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SACRAMENTO – A federal court judge has issued a tentative decision to block California officials from moving forward with a 10 percent Medi-Cal reimbursement rate cut, which was approved by the federal government.
The California Medical Association (CMA), the California Dental Association (CDA), California Pharmacists Association (CPhA), National Association of Chain Drug Stores (NACDS), California Association of Medical Product Suppliers (CAMPS), AIDS Healthcare Foundation (AIDS) and American Medical Response (AMR) applauded the federal court and Judge Christina Snyder for the tentative decision.
“The court’s tentative ruling is encouraging to those of us practicing medicine,” said James T. Hay, M.D., CMA President. “The state’s repeated attempt to slash Medi-Cal reimbursement rates is a short-sighted solution that balances the budget on the backs of the poorest and most vulnerable Californians. Rather, we need to be addressing long-term solutions relative to the cost of health care. Access to care is crucial for prevention and treatment; the court’s tentative decision today to block the Medi-Cal cuts means that those patients will still have access to health care.”
Last spring, the California Legislature passed and Governor Jerry Brown signed AB 97, which included a 10 percent reimbursement rate cut for physicians, dentists, pharmacists and other Medi-Cal providers. Federal approval was required before the state could implement its proposed cuts.
“CDA is pleased that the judge considered the facts in this case, that the state’s attempt to cut reimbursement rates would harm patients and their ability to access care,” said CDA President Dan Davidson, DMD. “The state already eliminated most adult Denti-Cal services and making further cuts to children’s services would have been devastating to their oral health.”
The groups said the information that the Centers for Medicare & Medicaid Services relied on to approve the state's cuts do not measure whether and how patients' access to care would be impacted or otherwise take into consideration, as required by law, the costs to provide the care.
"We commend the court's tentative ruling in favor of preserving and protecting patient care," said NACDS President and CEO Steven C. Anderson, IOM, CAE. "Drastic cuts are not in the best interest of patient care or the state's finances. Community pharmacies help to reduce health care spending and improve patient health through pharmacy services including medication counseling, vaccinations, education and screenings as well as the utilization of generic medications. Jeopardizing patient access to community pharmacy would diminish health and increase the reliance on more costly forms of care."
Because California Medi-Cal rates are already extremely low and many prescription medications are reimbursed at breakeven rates, many providers cannot afford to participate. Kaiser State Health Facts lists California as the lowest reimbursed state in the nation.
“We are fighting for an injunction against these cuts on behalf of patients and the pharmacists who serve them,” said Jon R. Roth, CPhA chief executive officer. “The Legislature needs to realize that using the Medi-Cal program to close the budget is bad medicine for California. When the Legislature asked, we provided them with cost-effective solutions that would have helped close the budget gap. However, they effectively slammed the door on our proposed solutions when they voted to reduce reimbursement to providers by 10 percent and in turn have ensured that access to care for California’s most vulnerable citizens is put in jeopardy.”
The lawsuit was filed against the California Department of Health Care Services and the U.S. Department of Health and Human Services on Nov. 21, 2011.
Judge Snyder has issued a 25-page tentative order, wherein she favored the plaintiffs’ request for a preliminary injunction. A final order, if consistent with her tentative ruling, will enjoin the cuts and is expected in the near future.
“We applaud the ruling of the court today to help preserve the ability of Medi-Cal providers to continue to provide services to the most needy of our population,” said Bob Achermann, CAMPS executive director. “Providers of durable medical equipment and medical supplies allow Medi-Cal patients to remain in their homes and avoid more costly care in hospitals or other types of facilities. The continued cuts in reimbursement threaten the ability of these patients to access these important services. We hope that this tentative ruling is confirmed by the court.”
"The ruling today is another in a long line of decisions, now going back years, from courts telling the state that it has not followed the law when attempting to implement these crushing rate reductions. At this point, it seems pretty obvious that the state is doing this deliberately, and that it cannot justify these cuts within the bounds of the law," said Tom Myers, general counsel for AIDS Healthcare Foundation.
“As California’s largest emergency ambulance provider, American Medical Response provides a critical healthcare safety net to California’s most vulnerable citizens. We are pleased with the Court’s tentative decision today granting a preliminary injunction to stop these shortsighted cuts,” Tom Wagner, CEO of AMR’s West Region said.
CMA, CPhA, and CDA successfully sued in the past to enjoin prior Medi-Cal cuts and expect to once again demonstrate that federal law, which ensures that Medi-Cal patients have equal access to health care, was not followed.
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LOWER LAKE, Calif. – Continued reductions in educational funding are forcing the Konocti Unified School District’s board to begin the process of deciding how to cut millions of dollars in order to balance its coming year’s budget, a task that will involve considering the possible elimination of dozens of jobs.
The initial discussion on fiscal year 2012-13 budget cuts by the Konocti Unified School District Board of Trustees will take place during its regular meeting, which begins at 6:15 p.m. Wednesday, Feb. 1, in the Carol McClung Conference Center, 9430-B Lake St. in Lower Lake.
The item on “The KUSD Zero Based Model” will be discussed under budget and facilities items.
Marty Aarreberg, executive administrative assistant to district Superintendent Bill MacDougall, said no decision will be made at the Wednesday meeting, and that further discussion and a decision are expected at a special daylong budget session beginning at 8:30 a.m. Saturday, Feb. 11. Aarreberg said all community members are welcome – and encouraged – to attend.
MacDougall, who was in meetings throughout Monday afternoon, did not return a message seeking comment on the Wednesday meeting and the proposal to cut services and jobs.
However, MacDougall and district Business Manager Laurie Desimone submitted an in-depth memorandum to the board of trustees, outlining the challenges the district is facing.
In a memo explaining the zero based model, the memo begins by stating, “The financial challenge with which we are faced is not one of the district’s choosing, nor have we created this problem. The current financial distress has been created as a result of the state and national economic circumstances and governmental decisions and given to us to resolve for our district.”
MacDougall’s and Desimone’s memo said that the four main budget issues the district must face are the complete elimination of state transportation funding; a mid-year trigger cut of $370 per student for average daily attendance, which exceeds $1 million for Konocti Unified; the exhaustion of federal jobs funds, a loss of $571,000; and an estimated $400,000 in step and column advancement and other bargaining agreement-associated costs for staffers.
Those four items total almost $2.8 million, which MacDougall and Desimone reported is more than 10 percent of the district general fund budget.
“Along with these unprecedented cuts, the Governor proposes the greatest budget flexibility seen in decades,” the memorandum said. “These changes if adopted by the legislature would pool nearly all state categorical funds into a single revenue stream for districts to utilize in the manner decided by the local district, without the ‘strings’ of the past program guidelines.”
The memo said the board directed district staff to develop a zero based budget model, which starts at zero and builds upward by prioritizing essential programs and personnel.
The message from MacDougall and Desimone to the board acknowledges that the decisions before trustees will have far reaching impacts on programs and staff.
“We want to be sure that we can give earliest notice possible to staff who may be laid off or will have their hours reduced,” they wrote. “We anticipate that action by the board on lay off notices will be made no later than the March 7th regular board meeting.”
The zero based model’s proposed staffing cuts are deep, according to an early version of the report released as part of the agenda packet.
Up for possible elimination are the Carlé Continuation High School principal’s job; eight to 10 kindergarten through third grade teaching positions; all K-8 librarians and the K-8 music teacher; three six-hour licensed vocational nurses; director of technology and student services; one truancy investigator or partial position at the Lake County Office of Education; all site bilingual paraprofessionals and bilingual family liaisons; a 1.5-hour clerk position and one eight-hour mechanic in the transportation department; a half-time education specialist at Lower Lake Elementary; a two-hour California High School Exit Examination paraprofessional at Carlé High; and a half-time contracted alternative education teacher.
Further, the plan proposes to cut one eight-hour librarian, three six-hour student management assistants, one seven-hour student management assistant and one two-hour site secretary at Highlands Academy, adding back one seven-hour site secretary.
At the high school, possible cuts include one ROP teacher, one 11-month high school secretary, one-eight hour librarian, one eight-hour career center clerk/site testing coordinator, one eight-hour high school campus supervisor, four periods of an in school school suspension teacher, two sections for the athletic director, 12 hours for a bilingual paraprofessional, one five-hour bilingual family liaison, junior varsity coaching stipends and two sections of the academy director.
The food services director’s salary would be cut by one month, and bus drivers, paraprofessionals and some other support positions would see their work year cut by five to six days.
Also on the list of possible eliminations are drama and band for K-8; seven to eight bus routes would be cut, with reduced hours for five to six other routes; the teacher in charge for Lewis School would no longer receive a stipend; and class size reductions for K-3 and the Community-Based English Tutoring program would end.
Blue Heron School, for grades nine through 11, is proposed to be reduced to a single session and moved to Burns Valley.
MacDougall and Desimone concluded their memo by writing, “Together we can make the tough decisions necessary and do what we must under these difficult circumstances to provide the highest quality education possible for our students.”
Management staff are set to meet on Tuesday to finalize their recommendations for the board's Wednesday meeting.
E-mail Elizabeth Larson at
CLEARLAKE, Calif. – A Clearlake home sustained major damage in a Saturday afternoon fire.
The fire, reported over the radio shortly before 4 p.m. Saturday, Jan. 28, was located in a residence at 14415 Alvita Ave., according to Lake County Fire Protection District Capt. Brice Trask.
Initial reports from the scene said there was heavy smoke coming from the home’s eaves.
Trask said firefighters arrived at the scene of the single-story, single-family home, and were quickly able to contain the fire to the room of origin, which he said was the living room.
He estimated that it took only about 10 minutes to suppress the fire and mop up the scene.
The residence has been undergoing remodeling, and had the utilities turned on, he said.
He said the home appeared to have been illegally entered by an unknown person or persons.
“Activities inside the house resulted in a fire to the couch,” he said.
However, Trask said the exact cause wasn’t not known on Monday, with the incident still under investigation.
He estimated that the structure suffered $30,000 in damage from fire and smoke.
E-mail Elizabeth Larson at
SONOMA COUNTY, Calif. – The Department of Fish and Game (DFG) recently released adult coho salmon in Salmon Creek, Sonoma County to reestablish a coho salmon population.
This is the fourth consecutive year adult salmon were released, the agency reported.
The Department of Fish and Game said 200 adults were released on two separate occasions in late December 2011 and early January 2012.
The released coho included 120 males and 80 females, predominantly hybrids derived from mating between coho salmon of Russian River and Olema Creek origin, with a small number of pure Russian River coho and Olema Creek coho, Fish and Game said.
“We are at a critical moment in the survival of the coho salmon on the California coast,” said Manfred Kittel, the Department of Fish and Game Coho Salmon Recovery coordinator. “DFG and our federal and environmental partners must take aggressive actions to save the species from becoming extinct in central California.”
As in previous years, this year’s fish were released near the mouth of Salmon Creek with the hope that the fish will migrate upstream to find suitable spawning habitat in one of Salmon Creek’s tributaries, according to the Monday report.
Despite the general lack of rain this season, biologists are optimistic that the recently released coho should be able to find spawning habitat in some upstream portions of Salmon Creek and its tributaries.
The release of adult coho in Salmon Creek is a joint effort between DFG, the National Oceanic and Atmospheric Administration and other entities, including private landowners. The Salmon Creek access site is located a few miles north of Bodega Bay on the Chanslor Ranch owned by George Gross.
“The entire coho recovery team appreciates Mr. Gross allowing us to access the creek on his property for the past four years,” said Kittel. “There are few optimal places where adult coho can be released and we appreciate the help we get from Chanslor Ranch.”
In 2008, 2009 and 2010 field biologists collected tissue samples and confirmed that the released coho spawned successfully in several tributaries and in all possible mating combinations.
Fish surveys planned for the coming summer in the Salmon Creek watershed will tell DFG biologists whether the latest released group of adult coho salmon has reproduced successfully and whether any of the progeny from the first release in winter 2008 have returned this season from the ocean to spawn in the watershed where their life’s journey began three years ago.
Releasing hatchery-reared adult coho salmon is a relatively new technique that has the advantages of not requiring spawning in a hatchery, allowing the released fish to establish natural mating patterns and subjecting their offspring to natural selective pressures from birth on.
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SACRAMENTO – The Department of Water Resources (DWR) will conduct this winter’s second snow survey on Wednesday, Feb. 1.
One focus of attention will be the manual survey scheduled for 11 a.m. off Highway 50 near Echo Summit.
This and other manual surveys up and down the state as well as electronic readings from remote sensors will determine the water content in the snowpack.
Electronic readings on Monday indicated that water content in the statewide snowpack is just 38 percent of normal. That is 23 percent of the average April 1 reading, when the snowpack is normally at its peak before the spring melt.
While those numbers are low, DWR said they’re an improvement over results of this winter’s Jan. 3 survey, which recorded snowpack water content at 19 percent of normal for that date, and only 7 percent of the average April 1 reading.
”Conditions so far this winter continue to be much drier than we would like,” said DWR Director Mark Cowin. “We are fortunate that most of the state continues to benefit from good reservoir storage carried over from last winter, and we remain optimistic for a return to a normal weather pattern between now and spring to sustain adequate water deliveries.”
Lake Oroville in Butte County, the State Water Project’s principal storage reservoir, is at 107 percent of average for the date (72 percent of its 3.5 million acre-foot capacity), Lake Shasta north of Redding, the federal Central Valley Project’s largest reservoir with a capacity of 4.5 million acre-feet, is at 100 percent of its normal storage level for the date (68 percent of capacity).
San Luis Reservoir in Merced County, an important storage reservoir south of the Delta, is at 121 percent of average for the date (96 percent of its capacity of 2,027,840 acre-feet). San Luis is a critically important source of water for both the State Water Project and Central Valley Project when pumping from the Delta is restricted or interrupted.
For context, an acre-foot is 325,851 gallons, enough to cover one acre to a depth of one foot.
In addition to better-than-average storage, it is expected that storms later this winter will deepen the snowpack and increase runoff into the state’s streams, reservoirs and aquifers.
Conditions between now and early spring will determine the amount of State Water Project (SWP) water DWR will be able to deliver this calendar year.
The initial estimate is that DWR will be able to deliver 60 percent of the slightly more than 4 million acre-feet of water requested by the 29 public agencies that distribute SWP water to more than 25 million Californians and nearly a million acres of irrigated farmland.
The initial delivery estimate for calendar year 2011 was only 25 percent of requested SWP water.
As winter took hold, a near-record snowpack and heavy rains resulted in deliveries of 80 percent of requests in 2011. The final allocation was 50 percent in 2010, 40 percent in 2009, 35 percent in 2008, and 60 percent in 2007.
The last 100 percent allocation – difficult to achieve even in wet years because of pumping restrictions to protect Delta fish species – was in 2006.
DWR and cooperating agencies conduct manual snow surveys around the first of the month from January to May. The closely-monitored snowpack normally provides approximately one-third of the water for California’s households, industries and farms as it melts in spring and summer.
Electronic snowpack readings are available on the Internet at http://cdec.water.ca.gov/cgi-progs/snow/DLYSWEQ.
Electronic reservoir level readings may be found at http://cdec.water.ca.gov/cdecapp/resapp/getResGraphsMain.action.
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The California Department of Fish and Game will co-host the first of five public information sessions to address the national threat of climate change.
The discussion will be held Tuesday, Jan. 31, from 9 a.m. to 1 p.m. at California State University, Sacramento in the Willow Room Suites of Modoc Hall.
The session also is sponsored by the Association of Fish and Wildlife Agencies, and will center on the draft National Fish, Wildlife and Plants Climate Adaptation Strategy.
The draft national strategy came out of a partnership of federal, state and tribal fish and wildlife conservation agencies and is describe as an integrated, coordinated and comprehensive response to the pressures of climate change.
It is available for public review and comment through March 5 at www.wildlifeadaptationstrategy.gov.
The site also provides instructions for submitting comments and the dates and locations of all five public sessions and two Webinars.
Department of Fish and Game Chief Deputy Director Kevin Hunting, a member of the steering committee, will present opening remarks at Tuesday’s session. He said the strategy offers a platform for enhanced coordination and cooperation in tackling the challenges associated with climate change.
“The draft outlines a sound set of goals, strategies and actions that address resource management challenges that a warming climate presents,” said Hunting. “Many of these actions have been called out in existing statewide climate adaptation planning strategies, such as the 2009 California Climate Adaptation Strategy, and further solidify the importance of these key goals and actions we’re taking at the state level.”
The adaptation strategy represents a draft framework for unified action to safeguard fish, wildlife and plants, as well as the important benefits and services the natural world provides the nation every day, including jobs, food, clean water, clean air, building materials, storm
protection and recreation.
In 2010, Congress called for a national, government-wide strategy to be developed by the President’s Council on Environmental Quality and Interior.
The council assembled an unprecedented partnership of federal, state and tribal fish and wildlife conservation agencies to draft the strategy.
This partnership includes the Department of the Interior’s U.S. Fish and Wildlife Service, the Department of Commerce’s National Oceanic and Atmospheric Administration and the New York State Department of Environmental Conservation, representing state fish and wildlife
agencies.
Teams composed of more than 100 diverse researchers and managers from across the country participated in the drafting for the partnership.
Each team focused on an ecosystem-based section of the strategy: freshwater/inland water systems, coastal systems, marine systems, forested systems, and grassland and scrub-land systems (including deserts and tundra).
The teams ensured that the strategy was developed with a thorough understanding of the ecological implications of climate change on major natural systems.
Other public sessions are planned for Madison, Wis., Charleston, S.C., Anchorage, Alaska and Albany, N.Y.
To register for these meetings and for more information on the public comment process, visit www.wildlifeadaptationstrategy.gov/public-comments.php.
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