Public Health Officer Dr. Thomas Prendergast reported no SARS cases have been documented in the county. He stated there is now a specific test available, and data shows that of all the reported cases in the United States only five have been proved to be SARS. Most of the cases that were picked up with the relatively new screening criteria for people coming off planes from countries infected with SARS appears to be something else. It looks like the virus is being contained. Smallpox vaccination has virtually been halted, although, the Public Health Department is still vaccinating the occasional hospital employee. They do plan to do first responders based on the urgency need, but it is probable that it will not be many.

Dr. Prendergast also reported the environmental health inspection for fast food restaurants that the Public Health Department performs, has been changed. The format for the inspection report now identifies key issues, such as temperature control. Restaurants will now post a standard-sized paper with the San Bernardino County logo and Dr. Prendergast's signature stating the restaurant has been inspected. The public is entitled to request a copy of the inspection report.

IEHP Medical Director, Dr. Brad Gilbert, reported total membership is 258,325. Medi-Cal enrollment is 226,089 with 28,690 enrolled in the Healthy Families program. Healthy Kids enrollment is 3,546. The auto assignment percentage in April was approximately 28 percent. He provided a Physician Incentive Program (PIP) update. To date there are 514 practitioners participating in the program. PIP incentivizes physicians for performing services in the following areas: immunizations, well child visits, adult physical exams, pap test, chalmydia screening test, perinatal services, and continuity of care. In 2002 IEHP reimbursed physicians over $8 million for the services provided. As part of its monitoring activities, IEHP conducts on-going audits of PIP physicians for compliance with requirements. Providers are sent letters and newsletters to communicate any PIP program or policy changes. Updated training at physician offices is also provided. IEHP is proposing a Pay For Quality Program that would begin July 2003, as an addition to the PIP program that will reimburse physicians for providing specific services for their diabetic patients.

The board approved the 2003/2004 committee assignments. Committee assignments will be published in the SBCMS section of the July 2003 SCP magazine. This will serve as the physician's notice of their assignment. The board also approved SBCMS' 2002-2004 budget as submitted.

District II Delegation Chair Dr. Thelma Korpman reported on the Speakers' Advisory Committee meeting. An assessment of the 2003 House of Delegates (HOD) was recapped. The number of delegates decreased due to downsizing of the Specialty Delegation. The number of resolutions submitted (132) was up from previous years, but almost all of them had to be rewritten by the reference committees. Some of the high priority resolutions at the 2003 HOD included medical staff governance, MICRA defense, and conflict of interest. The 2004 HOD is one day less than the 2003 HOD. It is scheduled for March 13-15, 2004 in Sacramento. Under consideration for the next HOD meeting are a dinner Sunday evening and a 15-minute time limit for debate. Speeches may be cut and there will probably be no breaks, so delegates would have to stay close at hand. The responsibilities of the Rules Committee have been expanded. Resolutions not supported by a delegation would be forwarded to the Rules Committee and if not supported the resolution would be treated as a late resolution.

Dr. Randolph reported on the April 30 Legislative Leadership Day where we had one of the largest groups attending. Ten SBCMS medical student members attended, and the board would like to continue seeing more students participate in this annual event. Under consideration for next year would be to invite a reporter from one our local newspapers to join the group to attract more media attention.

The board approved the 2002/2003 annual reports from the committee and commission chairs. Doctor Victor Ching was appointed to fill the unexpired term of District 2 board representative Dr. Linda Bosserman.

Dr. Randolph said CMA and its coalition to preserve Medi-Cal have protected Medi-Cal reimbursements in this year's budget, but deeper cuts are expected for next year's budget. Proposed cuts include a reimbursement reduction in Medi-Cal by 15%, cuts to 18 optional benefits, and cuts to eligibility through rescinding a recent eligibility expansion from the working poor. CMA will propose an account shift used by previous Governors with budget deficits. It would require the DHS and the Department of Finance to change the basis for the accounting of the Medi-Cal program from accrual to cash. Provider services would be accounted for in the fiscal year they are received and paid, not when they were rendered. This would result in a one-time savings of $1.2 billion in this fiscal year. Dr. Randolph encouraged board members to contact members of the Assembly and Senate Budget Subcommittees on Health urging them to protect Medi-Cal using the Medi-Cal accounting shift.

Dr. Randolph referenced the SBCMS, RCMA, HASC letter to the IEHP board requesting expansion of the IEHP board to include providers. Dr. Randolph testified at the May 12 IEHP board meeting. The board unanimously voted to direct IEHP staff to develop recommendations for increasing the size of the IEHP board to include provider representatives. This successful first step was one of many hurdles the SBCMS, the RCMA, and the HASC must overcome in their collaborative effort to change the composition of the IEHP board. The next step will be to work with IEHP on developing the roadmap. Dr. Gilbert stated IEHP is currently working on a roadmap that will include what process would be taken to amend the Joint Powers Authority incorporating a new board structure. This draft layout will be given to SBCMS, RCMA and HASC for their review before it goes to the IEHP board for approval.

The Medical Board of California is seeking nominees for their Physician Recognition Program, which will recognize the demonstration of excellence by individual physicians and/or groups of physicians who strive to improve access and to fill gaps in the healthcare delivery system for underserved populations in California, or who have advanced status of the public through innovation and commitment to medical education. Awards will be granted annually, and award applications should be submitted on behalf of those individuals, services or projects that ultimately provide benefit to the public. Application deadline is August 30, 2003.

Dr. Randolph reported that two scope of practice bills, SB 77 - Physical Therapy and AB 932 - Podiatry, considered the two worst scope bills of 2003 have been derailed. A copy of "Talking Points for Physician Leaders" was provided to the board to be used when talking to colleagues who are non-members or at medical staff meetings. He also reviewed the 2003 Legislative Hot List (as of May 13, 2003) that was provided by CMA. These CMA-sponsored bills can be viewed on CMA's website www.cmanet.org.

The board was provided a copy of "CALPAC Quarterly Report". The report included a listing of the new CALPAC Board of Directors as well as information on the success of the MICRA Defense Pilot Program. The purpose of the program was to increase physician participation in organized medicine's political activities and increase total dollars contributed to CALPAC. Each of the five participating medical societies has increased both contributions and physician participation dramatically, and it appears to be an overwhelming success. The preliminary data received was quite encouraging, and CALPAC is confident that this success will continue throughout its remaining 2003 billing cycle.

The Institute of Medical Quality (IMQ) is seeking CMA and county medical society's support in retaining the CALS survey process. IMQ reports CHA leadership want to end the CALS process. The CALS process is the only place where actively practicing physicians participate in the surveys to make them practical and relevant to today's practice. CHA's two primary objections were that there is conflict between IMQ and JCAHO surveyors, and that IMQ surveyors espouse CMA philosophy. Although no specific cases were presented, they acknowledge that the conflict between IMQ and JCAHO may be as much a problem of JCAHO. CHA was extremely unreceptive to discussing opportunities for improving the process or working together. Dr. Randolph encouraged the SBCMS board to contact their hospital administrators and medical staff leaders and educate them about this issue and to let CHA and JCAHO know they support the continuation of the CALS survey process.

Dr. Randolph reported that the CMA Board of Trustees (BOT) reviewed the CMA policy and strategies with respect to the Prompt Pay/1455 Regulations at their May 9th meeting. The BOT decided to proceed in getting the regulations implemented, while taking strong advocacy action to pursue additional protections for non-contract physician ED/on-call care reimbursement that the current provisions in the regulations do not satisfactorily address.