San Bernardino County Public Health Officer Dr. Thomas Prendergast reported smallpox vaccinations in the county have gone very well. Over 75 public health and hospital employees were vaccinated. DPH will continue to vaccinate for Phase I for the next several weeks. It has sometimes been difficult to coordinate vaccination schedules with each hospital. The CDC has noted that several people who were vaccinated had cardiac incidents in the weeks following vaccination. They are investigating the relationship between vaccination and the events. In the mean time there are new screening criteria that exclude people who have a history of angina pectoris, previous heart attack, cardiomyopathy, congestive heart failure or chest pain or shortness of breath with exertion.

Dr. Prendergast reported that no cases of Severe Acute Respiratory Syndrome (SARS) have been reported in San Bernardino County. Dr. Frykman stated that the Public Health Department is working with area hospitals to ensure they are performing standard infection control methods to protect residents. The CDC has suggested that the illness may be linked to another virus. Two patients with SARS also tested positive for coronavirus, a family of viruses that includes the common cold.

Dr. Prendergast reported that part of the County's Bioterrorism plan designates developing a Medical Reserve Corps (MRC). MRC funding will be announced in mid-April. He has proposed that the County use their MRC funding to collaborate with the SBCMS' MRC.

Dr. Sam Wilson reported that Inland Wellness Information Network's African American Health Initiative has received a two-year $268,620 grant from the California Endowment for an African American Health planning project. The project will address the health disparities of African Americans in San Bernardino County by engaging in a participatory planning process that will identify, assess, and implement culturally specific strategies for the prevention and treatment of targeted chronic diseases. A program coordinator and community outreach workers will be selected to lead this project.

National MICRA/Feinstein Bill - Senator Feinstein chose not to submit a modified tort reform bill with a higher cap that CMA could not support. Conversation will be kept open in the Senate regarding tort reform, until a measure that can be supported can gain requisite support of more Democratic Senators.

DHSS has announced that physician payments will likely be reduced by 4.2% in 2004 because of increased physician global payment totals due to increased utilization. These cuts would have nothing to do with the RBRVS victory and the $54 billion that was recently added to Medicare. The cuts relate to other budgetary processes for which CMS has authority to institute to stay within the budget. The proposed cuts will not go into effect until the budget and DHHS public notice processes take place later this year. Dr. Bangasser stated he would be going to Washington, D.C. to address this problem.

Dr. Randolph announced SBCMS would hold a "Get with the Guidelines" seminar in late June 2003. Greg Fonarow, MD will be the speaker. Bristol Myers Squibb will provide support. He stated that SBCMS and RCMA would co-sponsor with Riverside & San Bernardino County Health Departments a Hepatitis conference, in the summer or fall of 2003.

Dr. Randolph encouraged board members to send in nominations for the SBCMS Annual Outstanding Awards. The deadline to submit nominations is April 11th. He announced a total of 45 SBCMS/RCMA members would attend CMA's Legislative Leadership Day, April 30th. Physicians will receive one hour of CME. He reminded those attending to bring their white coats to march on the Capitol.

Dr. Randolph provided the board with the 2003/2004 SBCMS Committee survey. He encouraged board member to ask their colleagues who might be interested in serving on any of SBCMS committees to complete and return the survey no later than April 25th.

The Board congratulated Dr. Bangasser on his installation as CMA President. He thanked the board for their support. He reported that the RICO lawsuit is coming along just fine and they will meet with CMA's RICO TAC to discuss proposals.

Dr. Randolph accepted Doctor Damodara Rajasekhar resignation as an Alternate Delegate to the CMA HOD. Dr. Rajasekhar was elected March 21, 2003 to serve as a CMA OMSS Delegate.

Dr. Randolph reviewed the 2003 Legislative Hot List that was provided by CMA. These CMA-sponsored bills can be viewed on CMA's website www.cmanet.org.

Complimentary copies of the 2003 SBCMS pictorial membership directory were mailed to SBCMS members this week. Members wishing to purchase additional copies should contact the Medical Society office.

Dr. Randolph welcomed IEHP's new associate medical director Dr. Edgar Fernandez. He directed the board's attention to IEHP's response to SBCMS' concerns regarding direct contracting and the percentage of members being auto-assigned. IEHP's letter outlined the specific circumstances that their Governing Board has approved under which IEHP can directly contract with primary care physicians. Regarding IEHP's auto-assignment, IEHP has no control over the enrollment process; the Department of Health Services manages it. IEHP welcomes any support from the SBCMS in working with DHS to improve the enrollment process for IEHP members. Some board members still voiced concern over the process that IEHP uses. They feel that IEHP should make a presentation to the board which would include how the process works to sign people up, enrollment numbers, lives that are covered under direct contracting (primary & specialists), and the effect it has on the market place relative to IPAs. Dr. Fernandez, will take the request back to IEHP and give a report at the April 28 SBCMS board meeting.
Dr. Randolph encouraged board members to review the 14-page CMA HIPAA training manual that provides general training and overview necessary to comply with the mandate for the general office staff.

IEHP has joined a pilot program with Integrated Healthcare Association (IHA) to expand its Pay for Performance initiative. IHA is a statewide leadership group active in health policy and managed care issues. With help of providers like IEHP and nearly $500,000 grant from the California HealthCare Foundation, IHA will develop programs aimed at rewarding providers with incentives for improving preventive and chronic care services for the state's one-million children enrolled in government-funded healthcare. Dr. Bangasser stated IHA would be collecting data to be able to see differences and to keep track of measuring tools and mechanisms in California. Dr. Flynn said that we need to impress upon providers that this is the direction we want to go.

Dr. Randolph reported that the Medical Board of California would soon be mailing a survey to all physicians holding a California license. The law requires the Medical Board to collect and publish certain information on training and practice characteristics. While much of the required survey data will be published on the MBC's website, certain information will be published only with permission. He also reported that the Department of Health Services would be providing training for medical providers and medical interpreters. The goal of the training is to educate participants so they will be able to identify language and cultural interpretation needs of non-English speaking refugee clients and for interpreters to gain knowledge and understanding of the clinical systems issues in mental health in order to more effectively serve the clients in a refugee clinic.