SAN FRANCISCO HEALTH REFORM TASK FORCE FINAL REPORT Presentation - - PowerPoint PPT Presentation
SAN FRANCISCO HEALTH REFORM TASK FORCE FINAL REPORT Presentation to the San Francisco Health Commission April 19, 2011 Tangerine Brigham, Deputy Director of Health/Director of Healthy San Francisco, San Francisco Department of Public Health
Presentation to the San Francisco Health Commission April 19, 2011
Tangerine Brigham, Deputy Director of Health/Director of Healthy San Francisco, San Francisco Department of Public Health Wade Rose, Vice President, Public Policy and Advocacy, Catholic Healthcare West
Mission To plan for a San Francisco health care safety net that thrives under Health Reform and the State’s Section 1115 Medicaid Waiver
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Purpose To develop local, State and federal policy recommendations for consideration by the Mayor, the Board of Supervisors, and the Health Commission that would better position San Francisco’s health care safety net for implementation of Health Reform
Key Issue Areas ■ Enrollment ■ Economics ■ Infrastructure ■ Local Programs ■ Capacity
Defined the San Francisco Health Care Safety Net Addressed each of the five key issue areas
Due to the link between Economics and Capacity, discussions and
recommendations in these issue areas were combined
Monitored State and federal HR implementation activities to inform
recommendations
Developed 37 policy recommendations
Local, State and federal level recommendations Recommendations made in each key issue area Not all areas lent themselves to recommendations at all levels of government
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KEY TASK FORCE FINDING: There will be a continued need for a health care safety net in San Francisco after Health Reform.
Rationale for continued health care safety net
HR does not expand coverage to all uninsured – several populations will continue
to rely on safety net systems after 2014
Eligible but not enrolled in public health insurance Undocumented Incarcerated Individuals with religious objections Individuals with affordability exemptions Persons who elect not to fulfill individual mandate
Safety net systems will continue to be relied upon to care for many of the people
who will be newly eligible for Medicaid and Health Benefit Exchanges
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Safety Net Providers
Public and private non-profit organizations that provide significant health
care services to low-income, uninsured, publicly-insured, and vulnerable populations.
Safety Net Population
San Franciscans eligible for Medi-Cal, Healthy Families, Healthy Kids,
Healthy Workers, and Healthy San Francisco.
Patients served by the clinics of the San Francisco Community Clinic
Consortium, by the Department of Public Health, and by the Department’s contracted providers, as well as charity care patients seen by San Francisco’s non-profit hospitals and private providers.
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Final report to be submitted to the Mayor Recommendations organized by level of government
Local: For consideration by the Mayor State: For consideration by the Mayor’s State Legislative
Federal: To be submitted to the City’s federal lobbyist for
Following is a summary of recommendations by key
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Majority of recommendations at State level given primary role that State has in coordinating/interfacing State and county eligibility and enrollment databases for Medi-Cal and the California Health Benefits Exchange Recommendations acknowledge importance of:
Consumer-friendly enrollment Privacy protections for coordinated databases Outreach and retention strategies for enrollment
Promote maintaining San Francisco’s current database systems
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1.
Local eligibility and enrollment systems should support, and as appropriate, interface with the State systems.
2.
Local outreach efforts should complement the State’s
3.
Investment in a new local enrollment system is not advised, though adjustments will likely be needed.
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Recommendations are in the area of information technology infrastructure needed to facilitate enrollment and exchange of information across systems to improve quality of care and better monitoring of health care Recommendations fall into two different categories
On the federal level, adequate, accelerated and direct payments to safety net providers (hospitals and Federally- qualified health centers) investing in electronic health records On the local level, support for regional and local health information exchanges (for patient health information)
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4.
San Francisco’s health care community should support the efforts of the San Francisco health information exchange.
5.
San Francisco’s health care community should support the community fundraising effort of the San Francisco health information exchange.
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The San Francisco health information exchange should continue to pursue partnerships with other exchanges in the Bay Area.
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Organizations analyzing citywide health care statistics should work with the San Francisco health information exchange to determine if aggregated data may assist with health care planning.
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Recommendations focus primarily on opportunities for the State and federal government to build clinical capacity via increased provider participation or expanded clinical models
Streamlining Medi-Cal administrative processes to attract provider participation Enhancing primary care capacity via loan repayment programs, additional nurse practitioner delivery models, Enhancing provider capability and flexibility to serve seniors and persons with disabilities Planning for long-term and community-based care capability
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8.
The Health Care Services Master Plan should consider a range of options implementable at the local level that can build capacity within San Francisco’s health care provider community.
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Recommendations are primarily focused on potential changes to San Francisco’s health care programs and support the general principal that encourages movement toward the health insurance
San Francisco should not, at this point, make any changes in the
eligibility and enrollment for its local programs (i.e., Healthy San Francisco, Healthy Kids, and Healthy Workers)
State and localities should maximize take up in Medi-Cal and
Health Benefits Exchange and monitor progress
Eligibility, enrollment and/or benefit provisions for local programs
and the Health Care Accountability Ordinance should be aligned with HR provisions
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9.
The Healthy San Francisco (HSF) eligibility and enrollment system should identify applicants eligible for a subsidy under the California Health Benefit Exchange (Exchange) and reflect new Medi-Cal eligibility criteria for 2014.
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Eligibility rules for local programs (i.e., HSF, Healthy Kids, and Healthy Workers) should be refined to ensure full participation in Medi-Cal and subsidized health insurance offered in the Exchange.
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HSF and San Francisco Health Plan application assistors should route eligible individuals to Medi-Cal or the Exchange.
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DPH should carefully monitor HSF provider capacity after implementation of Health Reform to ensure appropriate access to care.
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DPH and the Health Commission should ensure that the Health Care Accountability Ordinance’s minimum standards are in alignment with the minimum standards for plans in the Exchange.
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Task Force did not consider the Employer Spending
Review by DPH and the City Attorney indicates that
Should any inconsistency arise, can be addressed
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Bill Shore (Alternate), San Francisco Organizing Project
Dana Vinicoff, San Francisco Organizing Project
Darlene Zane (Alternate), San Francisco Organizing Project
Dick Hodgson (Alternate), San Francisco Community Clinic Consortium
Donna Calame, IHSS Public Authority
Herb Levine, Independent Living Resource Center
Jim Lazarus (Alternate), San Francisco Chamber
John Gressman, San Francisco Community Clinic Consortium
Loy Proffitt, Mental Health Board
Margaret Baran, Long Term Care Coordinating Council
Maria Luz Torre, San Francisco Health Plan Member Advisory Committee
Mark Pastore, Small Business Representative
Mary Lou Licwinko, San Francisco Medical Society
Nina Maruyama, San Francisco Health Plan
Patrick Regan, Mental Health Contractors’ Association
Ra Criscitiello, SEIU Local 1021
Ron Smith, Hospital Council of Northern and Central California
Steve Falk, San Francisco Chamber of Commerce
Susan Poor (Alternate), Long Term Care Coordinating Council
Tracey Faulkner (Alternate), San Francisco Health Plan Member Advisory Committee
Trent Rhorer, San Francisco Human Services Agency
Tom Conrow (Alternate), San Francisco Human Services Agency
Tangerine Brigham, Task Force Co-Chair, San Francisco Department of Public Health
Wade Rose, Task Force Co-Chair, Catholic Healthcare West
Kathy Murphy, Task Force Counsel, San Francisco Department of Public Health
Colleen Chawla, Task Force Staff, San Francisco Department of Public Health
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