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New bill bolsters fight against Medi-Cal cuts

April 1, 2013

A multi-faceted effort is under way to save small, rural skilled nursing facilities, like the one at Southern Inyo Hospital, from devastating Medi-Cal cuts. A new bill has been introduced, CHA is leading a campaign and locals are encouraged to personally let legislators know how the cuts will affect their community, families and nearby healthcare facilities. Photo courtesy MetroCreativeConnections

A new state bill has been introduced to combat the devastating effects of impending Medi-Cal cuts on small rural skilled nursing facilities and the community is being called upon to spring into immediate action to support it.
The California Hospital Association continues to challenge implementation of AB97’s “devastating” Medi-Cal cuts which affect rural long-term care patients as well as the districts and facilities that serve them, including Southern Inyo Hospital and its Skilled Nursing Unit.
“The (CHA) has made fighting the cuts outlined in AB97 their top priority,” said Southern Inyo Healthcare District CEO/CFO Lee Barron in a March 7 letter asking community members to write their elected representatives in opposition to the bill.
CHA’s ongoing efforts to remove the stinger from AB97, which include “litigation, legislation and direct communication with the Department of Health Care Services and the California Health and Human Services secretary,” were fortified by a new bill, AB 900 (Alejo) Medi-Cal: Reimbursement: Distinct-Part Nursing Facilities, Barron said.
District 30 Assemblymember Luis Alejo (D-Salinas) introduced AB900, which CHA sponsors, to revoke the Medi-Cal cuts established by AB97. According to the Official California Legislative Information website, www.leginfo.ca.gov, AB900 would require that the Medi-Cal cuts “not apply to skilled nursing facilities that are a distinct part of a general acute care hospital for dates of service on or after June 1, 2011. This bill would declare that it is to take effect immediately as an urgency statute.”
According to an AB900 timeline on LegTrack.com, the bill was introduced on Feb. 22. It was heard in a Feb. 25 State Assembly policy committee meeting and on March 7, it was referred to the state Commission on Health – “end status: In Committee Process.”
A Feb. 22 Alejo press release states that if AB97 cuts are implemented, services to fragile senior community members will be devastated. “The proposed Medi-Cal rate reduction would impact many small facilities by several million dollars annually, forcing providers to be reimbursed (20-40 percent) below their actual cost to provide long-term care services, and will eliminate hundreds of jobs in areas with economies that cannot sustain full-time benefited job losses by the major employers in that community.”
CHA is creating a public relations campaign “designed to highlight the ‘real life’ impact” of the Medi-Cal cuts, Barron said. The campaign includes “member impact videos, a media tool kit and additional suggestions for legislative advocacy.”
During the week of Feb. 25, Barron, as part of the District Hospital Leadership Forum, met with legislative and Department of Health Care Services representatives in Sacramento. She said that 18th District Senator Jean Fuller’s top aide reported that the senator had received many letters of support from Lone Pine. “This is exactly what we need,” Barron said. “I want to thank everyone for their support,” but much more is needed. Barron said she encourages community members who haven’t written to do so and asked that everyone also send a letter to Alejo in support of AB900.
Letters may be sent to: Fuller at State Capitol, Room 3063, Sacramento, CA 95814; Alejo at P.O. Box 942849, Sacramento, CA 94249; 26th District Assemblywoman Connie Conway at State Capitol Office, Room 2174, Sacramento, CA 94249-0034; and Secretary Diana Dooley and Director Toby Douglas of the Deparment of Health and Human Services at P.O. Box 997413, Sacramento, CA 95889.
For constituents who want face-time, Fifth District Supervisor Matt Kingsley will be hosting Conway’s field representative, Justin Stoner, from 11 a.m.-3 p.m. on Friday, April 5 at Kingsley’s office located at 325 S. Main St., Lone Pine. According to Kingsley, Stoner will be available to hear public input on AB97, AB900 and other state issues. In an email, Kingsley said that “an overwhelming show of interest, engagement and support from community members will have an effect on the level of interest we get from our legislators.”
Barron said she is hopeful that an ongoing campaign will be successful in staving off AB97 permanently.
In 2011, a lawsuit against AB97 resulted in an injunction that halted the bill’s enforcement but the injunction was overturned in February. Now, AB97 will roll Medi-Cal reimbursement current rates, about $266 per day per resident, back to those of 2008-09, less 10 percent, about $182, retroactively effective June 2011.
“With almost 92 percent of our skilled nursing residents on Medi-Cal for their primary insurance, the annual loss of revenue amounts to $856,044, which is 11.5 percent of our total operating revenue for the entire district,” Barron said. She said the district cannot absorb this loss, “let alone (approach) the retroactive collection of reimbursements, a sum that now stands at $1,426,404 as of this January. This sum could become due this month, she added.
Barron explained that Dooley and Douglas “are charged with implementing the cuts. Letters to them are urgent” and the “best letters are personal.” The cuts “will lead to (skilled nursing facility) closure and potentially leave our residents we care for homeless … Tell them how this will affect you … Our residents, their families, our hospital and our community will be in grave danger should these cuts be implemented.”
According to Barron, CHA President Duane Dauner “specially urged all of our communities to continue to write letters to our legislative representatives,” saying that “‘losing is not an option at this point.’”
Barron said, “I do feel confident that together, we can stop the cuts.”
For more information, call Barron at (760) 876-2225.

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