Policy

Actions by people in power – lawmakers, regulators and the like – can make a difference to your health, for better or for worse. We keep you informed

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Governor Appoints New Director of Health Care Services

Jennifer Kent was  most recently executive director of Local Health Plans of California.

Jennifer Kent was most recently executive director of Local Health Plans of California. (Courtesy: DHCS)

By David Gorn, California Healthline

On Monday, Gov. Jerry Brown (D) appointed Jennifer Kent as the new director of the Department of Health Care Services, a $9 billion state agency that oversees the Medi-Cal program.

DHCS is the agency that oversees Medi-Cal.    
Kent had most recently been the executive director of Local Health Plans of California, an organization representing 14 not-for-profit public health plans across the state.

“I’m very excited,” Kent said. “It’s a big job, so I’m both thrilled and a little overwhelmed.”

Kent replaces Toby Douglas, who was DHCS director for the past four years. Kent has worked at DHCS in the past — in fact, she and Douglas were both deputy directors in the department at the same time. Kent worked at the department from 2004 to 2007. She headed legislative affairs for Gov. Arnold Schwarzenegger (R) and has experience in both the public and private spheres of health care. Continue reading

Judge Rules on Medi-Cal Backlog, Orders Timely Access to Benefits

(s_falkow: Flickr)

(s_falkow: Flickr)

By David Gorn, California Healthline

On Thursday, an Alameda County Superior Court judge issued a preliminary injunction requiring the state to adhere to a 45-day limit for processing Medi-Cal applications.

The ruling by Judge Evelio Grillo was a victory for health care advocates in a lawsuit over the state’s extensive backlog in processing Medi-Cal applications. The Medi-Cal expansion and the first open enrollment period for Covered California brought millions of applications to the door of the Department of Health Care Services, which oversees Medi-Cal.

Computer issues hampered the processing of many of those applications, and in March 2014 the backlog of unprocessed claims peaked at more than 900,000 applications. It took many months to clear the bulk of those applications. Some of them are still hanging fire almost a year later, said Jen Flory, senior attorney in the Sacramento office of the Western Center on Law and Poverty. Continue reading

California Bill Would Allow Terminally Ill to End Their Own Lives

Brittany Maynard, 29, terminally ill with brain cancer, ended her own life on Nov. 1, 2014. (Compassion and Choices/BrittanyFund.org)

Brittany Maynard, 29, terminally ill with brain cancer, ended her own life on Nov. 1, 2014.
(Compassion and Choices/BrittanyFund.org)

By April Dembosky

State lawmakers are renewing a call to give terminally ill patients more say over how and when they die. Senators Lois Wolk of Davis and Bill Monning of Santa Cruz introduced the “End of Life Option Act” on Wednesday. The bill would allow physicians to prescribe lethal medication to patients who request it.

If the bill passes, California would become one of six states that allow ‘aid in dying.’
“Seeing a daughter suffer and die slowly is torture,” said Robert Olvera, whose daughter, Emily Rose, died of leukemia last year at age 25.

The last four months of her life, she was bedridden, blind, and plagued by excruciating headaches that no medicine would alleviate. Olvera, a doctor, says his daughter wished she’d had the option to end her own life. Continue reading

Some Employers Say Same-Sex Couples Must Get Married

(David Lucas/Getty Images)

(David Lucas/Getty Images)

By Julie Appleby, Kaiser Health News

Until recently, same-sex couples could not legally marry. Now, some are finding they must wed if they want to keep their partner’s job-based health insurance and other benefits.

Will companies eliminate benefit programs for unmarried partners?

With same-sex marriage now legal in 35 states and the District of Columbia, some employers that formerly covered domestic partners say they will require marriage licenses for workers who want those perks.

“We’re bringing our benefits in line, making them consistent with what we do for everyone else,” said Ray McConville, a spokesman for Verizon, which notified non-union employees in July that domestic partners in states where same-sex marriage is legal must wed if they want to qualify for such benefits. Continue reading

Kaiser Nurses Reach Agreement, Call Off Strike

Nurses carry signs as they strike outside of Kaiser Permanente hospital in San Francisco last week. (Justin Sullivan/Getty Images)

Kaiser nurses staged a two-day strike in November, citing concerns about Ebola preparedness. (Justin Sullivan/Getty Images)

The California Nurses’ Association has called off a two-day strike scheduled to begin Wednesday after reaching a tentative agreement with Kaiser Permanente on a new three-year contract.

The nurses’ bargaining team is recommending ratification of the proposed contract that would affect 18,000 registered nurses and nurse practitioners at 86 Kaiser sites throughout Northern and Central California.

“It’s really, really a good deal,” said Diane McClure, a nurse at Kaiser’s South Sacramento facility and a member of the bargaining team, adding that the strike threat strengthened the nurses’ position with Kaiser. “They saw the momentum the nurses had. They didn’t want us out in the public, because they knew the public was behind us.”

Kaiser issued a statement saying it was pleased with the economic priorities accomplished by the agreement, including “slowing the growth of our long-term liabilities,” and offering benefits to nurses that are “consistent with our commitment to affordability.” Continue reading

Gov. Brown: ‘Not A Lot Left in Budget’ to Cover Undocumented

(Justin Sullivan/Getty Images)

(Justin Sullivan/Getty Images)

Gov. Jerry Brown unveiled his $164.7 billion budget proposal Friday and while health figures big, the governor also stopped short of funding some key advocacy goals.

For starters, there’s no money set aside in the budget to provide health insurance to undocumented immigrants. The “Health for All Act” was re-introduced in December, after falling short in the legislature last year. But when Brown was asked specifically about covering the undocumented, he said “There’s not a lot of money left in the budget. … It’s very tight.”

Then there are the million undocumented immigrants in California estimated to be eligible for deferred action under President Obama’s executive order. Advocates say that these immigrants, once approved for deferred action, become eligible for Medi-Cal, as long as they qualify by income. Continue reading

Plenty of Responsibility, But No Required Training, for In-Home Caregivers

Oliver Massengale took over as his brother’s full-time caregiver six years ago. He says he hasn’t had time for himself in years. (Heidi de Marco/KHN)

Oliver Massengale took over as his brother’s full-time caregiver six years ago. He says he hasn’t had time for himself in years. (Heidi de Marco/KHN)

By Anna Gorman, Kaiser Health News

Born just a year apart, Oliver Massengale and his brother Charles grew up together. Now, in a two-story home in Compton, they are growing old together. But Charles Massengale, 71, can do little on his own.

The former tree trimmer has severe brain damage from a 30-foot fall, as well as dementia, diabetes and high blood pressure. Six years ago, Oliver took over as his brother’s full-time caregiver. He’s paid about $10.00 an hour by the state.

It was not a job he was trained to do.

“I didn’t have a clue,” said Oliver, a retired grounds manager at a college. “I was just so afraid of what I was doing.”

He constantly worried –- about giving Charles the wrong medication, about him getting bedsores, about his blood pressure. And he had no idea how easily his brother could fall over. One day, he was cooking and Charles was on a stool at the kitchen counter. Continue reading

Lack of Oversight for In-Home Caregivers Can Lead to Neglect and Death

Linda Maureen Raye at her sentencing at the Riverside County Hall of Justice. Raye pleaded guilty to elder abuse that led to the death of her mother. (Heidi de Marco/KHN)

Linda Maureen Raye at her sentencing at the Riverside County Hall of Justice. Raye pleaded guilty to elder abuse that led to the death of her mother. (Heidi de Marco/KHN)

By Anna Gorman, Kaiser Health News

Yolanda Farrell lay mostly paralyzed in a nursing home, unable to feed or dress herself, when her homeless daughter persuaded her to move out.

“Essentially neglected to death” by her own daughter.  

Linda Maureen Raye, who relatives say had been living in her car with her dog, used her mother’s Social Security to pay for a one-bedroom Riverside apartment and took over as Farrell’s sole caregiver in 2010.

Over the next two years, according to police and court records, Raye, 60, took her elderly mother to the doctor once. As her mother’s health declined, Raye stopped cooperating with a nurse sent to advise her on preventing bedsores.

Yet in 2012, Raye was hired officially: She began collecting about $900 a month from taxpayers under the state’s in-home care program for poor people, according to law enforcement authorities. Continue reading

Brown on Health Coverage: “Right Thing to Do. But It Isn’t Free.”

Gov. Jerry Brown is sworn in as California governor for the fourth time. (Andrew Nixon/Capital Public Radio)

Gov. Jerry Brown is sworn in as California governor for the fourth time. (Andrew Nixon/Capital Public Radio)

Jerry Brown was sworn into his fourth term as governor of California Monday morning. In a wide-ranging inaugural address (that doubled as a State of the State address), he included some brief remarks about the Affordable Care Act.

Here’s the text of what he said:

Along with education, health and human services constitute a major part of what state government does. And in the past few years we have made massive commitments in this area, which will require increasing levels of spending, the full extent of which is not yet known. For example, two years ago California embraced the Affordable Care Act, dramatically increasing its health insurance coverage under the Medi-Cal program. The state will enroll 12.2 million people during this new budget year, a more than 50 percent increase.

Providing the security of health coverage to so many Californians who need it is the right thing to do. But it isn’t free. Although the federal government will temporarily foot much of the bill, new state costs – now and more so in the future – will run into the billions.

Before we take a deeper look at his statements about Medi-Cal, let’s go back a year ago to last year’s budget. Then, Brown’s budget proposal included an additional $670 million for Medi-Cal, at least in part because of the expected additional costs due the expansion of Medi-Cal under the Affordable Care Act. Perhaps more importantly, “The Medi-Cal caseload is expected to be approximately 24 percent of the state’s total population,” the governor said when he released last year’s budget.

Speed forward a year. Obamacare sign-ups surged in California during 2014 and outstripped all estimates. Specifically in Medi-Cal, it’s not 24 percent of the population that is covered by the program, it’s closer to 33 percent.

While the ACA  pays for 100 percent of the people who are newly eligible for Medi-Cal, many people who signed up in 2014 were already eligible before the ACA expansion. They just had not enrolled. With all the hoopla around the ACA, plenty of those previously-eligible people signed up. Many refer to this as the “woodwork” effect.

Estimates are of the 2.4 million people who signed up for Medi-Cal by Mar. 31, about 800,000 of them were previously eligible. The federal government funds those people at the non-expansion rate of 50 precent. That’s why in the May revision of his budget, Gov. Brown included an additional $1.2 billion to fund the caseload.

Brown closed his brief remarks about health with a remark about the state’s costs “in the future.” The federal government is funding 100 percent of the Medi-Cal expansion only through 2016. Come 2017, the match will start to drift down and ultimately end at 90 percent. Yes, this is still a generous federal outlay. But 10 percent of billions of dollars is a lot of money.

The governor is expected to release his budget proposal on Friday.

Top 5 Stories on State of Health in 2014

President Obama took a victory lap on Apr. 1 as the first open enrollment of the Affordable Care Act came to a close and millions had signed up. A story about the ACA was in State of Health's top five posts this year. (Nicholas Kamm/AFP/Getty Images)

President Obama took a victory lap on Apr. 1 as the first open enrollment of the Affordable Care Act came to a close and millions had signed up. A story about the ACA was in State of Health’s top five posts this year. (Nicholas Kamm/AFP/Getty Images)

It’s been a big year in health: the launch of the Affordable Care Act, an ongoing Ebola epidemic and the first soda tax in the country, passed by Berkeley voters.

Here on State of Health, all those stories got plenty of attention from you, the readers. But the Top 5 might surprise you. We crunched the numbers and here are the posts that netted the most views this year.

1) What Philip Seymour Hoffman’s Tragic Death Teaches Us About Addiction

Philip Seymour Hoffman arrives for the Los Angeles premiere of 'The Hunger Games: Catching Fire' in Los Angeles, California, last November. Robyn Beck/AFP/Getty Images)

Philip Seymour Hoffman arrives for the Los Angeles premiere of ‘The Hunger Games: Catching Fire’ in Los Angeles, California, last November. Robyn Beck/AFP/Getty Images)

We all know the sad details. In February, Philip Seymour Hoffman died of a drug overdose. He had been an addict as a young man, but given up drugs and alcohol at 22. His relapse cost him his life. But what troubled me most after his death were the heartless social media attacks about his “selfishness” and “poor choices.” Continue reading