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WASHINGTON – On Thursday, Reps. Mike Thompson (D-CA) and Jim Ramstad (R-MN) introduced legislation to improve beneficiary access to Medicare's cancer screening services.
The Medicare Early Detection of Cancer Promotion Act will waive co-pays for colonoscopy and mammography services and extend the eligibility period for the "Welcome to Medicare" visit from the current time frame of six months to one year.
"The vast majority of cancer diagnoses and deaths happen to older Americans, so we should be making it as easy as possible for seniors to get regular cancer screenings," said Thompson.
Sixty percent of new cancer diagnoses and 70 percent of cancer deaths occur in people over 65. "Co-pays for these services create a barrier to care," added Thompson. "If we eliminate the co-pays, more seniors will get screened, saving lives and money."
"Nearly 100,000 Americans will die this year from colorectal and breast cancer, yet many of these deaths could have been prevented" said Ramstad. "By passing the Medicare Early Detection of Cancer Promotion Act, we can expand access to life-saving colonoscopy and mammography services, services that are truly the first line of defense in preventing cancer deaths."
Currently, beneficiaries pay no coinsurance for most cancer screening services covered by Medicare, but they must pay a 20 percent co-pay for colonoscopy and mammography services.
This legislation will eliminate co-pays for mammograms and colonoscopies, prompting more seniors to utilize these live-saving services.
In addition to saving lives, promoting cancer prevention also saves Medicare – and the American taxpayer – money.
Preventive services cost considerably less than caring for people with cancer. For example, Medicare pays between $200 and $400 for a colonoscopy – but if colon cancer metastasizes, total costs of care can exceed $58,000 per patient.
The efficacy of cancer prevention screening is clear. When caught in the first stages, the five-year survival rate for breast cancer is 98 percent and the five year survival rate for colorectal cancer is 90 percent.
However, if these cancers move into more advanced stages, the survival rates are only 26 percent for breast cancer and 10 percent for colorectal cancer.
This legislation will also increase the number of seniors who seek cancer prevention services by extending the "Welcome to Medicare" period. During these physicals, Medicare beneficiaries can take advantage of certain screening and preventive health services and learn about others.
Currently, fewer than 5 percent of new beneficiaries are seeking appointments for the "Welcome to Medicare" visit, and extending the eligibility period means that more people will be able to benefit from it.
Thompson and Ramstad are both members of the Ways & Means Health Subcommittee.
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SACRAMENTO – The Assembly Committee on Public Safety voted 4-0 July 2 to approve SB 568, a bill by Senator Patricia Wiggins (D-Santa Rosa) to allow county jail facilities to provide medications to defendants with mental illnesses so the defendants can stand trial.
Existing law provides that if a defendant is found to be mentally incompetent to stand trial or “IST,” the trial or judgment is suspended until the IST defendant is restored to mental competency. Existing law also requires the county sheriff to take the IST defendant to a state hospital or treatment facility in order to restore the defendant to competency.
If an IST defendant has been accused of committing a felony offense, involving great bodily harm or another serious crime, the law allows the defendant to be involuntarily medicated in a mental hospital or facility. Unfortunately, it can take up to six months from the date a defendant is determined to be incompetent until the time they are moved to a treatment facility due to a shortage of suitable beds.
“This is an unfortunate situation for all parties – the defendant with a mental condition, the sheriff subjected to a defendant who can refuse medications or treatment in a jail facility, and other individuals who are incarcerated along with the mentally ill defendant,” Wiggins said.
If SB 568 becomes law, counties would be allowed (following a required court hearing) to medicate defendants diagnosed as mentally ill and found by a judge or jury, in concurrence with the county board of supervisors, the county mental health director, sheriff and chief of corrections, to be incompetent to stand trial.
The bill also requires the evaluating psychiatrist to determine whether a defendant could be effectively medicated and restored to competency in a jail or, if not, what level of hospitalization would be needed to restore the defendant to competency. In addition, SB 568 requires the Department of Mental Health to report to the Legislature on such items as the number of IST defendants currently in the system and the resources available for treatment.
During the past year, 28 mentally ill defendants spent 1,578 days (an average of 56 days) incarcerated in the Sonoma County jail while awaiting transfer to an inpatient unit or state hospital – at a cost to the county of $246,000.
"The reality is, more and more mentally ill are being housed in jails, which by definition are not treatment facilities,” Wiggins said. “This bill serves as an interim measure and the county jails have assured me they have no intention of becoming permanent mental hospitals.”
SB 568 is supported by the California Psychiatric Association, the California Mental Health Directors Association, the Sonoma County Board of Supervisors, California State Association of Counties, the California Sheriff’s association, and many other county sheriffs’ offices throughout the state. The bill will be heard in the Assembly Appropriations Committee in the next few weeks.
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CLEARLAKE – To honor the memory of Youth League Coach Michael Hoefer, Redbud Community Hospital and St. Helena Hospital recently presented a portable defibrillator and a training program to Middletown High School.
Hoefer recently suffered a fatal heart attack during a game at the high school.
Principal Chris Heller and Carrie Hoefer, widow of Michael Hoefer, accepted the defibrillator in Hoefer’s honor.
“We feel deep sympathy for the Hoefer family, and understand the critical need for everyone to have access to this life-saving device,” said Tricia Williams, regional vice president, Business Development for St. Helena Hospital and Redbud Community Hospital. “The importance of having a defibrillator available for the school and our community can’t be stressed enough.”
Both Williams and Terry Hansen, senior vice president of Operations at Redbud, feel that the donation of a defibrillator expresses their support to both the Hoefer family and community members.
Hansen added: “I feel this is my way of helping make this critical service available to more people in Lake County.”
Hansen has first-hand experience with defibrillation — it saved his life during his heart attack. “Every day is a gift. My challenge is to never forget the miracle that returned me to life.”
Hoefer’s mission was to affect children’s lives in a positive way. He accomplished this with his a zest for life and boundless energy, sharing both unselfishly with all the children he coached. People whose lives he had touched rallied to support his family, raising money for them through a community barbecue, and finishing construction on the Hoefer’s home.
Portable defibrillators are one of the most important tools carried by ambulances. They are the only proven way to resuscitate a person who has had a cardiac arrest.
Defibrillation consists of delivering a therapeutic dose of electrical energy to the affected heart with the device. Automated External Defibrillators can analyse the heart rhythm by themselves, diagnosing the shockable rhythms, and then charging to treat. This means that no clinical skill is required in their use, allowing lay people to respond to emergencies effectively.
Early defibrillation does save lives. According to the American Heart Association, CPR is just one of the links in what's known as the “chain of survival.” Along with recognizing an emergency situation and calling 911 to get advanced life support personnel on the scene, defibrillation plays a leading role in preserving life.
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SACRAMENTO – The CalPERS Board of Administration on Wednesday approved the lowest health benefit rate increase in a decade. The 2008 rate package will increase overall premiums by 6.3 percent. Basic HMO premiums will increase 7.4 percent.
Rob Feckner, chair of CalPERS Board of Administration, said the benefit package was the result of months of hard work and a great deal of effort in striking the right balance for the entire risk pool of members.
“This 2008 benefits program is substantially lower than what consultants are anticipating for U.S. employers next year,” he said. “More importantly, it is strategically aligned to deliver high standards of efficient health care and disease prevention, and achieve rate increases well below the average in today’s marketplace.”
For the large majority of CalPERS members, the 2008 program will bring new health plan choice, ensure a standardized disease management program, and save the State money in the last half of the current fiscal year.
The 2008 health care program will include:
• A $5 increase in HMO co-pays for office visits, standardized urgent care co-pays to $15 for HMOs and an annual out-of-pocket maximum ($1500 single, $3000 family) for Blue Shield. (Kaiser already had this maximum in place.)
• Free (no co-pay) office visits for many preventive care services.
• The addition of two new high performance health plans (Blue Shield NetValue and PERS Select) that will be less expensive in premium than the standard plans from Blue Shield and PERS Choice. (Current Blue Shield members who move to Blue Shield NetValue will pay a lower premium than they did in 2007. For example, a family moving from Blue Shield’s standard HMO plan into NetValue next year will save over $180 in premiums.)
• An HMO Medicare rate that is 1.6 percent less than last year.
• Withdrawal of Blue Shield’s HMO from the four costliest rural counties – Lake, Napa, Plumas and parts of El Dorado – and elimination of Sacramento-region based Western Health Advantage (WHA) because of WHA’s expressed inability to meet CalPERS requirement for data and disease management, and expressed reluctance to modify its business model to expand into more regions of the State.
All efforts to develop the 2008 health care program shaved $144 million off of initial plan proposals. The overall increase of 6.3 percent is less than one-half the average of increases in the previous five years.
Overall, CalPERS plans to spend $5.3 billion to purchase benefits for more than 1.2 million state and local government employees, retirees, and their families next year, up from $4.9 billion this year.
“We recognize that in this tough health care marketplace, a combination of approaches is necessary to keep rate hikes low and quality high. We have strategic health plan partners who share our vision, and are committed to helping us make that vision a reality,” said George Diehr, Chair of the Health Benefits Committee. “We will continue to pursue innovative, aggressive approaches with our health plans to get better value for our dollars, and provide our members with opportunities and incentives to obtain the highest quality of care at the most affordable price.”
The package benefits employers, who will have new high performance network offerings for many of their employees. The State of California, which had projected a 9.5-percent increase for health care costs, would also see some relief in its budget forecast for 2007-08. Based on a 6.3 percent hike, the State’s projection would be about $65 million less than anticipated.
This year’s rate package will also have an effect on the state’s retiree health benefits projection. In April, actuaries for the State Controller used a 10- percent increase assumption in the rise of health care costs. Staff estimated that the 6.3 percent rate increase would reduce the state’s long-term liability by roughly $1 billion to $1.6 billion, depending on how the state funds the liability in the future.
For additional information, visit www.calpers.ca.gov.
CalPERS is the nation’s third largest purchaser of employee health benefits and the largest in California, with 1.2 million state and public agency employees, retirees, and their dependents.
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