New Report Warns of Health Care Workforce Shortage 

The California Wellness Foundation has released an annual report outlining the challenges caused by a shortage of health care workers in the state. 

Titled “Warning! Health Workforce Shortages: Who Will Take Care of All These People?”, the report addresses shortages in California’s health care workforce and offers strategies to develop a culturally and linguistically competent workforce. This report is especially timely, as the state is on the cusp of implementing the federal Affordable Care Act, and must figure out how to serve millions of newly insured patients starting in 2014. 

The report also provides an update on the Foundation’s activities and a list of the year’s grants. Click here to access the report or visit www.calwellness.org.

Emergency Medical Services

AB 210 (Solorio) – Watch
As Amended on September 1, 2011

AB 210, by Assembly Member Jose Solorio, was gutted and amended on September 1. The bill no longer pertains to Emergency Medical Services. It now relates to maternity services provided by health plans.

CSAC understands that the August 15 version of AB 210 may be amended into another measure. CSAC sent a letter of concerns on the August 15 version. The August 15 version would have amended what is commonly known as Section 201 (Health and Safety Code Section 1797.201-224) of the Emergency Medical Services (EMS) System and the Pre-Hospital Emergency Medical Care Personnel Act (EMS Act) to require grandfathered EMS transportation providers to enter into a written agreement with their respective Local Emergency Medical Services Agency (LEMSA) by 2014.

Previous versions of the measure were intended to address Section 201 issues surrounding regulatory authority, local control, and operational control in local EMS systems. The bill also includes an attempt to create a standard set of definitions for Section 201. AB 210 was originally envisioned as a vehicle for the recommendations of a state Emergency Medical Services Commission subcommittee, but that committee has not fully reached consensus on its provisions. 

CSAC joined with the Regional Council of Rural Counties, Urban Counties Caucus, and the County Health Executives Association of California asking Assembly Member Solorio to make AB 210 a two-year bill. This would give the stakeholders more time to develop mutually agreeable language and address our specific county issues. CSAC will be monitoring amended bills watching for EMS language in another vehicle.

Earlier this week, Assembly Member Solorio agreed to make it a two-year bill. CSAC wants to thank Assembly Member Solorio for listening to the many county concerns and maintaining his commitment to a consensus bill. We look forward to continuing to collaborate with the other stakeholders to craft a workable vehicle. 

Medi-Cal

ABX1 30 (Blumenfield) – Watch
As Amended August 31, 2011

SBX1 9 (Committee on Budget & Fiscal Review) – Watch
As Amended September 1, 2011

The Legislature has amended two measures in the last two days to implement a managed care plan tax on Medi-Cal managed care plans. The tax was proposed as part of the budget package but was not acted on in June.

SBX1 9 would extend the sunset on gross premiums tax on managed care plans from July 1, 2011 until July 1, 2012. The gross premiums tax, also called a “MCO tax” was originally created through AB 1422 (Bass, Chapter 157, Statutes of 2009). The tax is projected to produce $207 million in revenue in 2011-12. These revenues will be matched with federal funds (for total funds of approximately $500 million) and used to provide a reimbursement rate increase to Medi-Cal Managed Care Plans and to fund the Healthy Families Program.

Additionally, the measure would clarify that the tax would remain in effect if there are no further law changes to do any of the following:

• Transition Healthy Families Program enrollees to Medi-Cal or other state programs
• Transfer administrative functions for the Healthy Families Program away from the Managed Risk Medical Insurance Board or its vendors
• Cease operations or repeal the Healthy Families Program
• Cease operations or repeal the Managed Risk Medical Insurance Board

The Legislature has passed AB 1422 with industry support. ABX1 30 will restore funding to the Healthy Families Programs with revenues from the tax. SBX1 9 requires a 2/3 vote.

In-Home Supportive Services

SB 930 (Evans) – Support
As Enrolled on August 30, 2011

SB 930, by Senator Noreen Evans, would eliminate the requirements for counties to collect the fingerprints of each IHSS consumer and have both providers and consumers to submit fingerprints on each IHSS timesheet (a provision of current law that is scheduled to go into effect on July 1 of this year). The bill would also repeal statute that prohibits providers from using a Post Office Box (P.O. Box) for IHSS forms, including for paychecks. A final amendment will increase communication between the state Department of Social Services and the public authorities when a prospective provider is denied employment. 

For these reasons, CSAC supports SB 930. The Assembly passed SB 930 on September 1 and it now goes to the Governor.

Child Welfare Services/Foster Care

SB 578 (Negrete McLeod) – Support
As Enrolled on August 30, 2011

SB 578, a bill by Senator Gloria Negrete McLeod, would help foster children graduate from high school by establishing a system to recognize and properly classify previous coursework or credit from other schools and institutions. 
Counties believe that SB 578 will give foster youth the opportunity to apply prior satisfactorily completed work toward a high school diploma and thereby increase the population of foster youth who are able to satisfactorily complete educational requirements and graduate from high school. The Senate passed the bill on August 30, and it now goes to the Governor.

Adult Protective Services

SB 33 (Simitian) – Support
As Enrolled on August 30, 2011

SB 33, by Senator Joe Simitian, would repeal the sunset date for statute that designates certain financial institution employees as mandated reporters for suspected financial abuse of elder or dependent adults. 
Senator Simitian authored SB 1018 in 2007 to expand the definition of mandated reporters of elder or dependent adult abuse to those who work at financial institutions. SB builds that statute by removing the January 1, 2013 sunset date. 

CSAC supports SB 33, which was passed by the Assembly on August 30 and now goes to the Governor. 

SB 718 (Vargas) – Support
As Enrolled on August 30, 2011

SB 718, by Senator Juan Vargas, would make it easier to report suspected elder abuse.

Senate Bill 718 would allow a county or long-term care ombudsman program to implement a confidential Internet reporting tool that mandated reporters may use to report suspected elder abuse. Senate Bill 718 also would allow the state, in conjunction with counties and other stakeholders, to develop a form for written reports, as well. The bill also specifies the information to be gathered by both methods, which will speed efficiency in both making and processing reports of suspected elder abuse. Recent amendments also compel any county that chooses to use this method to issue reports on the system to the Legislature, which is a common state oversight tool. Recent amendments also link SB 718 to SB 33 (Simitian), requiring that both bills must pass the Legislature and be signed by the Governor to become operative. 

Counties are responsible for investigating reports of suspected elder abuse, and have a vested interest in ensuring the safety and financial security of elder Californians living in our communities. Senate Bill 718 would serve this interest by giving counties the option to implement a new Internet-based system with the goal of increasing the ease by which a mandated reporter may submit a report of suspected elder abuse. 

The Senate passed SB 718 on August 30, and it now goes to the Governor.