Board Briefs
October 30, 2000
Dr. Linda Bosserman introduced Scott J. Ferrell, a consumer health attorney with the law firm Call, Clayton & Jensen. She invited him to share his insight and discuss the issues his physician clients confront in seeking reimbursement from intermediary IPAs and HMOs. Mr. Ferrell believes that physicians should be able to look to the HMOs as the ultimate payors. He said that physicians must be aggressive with the HMOs.
Public Health Officer Thomas Prendergast, Jr., M.D. announced that it is likely that there will be a change of administrators at the San Bernardino County Public Health Department. The new director will probably be a nonphysician. SBCMS has consistently held that a physician should occupy this position, but other health departments in the state are following this trend. The Executive Committee will investigate the reasons for having a nonphysician as Administrator of the Public Health Department, and Dr. Lane suggested there be a letter from the Board.
Dr. Prendergast also announced that the delivery of the flu vaccine has been further delayed to December. Board members agreed that the hospitals should share their contingency plans for a serious flu epidemic, which are likely to be very similar, and then coordinate patient care. Dr. Lane will contact Mark Gamble, Vice President, Inland Area, of the Healthcare Association to ask what the next steps are and suggest that SBCMS would support a regional plan.
Dr. Kenneth Lane thanked Board members for their letters and calls to the Board of Supervisors in support of his appointment as an At Large Member of the Tobacco Settlement Ad Hoc Committee. He will make prevention, indigent care, and reimbursement for physicians who take care of these patients his mission.
Inland Empire Health Plan Medical Director Bradley Gilbert, M.D. reported that Medi-Cal enrollment currently stands at 173,139 and Healthy Families enrollment at 12,058. The PIP 2000 Program has been highly successful and IEHP looks forward to providing additional income to their physicians.
African American Health Initiative Director Lisa Perry-Gilkes, M.D. provided an update on the initiative’s progress. Over 30 community-based organizations serve on the Advisory Committee. The AAHI has developed a mission statement, an organizational chart, hired a grant writer, and have broken down into a number of working committees. The California Endowment has awarded AAHI a $25,000 grant.
Dr. Gnanadev thanked Dr. Victor Ching and San Antonio Community Hospital for successfully bringing together representatives from CMA, KPC Medical Management and interested physicians to air their concerns at the KPC Medical Management Open Forum on October 4. Over 130 physicians attended.
Dr. Ron Bangasser reported that the CMA put together a terrific program at the Leadership Academy October 16-18 at the LaQuinta Resort where it will be held again next year. Thirteen physicians from SBCMS attended.
November 27, 2000
Roy Musgrove, Vice President Sales & Marketing of NORCAL Mutual Insurance Company and NORCAL’s Inland Empire Account Executive Greg Hartman presented a comprehensive overview and update on the company’s current business. Mr. Musgrove reported that a recent five-year actuarial study conducted by NORCAL revealed an overall decrease in claims frequency and a 63.9 percent increase in severity of claims. Based on this study, NORCAL’s 2001 rates will increase in all counties and specialties. Depending on their specialties, San Bernardino County NORCAL-insured physicians will experience rate increases from 4.27 to 13.5 percent effective January 1, 2001, the average increase being 9.25 percent. A notice of the rate change and invoices was sent to all NORCAL policyholders on November 15.
SBCMS Alliance President Lorene Sponsler reported that the Christmas Sharing Card has brought in $3,000 to date. The Lion King excursion on December 20 is booked up and there is a waiting list. The bus will depart from the SBCMS building at 11 a.m. She also announced that the Alliance will prepare the refreshments for the Medical Museum Open House on February 4, 2001.
San Bernardino County Public Health Officer Thomas J. Prendergast, M.D. announced that the current Centers for Disease Control report projects a mild flu season. The Health Department has seen no positive cultures in San Bernardino County. The health department has received 34,000 doses of flu vaccine, which he feels should be sufficient.
SBCMS Executive Director Linda Stratton presented the financial report and budget comparison for the four-month period July 1 through October 31, 2000. Total revenue is $189,347, $3,020 more than budgeted. Total expenses before depreciation are $155,594. Ms. Stratton reported that SBCMS ended the period with a net surplus of $19,633.
IEHP Medical Director Bradley Gilbert, M.D. reported that Medi-Cal enrollment is currently at 173,021. Healthy Families enrollment is 12,218 and slowly increasing. The auto assignment percentage in October was approximately 20 percent. IEHP, with the assistance of the SBCMS and RCMA executive directors, has selected the name, Eradicator, for its new anti-tobacco character. A graphic artist is preparing a design and a new comic book. A costume has been ordered for the Eradicator, who will appear with IEHP’s bicycle safety character, Rad Rider, at public events.
Dr. Gnanadev referenced CALPAC Executive Director Dean Chalios’ CALPAC 2000 General Election Report. In the November 7 general election, CALPAC won 141 of the 145 races in which they were involved for an overall success rate of over 97 percent. CALPAC and AMPAC supported the winning candidates in 46 of the 49 U.S. House races in which they were involved.
Dr. Bangasser discussed the AMA Interim House of Delegates meeting, which will be held in Orlando December 3-6. He announced that he will run for a seat on the AMA Council on Medical Services.
Dr. Gnanadev referenced a November 27th letter from County Administrative Officer William H. Randolph regarding the status of the Public Health Officer and the executive management of the County Department of Public Health. This letter responds to SBCMS’ letter regarding the proposed change and concern that the professional control of public health issues will be diminished if a physician is no longer the Director of Public Health. Mr. Randolph states that he is planning to divide the management of the health department into two distinct functional areas: departmental administration/operations and County Health Officer duties. The action is patterned on the model of the Arrowhead Regional Medical Center. The duties of both areas are currently handled by Public Health Officer Dr. Thomas Prendergast.
Although Mr. Randolph did not address it in his letter, Dr. Prendergast believes it is likely that he will report to the new department administrator. The board is concerned how this change will affect public health in our county. The board directed that a letter be sent to Mr. Randolph asking for a precise definition of the duties of the two administrators and who will have the ultimate responsibility.
Board members were provided copies of a 15-page memo from CMA to physicians contracting with KPC Medical Management. CMA’s support of KPC has been controversial. Dr. Gnanadev said that CMA’s goal was to make sure physicians got paid. CMA made sure that KPC’s Medical Director came to the October 4 meeting at San Antonio Community Hospital and that the monies loaned by the health plans to KPC went to the doctors. Dr. Bangasser suggested that the board post a follow-up article on the SBCMS web site about what CMA accomplished. Ms. Stratton will talk with the CMA staff and ask if they would prepare a one or two page memo or article that could be sent out to all doctors.
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