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January 23, 2017 | VOLUME 24 | NUMBER 4

T O P S T O R I E S

Counties Seek Relief for Funding Cuts to Supportive ServicesBudget adjustments could cost $4.4 billion over 6 yearsThe California State Association of Counties (CSAC) is hoping to work out a compromise with state officials over a budget proposal that eliminates state funding to counties for In-Home Supportive Services (IHSS).

The budget proposes to phase out elements of the state’s Coordinated Care Initiative (CCI) that include an IHSS program that provides funding to counties. The budget will eliminate the IHSS Maintenance of Effort (MOE) agreement as part of its modification of the CCI plan, which provides managed care for 114,000 dual-eligible Medicare-Medicaid patients in the state. Phasing out the MOE “would add an estimated $625 million to county costs for IHSS in fiscal 2018 and an estimated $4.4 billion over the next six years,” according to the CSAC.

“This would be devastating to counties all over the state,” said CSAC President and Alameda County Supervisor Keith Carson. “We undoubtedly would have to make cuts to other vital social services to cover these costs.” The shift represents “the single largest change in the budget from last year and unfairly burdens counties with costs they cannot control nor afford,” according to a CSAC statement.

IHSS costs have increased sharply since the program began five years ago, driven by a hike in the state’s minimum wage, new paid-sick-leave provisions for IHSS employees, and federal overtime regulations, CSAC officials said.

“Counties will have to find a way to pay for these additional costs, because the program is much more expensive now than it was five years ago,” said Far-rah McDaid Ting, a legislative representative for the CSAC. “It will probably mean that counties will have cut health and mental health programs to deal with the additional costs, or take money out of the general fund.”

The CSAC is hoping to work with state officials and legislators to develop a compromise plan that would provide counties with financial help for IHSS. “We’re hoping to come up with legislation that will create a cost-sharing pro-gram to help counties with the added expense,” said McDaid Ting.

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� Scripps Health and insurer CignaInc. have entered into an agreement to offer a Scripps HMO Health Plan to employers in San Diego County that have at least 100 employees. According to a joint press release from Cigna and Scripps, the HMO plan will be available starting April 1 and will offer value-based incentives that encourage pre-ventive care. “Our joint approach to healthcare is different from a tradition-al one because it’s based on very close integration between Scripps Health and Cigna,” said Gene Rapisardi, presi-dent and general manager for Scripps’ Southern California and Nevada mar-kets. The Scripps HMO Plan will provide access to care at Scripps acute care hospitals in San Diego County along with Scripps medical clinics, specialty services, and physicians from two medi-cal groups.

� St. Joseph Hoag Health hasappointed new CEOs for Mission Hospital, St. Jude Hospital, and St. Joseph Hospital. Jeremy Zoch, PhD, has been appointed CEO of St. Joseph Hospital in Orange. Zoch will replace current President and CEO Steven C. Moreau when Moreau retires in late March. Zoch is currently the execu-tive vice president and chief operat-ing officer for St. Joseph Hospital and previously served as COO of Mercy Hospitals in Bakersfield. St. Joseph Hoag also appointed Tarek Salaway CEO of Mission Hospital in Mission Viejo and St. Jude Hospital in Laguna Beach. That appointment was effective

I N B R I E F T O P S T O R I E S CONTINUED FROM PAGE 1

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IHSS Funding Cuts cont.

The main component of the CCI program—Cal MediConnect—will remain in place. The budget proposal stated the program has demonstrated that it can gener-ate cost-savings and proposed to “extend the Cal MediConnect program and continue mandatory enrollment of dual-eligible members.”

The $122.5 billion state budget unveiled by Gov. Jerry Brown on January 11 calls for few healthcare funding increases other than an additional $800 million for Medi-Cal to help fund Medicaid expansion, which has added an additional 3.7 million new members to Medi-Cal and boosted total state enrollment to 13.5 million.

Some healthcare advocates have raised concerns about how the budget proposes to spend funds from a new cigarette tax. Proposition 56, which lev-ies a $2-per-pack tax on cigarettes and an equivalent tax on e-cigarettes, was approved by voters last November. It will go into effect on April 1 and could gen-erate as much as $1.2 billion in revenue in fiscal 2018.

Brown’s budget proposal commits Proposition 56 revenue toward the General Fund and states that details on spending will be worked out with state legislators. The California Medical Association (CMA) said that cigarette tax revenue was intended for Medi-Cal and smoking prevention programs.

“We’re disappointed that Governor Brown’s budget ignores the will of vot-ers who supported Proposition 56 by proposing to offset general fund obligations with tobacco tax revenues rather than investing in the overburdened Medi-Cal system to improve access to care,” said CMA President Ruth E. Haskins, MD. —DOUG DESJARDINS

Gardens Regional Hospital is Shutting its Doors Hospital closing after acquisition deal falls through A Los Angeles hospital began shutting down last week after state officials were unable to finalize a deal with a potential buyer.

Gardens Regional Hospital and Medical Center in Hawaiian Gardens began shutting down on January 18 after its proposed sale to Riverside-based Strategic Global Management Inc. fell through over a provision that required the prospective buyers to provide $2.25 million per year for charity care over six years.

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T O P S T O R I E S CONTINUED FROM PAGE 2I N B R I E F Continued from page 2

December 16, 2016. Salaway most re-cently served as chief operating officer for USC Keck Medical Center in Los Angeles and previously held executive positions at Stanford Health Care and Providence Health & Services.

� St. Francis Medical Center hasappointed Derek Drake, DNP, RN, as its new chief nursing officer. Drake most recently served as director of Emergency and Trauma Services a t Re–nown Health in Reno, Nevada, where he led nursing operations at emergency departments for three hospitals. Prior to that, he served as nursing manager for the cardiac intensive care unit for Renown Regional Medical Center. “Derek Drake is a perfect fit with St. Francis,” said Gerald Kozai, president and CEO of St. Francis Medical Center in Lynwood. “He brings a fresh perspec-tive to our nursing and executive man-agement teams and shares with us a passion for nursing excellence.”

� A group seeking to recall a memberof the board of directors for Tulare Regional Medical Center has turned in 1,375 signatures for its recall effort. According to a report in the Visalia Times-Delta, a group of local residents submitted the signatures in an effort to recall board member Parmod Kumar, MD, who has served on the board since 1994. The group needs 1,049 verified signatures of registered voters in the Tulare Regional Healthcare District to stage a recall election. Tulare County deputy elections supervisor Emily

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Strategic Global submitted a bid in August to purchase the assets of Gar-dens Regional Hospital, a 137-bed not-for profit acute care facility, for $19.5 mil-lion. However, Strategic Global was apparently unable to meet the charity care provisions required by the state Attorney General as a condition of the sale.

Lawyers representing Strategic Global filed an emergency motion in U.S. Bankruptcy Court in Los Angeles to close the hospital. The motion stated that “with its remaining cash on hand dwindling, and no other buyer willing to acquire Gardens’ assets as a going concern, the debtor has determined in its best busi-ness judgment that it must close the hospital.”

Gardens Regionals executives could not be reached for comment but a hospital representative said Gardens Regional closed its emergency department at 7:00 a.m. on January 18, was no longer accepting new patients, and planned to shut down completely after its current patient base was discharged. Officials from Strategic Global Manage-ment did not return calls seeking comment.

A January 17 letter from the Los Angeles County Emergency Medical Services Agency notified emergency medical personnel in the Hawaiian Gardens area that Gardens Regional Hospital and Medical Center “will be closing its emergency department at 7 a.m. on January 18,” and would no longer be a receiving hospital for emergency transport.

Gardens Regional filed for bankruptcy in June 2016 and entered an acquisi-tion agreement with Strategic Global in August. In its bankruptcy filing, the safe-ty net hospital, located just south of Los Angeles, cited a number of factors for its financial problems that included a dwindling patient base that was comprised mainly of patients enrolled in Medicaid and Medicare.

“Medi-cal and Medicare reduced their payment rates in the range of 2.9% to 10% in or after 2010, which whittled down our reimbursement revenues,” the filing stated. Court documents also stated that Gardens Regional needed to generate $119,474 per day in revenue to cover its operating costs but was only generating $91,830 per day.

Adding to its problems were “unanticipated operational costs, a decline in bariatric and other surgeries, difficulties in implementing required changes to electronic health records, managing the length of stay for patients, and difficul-ties in collection and billing, among other things.” At the time of the filing, Gar-dens Regional reported more than $20 million in unsecured debt.

The last hospital in California to shut down was Colusa Regional Medical Center, a rural hospital that closed last April..—DOUG DESJARDINS

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T O P S T O R I E S I N B R I E F Continued from page 3

Oliveira said the county has 30 days to verify the signatures and the hospi-tal board would have to hold a recall election within 88 days if enough sig-natures were gathered. The group lead-ing the recall effort describes it as an attempt to hold Kumar and the Tulare Regional board responsible for “aban-doning its fiduciary duty to its citizens.”

� Children’s Hospital Los Angeles(CHLA) announced that a laptop com-puter that may have contained the personal information of approximately 3,600 former patients was stolen from a physician’s car. The laptop was pro-tected with a password, but it’s not clear whether the healthcare data from the laptop was encrypted, according to a January 16 report in the Los Angeles Daily News. Children’s Hospital is in the process of notifying parents of the chil-dren potentially affected by the theft. “Following the notification regarding the burglary, an investigation took place to determine whether patient health information existed on the lap-top,” said CHLA spokesman Lorenzo Benet. “Based on the investigation, the laptop has not been used to access the Internet. From that information, we believe that all data may have been erased from the device without any patient data being accessed.” CHLA said it is notifying parents about the potential breach “out of an abundance of caution.”

� Huntington Memorial Hospitalin Pasadena is notifying patients who

More Measles Cases Confirmed in Ventura, Los Angeles CountiesOutbreak now stands at 20 cases in Southern CaliforniaState health officials say the number of measles cases in Southern California has increased from 12 cases to 20 in an outbreak that began shortly before Christmas.

The Ventura County Department of Public Health confirmed the new-est case in Southern California on January 11 and the first case in that county to date. Ventura County officials believe the case is linked to an outbreak that began in Los Angeles County on December 23 and has infected 18 county residents since then.

“We are making our best effort to contain this measles outbreak so that we can prevent any further cases in the county,” said Robert Levin, MD, Ventura County Public Health Officer. Measles is a highly contagious disease, Levin said, and he urged anyone who has not been vaccinated for measles to get vaccinated.

The only other case of measles outside Los Angeles County was reported at Goleta Valley Cottage Hospital in Santa Barbara on December 27. Santa Bar-bara County health officials said the hospital was "quickly able to verify that all exposed healthcare workers had been vaccinated against the measles virus" and that no new cases have been reported since then.

The California Department of Public Health (CDPH) said seven new cases of measles have been reported in Los Angeles County since the first wave of 11 cases in late December.

“Since December 2016, a total of 20 measles cases have been reported to the CDPH that have been linked to the ongoing outbreak in Southern California,” the CDPH said in a statement. “A total of 18 cases were from Los Angeles, one was from Santa Barbara, and one from Ventura.”

Measles has an incubation period of up to three weeks, which means it can take several weeks for new cases to appear after a case is reported, according to the Centers for Disease Control and Prevention. The CDC defines a measles outbreak as three or more cases that are part of the same train of transmission.

The last outbreak of measles in California started at Disneyland in Anaheim in December 2014 and eventually infected 131 state residents. An investigation conducted by the CDPH found that 57 of the people infected during that out-break had never been vaccinated for measles and 25 patients did not receive a full round of measles vaccinations.—DOUG DESJARDINS

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T O P S T O R I E SBlue Shield to Appeal State Decision

to Revoke Not-for-Profit Status

Insurer says appeals process could take two years

Blue Shield of California plans to appeal a state decision to rescind its tax-

exempt status in California as a not-for-profit insurer.

The ruling by the California Franchise Tax Board

Shield to pay millions of dollars in retroactive state taxes. Blue Shield vice president

of corporate communications Steve Shivinsky

decision. “We have filed a protest against the FTB ruling and this will take up to

two years to decide,” said Shivinsky. “Blue Shield as a company and a management

team firm believes it is fulfilling its not-for-profit mission and commitment to the

community. We are, and will remain, a not-for-profit company…”

Shivinsky noted that the decision only pertains to Blue Shield’s status in the

state. “Blue Shield has paid federal taxes since 1986,” said Shivinsky. “Blue Shield

of California’s e�ective tax rate on pre-tax profits exceeds 45% annually …” Blue

Shield of California and other Blue Cross and Blue Shield plans in the U.S. lost their

federal tax-exempt status under reforms to the federal tax code approved in 1986.

O¢cials for the Franchise Tax Board declined to comment on the ruling or

what prompted the state audit that led to its decision issued in August 2014. The

FTB added Blue Shield to a list of companies that had their tax-exempt status

revoked and posted the information on its website but did not comment on it at

the time. The decision will also require Blue Shield to file tax returns dating back

to 2013. While state and federal laws regarding not-for-profits have changed over

the years, the action taken against Blue Shield is unusual. “I am not aware of any

nonprofit health insurer that has been stripped of its tax-exempt status prior

to Blue Shield,” said Gerald Kominski, a professor of health policy at the

Fielding School of Public Health and director of the

Policy Research. Kominski said Blue Shield has the option of converting to a for-profit insurer

but that it’s more likely to negotiate a settlement with state o¢cials if its appeal of

the Franchise Tax Board decision fails. “I imagine that Blue Shield will try to reach

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January 23, 2017

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E V E N T SI N B R I E F Continued from page 4

Feb. 14–15. CPCA Quality Care Con-ference. Hyatt Regency Newport Beach. An educational conference for primary care providers focused on inno-vative projects in healthcare information technology, quality care improvement, and practice transformation. To register, visit http://www.cpca.org/index.cfm/training-and-events/conferences/2017-quality-care-conference

Feb. 18–21. Scripps’ 37th Annual Conference: Clinical Hematology and Oncology. Omni San Diego Hotel. A conference for oncologists and hema-tologists focused on advances in the treatment of cancer and blood-based diseases. To register, please visit http://www.scripps.org/events/scripps-37th-annual-conference-clinical-hematology-oncology-2017-February-18-2017

Feb. 23–24. 26th Annual Health Care Forecast Conference. The Beckman Center, Irvine. A conference for healthcare professionals that examines new health-care trends and how they’re affecting patient care and payment models. To reg-ister, please visit http://merage.uci.edu/events/merage/2017HCFC/

March 8–10. 12th Annual Value-Based Payment and Payfor Performance Summit. Grand Hyatt, San Francisco. A national forum focused on pay-for-per-formance and value-based care models. Sponsored by the Integrated Healthcare Association. To register, please visit http://www.pfpsummit.com/

underwent open-heart surgery that they may have been exposed to potentially dan-gerous bacteria. According to a January 13 report in the Los Angeles Times, patients receiving the warning underwent surgery using a device that regulates blood tem-peratures during procedures and has been linked to infections from Mycobacterium chimaera. Huntington hospital officials are notifying patients who had open-heart surgery dating back four years and said that, to date, no patients have reported any problems with surgery-related infections. Patients can develop Mycobacterium chimaera infections years after exposure, making it difficult to trace and detect, according to the Centers for Disease Control and Prevention.

� Kaweah Delta Medical Center in Visalia set up a tent outside its emergency department to handle a high volume of flu patients. According to a January 11 report in the Fresno Bee, the hospital erected the 570-square-foot tent after its 33-bed ED handled 289 patients in one day. “We had 45 patients at one point who were admitted but holding in the emergency department for hospital beds,” said Edward Hirsch, MD, chief medical and quality office at Kaweah Delta. Nearby Clovis Community Medical Center had to take similar measures on January 10 when it turned its main lobby into a temporary waiting room to handle an over-flow of ED patients. Influenza activity is now “widespread” in Northern California, according to the California Department of Public Health.

� A new report from the Office of Statewide Health Planning and Devel-opment (OSHPD) found that 92% of hospital buildings in California are now compli-ant with state seismic safety standards. The report issued by OSHPD on January 12 found that “92% of hospital buildings do not have a significant risk of collapse” in the event of a major earthquake. The report estimates that approximately 225 of 3,037 hospital buildings in the state are still at significant risk of collapse and must be either replaced or retrofitted in order to remain open.

� A study from the UCLA Center for Health Policy Research estimates that 4.9 million state residents could be impacted by a repeal of the Affordable Care Act (ACA). The study estimates that 3.7 million state residents have gained health cover-age through Medicaid expansion and that 1.2 million have received federal subsidies averaging $309 per month to purchase health coverage on the Covered California state insurance exchange. The study also estimates that Medi-Cal enrollment in some counties increased by double digits during Medicaid expansion. The study esti-mates that 13.9% of residents in both Mendocino and Humboldt counties enrolled for coverage through Medicaid expansion, followed by 13.6% of residents in Trinity County and 12% in Fresno County.

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F E A T U R E D C A R E E R O P P O R T U N I T I E S

KERN HEALTH SYSTEMS is now hiring!

• UM Outpatient Clinical SupervisorRegistered Nurse/RN

• UM Nurse RN, Facility Based (Weekend)

• Disease Management Case ManagerRegistered Nurse

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Compensation is based on experience, education and qualifications. For a complete position description on these exciting career oppor-tunities, please visit our career center at kernhealthsystems.com or

email resume to: recruitment@khs-net.com. E.O.E

Director, Physician ContractingAdventist Health Managed Care is seeking an expe-rienced managed care professional to support physician contracting in the southern California region. The appli-cant will have responsibility for negotiations of payer contracts and will collaborate in the development of strategic regional initiatives involving physician and clinic contracting.

Experience/Requirements: A minimum of 5 years’ experience in successfully negotiating various types of physician, IPA and clinic managed care contracts, developing revenue growth opportunities and establish-ing strategic alliances is necessary. Position is located in Glendale, CA. A Bachelor's Degree is required; Master’s Degree preferred.

Qualified candidates should email their resume with salary history to Martha.ibarra@ah.org

To apply, visit our website at: http://www.scanhealthplan.com/careers/

Search for Job # Req. above

Ventura Career Fair Friday 1/27/2017

9:00am – 2:00pm SCAN Health & Wellness Center 6633 Telephone Road, Ventura, CA 93003

Please Apply Online at www.scanhealthplan.com and RSVP to Kim Brooks, Recruiter at kbrookscanhealthplan.com or call 562-989-5299

Open Positions • Care Manager - Home to Provider (Redlands) Req. #16-0512

• Community Health Worker - Home to Provider (Redlands)Req. #16-0513

• Health & Wellness Representative (Ventura) Req. #17-0012

• Manager, Health & Wellness Center (Ventura) Req. #17-0006

• Volunteer Coordinator (Ventura) Req. #16-0436

Don’t miss this opportunity - Hiring Managers and Recruiteron site day of Career Fair to interview qualified applicants

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F E A T U R E D C A R E E R O P P O R T U N I T I E S

Managed Care SpecialistEl Segundo, CAPRACTICE OVERVIEW

Radiology Partners is the largest and fastest growing on-site radiol-ogy practice in the US. We are an innovative practice focused on transforming how radiologists provide consistently exceptional services to hospitals, imaging centers, referring physicians and patients. With our state-of-the art clinical technology, specialized expertise, access to capital, and retention of top physician talent, Radiology Partners reliably exceeds the expectations of our clients, patients, and partners. We serve our clients with an operational focus, and, above all, a commit-ment to quality patient care. Our mission is To Transform Radiology.

POSITION SUMMARY

Radiology Partners is seeking a Managed Care Specialist who will support the Payor Contracting Department. This position will under-stand the terms of the contract portfolio, negotiate managed care contracts, monitor implementation of managed care contracts, and assist in researching and resolving payor-related matters. This position will work closely with other members of the Revenue Cycle team and perform special projects as assigned.

POSITION DUTIES AND RESPONSIBILITIES

• Review and negotiate contracts with commercial and govern-ment payors

• Monitor contract performance and track issues including claim payment, reimbursement, and operational issues

• Maintain knowledge and expertise of managed care payors and contracts

• Collect and assimilate managed care contract information and ensure contract implementation and performance

• Research and recommend resolution to claim payment, reimburse-ment, credentialing, payment variance, and operations issues

• Perform market, payor, and legislative research

DESIRED PROFESSIONAL SKILLS AND EXPERIENCE

• Minimum educational requirement is a Bachelor’s degree• Minimum of two years of healthcare or legal experience are

necessary• Excellent written and oral communication skills are necessary• Strong organizational, analytical, attention to detail, and problem-

solving skills are essential• Strong Microsoft Word, Adobe Acrobat, and Excel experience

preferred

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