SBCMS President Dr. Sam Wilson welcomed and congratulated AAHI Health Planning Project Coordinator, V. Diane Woods, on the outstanding work she has done with AAHI's Health Planning Project. The project addresses the health disparities of African Americans in San Bernardino County by engaging individuals and communities to identify, assess, and implement culturally specific strategies for the prevention and treatment of hypertension, heart disease, HIV/AIDS, and prostate and breast cancer.

Ms. Woods asked the board to visit AAHI's Health Planning Project site on the IWIN website. The site is updated regularly and includes the Project's schedule and activities and allows those interested in participating to sign up. AAHI developed a flyer referencing Black men and women die younger than other ethnic groups. The flyer, distributed throughout the county, is intended to get the Black community to call AAHI and share their comments and ideas about the health care delivery system. It also encourages them to take more responsibility for their health. Ms. Woods stated data collection of residents and providers will begin in February. The provider survey, available on-line, asks physicians, faith based organizations, private health systems, etc. questions on the structure of care provided. The data will be maintained in a GIS (geographical information system). Ms. Woods welcomed comments and input from the board.

Phil Waller, Rogers, Anderson, Malody & Scott audits the SBCMS every other year. He presented the 6/30/2002 audit report at the November 2002 SBCMS board meeting but the audit was not approved. He then requested and received formal approval of the 6/30/2002 audit report. Mr. Waller then discussed the review he conducted of SBCMS' financials for period ending 6/30/2003. The review consists principally of inquiries of SBCMS' personnel and analytical procedures applied to financial data and is substantially less in scope than an audit. He advised SBCMS' total assets were up $162,218 from 2002; net assets at the end of the year were $519,490 as compared to $379,595 the year prior. Cash on 6/30/2003 was $267,267, up $63,000 from 2002. The board approved the 6/30/2003 review as submitted.

Alliance President, Lorene Sponsler, encouraged the board to attend the Alliance's Annual Day at the Santa Anita Races on 1/31/2004. This year's trip is on a Saturday, so it will make it easier for everyone to attend. The group will sit in Santa Anita's indoor gourmet dining room. The cost is $55 per person, which includes the bus trip, entry into the clubhouse, lunch, and the daily racing program. The Alliance will provide the refreshments for the Medical Museum's Open House on 2/8/2004. Dr. W. Benson Harer, SBCMS past president, will address "Medicine in Ancient Egypt".

On 1/22/2004, Public Health Officer Dr. Thomas Prendergast participated in the first of seven statewide hearings on the prevention of coronary disease and stroke in California The meeting was held in SBCMS' conference room. Many San Bernardino County organizations participated. The input received was good and there was a powerful emphasis from a Molina Healthcare representative on the proportion of people who are insured vs. those that are uninsured. He reported on the influenza epidemic at week 50, stating 22% of the emergency room visits were due to influenza. Considering how many people have been ill this season, there have been very few admissions to the hospital.

IEHP Medical Director, Dr. Brad Gilbert, reported total membership is 272,205. Medi-Cal enrollment is 232,226 with 33,621 enrolled in the Healthy Families program. Healthy Kids enrollment for San Bernardino County is nearly 915. Riverside's Healthy Kids enrollment is 5,443. The auto assignment percentage in December was 31 percent. Enrollment for Medi-Cal is slowing down since it has become harder to enroll patients.

The IEHP Board approved revised rate and expense reductions of selected providers as a result of the DHS fee-for-service Medi-Cal rate reduction being suspended. Dr. Gilbert stated that although CMA obtained a preliminary injunction suspending the 5% reduction in the fee-for-service Medi-Cal rate schedule (scheduled for implementation 1/1/2004), the injunction did not halt the rate reduction to Medi-Cal managed care plans that was effective 10/1/2003. IEHP still received a $5.1 million rate decrease. He reported IEHP would implement the following reductions: reduction of IEHP net surplus; miscellaneous IEHP contract rate reductions including IEHP direct PCP capitation rates; and reductions in the physician incentive program. With the suspension of the proposed provider rate reduction, IEHP will still have a $2.8 million budget shortfall. IEHP management will re-evaluate where provider reductions should be made to make up the $2.8 million shortfall and discuss them with the Physician Advisory Council and bring the recommendations to the February IEHP Board for review and approval.

CMA Trustee Dr. Dev Gnanadev encouraged the board to make their reservations for CMA's 4/28/2004 Legislative Leadership Day. The $200 registration fee includes roundtrip airfare, chartered bus transportation to and from the airport, and a sit down dinner. The deadline is 2/27/2004.

Dr. Gnanadev updated the board on the CPEC initiative and encouraged everyone to pay the $95 PIC line item on their dues statements. This money is needed to fund the CPEC initiative. A signature campaign to place the initiative on the November 2004 ballot is now underway. SBCMS board members can assist in collecting signatures from colleagues, family and friends; forms will be mailed along with brochures explaining the initiative. CMA has raised $200,000 of the needed $900,000 to fund the initiative. The CMA Board will discuss other ways to raise the needed monies. The initiative, sponsored by a coalition of hospitals, physicians, nurses, community clinics, and firefighters is to stabilize the emergency medical system in California. It will yield $200 million per year in new revenue for physician uncompensated care reimbursement for emergency room and on-call physicians.

AMA Alternate Delegate Dr. Victor Ching provided highlights of the December 2003 AMA HOD Interim meeting. The California Delegation endorsed the nomination of Dr. Peggy Fritzsche to the AMPAC Board. A California resolution calling for the AMA to support legislation or regulation to prevent insurance companies and other entities from using DEA registration numbers for identification of physicians was adopted. The HOD referred a resolution introduced by the California delegation which calls for the AMA to: 1) to refrain from implementing new or significantly revised E&M code descriptors and clinical examples as proposed by the AMA CPT Editorial Panel until input is sought from state medical associations, specialty societies, and practicing physicians; 2) refrain from implementing new or significantly revised codes descriptors and clinical examples until the CMS has stated in writing that it will accept the new E&M code descriptors for Medicare and Medicaid payment and not create their own, nor adopt another, coding system for E&M services; and 3) refrain from implementing new codes until CMS has indicated in writing, what if any, set of standards or means, including documentation guidelines, they will use to audit medical necessity, monitor program integrity, and determine payment based on such new E&M code descriptors.

The AMA HOD also referred another resolution by the California delegation dealing with the provision of updated billing software by the CMS. This calls for the AMA to: 1) work with other professional physician organizations to advocate that the CMS provide free of charge, to all licensed physicians who treat Medicare-eligible patients, current updated computer software programs for posting, coding and electronic claims submission; 2) encourage CMS to update its billing software semi-annually, and to ensure its compatibility with all payors, including crossover with Medi-Cal and other secondary plans; and 3) encourage local Medicare carriers to provide toll-free phone access for electronic claims submission. The AMA will continue to support MICRA as one of their highest legislative priorities.

Dr. Randolph reported the Nominating Committee met 1/7/2004. He presented a slate of nominations for SBCMS officers, one-year term (2004-2005); nominations for the SBCMS Board for two-years terms (2004-2006); as well as nominations for CMA Delegates and Alternate Delegates. The board accepted the nominations as submitted. The slate will be printed in the March SBCMS section of SOUTHERN CALIFORNIA PHYSICIAN magazine.

Finance & Strategic Planning Committee Chair, Dr. Edward Hess, reported SBCMS has $1,285,754 in its checking, money market and certificate of deposit accounts. This includes the proceeds from the sale of the building that were invested through Citizen's Business Bank's diversifier program. At their 2/12/2004 meeting, the Finance Committee will discuss other investment opportunities. Various San Bernardino County properties as well as the RCFMC building are being considered as potential sites for SBCMS' relocation. Board members were invited to view the sites with the Finance Committee on 1/28/2004. Dr. Hess reported moving costs (without packing) for SBCMS are estimated at $4,000. Moving costs for the Medical Museum are estimated at $3,000. Relocating the telephone and computer systems will be approximately $2,000. Some board members voiced their concern about SBCMS' relocating to Riverside. They do not want SBCMS to change its name or lose its presence in San Bernardino County. Dr. Hess stated the Finance Committee meets on 2/12/2004 to discuss all potential sites. They will take into consideration the concerns addressed by the board and will make a recommendation at the 2/23/2004 SBCMS Board meeting.

Ms. Stratton updated the board on the transition of the Pacific Foundation for Medical Care (PFMC) network in San Bernardino County to the Riverside County Foundation for Medical Care (RCFMC). PFMC is willing to sell its San Bernardino County network to RCFMC. The two foundations are negotiating a selling price. The board felt the combined Riverside/San Bernardino PPO network (to be renamed Inland Empire Foundation for Medical Care) would greatly benefit both RCMA and SBCMS members.

Blood Bank of San Bernardino and Riverside Counties Medical Director and Chief Executive Officer Dr. Arthur Silvergleid notified the board he will retire in July and will relocate to St. Petersburg, Florida. The board will send a letter acknowledging his retirement and thank him for his 27 years of service.

In other business, the board nominated Dr. Rodney Borger for CMA's YPS Leadership Award for Community Service. The award encourages excellence in community service activities carried out by young physicians. SBCMS nominee Dr. Ernest Levister has been selected by the CMA Foundation to receive the Robert D. Sparks, M.D. Leadership Award on 3/13/2004 during the CMA Annual Session. Dr. Wilson reminded the board to submit nominations for SBCMS' 2004 Outstanding Physician and Citizen Awards. The deadline for nominations is 4/9/2004.