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The bill would allow qualified aged, blind or disabled individuals to obtain IHSS services at their own expense.
Under existing law, Medi-Cal provides funding for the IHSS program, under which (either through employment by the recipient or through contract by the county) qualified, aged, blind, and disabled persons receive services enabling them to remain in their own homes. Counties are responsible for the administration of the IHSS program.
SB 1599 would require the Department of Social Services (DSS) to establish the “Project for California Independence,” which would authorize certain individuals who are not currently eligible financially to receive in-home supportive services to purchase those services.
The bill would require the Project to be conducted in any county that chooses to participate, and would require DSS to develop eligibility guidelines for individuals wishing to purchase services and to consult informally with designated entities.
Wiggins said that even though California has an increasing number of aged persons, the state has no plan designed to address the health care needs of these individuals. The IHSS program is limited to persons who meet a means test that excludes lower-middle-class individuals and families.
According to the Legislative Analyst’s Office, the number of Californians 65 years of age and older will increase by 2.4 percent per year between 2004 and 2010, which will result in an increase of more than 604,000 people in this age group in just six years. The state Department of Finance projects that the number of Californians over 65 years of age, which was 3,627,284 in 2000, will have grown to at least 4,526,578 by 2010.
“This explosion in our aging population will devastate California’s health care delivery system unless action is taken to improve our ability to provide low-cost personal care services as an alternative to acute care and nursing home stays,” Wiggins said. “Unique public-private partnerships should be created to effectively and efficiently deliver services to this population.
“California has developed the In-Home Supportive Services delivery system that is, by virtue of its ubiquity and cost-effectiveness, uniquely qualified to help deal with this growing aging population,” Wiggins added. “The IHSS delivery system is a publicly-funded program aimed at reducing costs by allowing people to be cared for in their own home. Making these types of services available to other Californians who do not qualify for Medi-Cal is an appropriate benefit and justification for the taxpayers, who have paid into the creation of this infrastructure.”
Wiggins argued that persons who meet the requirements of the bill – that is, they are aged, blind or disabled and have incomes below 300 percent of the federal poverty level – should be allowed to purchase IHSS services, “an economical way for them to stay in their own homes, rather than move to settings that allow less independence and cost more.”
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From the time you enter the emergency department until the nurse has completed the initial screening, you’ll wait an average of 18 minutes, according to John Severs, RN, BSN, director of the emergency department. Severs says the average time spent in emergency from door-to-discharge is three hours, which is equal to the national average.
“Our goal is to get people in, treated and out of the emergency department within two hours,” says Severs. “We’ll keep working on it until we get there.”
One major advance is new equipment in the emergency department that tests the blood for heart attack markers – and gives positive results within 15 minutes and completely rules out a heart attack in two hours. It used to take eight hours.
Elevated blood levels of cardiac troponin 1 are highly indicative of a heart attack. If the initial test shows normal (negative), the test is run twice more within two hours. If all tests come back normal, it’s nearly 100 percent certain there’s no heart attack, Sever explains.
“Before, we couldn’t take the chance. So we would fly patients with cardiac symptoms to St. Helena Hospital for emergency cardiac evaluation,” he said. “Now, we know quickly when tests are negative, allowing us to safely keep patients here for observation and referral to the cardiologist.”
Not only is that less expensive, Sever notes, but it is easier on the patient and the family.
Severs’ team continuously audits patient records to find out how the process screening and treatment process needs improvement.
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“I am so honored to receive this award,” said Berg, D-Eureka. “Californians rely on clinics and health centers for much of their health care needs. These important health care providers play an important role in the lives of many Californians.”
Berg was chosen for her work on the Budget Subcommittee on Health and Human Services and her work on a bill last year that would stabilize funding for rural health, migrant workers, and community clinics.
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Assembly Bill 2543 would provide assistance to physicians, registered nurses, social workers, and marriage and family therapists who commit to a minimum of three years of service to geriatric patients and clients. The program would not add pressure to the state’s beleaguered general fund, because it relies on fees paid by practitioners during the licensing process.
“We have a shortage of professionals working in geriatric settings,” said Berg, D-Eureka. “As Baby Boomers move into old age, that shortage will reach crisis proportions unless we start making changes now.”
California only has 890 board-certified geriatricians, which accounts for one geriatrician for every 4,000 Californians over the age of 65. That imbalance is expected to become increasingly worse in coming years. Similar shortages of trained experts exist among nurses, social workers and therapists.
“The goal here is to entice our college students to go into these fields,” Berg said. “A program that covers their incurred educational debt is a big step in the right direction.”
The office of Statewide Health Planning and Development will administer the loan program. The bill was approved by the Assembly Business and Professions Committee on Tuesday. It now goes to Assembly Health Committee.
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