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HomeMy WebLinkAboutMINUTES - 04132010 - D.1RECOMMENDATION(S): Accept a preliminary report from Contra Costa Health Services on the possible impact of federal health reform on health care delivery in Contra Costa County. FISCAL IMPACT: Unknown at this time. BACKGROUND: 1. Last month, Congress passed and President Obama signed HR 3490, the Patient Protection and Affordable Care Act. 2. Some of the provisions of the new law will be effective immediately; the largest impacts won’t be felt until 2014. Today Health Services is going to provide a broad view of what we can expect. Many details are yet to be worked out. 3. Some provisions of the new law will happen almost immediately or in the very near term: a. Seniors who have reached their ceilings (known as the doughnut hole) for prescription APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 04/13/2010 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Gayle B. Uilkema, District II Supervisor Mary N. Piepho, District III Supervisor Susan A. Bonilla, District IV Supervisor Federal D. Glover, District V Supervisor Contact: William Walker, 957-5403 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: April 13, 2010 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: Tasha Scott, Barbara Borbon , Julie Freestone D. 1 To:Board of Supervisors From:William Walker, M.D., Health Services Director Date:April 13, 2010 Contra Costa County Subject:Report to the Contra Costa Board of Supervisors regarding federal health reform drugs under Medicare Part D will BACKGROUND: (CONT'D) receive $250 to help them continue to get medication. b. Children with preexisting conditions who have been denied coverage will now be able to get insurance. c. Medically uninsurable people will have access to coverage through high risk pools. d. Parents will be able to keep their dependent children on their health insurance until the dependent reaches age 26. e. Approximately $15 billion dollars dedicated to community prevention will be available to expand and sustain national investment in prevention and public health programs over the next ten years. Half a billion will move directly to US communities immediately, through community grants that will be used to reduce chronic disease and injury rates and promote equity. f. Beginning next year, $11 billion in new funding will flow to Health Centers/community clinics over five years; $9.5 billion to expand operational capacity to serve nearly 20 million new patients and to enhance medical, oral, and behavioral health services; $1.5 billion for expanding and improving existing facilities and constructing new sites. g. This level of funding for community health centers – we assume that includes our federally qualified health centers - and the community clinics represents an extraordinary level of commitment by the White House and Congress to our model of care. 4. Beyond the immediate changes, expansion of health coverage to nearly all Americans will eventually be accomplished beginning in 2014 in a number of ways: a. Medi-Cal will cover many more Californians and in Contra Costa, that means many of the patients we now cover with County general fund money through our Basic Health Care program will be covered by Medi-Cal along with others who have no coverage at all now. b. Our Health Plan will be allowed to offer health insurance coverage to many more residents as well as sustaining the Healthy Families Program. c. Most of these new Medi-Cal patients will probably use our services because we are one of the few providers that accept Medi-Cal rates – and those rates are not likely to increase. d. Insurance exchanges will allow Americans to compare private insurance policies in terms of price and defined benefits, choose one they want and receive subsidies to help pay the premiums if they need them. e. Small businesses will receive tax credits to offer insurance to their employees through private plans. 5. Most of the immediate measures will not address our current problems: a. More than 15% of Contra Costa residents have no health insurance and that could continue for almost four more years. b. Our residents are continuing to lose their jobs and with that, their health coverage. Most of those people will have no options but to seek services in our system, from the community clinics and local emergency departments until 2014 c. With their unemployment insurance and Cobra health insurance ending, Contra Costa residents will continue to strain our capacity to deliver primary, emergency and inpatient care. d. Systems like ours here in Contra Costa are mentioned in the new legislation as coordinated care networks but there is no funding to enhance our capacity to collaborate and improve delivery and to prepare for 2014. e. California’s agreement with the federal government for a package of Medi-Cal funded programs is still being negotiated. This “waiver” establishes reimbursement rates and the scope of services covered. Successful conclusion of this waiver negotiation is critical to our ability to make it to 2014 intact and ready to respond to the expansion. 6. As important as meeting the continuing and growing demand for health care, there is another critical issue that we all must keep in mind: if our community is to benefit from this health reform, we must keep our current health delivery structure in place so that in 2014, we are prepared to respond to the true expansion of health care to include nearly every Contra Costa citizen. If we don’t do that, there will be no capacity to serve those who will have coverage. We have all struggled for years to continue providing services to residents and to honor our commitments. We’ve never known from year-to-year what the next year will hold. Now we have a date certain – 2014 – for significant relief for our local obligation. Working in partnership with community clinics, hospitals and many other organizations, with the efforts of our dedicated staff, and the long-term support of the Board of Supervisors, we have been successful in continuing to deliver quality care and services despite reduction in resources and significant increases in demand. We must continue to work together to meet the needs of the residents and prepare for 2014. CLERK'S ADDENDUM Speakers:  Paulina Maffia, CCISCO; and Flor Guzman, CCISCO; Barbara Gallman, CCISCO did not wish to speak but presented written comments.