San Bernardino County Public Health Officer Thomas J. Prendergast, M.D. reported that the comprehensive bioterrorism preparedness plan for San Bernardino County was approved by the County Board of Supervisors and has been submitted to the State. A meeting was held at Community Hospital of San Bernardino to discuss the flu season and respiratory illness problems. The Health Department is increasing its focus on respiratory interstitial virus and making it a reportable condition. At the present time, the Health Department is unaware of the number of cases and wants to get a handle on it.

There has been only one reported case of West Nile virus on the west coast in Los Angeles, and the origin of the infection is unclear. Exotic Newcastle Disease has been found in fighting cocks. The infection so far is focused in Riverside and Los Angeles counties. The disease is devastating because of the potential for loss in the poultry industry; however, there is no potential for human illness outside of possible conjunctivitis in those exposed to the infected chickens.

IEHP Medical Director Bradley Gilbert, M.D. reported that total IEHP membership is 244,556. Medi-Cal enrollment is 219,260 with 25,296 enrolled in the Healthy Families program. The auto assignment percentage in September was approximately 25 percent. IPA enrollment as of August 1, 2002 is 242,312. In response to the Governor’s signing of AB 3006, which rescinded his proposed reduction of Medi-Cal provider rates and maintained the 16.7% average increase that was enacted last year, IEHP also rescinded its reimbursement reductions to the IPAs.

Dr. Ching reported that the Inland Global Medical Group (IGMG) has closed its doors and $3.6 million is owed to providers. 48,000 covered lives are involved, and patients have been reassigned to other groups. The closure is severely affecting physicians who were members of IGMG. Several physicians are talking about leaving the area and others are nearly bankrupt.

Board members discussed how SBCMS could help the physicians in the IPA and several suggestions were offered. Dr. Ching and Ms. Stratton have been in dialogue with CMA, who is working aggressively to seek payment for the physicians and help them maintain their patients as the health plans reassign patients to new physician groups and plans. Ms. Stratton said at present the situation is not clear enough to make a recommendation, but the CMA is doing a thorough investigation as to what can be done to help these physicians.

Dr. Lisa Perry-Gilkes, Director of the African American Health Initiative (AAHI), reported on the “Breaking Bread & Building Bridges Dinner” held October 15, 2002 at Community Hospital of San Bernardino. The purpose of the meeting, to come together to increase solidarity among key community leaders and individuals and to share information about goals, objectives and missions and strategize about effective approaches to improve the health of African Americans in our community. Approximately 40 community leaders attended. The meeting allowed SBCMS to interact in a positive way with people who are involved in activities similar to the community outreach AAHI is doing. A resource directory will be created that will list the efforts of each group and identify people with specific skills who could assist other groups in the community. Dr. Wilson said that those attending saw clearly that physicians have a special interest in the problems they are struggling with. The group was eager to continue the momentum of their meeting and agreed to meet again on Tuesday, October 29.

Dr. Randolph thanked Doctors Manmohan Nayyar and Ruchir Sehra for their successful membership recruitment efforts. Dr. Nayyar recruited nine new members from St. Mary Choice Medical Group and Dr. Sehra brought in eight new members to Loma Linda University’s $999 group membership.

Board members voted to accept the SBCMS Executive Committee’s recommendation to approve the revised SBCMS Bylaws with two minor modifications: Associate Members will pay full dues when transferred to Active status, and Out of State members will pay discounted dues.

The Unforgettables Foundation has announced that their “Top Doctor Award” will be presented (for the second year) on December 31, 2002 at the Third Annual Lights for Little Lives March. Mr. Tim Evans requests that SBCMS nominate a pediatrician to receive the honor. Winners represent three distinct focus areas: San Bernardino County, chosen by the SBCMS; Riverside County, selected by RCMA; and The Children’s Hospital at Loma Linda, chosen by a panel of pediatricians. Dr. Sehra will discuss the nomination with last year’s award recipient, Dr. Elliot Weinstein, and bring their recommendation to the November 25 Board of Directors meeting.

Board members were provided copies of a CMA recruitment poster announcing CMA’s success in restoring $1.3 billion for health care in the state budget. Board members have also received the poster by mail and email. Ms. Stratton encouraged them to post them in their hospitals and to use the information when discussing membership with other physicians.

Board members were provided an AMA Federation Alert “Message to Physicians’ Grassroots Network.” Under the current law, Medicare payments to all physicians will be cut by another 12% over the next three years, beginning with a 4.4% cut effective January 1, 2003. Dr. Gnanadev reported that Congress recessed without fixing the Medicare reimbursement problem. They are expected to return on Tuesday, November 12 to conduct a “Lame Duck” session to extend budget authorizations. Dr. Randolph encouraged Board members to contact their Senators and Representatives while they are in their home districts and before they return to Washington, D.C. He encouraged the members to complete CMA’s Medicare Alert and Survey and to contact the district offices of our senators and members of congress before November 12th. CMA has provided talking points for their discussions.

Ms. Stratton received word that the Department of Health Services denied SBCMS’ grant proposal for developing a Medical Reserve Corps. Out of 177 applicants, 42 proposals were funded. The DHS encouraged Ms. Stratton to submit the grant proposal again next year when more money will be available. The DHS will send SBCMS an official letter and point out the weaknesses in the grant proposal.

Dr. Eric Frykman provided an article from the August 6, 2002 Annals of Internal Medicine, a review of West Nile Virus: A Primer for the Clinician. The article provides the clinician with an understanding of the epidemiological and biological characteristics of West Nile virus in North America, as well as information on the diagnosis, reporting, and management of patients with suspected West Nile infection and on advising patients about prevention.