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LAKE COUNTY – Citing extraordinarily high health care costs, Blue Shield of California is pulling its health care plan out of Lake County, a decision expected to affect nearly 2,100 county government employees and family members.
On Tuesday, the CalPERS Board of Administration approved Blue Shield's plan to stop offering its health maintenance organization (HMO) plan in Lake and three other rural Northern California counties, according to Karen Perkins of CalPERS' Public Affairs Office.
CalPERS, based in Sacramento, is the country's third-largest provider of health benefits. It currently offers insurance and benefits to 1.2 million state and public agency employees, retirees and their dependents.
Blue Shield asked to withdraw its HMO health care product from Lake, Napa, Plumas and parts of El Dorado counties, citing health care costs 78 percent above the state average, Perkins reported.
CalPERS said it will provide other health care options to public employees in lieu of the withdrawn Blue Shield coverage.
The plan change will impact about 9,100 CalPERS members among the four counties, including 1,200 in Lake County, Perkins said.
Those affected locally are primarily state and county employees; the cities of Lakeport and Clearlake are not CalPERS subscribers, Perkins noted.
The move is expected to save $30 million in premiums, CalPERS reported.
“For years, other members [outside the four counties] have, in effect, subsidized these costs, but costs have become so high we are not able to continue this,” said George Diehr, Chair of the CalPERS Health Benefits Committee. “We are disappointed that providers in this area were not able to be responsive to the need for more affordable care.”
Blue Shield finds higher costs
Perkins said Blue Shield originally looked at 11 rural Northern California counties before settling on the four in question.
In Lake County in particular, a Blue Shield study found health care costs were 89-percent higher than the statewide average, according to CalPERS.
Blue Shield asserted that hospitals “are a key driver of health care costs,” in Lake County.
Annual hospital costs are estimated by Blue Shield to be 175 percent higher in that county – $3,923 per day, compared with $1,429 per day. Average hospital inpatient costs are 61 percent higher in Lake County – $8,325 per day, compared with the statewide average of $5,166 per day.
Representatives from Sutter Lakeside Hospital and Adventist Health's Redbud Community Hospital could not be reached for comment at midafternoon on Blue Shield's assertions.
Perkins said the study found several “common denominators” amongst the four counties in question.
“Some of the issues are that in these counties what we've found overall is that a greater percentage of the population are receiving services that are categorized as 'chronic,'” she said.
“Chronic” diseases, she said, include asthma, diabetes, congestive heart failure and kidney failure. Cancer, she added, is not among those diseases.
Along with having a population that has more chronic health conditions, the study found Lake County had higher-than-normal hospital, surgery and pharmacy costs.
From September 2006 through February 2007, Blue Shield conducted Regional Council meetings in Lake County to identify health care cost drivers and discuss ways to improve affordability in the county, CalPERS reported.
During that time, Blue Shield sought assistance from physicians and hospitals to organize them into health care delivery networks that would reduce costs and enhance delivery of care, according to CalPERS. However, Blue Shield reported their efforts met with limited success.
There is a lack of alternative health facilities, said Perkins, with more procedures that could be done on an outpatient basis having to be done in the local hospitals.
The US Census Bureau's most recent population estimate for Lake County is 65,933, of which 16.2 percent – or 10,549 people – are above the age of 65.
Could those numbers account for the the higher incidences of chronic conditions found?
Perkins said she wasn't aware if the Blue Shield study disseminated those numbers, although it was referenced in the Regional Council meetings.
“They didn't pinpoint it as being the main cause, necessarily,” she said. “They referenced it in passing.”
Kathy Ferguson, the County of Lake's personnel director, said the county worked with Blue Shield on its Regional Councils, which studied the health care costs.
As to the findings about Lake County's health care costs and unique conditions, Ferguson said, “The information they were providing seemed to be accurate.”
What the changes mean for employees
Ferguson said the Blue Shield HMO plan being eliminated is the most popular among county employees. While the choices aren't as great as in a preferred provider organization – or PPO – and there are higher premiums, there typically aren't deductibles with HMOs, she explained.
Information provided from CalPERS shows that of the more than 1,700 employees in Lake County who subscribe to CalPERS health coverage, nearly 1,200 use the Blue Shield plan.
The plan covers a total of 2,105 people, which includes the employees and their family members, CalPERS reported. Of those, about half live in and around Lakeport and Kelseyville.
The changes resulting from Blue Shield's exit will take effect Jan. 1, 2008, said Ferguson, at the start of the health plan year.
CalPERS reported its members in Lake County will continue to receive quality health care either through one of the system’s other HMO or PPO offerings.
Members also can enroll in an additional PPO plan – PERS Select – approved by the board Tuesday. PERS Select is provided at a lower cost than the standard PPO, and utilizes a smaller panel of doctors and specialists identified by Blue Cross of California as meeting certain efficiencies and patient satisfaction standards.
In addition, CalPERS reported that some members in Lake County can also take advantage of the Rural Health Care Equity Program, which would provide a subsidy of up to $1,500 per year.
Ferguson said she was waiting to receive the final information on the proposed changes to the other CalPERS health plans.
She said she's not certain how reenrollment in the other plans will happen, but in the past, when there have been plan changes, CalPERS has simply switched employees over to plans they believe will be the most popular, allowing employees to change later if they choose. That results in less of a paperwork headache for county staff.
Health care plans leaving the county isn't new, said Ferguson.
“HMOs have come and gone out of the county several times before,” she said.
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The light brown apple moth has been found in neighboring Napa County, state and federal officials confirmed Wednesday.
The California Department of Food and Agriculture and the U.S. Department of Agriculture reported that a single adult light brown apple moth was found May 9 in a residential area of Napa.
Officials made the announcement following lab confirmation by Department of Food and Agriculture entomologists, with supporting confirmation by USDA scientists.
“This moth is a threat not only to agriculture but also to our urban environment – our landscaping, our parks and our natural habitat,” state Agriculture Secretary A.G. Kawamura said in a statement. “We are moving quickly to detect the extent of any infestation and contain the problem in the smallest possible area.”
The Department of Food and Agriculture, USDA and the county agricultural commissioner's office have already begun setting and collecting additional traps in the area to determine the extent of the problem. No additional moths have been found in the vicinity to date.
The light brown apple moth, which is native to Australia, was first detected in the Bay Area in February, state officials reported. Since then, it has reached nine counties – Alameda, Contra Costa, San Francisco, Marin, Monterey, Santa Clara, Santa Cruz, San Mateo and now Napa.
More than 2,000 moths have been detected in those nine counties since February, the Department of Food & Agriculture reported, with most of the moths found in Santa Cruz, which officials believe may be an original infestation point.
Trapping is taking place in 40 of the state's 58 counties, but so far Lake hasn't been added to that list. However, trapping is taking place in Mendocino, Sonoma and Yolo.
Officials say the light brown apple moth is of particular concern because it can damage a wide range of plants including many commonly found in our urban and suburban landscaping, public parks and natural environment.
The list of agricultural crops that could be damaged by this pest includes as many as 250 plant species, from grapes and pears to citrus and stone fruits. The pest damages plants and crops by feeding on leaves, new shoots and fruit.
On Tuesday, SB 556, a piece of urgency legislation introduced by North Coast Sen. Patricia Wiggins to address the moth issue, passed the Senate Agriculture Committee. The bill would create an advisory task force to advise Kawamura on the moth issue.
“As we find out more about the spread of this pest, the department and the Legislature will be better able to assess what resources and programs California may need to protect our precious and vulnerable agricultural products from potential harm,” she told the committee at the hearing.
This week, the USDA informed county agricultural commissioners that Mexico has implemented restrictions on shipments of certain fruits and vegetables to that country from the infested counties.
In addition, the USDA reported that seven states – Arizona, Colorado, Florida, Georgia, Nevada, Oregon and Wisconsin – have asked the Department of Food & Agriculture for advance notification of shipments from the quarantined counties.
Late in April state agricultural officials established a quarantine to cover the affected counties, which required inspections and clearances for shipments of plants and fruits from within the affected counties.
On May 2, the USDA added a federal quarantine regulating movement of plant materials between California and other states, with similar inspection requirements as those found in the state quarantine.
USDA and the Department of Food & Agriculture reported that they have assembled a technical working group comprised of international experts on light brown apple moth to discuss survey and mitigation strategies to safeguard against this potentially damaging pest and prevent its further spread.
The group will meet in San Jose today and Friday, May 17-18, to discuss California's situation and make recommendations about the project.
For more information on the light brown apple moth, visit the Department of Food and Agriculture's Web site, www.cdfa.ca.gov.
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SACRAMENTO – The Senate Appropriations Committee on Monday approved the following bills by Sen. Patricia Wiggins (D – Santa Rosa):
– SB 557, which seeks to include qualified doctors of audiology among those medical professionals who may be appointed by the administrative director of the Division of Workers' Compensation as qualified medical evaluators.
The bill’s sponsor, the California Academy of Audiology, asserts that an audiologist is the most qualified professional to determine whether a hearing loss would impair a worker's ability or whether a hearing loss was secondary to noise exposure on the job.
– SB 565, which would create the position of hospital and health services director at the Yountville Veterans’ Home.
Yountville is the only state veterans’ home with a hospital. Yountville has an emergency room, skilled nursing facility, pharmacy, and an Alzheimer unit. Yountville has a medical director and a nursing director but no one to administer and coordinate the medical care and medical personnel for all the facilities on the property.
Veterans and veterans’ advocacy groups believe that patients would be better served with a hospital and health services director on-site.
– SB 581, which would transfer the Volunteer Firefighters Length of Service Award System away from CalPERS and direct administrative responsibilities of the program to the California State Fire Employees Welfare Benefit Corporation.
Currently there are approximately 54 fire departments participating in the program, and 128 volunteer firefighters who are receiving monthly payments and who are eligible for the death benefit. The total membership is comprised of 3,983 volunteer firefighters and the balance in the fund is approximately $2.6 million.
In 1998, CalPERS changed the methods and assumptions it used in determining the administrative costs of the VFLSA. Since that time, the administrative costs have increased from $10,000 to an estimated cost of $139,025 for 2007-08.
The system is funded entirely by contributions from contracting fire entities and investment earnings.
– SB 861, which would authorize the North Coast Railroad Authority (NCRA) to use $5.5 million in previously allocated state funds for environmental cleanup of rail lines.
Specifically, this bill would allow the NCRA to use $5.5 million in funds allocated through the Transportation Congestion Relief Program to meet cleanup obligations under an environmental remediation consent decree ($4 million), along with some administrative responsibilities.
The authority would be prohibited from spending more than $500,000 annually on administrative expenses.
Monday's actions mean that all four bills are now eligible for a vote by the full Senate.
Wiggins represents California’s 2nd Senate District, which stretches from Solano County to Humboldt County and includes part or all of Lake, Mendocino, Napa and Sonoma Counties as well. Visit her Web site at http://dist02.casen.govoffice.com/.
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CLEARLAKE – Oak Hill Middle School will receive more than $2 million over the next several years to help reduce class sizes and boost performance.
State Superintendent of Public Instruction Jack O’Connell recently submitted to the State Board of Education a list of 488 low-performing schools from throughout California that will receive dramatically increased new funding to invest in programs aimed at boosting student achievement. Oak Hill was on that list.
The funds, according to O'Connell's office, were allocated through the Quality Education Investment Act that was passed last summer.
The act was part of a settlement of a lawsuit filed by O’Connell and the California Teachers Association against Gov. Arnold Schwarzenegger and the California Department of Finance for failing to properly fund Proposition 98 in the 2004-05 and 2005-06 budget years.
"The Quality Education Investment Act allows us to invest significant resources for some of our lowest-performing schools," O’Connell said. "We can change the direction of these schools by hiring new, motivated teachers, decreasing class size, improving the student-to-counselor ratio, and providing more assistance and training for existing teachers and principals.”
The Quality Education Investment Act provides $2.7 billion over seven years to the selected schools, O'Connell's office reported.
When the Act is fully implemented by fiscal year 2008-09, the funds will be distributed on a basis of $500 per pupil for grades kindergarten through third, $900 per pupil in grades fourth through eighth, and $1,000 per pupil for grades ninth through 12th. In the initial funding year (fiscal year 2007-08), the amount distributed to schools will be slightly lower.
Schools eligible for the new Quality Education Investment Act funding were elementary, secondary, and charter schools that ranked in the lower deciles of 1 or 2 as determined by the 2005 Academic Performance Index (API) base.
Oak Hill's 2006 Academic Performance Index score was 620, the second-lowest score in the district.
Oak Hill, which has grades sixth through eighth, will receive $332,971 for six years, with a smaller amount the first year, said Konocti Unified School District Superintendent Dr. Louise Nan.
Beginning in the 2007-08 academic year, Nan said the school will start receiving funds for startup and planning purposes.
“The main focus of the grant is to reduce class size to 25 or fewer students and provide professional development,” she said.
The professional development includes 40 hours of training per teacher, she said.
The school's contract limit is current 32 students per teacher, said Nan. “We staff at around 29 to 1.”
Class sizes vary depending on the subject area, said Nan, with physical education classes having the largest enrollments.
The school must undergo academic reviews of test scores, and meet specific goals over the first three years of the grant in order to remain eligible for the funds, Nan explained.
At the end of seven years, the district must be prepared to “ramp down,” said Nan, which would include going back to regular class sizes.
“That could result in a layoff of staff,” she said, although normal staff attrition – such as through retirement – could reduce staff without layoffs.
The Quality Education Investment Act, said nan, is “an experiment in adequate funding,” with the state interested in seeing if more money really works in solving the problems of certain schools.
“If there is a strong difference, perhaps the legislature will see its way clear to continue funding the program in the long run,” she said.
As to why Oak Hill has been a lower-performing school, Nan said the district has been exploring that question.
“We've just completed a complete review through a district school liaison team,” she said.
The school district's board recently approved the team's recommendations, and will begin implementing them in the 2008-09 school year.
One of the primary recommendations suggests breaking up Oak Hill into a group of smaller “learning communities,” a process Nan said would have taken place even without the Quality Education Investment Act funds. Those changes at Oak Hill will begin next fall.
The learning communities will be established within each grade level and will include the core academic areas of math, science, history, social science, and language arts, according to the recommendations.
Teams of teachers will share the same group of students throughout the day in order to create a “school within a school,” the plan says. Focus will be placed on creating a culture of success for all students, and teachers will be trained in strategies aimed at engaging students in particular grades and subjects, the plan says.
Staff culture will be encouraged to create a culture of “Our Kids” vs. “The Kids,” which will include adding student activities and celebrations, mentoring programs between grades, social skills classes, repairing the school's exterior in time for the new school year, increase a feeling of safety at the campus through a perimeter fence, and coordinating community volunteer activities at the school, according to the report.
Schools that submitted applications were then randomly selected using a process that accounted for statutory requirements for geographic and grade-level distribution.
Up to $2 million will be allocated to county offices of education across the state to annually monitor the implementation of this investment program in funded schools.
Upper Lake High School Principal/Superintendent Patrick Iaccino had reported earlier this year his intention of applying for the funds, however, that school wasn't listed among the recipient schools. Iaccino could not be reached for comment for this article.
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