. The Department has posted the implementation schedule, including details about which services will be exempted and which cuts will be retroactive.
A decision by the California Supreme Court allows trained, unlicensed school personnel to administer prescription medications such as insulin "in accordance with the written statements of a student's treating physician and parent." Read more.
The State of California has released an assessment of the adequacy of the Medi-Cal managed care network in eight far northern California counties, as part of the transition of children from the Healthy Families program (HFP) to Medi-Cal managed care. These rural counties face a chronic shortage of pediatric subspecialists. Advocates are concerned that many children with special health care needs will lose their current coverage as part of the transition. Read the state's report and send your comments.
The board of Covered California, the state's health benefit exchange, has voted to delay soliciting bids for "embedding" pediatric dental care in medical plans that will be sold in 2014. The Exchange instead will offer five stand-alone dental plans, and one stand-alone plan that will be "bundled" with a health plan. Board members said they will aim to include dental care in health plans in 2015. A coalition of children's advocacy organizations had lobbied for embedded plans in 2014. Read more.
In a provision that could be significant for some families of children with chronic conditions, the Affordable Care Act allows some health plans to delay limits on consumers' out-of-pocket health care expenses until 2015. However, on Aug. 13 the California Assembly passed a bill that would put the limits in place in 2014. We will continue to follow this issue. Read more.
In an open letter to the mental health community, US Senate Finance Committee Chair Max Baucus and Ranking Member Orrin Hatch are requesting public input on the challenges and barriers patients face in trying to access quality mental health care. In the letter, the senators pose three questions about how to improve care. They request responses by Sept. 30 to MentalHealth@finance.senate.gov. For more information, call (202) 224-4515.
Telemedicine consultations between specialists and medical staff in rural emergency rooms in Northern California improved the quality of pediatric care and parental satisfaction with the care, according to a new study from the UC Davis Children's Hospital. Read the story.
A new toolkit from the Vanderbilt Kennedy Center for Excellence in Disabilities offers guidance to families on helping children with disabilities navigate puberty. Organizations may distribute the publications, which are tailored to girls and boys. See details here.
Covered California, the state's health benefit exchange, continues its series of town hall meetings across the state regarding the enrollment process. For more details and to find the town halls for August 16-September 27, click here. Also see an article about one of the first Town Hall meetings.
What do specialists need from PCPs for better care coordination?
Let us know what's happening with your organization or family. E-mail Network Manager Janis Connallon at Janis.Connallon@lpfch.org with your news or updates.