California Department of Public Health Guidance on COVID-19 Death Determination, Evaluation, and Certification Guidance on COVID-19 Death Determination, Evaluation, and Certification - DOWNLOAD IT HERE This document provides guidance on the determination and evaluation of deaths when Coronavirus Disease 2019 (COVID-19) is being considered as an underlying cause or a significant contributing condition. This document reviews existing guidance from federal, state, and independent expert organizations for certifying deaths due to COVID-19 and outlines the process in seeking further assistance from the California Department of Public Health Guidance (CDPH). June 4, 2021 General guidance on COVID-19 death determination, public health 0 0 Comment Read More »
CDPH Advisory: Ongoing Risk of Highly Drug-Resistant Infections in Patients Following Hospitalization or Invasive Procedures in Mexico DOWNLOAD CDPH ADVISORY HERE Ongoing Risk of Highly Drug-Resistant Infections in Patients Following Hospitalization or Invasive Procedures in Mexico February 2021 The California Department of Public Health (CDPH) and local public health partners are alerting healthcare providers of a recent increase in reports of VIM-producing carbapenem-resistant Pseudomonas aeruginosa (VIM-CRPA) in patients following hospitalization or invasive medical procedures in Mexico for routine healthcare visits, medical emergencies, and medical tourism. Since our November 2019 Health Advisory describing an initial cluster of five VIM-CRPA cases with similar exposure from August to October 2019, there have been three additional reports of VIM-CRPA identified in California from August to December 2020. These patients reported undergoing invasive procedures in Guadalajara and Tijuana, Mexico. The most recent case was identified in December 2020; the patient reported having plastic surgery at a Tijuana-area healthcare facility in October 2020. The CDPH Healthcare-Associated Infections (HAI) Program recommends healthcare providers be vigilant for the possibility of VIM-CRPA and other multidrug-resistant organisms (MDRO) in patients following hospitalization or invasive procedures in Mexico. To identify and control the spread of these pathogens in California, the HAI Program recommends the following strategies to healthcare facilities: When caring for patients who have a history of hospitalization or invasive procedures in Mexico, obtain cultures, perform antimicrobial susceptibility testing to guide treatment, and test any carbapenem-resistant bacteria for VIM and other plasmid-mediated carbapenemases. VIM-CRPA are highly resistant and difficult to treat, requiring protracted and complex antibacterial drug combinations and courses; consult with an infectious disease specialist for treatment guidance. Consider colonization screening for patients who have reported receiving healthcare outside of the United States during the 12 months prior to their hospitalization in the US. For patients identified with VIM-CRPA, inquire about receipt of healthcare in Mexico or anywhere outside of the United States, including hospitalization or invasive procedures in the prior 12 months Implement important containment strategies for VIM-CRPA and other MDRO: Place patients on Contact precautions and in a single-bed room, whenever possible. Perform hand hygiene before donning personal protective equipment (PPE), after doffing PPE, and before and after patient contact. Routinely clean and disinfect healthcare surfaces and shared medical equipment using an Environmental Protection Agency (EPA)-approved hospital-grade disinfectant. Perform colonization screening on any epidemiologically-linked patients (e.g., roommates prior to implementation of transmission-based precautions or patients exposed to common medical device or instrument) Monitor adherence to infection prevention practices (https://www.cdph.ca.gov/Programs/CHCQ/HAI/Pages/MonitoringAdherenceToHCPracticesThatPreventInfection.aspx) Communicate VIM-CRPA or other MDRO status to a receiving healthcare facility at time of patient transfer. Report any cases of VIM-CRPA and other healthcare-associated unusual or highly-resistant organisms to your local health department and the CDPH HAI Program at HAIProgram@cdph.ca.gov. Carbapenemase mechanism testing for CRPA and other carbapenem-resistant organisms is available through some local public health laboratories and the CDPH Microbial Diseases Laboratory. To prioritize testing of CRPA isolates for carbapenemase testing, please submit CRPA resistant to imipenem, meropenem, or doripenem by standard antimicrobial susceptibility methods and non-susceptible to cefepime, ceftazidime, or ceftolozane/tazobactam. Colonization testing (screening) for carbapenemase-producing (CP) organisms, including CP-CRPA, is available at no cost through the CDC Antibiotic Resistance Laboratory Network. These services can be accessed through your local health department in consultation with the CDPH HAI Program by contacting HAIProgram@cdph.ca.gov. For more information about VIM-CRPA and investigation and response measures, please visit: https://www.cdph.ca.gov/Programs/CHCQ/HAI/CDPH%20Document%20Library/CRO_Quicksheet_Oct2020.pdf. For more information about MDROs, please visit: https://www.cdph.ca.gov/Programs/CHCQ/HAI/Pages/AntimicrobialResistanceLandingPage.aspx. February 16, 2021 General California Department of Public Health (CDPH), public health, VIM-CRPA 0 0 Comment Read More »
California vaccination wars at the Capitol in Sacramento Lack of faith in scientific consensus is a sad but permanent feature of our social media-driven world. Paranoia is an effective business model. Parents who oppose vaccines are not stupid; in fact, they are often surprisingly well-educated, considering the pseudoscience and unfounded claims they are willing to embrace. It should come as no surprise, then, that many have found a way around the law, which still allows for medically necessary exemptions. Read more here. Reprinted from Los Angeles Times by Robin Abcarian Photo courtesy of Rich Pedroncelli/Associated Press April 30, 2019 General Vaccinations, Immunizations, Public Health 0 0 Comment Read More »
Newsom's first budget puts health care access, costs front and center SACRAMENTO -- Gov. Gavin Newsom released his first state budget proposal on Thursday, including a number of new goals and programs aimed at making health care more affordable and accessible to all Californians. The governor is following through on a key campaign promise by investing more than $1 billion in Proposition 56 tobacco tax revenue to increase access for Medi-Cal patients. That investment will help make it easier for low-income patients throughout California to see a physician and make Medi-Cal coverage more meaningful and effective for patients. Much of Newsom’s health care focus aims at low- and middle-income residents. His spending blueprint boosts overall state general fund spending on Medi-Cal by $2.2 billion. Some of that increased spending is due to the state paying a larger share of Medi-Cal coverage for single adults, but Newsom also introduced some new programs under the Medi-Cal umbrella. The governor proposed spending up to $194 million in state general fund revenue to expand Medi-Cal eligibility to about 138,000 undocumented adults aged 19-25. California currently pays for coverage of undocumented children up to age 19. Newsom’s proposal also includes plans to expand subsidies to middle-class Californians who receive coverage under the state’s health care exchange, Covered California. Currently, subsidies are available to individuals making up to $48,000 per year. Newsom’s plan would offer subsidized premiums to individuals making up to $75,000 per year, or families with a joint income of $150,000. In addition to these new investments, Newsom is also making sustained commitments to increasing the number of physicians in California to address the state’s physician shortage and the need to have highly trained, quality physicians in every part of the state. “Gov. Newsom’s budget sets ambitious goals to expand access to care for millions of Californians who still do not have the ability to see a physician or medical professional when they need one,” said California Medical Association (CMA) President David H. Aizuss, M.D. “We look forward to working with the administration and legislature to help bring down health care costs and improve health care access and quality for all Californians.” Earlier this week, the governor outlined some of these programs in an executive order. In that order, Newsom also called for California to create a prescription drug bulk-purchasing plan, and to create a new state Surgeon General position to focus on public health issues. January 14, 2019 General Access to Care, Public Health 0 0 Comment Read More »
Gov. Newsom signs executive order expanding health care access Within hours of being sworn in as California’s 40th governor on Monday, Gavin Newsom signed an executive order that will help control health care costs and expand access to care for millions of Californians. Gov. Newsom announced the creation of the nation’s first state-run purchasing program for prescription drugs to help bring down costs via bulk purchasing. He also announced his intention to expand Medi-Cal coverage to undocumented Californians up to age 26. (California current allows anyone under age 19 to receive Medi-Cal benefits, regardless of immigration status.) The governor also plans to create a state mandate for all Californians to carry health insurance, and to expand subsidies for those purchasing health coverage through the state’s health exchange, Covered California. Currently, subsidies are available to individuals making up to $48,000 per year, or 400 percent of the federal poverty level. The Newsom administration plans to both increase the size of subsidies and to make them available to individuals making up to $72,840 (or families earning up to $150,060). More details are expected on Thursday when Newsom unveils his budget for the 2019-2020 fiscal year, but many of the governor’s moves on Monday reflect long-standing priorities for the California Medical Association (CMA). “Gov. Newsom is backing up his words with action, helping make health care more affordable and available to all Californians,” said CMA President David H. Aizuss, M.D. “By making this his first act as governor, he is sending a clear signal that expanding access to care will be a top priority for his administration.” To read the full text of Newsom’s executive order click here. January 14, 2019 General Access to Care, Public Health 0 0 Comment Read More »
New Laws 2019: What physicians need to know The California Legislature had an active year, passing many new laws affecting health care. In particular, there was a strong focus on health care coverage, drug prescribing, public health and mental health issues. To help physicians understand the most significant new health laws, the California Medical Association has published its annual new laws round up, “Significant New California Laws of Interest to Physicians for 2019.” This document is free to all interested parties. January 14, 2019 CMA, General Health Care Reform, Public Health 0 0 Comment Read More »
CDPH hosts webinar on California Parkinson's Disease Registry On July 1, 2018, the California Department of Public Health (CDPH) launched the California Parkinson’s Disease Registry, a statewide population-based registry that will be used to measure the incidence and prevalence of Parkinson's disease. MD’s, DO’s, PA’s, and NP’s who diagnose or treat Parkinson’s disease patients are required to report. The first deadline for data submission is March 29, 2019, for cases encountered during the first quarter the law was in effect (July 1 to September 30, 2018). Details on the reporting obligation can be found in the Implementation Guide, version 3.0. To date, 432 Parkinson's disease cases have been submitted to CPDR. The data collected will be used to measure the incidence and prevalence of Parkinson’s disease. CPDR considers California’s large and diverse population ideal for expanding the understanding of this disease to improve the lives of Parkinson’s patients. CDPH will be hosting a free webinar on Friday, November 16 at noon to provide an overview of the registry and help mandated reporters understand how to submit data to CPDR. The webinar will cover both manual data entry via secure web portal and automated electronic interface. To register for the webinar, click here. If you are a provider and need assistance submitting Parkinson's disease case information to the registry, please contact CDPH at CPDRhelp@cdph.ca.gov or (916) 731-2500. November 6, 2018 General Professional Development & Education, Public Health 0 0 Comment Read More »
Medicare publishes 2018-2019 influenza vaccine pricing The Center for Medicare and Medicaid Services (CMS) recently published an update on Medicare’s influenza vaccine payment allowances and effective dates for the 2018-2019 flu season. The Medicare Part B payment allowance limits for seasonal influenza and pneumococcal vaccines are calculated at 95 percent of the average wholesale price. Payment allowances and effective dates for the 2018-2019 flu season: Code Labeler Name Drug Name Payment Allowance Effective Dates 90653 Seqirus Inc Fluad (2018/2019) $54.673 08/01/2018 - 07/31/2019 90656 Seqirus Inc Afluria (2018/2019) $19.773 08/01/2018 - 07/31/2019 90662 Sanofi Pasteur Fluzone High-Dose (2018/2019) $53.373 08/01/2018 - 07/31/2019 90674 Seqirus Inc Flucelvax Quadrivalent (2018/2019) $24.047 08/01/2018 - 07/31/2019 90682 Sanofi Pasteur Flublok Quadrivalent (2018/2019) $53.373 08/01/2018 - 07/31/2019 90685 Sanofi Pasteur Fluzone Quadrivalent Pediatric (2018/2019) $21.813 08/01/2018 - 07/31/2019 90686 Seqirus Inc, GlaxoSmithKline, Sanofi Pasteur Afluria Quadrivalent (2018/2019), Fluarix Quadrivalent (2018/2019), Flulaval Quadrivalent (2018/2019), Fluzone Quadrivalent (2018/2019) [Preservative Free] $19.032 08/01/2018 - 07/31/2019 90687 Sanofi Pasteur Fluzone Quadrivalent Pediatric (2018/2019) $9.403 08/01/2018 - 07/31/2019 90688 Seqirus Inc, GlaxoSmithKline, Sanofi Pasteur Afluria Quadrivalent (2018/2019), Flulaval Quadrivalent (2018/2019), Fluzone Quadrivalent (2018/2019) $17.835 08/01/2018 - 07/31/2019 90756 Seqirus Inc Flucelvax Quadrivalent (2018/2019) $22.793 08/01/2018 - 07/31/2019 Q2035 Seqirus Inc Afluria (2018/2019) $18.236 08/01/2018 - 07/31/2019 90689 TBD TBD TBD 01/01/2019 - 07/31/2019 A new influenza virus vaccine CPT code (90689: Influenza virus vaccine quadrivalent [IIV4], inactivated, adjuvanted, preservative free, 0.25mL dosage, for intramuscular use) has been approved and will be payable by Medicare beginning with dates of service on or after January 1, 2019. This new code will be included in the 2019 Medicare Physician Fee Schedule Database file update and the annual Healthcare Common Procedure Coding System update. The new influenza virus vaccine code 90689 is not retroactive to August 1, 2018. No claims will be accepted for influenza virus vaccine code 90689 with dates of service between August 1, 2018, and December 31, 2018. The payment allowance for 90689 is not yet available, but will be provided when the product pricing information becomes available to CMS. More information on 2018-2019 influenza vaccine pricing is available in MM10914 or on CMS website. October 26, 2018 Medicare Public Health, Public Payors 0 0 Comment Read More »
Mosquitoes test positive for West Nile virus San Bernardino Two mosquitoes collected in the City of San Bernardino tested positive for West Nile Virus. These are the first mosquitoes that tested positive in 2018 within the area served by the Division of Environmental Health Services Mosquito and Vector Control Program (MVCP). MVCP is taking steps to eliminate mosquito breeding hazards. People bitten by an infected mosquito may develop West Nile fever and experience flu-like symptoms which may include fever, body aches, skin rash, and fatigue. In some people, West Nile fever can develop into a more serious form of the disease. If you have been bitten by mosquitoes and are experiencing these symptoms, contact your medical care provider. Residents can protect themselves from West Nile Virus by following these tips: Drain or dump – Remove all standing water around your property where mosquitoes can lay eggs such as birdbaths, green swimming pools, ponds, old tires, buckets, flower pots, clogged gutters, or even puddles from leaky sprinklers. Avoid spending time outdoors at dawn and dusk – this is when mosquitoes are most active. Dress appropriately when outdoors – Wear shoes, socks, and long pants and long-sleeved shirts that are loose fitting and light colored. Apply insect repellent – Check that your insect repellent contains DEET, Picaridin, IR3535, or oil of lemon eucalyptus and apply it according to manufacturer’s directions. Doors – Make sure doors and windows have tight-fitting screens. Repair or replace screens that have tears or holes to prevent mosquitoes from entering your home. Property owners with pools/spas are encouraged to keep them clean. Mosquitoes lay their eggs in unmaintained green pools and can fly up to 20 miles, potentially transmitting the virus and impacting entire neighborhoods. To learn more about West Nile Virus or to report a dead bird please visit www.westnile.ca.gov. For more information or to report a green pool or mosquito breeding source, contact the County of San Bernardino Department of Public Health Division of Environmental Health Services at (800) 442-2283 or visit our website. News Release October 1, 2018 General Public Health 0 0 Comment Read More »
House votes to expand health savings accounts On July 25, the U.S. House of Representatives passed two bills (H.R. 6199 and H.R. 6311) that would expand how health savings accounts (HSAs) and other tax-preferred accounts can be used on health care spending. HSAs, which are paired with high deductible health plans, allow people to contribute pre-tax earnings each year and save for medical expenses. The first bill—H.R. 6199, which passed 277 to 142—would allow individuals with HSA-eligible high-deductible health plans to use up to $250 a year (or $500 a year for families) on services like primary care and telehealth before they reach their deductibles. This bill also includes a provision that would count over-the-counter medications, menstrual products and certain sports and fitness expenses as qualified medical expenses. H.R. 6199 would allow employers to provide free or discounted on-site or retail clinic care without disqualifying employees with high deductible health plans from setting up HSAs. It would also no longer disqualify individuals with direct primary care service arrangements. The second bill—H.R. 6311, which passed 242-17—would nearly double how much an individual or family can contribute annually to an HSA. It would also expand who is eligible to set up an HSA, including working seniors enrolled in Medicare Part A who also have HSA-eligible high deductible health plans. Individuals with bronze or catastrophic level would also qualify for an HSA. H.R. 6311 also would allow anyone—not just people under 30—to purchase catastrophic health coverage. It would combine the risk pool for those catastrophic plans with the rest of the plans sold in the individual market. The bill would also allow flexible spending account balances to be carried over. The bill would also suspend the Affordable Care Act’s tax on health plans through 2021. Both bills passed with some democratic support, though democrats largely argued that the bills would add to the budget deficit and would only help those who are “better off” and can afford HSAs. Senate Republicans said they don’t have any plans to vote on an expansion of health savings accounts this year. August 15, 2018 General Access to Care, Health Care Reform, Public Health 0 0 Comment Read More »
