Board Briefs
March 29, 2004

The board observed a moment of silence for SBCMS Past President Merlin Hendrickson, MD, who passed away on March 1.

Alliance President Lorene Sponsler reported the Alliance yearbooks have been mailed to members who have paid their Alliance dues. The yearbooks can also be purchased for $10. Donations are being accepted for the Maxine McAllister Health Careers Scholarship Fund. The fund is in memory of Mrs. McAllister's dedication and volunteer work for the Alliance. Scholarships will be presented to students working towards a career in registered nursing and who will work in San Bernardino County. Schools receiving the scholarships are Cal State University San Bernardino, San Bernardino Valley College, Chaffey College, and Victor Valley Community College. Those wishing to donate should contact Alliance board member JoAnn Miller.

A presentation by Historical Committee member John Miller, MD, was made to request renaming the SBCMS Physician Outstanding Contribution to the Community Award in honor of Dr. Hendrickson, an SBCMS past president. Dr. Hendrickson was a founding member of the Medical Society's Historical Committee and Medical Museum and was very involved in the community and the medical society. He was also the first recipient of the award. The board approved the request. The award will now be known as the Merlin A. Hendrickson, M.D. Outstanding Contribution to the Community Award.

Interim Public Health Officer Dr. Eric Frykman reported a young teenage girl contracted the meningitis virus at a local mountain community school. It was a solitary case and no further cases have been reported. The Public Health Department is gearing up for West Nile virus. There appears to be more mosquitoes this year due to warmer temperatures, and this may be the year for California to have a large number of West Nile virus cases. The Public Health Department is beginning to monitor for cases and have been catching mosquitoes since December. They will enhance their efforts. A link to the Centers for Disease Control (CDC) will be placed on the Medical Society website so the public can obtain the most current information on West Nile. The community can also access information from the San Bernardino County Public Health Department. Dr. Frykman encouraged board members to keep this in mind when patients come for visits with neurological issues. If San Bernardino County is affected this year, next year should not be as bad because the population usually develops immunity to the virus.

Dr. Frank Randolph reported on this year's CMA House of Delegates (HOD) in Sacramento. A number of important and definitive policy actions were taken in the areas of access to care, health facilities, insurance, government, regulation and economic advocacy, professional standards, science and public health. Two major issues were not resolved. One was the difference of opinion on the future reimbursement methodology for Workers Compensation. The state wants to use RBRVS. Surgeons and many specialists feel this will pose problems, even though RBRVS would increase primary care and E&M reimbursement in a way that those specialties favor it over the current OMFS schedule. The other issue is Medicare's Geographic Practice Cost Index (GPCI). The GPCI is a disparity issue, which was referred back to the Board of Trustees (BOT). Both the BOT and last year's GPCI Task Force labored for months over how to solve the disparities of the most affected counties in a fair fashion. The problem remains hugely divisive among CMA members.

The HOD supported that CMA weigh in on preventing unintended consequences of nurse-staff ratios in the absence of sufficient numbers of nurses to meet the goal immediately. CMA sent a letter to DHHS Secretary Kim Belshe uring the importance of relaxing those aspects of nurse-staff ratio implementation in that it could threaten ER, inpatient, and other access and capacities in California hospitals. An itemized report of all resolutions can be viewed at CMA's website. This year's House of Delegates was one day shorter which seemed to please most members attending. There was some concern that members participating in reference committees were not able to attend speech and video presentations, which were conducted while the reference committees were meeting.

The board was provided a copy of the signed 5-year lease between Riverside County Foundation for Medical Care (RCFMC) and the San Bernardino County Medical Society. A local real estate attorney, Michael Lewin, reviewed the lease before both parties signed. The full-service lease begins July 1, 2004. SBCMS anticipates moving to the new location in mid-June. Capstone Construction was selected and will begin tenant improvements in mid-April and conclude the end of May. SBCMS' estimated portion of the construction costs for the administrative offices and conference room are $32,000. The board approved the expenditure to move forward with tenant improvements.

SBCMS President Dr. Sam Wilson announced the successful completion of our partnership with the RCFMC that merges the Foundation for Medical Care network providers in San Bernardino County (formerly affiliated with Pacific Foundation for Medical Care) with the Riverside County providers. The name of the new network, the largest independent, not-for-profit network in the Inland Empire, is Inland Empire Foundation for Medical Care (IEFMC). It is slated to begin May 1, 2004. At least one SBCMS member will be appointed to serve on the Board of Directors of the IEFMC. A letter will be prepared and sent out to SBCMS members announcing the formation of IEFMC. Membership in the IEFMC is a benefit of SBCMS membership and is available at no cost to members. Non-member physicians will pay $450 per year to belong. IEFMC directs patients to participating providers through its contracts with employers, insurance carriers, and self-funded employer groups.

Dr. Valenzuela again expressed his concern about IEHP's direct contracting. He questioned how it is possible for IEHP to pay higher rates to physicians who direct contract. Many feel this is an uneven playing field for IPA physicians because physicians who have direct contracts are paid more. Dr. Gilbert was not able to attend the March board meeting to address the issue. It was suggested that IEHP create a chart of their direct contracting growth for the past two years and that it be brought to the April SBCMS board meeting. In addition, the board requested Dr. Damodara Rajasekhar, the SBCMS appointed representative to the IEHP Physician Advisory Council, to take SBCMS' request about wanting more disclosure and discussion on IEHP's direct contracting policy to the next PAC meeting.

A copy of the 2004 SBCMS Pictorial Membership Directory was provided to the board. All members were mailed a complimentary copy of the directory in March, and any additional copies may be purchased for $30 by contacting the Medical Society office. Each board member received a CD-ROM with information on implementation of the CMA-sponsored AB 1455 Unfair Payment Practices, which became effective January 1, 2004. The regulations apply to Knox-Keen licensed health plans (HMOs, Blue Cross PPO, and Blue Shield PPO) and provide significant relief from pervasive and abusive practices. The CD is designed to inform physicians of what unfair payment practices are expressly prohibited under law and report violations to both the Department of Managed Health Care (DMHC) and CMA. Members can obtain their complimentary CD by contacting the Medical Society.

Dr. Wilson encouraged board members to sign up for the "Cruisin Thru Pain" 16-hour CME program, seven-night Alaska Cruise sponsored by both San Bernardino and Riverside County Medical Societies. The Cruise is scheduled for July 4-11, 2004.

Ms. Stratton reminded the board to turn in their 911 Emergency and Medical Care Initiative petitions no later than April 2. She advised CMA is confident they will gather 900,000 signatures to assure the initiative qualifies for the November 2004 ballot. The initiative, sponsored by a coalition of hospitals, physicians, nurses, community clinics, and firefighters is to stablize 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.

Dr. Wilson reminded the board that AAHI's Health Planning Project is currently conducting resident surveys and will soon be conducting provider surveys. A part of the planning process is to identify all current prevention programs and treatment services for five major health disparities (heart disease, high blood pressure, HIV/AIDS, breast and prostate cancer) that focus specifically on the Black/African American population in San Bernardino County. The healthcare provider survey is the assessment tool that will be used to determine services provided for the above-mentioned conditions. He encouraged each board member to have the appropriate person in their practice complete the electronic survey by linking to the African American Health Planning Project from the SBCMS website (www.sbcms.org).

The board was encouraged to send in their nominations by April 9 for this year's annual outstanding physician and citizen awards that will be presented at the Installation of Officers dinner meeting on June 17 at the Ontario Marriott. Information on participating in one of the many SBCMS Committees and Commissions was provided to the board. Physicians interested in serving on a committee during the 2004-2005 year should submit their form by April 28.

The board congratulated Dr. Eric Frykman on his appointment as the Interim San Bernardino County Public Health Officer. He assumed the role on March 19 after Dr. Thomas Prendergast retired as the county's public health officer. Board packets included forms for the Emergency Situation Driving Emblem. The emblem, in two usable formats, provides a waiver of most speeding laws when the physician's vehicle displays this CHP-approved emblem. The exemption applies unless the vehicle is being operated recklessly or without regard for the safety of others.