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 From the Desk of Ken Cohen, Executive Director
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Bylaws
The ACHD Board of Directors completed and presented the Amended and Restated Bylaws of the Association to our Membership. To better position ACHD to meet the challenges ahead, the Board has recommended support of the Amended and Restated Bylaws by Member Healthcare Districts. Members (and their official delegate) received their election materials either electronically or by certified mail.
Please note that ballots must be returned no later than June 16, 2017.
On May 8th and May 15th, 2017, ACHD's Board Chair Julie Nygaard, Vice-Chair of the Board and Chair of the Governance Committee, Julia Miller, ACHD's Attorney, Ashley West, and myself hosted a discussion to review the recommended changes to the Association's Bylaws. The webinar recordings are now available for you and is one way to have your questions answered. To obtain access to the webinar recordings, please contact
Zoe Kipping.
American Health Care Act
While the fate of the Affordable Care Act remains uncertain, on May 4, 2017, the House of Representatives passed HR 1628, otherwise known as the American Health Care Act of 2017 (AHCA). The House measure includes dramatic changes to Medicaid, including: rolling back Medicaid expansion, converting Medicaid from an entitlement to grant program, allowing states to seek waivers that would no longer require insurance companies to provide essential benefits, such as: mental health, maternity care, substance abuse services. According to the Congressional Budget Office (CBO) in 2026, an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law. Though the CBO analysis didn't address California specifically, both the state's Medicaid program and its individual insurance market could be seriously harmed if the legislation passes, according to legislators, consumer advocates and other critics. Additionally, the amount of federal funds that California can expect in the future is highly likely to be reduced or perhaps even shifted to other States. HR 1628 (AHCA) has now been referred to the Senate for their review and action, causing wide spread speculation regarding its future and possible wide-ranging outcomes. ACHD will continue to monitor HR 1628 and will communicate any impacts anticipated to Healthcare Districts in a timely manner.
Transitions
Eden Township Health District CEO Dev Mahadevan will be retiring from the Healthcare District in July. During his nine-year tenure at Eden, Dev fended off an attempt to dissolve the District by the State legislature, mapped out the future of the District's Dublin Gateway Medical Center, and tied up issues around the $20 million legal judgement that the district is paying to Sutter Health over San Leandro Hospital. I would like to acknowledge and thank Dev for his encouragement of ACHD, his friendship and support, and extend good wishes for all his future endeavors.
I would also like to extend our welcome and encouragement to Michael Mahoney, as he begins his new role with Eden. Prior to joining Eden, Mike served as the CEO for the San Francisco-based Pacific Vision Foundation since April 2015. He also successfully served as CEO of St. Rose Hospital from March 1992 to March 2012. Mike also serves as a board member for the Alameda County Fair, Hayward Chamber of Commerce and Tri-CED Community Recycling.
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Legislative Update
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Legislative Day 2017
View the highlights from this year's Legislative Day.
Little Hoover Commission
As previously reported, the Little Hoover Commission has scheduled a small and targeted roundtable meeting in June. This Advisory Committee Meeting will take place in Sacramento on June 22, 2017. Please note that the agenda is not set yet, but will be posted on their
website, when available. ACHD is continuing to work with CSDA on strategies to address the Commission and will be present at the meeting. Stay tuned for updates on details and the outcome of this advisory meeting.
Legislative Update
The Legislature is halfway through their legislative year, as the "House of Origin" deadline for legislation was on June 2. Legislation that failed to pass out of its house of origin by the deadline could be considered again next year as a two-year bill. Here is an update on the key bills ACHD has an active position on:
AB 387 (Thurmond, D-Richmond) requires health care entities to pay allied health students minimum wage for time spent in clinical or experiential training that is required for state licensure. This bill failed to pass out of the Assembly last week. ACHD actively opposed this measure, along with a large coalition of hospital and healthcare groups as well as educational institutions.
AB 893 (Garcia, Eduardo, D-Coachella) implements a study on the need for additional residency programs in Imperial County and similarly medically underserved counties. We anticipate this bill to be amended again later in the legislative session to provide funding for a new residency program for Pioneers Memorial Healthcare District. This bill passed out of the Assembly and will be heard next week in Senate Health Committee. ACHD supports this measure.
AB 979 (Lackey, R-Palmdale) allows special districts to vote on LAFCO representation in a meeting of the county's independent special districts selection committee. This bill passed out of the Assembly and will be heard next in the Senate Governance & Finance Committee. ACHD supports this measure.
AB 994 (Muratsuchi, D-Manhattan Beach) authorizes Beach Cities Health District to utilize the design-build process for a construction project on a pilot basis. This bill passed out of the Assembly on a 74-1 vote with the Chair of Local Government Committee, Cecilia Aguiar-Curry casting the only "no" vote. This bill will be heard next in the Senate Governance &Finance Committee. ACHD supports this measure.
AB 1612 (Burke, D-Inglewood) removes the physician supervision requirement for certified nurse midwives. This bill was not heard by the Assembly Appropriations Committee and failed passage. ACHD Supports this measure.
AB 1728 (Committee on Local Government) requires Healthcare Districts to: 1. create and maintain a website, which must include contact information for the district 2. annually adopt a budget 3. annually adopt policies for providing assistance or grant funding to ensure funding is spent on health care services consistent with the mission and purpose of the District. This bill passed out of the Assembly and will be heard in the Senate Governance &Finance Committee next. ACHD supports this measure,.
SB 448 (Wieckowski, D-Fremont) establishes new audit requirements for special districts, creates new categories of "inactive" and "idle" districts and amends the dissolution process for these new categories of districts, and requires counties to include additional information on the county tax bill related to the services provided in the county. This bill passed out of the Senate and will be heard by the Assembly Local Government Committee next. ACHD is opposed to this measure.
SB 793 (Hill, D-San Mateo) authorizes Beach Cities Health District and Peninsula Healthcare District to utilize the design-build process on a pilot basis. This bill passed out of the Senate and will be heard by the Assembly Local Government Committee next. ACHD supports this measure.
Please contact
Amber King with questions or comments.
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Budget Update
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The Legislature is in the process of completing their work on the State Budget, which must be passed by June 15. Here is a summary of the items that may impact your District.
Health Care Workforce
There are three separate health care workforce items before the Budget Conference Committee:
- Issue 4140: Primary Care Workforce. The Conference Committee will be discussing the amount of General Fund to expend for primary care residency slots and student loan repayments. The Governor proposed to eliminate the $33.3 million GF that was provided in the 2016-17 budget. The Assembly proposed restoring the full $33.3 million allocation for three years. The Senate proposed to restore $6 million GF over three years, with $5.7 million for Song-Brown Program primary care residency slots at teaching health centers and $333,000 for the Student Loan Repayment Program. The Conference Committee held this item open on June 4.
- Issue 4260: Graduate Medical Education & Public Hospitals. The Conference Committee will consider whether to limit Graduate Medical Education (GME) funding to designated public hospitals that contract with all Medi-Cal managed care plans in the hospital's service area. The Assembly adopted the language requiring the hospitals to contract with all the plans; the Senate did not. The Governor proposed $1.2 billion ($600 million federal funds, $600 million from local governments) to implement a graduate medical education program for the 21 designated public hospitals. The California Association of Public Hospitals and Health Systems (CAPH) and several counties are supporting the Senate version and opposing the Assembly version. The Conference Committee approved the Senate version on a 5-0, 5-0 vote on June 4.
-
Issue 6440: Graduate Medical Education & University of California.
The Conference Committee will also discuss whether to include $50 million GF in ongoing funding for the University of California. The Governor proposed allocating $50 million in Proposition 56 funds to UC for GME. The Proposition 56 revenue is being used to replace $50 million in GF fund revenue that supported GME at UC in 2016-17. The Governor is also proposing a $50 million unallocated reduction to the UC base. The Senate approved the Governor's proposal. The Assembly rejected the Governor's proposal and refunded the $50 million GF for the UC base and provided $50 million in Proposition 56 for GME, for a total of $100 million. The Conference Committee held this item open on June 4.
The Legislative Analyst's office (LAO) suggested a $135 million (over three years) conference compromise to address issue 4140 and issue 6440. The LAO's overview document on the proposed compromise on graduate medical education and workforce training can be found
here
.
Proposition 56
The two houses and the Governor differ in their approach to spending tobacco tax revenues generated from Proposition 56. The Governor proposed to spend $1.3 billion on Medi-Cal caseload costs in 2017-18. Both houses of the Legislature rejected the Governor's expenditure plan and instead focused on physician and dental rates, restoring optional benefits and expanding Medi-Cal coverage. The Proposition 56 item was held open on June 4.
The Legislative Analyst provided an overview of the items before Conference Committee. A few items of note:
- Additional General Fund will be needed to fund the existing Medi-Cal program under the Assembly and Senate Plans.
- Proposition 56 revenues are anticipated to decline beyond 2017-18. Therefore, the Proposition 56 spending package adopted by the Legislature should adapt to the amount of available annual Proposition 56 funding.
- The cost of expanding full scope coverage to undocumented immigrants ages 19-26 is likely significantly higher than estimated in the Assembly and Senate plans. The Administration is projected annual costs of the expansion to be $300 million; substantially more than the Legislature's estimate of $86 million annually.
- The LAO recommends targeting provider payment increases to geographic areas or specialties of high need.
The following provides a summary of the differences between the two houses:
| Proposal |
Assembly |
Senate |
| TOTAL |
$1 billion in 2017-18
|
$348.5 million in 2017-18 |
| Physician Incentive Payments |
$610 million in 2017-18 |
- |
| High-need Specialty Access pool |
- |
$150 million in 2017-18, growing to $700 million in 2020-21 and annually thereafter
|
| Dental Incentive Payments |
$247.3 million in 2017-18
|
- |
| Dental Reimbursement rates |
- |
$130 million annually beginning in 2017-18
|
| Family Planning and Abortion Services rates |
$50 million in 2017-18
|
$50 million annually beginning in 2017-18
|
| Intermediate Care Facilities- Developmentally Disabled rates |
$26.7 million in 2017-18
|
14.5 million annually beginning in 2017-18
|
| AIDS Waiver rates |
$2 million in 2017-18
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$4 million annually beginning in 2017-18
|
| Restoration of Optional Benefits |
** |
Effective January 1, 2019 restores:
Adult dental, optical, audiology, incontinence creams/washes, podiatry, and speech therapy
($52.9 million in 2018-19, and $105.8 million in 2019-20 and annually thereafter)
|
| Full-scope Medi-Cal coverage to all individuals up to age 26 regardless of immigration status |
$54 million in 2017-18
|
Beginning July 1, 2018, ($63.1 million in 2018-19, $85.8 million in 2019-20 and annually thereafter)
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| Pediatric In-Home Health Rates |
$10 million in 2017-18
|
- |
| Durable Medical Equipment Protection from Rate Reduction |
No cost |
- |
** In a non-Proposition 56 action, the Assembly approved $108.6 million in state General Fund to restore dental, optical, audiology, chiropractic, incontinence creams/washes, podiatry, and speech therapy in 2017-18.
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Register Today for ACHD's Inaugural Wellness Summit!
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In collaboration with the Stanford Health Improvement Program and WELL for Life program at Stanford University, ACHD is hosting a one-day Wellness Summit to provide Healthcare Districts and their Community Partners with valuable wellness tools and inspiration for embracing existing programs and envisioning new initiatives. Your attendance at our Wellness Summit will assist you and your colleagues in creating an action plan to implement healthy initiatives at your District and throughout your communities.
Together, ACHD and our Stanford Collaborators will present valuable wellness tools and initiatives that will allow Districts to continue to make strides in improving the overall community wellbeing.
When:
Thursday, July 13, 2017, 10:00 a.m. - 4:00 p.m.
Where:
California Endowment
1414 K Street, Suite 500
Sacramento, CA 95814
To read more about the Wellness Summit,
click here
.
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The Association's Education Committee has planned the 65th Annual Meeting with a focus on preparing Healthcare Districts for the challenges ahead and the role of District's in the face of change. Our program is designed to inspire innovation and motivate Districts to prepare for the future.
Newly elected, as well as experienced trustees and executives will want to attend our Annual Meeting. Networking with colleagues and sharing best practices will help elevate Healthcare District performance to the next level. This year's meeting will include wellness activities that will create a new level of energy!
Join us for what will be our best educational event ever!
Click here for a schedule of events.
Costs:
- Member: $800/attendee
- Non-Member: $1500/attendee
- Guest of Member: $250 (Meals only)
- Guest of Non-Member: $750 (Meals Only)
Note: Registration fees include all meals.
Please contact
Sheila Johnston
with any questions or concerns. We hope to see you there!
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| Call for Nominations - Submit Your Forms Today for Healthcare District and Trustee of the Year! |
ACHD would like to request nominations for District and Trustee of the Year. Each year, the Education Committee solicits nominations to recognize the work of Districts and Trustees in the community. Awards will be presented at the 65th Annual Meeting, taking place September 12-14, 2017, at the Kona Kai Resort and Spa in San Diego.
District of the Year
The ACHD District of the Year Award recognizes a District that has identified one or more initiatives implemented to improve the health and well-being of the communities served. Districts must demonstrate that the initiative(s) implemented achieved a healthier community.
Complete the District of the Year Nomination form
here.
Trustee of the Year
The ACHD Trustee of the Year Award recognizes a Trustee who has made notable impacts in the District through notable, significant achievements in governance, strategic planning/partnering, stakeholder relationships, leadership and/or finance. Eligible Trustees include current Trustees and Trustees that have served since May 2016.
Complete the Trustee of the Year Nomination Form
here.
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Apply Today to Serve on an ACHD Committee!
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Each year, ACHD solicits Members to participate on standing committees. The commitment is for one year and committees generally meet between 3 and 5 times per year.
The Governance Committee has started the process of constituting committees for 2017-2018. Member District Trustees and Executives who have an interest in being considered for a committee assignment are requested to register their interest by completing an interest form, along with a brief statement of why they are interested in the committee,
by Friday, June 16, 2017.
NOTE: All committees meet in person at least twice annually and at various other times by conference call. In-person meetings generally meet in Sacramento; however, locations may vary.
Those who wish to continue serving on a committee must re-submit their interest forms.
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Request for Electronic Consent Forms
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In order to comply with current law, we require your consent to send you electronic communication. At your convenience, please review and return the electronic consent form to me by email or fax. You may fax the form to 916.266.5201 or send by email. Access the consent form
here.
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| In Case You Missed It... Healthcare District News from Around the State |
   
AB 893 (Eduardo Garcia) would authorize The Office of Statewide Health Planning and Development to collect data from local public health agencies, physician groups, and professional and educational associations. This information will ascertain the number of graduate medical education slots necessary to meet the needs of medically underserved areas such as Imperial County. Click here to read the full article
The District provides trainees' books, a uniform, equipment, fingerprinting fee and the State's certification test fee. Click here to read the full article.
Marin General Hospital set to launch new breast clinic in Larkspur
Beginning next month, women will have access to a breast cancer screening technique in Marin that yields fewer false positives, reducing the anxiety of repeat exams.
Click here
to read the full article.
Petaluma Health Care District honors community leader and three nonprofits
Petaluma Health Care District announced the recipients of its second annual Community Health Awards, recognizing outstanding service benefiting the health and wellness needs of Southern Sonoma County residents. Click here to read the full press release
.
Camarillo Health Care District named Ventura County's "Optimal Aging Organization"
Camarillo Health Care District was named Ventura County's "Optimal Aging Organization" by the Ventura County Area Agency on Aging (VCAAA), in an inaugural presentation recognizing several agencies for their dedication and innovation in providing services that enhance quality of life for older adults.
Click here to read the full press release.
Sequoia Healthcare District Board approves 42 community grants
42 grants to local non-profits totaling more than $2 million dollars have been approved by the Sequoia Healthcare District Board. Click here for a list of grant recipients.
Eden Health District welcomes new CEO
Michael Mahoney, a former CEO of St. Rose Hospital in Hayward accepts the position of Chief Executive Officer for Eden Township Healthcare District (DBA Eden Health District). The District's current CEO, Dev Mahadevan, plans to retire from that position July 1, 2017, when his agreement expires. Click here to read the full press release.
Hearing device recipients no longer hear the sound of silence (Palomar Health)
Partnering with the Starkey Hearing Foundation, Palomar Health and Chief Audiologist Dr. David Illich are collecting used hearing devices to change people's lives all over the world. Click here to read the full article.
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Healthcare District Engagement Tour
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ACHD's Senior Legislative Advocate, Amber King, and Member Services Specialist, Sheila Johnston, began visiting Healthcare Districts this month. Over the course of the next three months, Amber and Sheila will meet with a variety of Districts to hear about the issues of utmost importance to the District and share information regarding the tools the Association provides. In May, Amber and Sheila traveled over 465 miles to meet with Corning Healthcare District in Corning, Bloss Memorial Healthcare District in Atwater, and Westside Community Health District in Newman. You can follow Amber and Sheila's tour on Twitter and Facebook!
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Join CAPP Today!
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The Association of California Healthcare Districts (ACHD) is a member of
Californians Allied for Patient Protection (CAPP), the coalition created to protect access to health care through California's Medical Injury Compensation Reform Act (MICRA). ACHD continues to strongly support the preservation of MICRA.
In 2014, California voters definitively rejected Proposition 46, an attempt by the trial lawyers to quadruple MICRA's non-economic damages cap.
Had this ballot measure passed, California would have seen higher health care costs and decreased access to care, especially among vulnerable populations who are most in need. Despite this victory, the battle to protect MICRA continues.
ACHD is strongly urging its members to individually become supporters of the CAPP coalition.
There is no cost to be a member of CAPP, and you will be in good company. Seven out of 10 Board Members are already CAPP members, with more than 1,000 other organizations representing community clinics, hospitals, physicians, nurses, EMTs, labor unions, local governments, dentists and other health care providers. A complete coalition list can be found on the CAPP website at
www.micra.org
.
As a CAPP member, you will receive quarterly newsletters with updates on legislative activities concerning MICRA and direct access to the CAPP staff to be your one stop resource on MICRA. Additionally, CAPP holds events for legislators in their legislative district and CAPP members are invited to attend free of cost.
Please take a moment to complete and return the
CAPP Coalition Sign-Up Form
. Thank you for endorsing this important organization and its goal to preserve MICRA.
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100 Million Healthier Lives
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The 100 Million Healthier Lives (100 MHL), created by the Institute for Healthcare Improvement (IHI), is an unprecedented collaboration of change agents who are fundamentally transforming the way we think and act to improve health, wellbeing and equity. ACHD would like to provide you with information should your Healthcare District wish to join the 100 MHL Movement.
Why 100 Million Healthier Lives?
The time is right for a major leap forward in the creation of health, wellbeing, and equity. The rising tide of chronic disease, an aging population, structural inequity in health outcomes (despite advances in health care), and technology demand a fundamentally different approach, one which brings us together across sectors to address the physical, social and behavioral contributors to health together.
By choosing an audacious goal -- 100 million people living healthier lives by 2020 -- that no one group can achieve alone, we are committing to unprecedented collaboration, a humble spirit of learning, innovation and improvement, and systemic change to create an equitable health and wellbeing system.
Why Healthcare Districts?
Healthcare Districts are in a perfect position to impact the health of the people they serve. They are a trusted organization in the community and have the infrastructure to reach their members. They have a great potential to change lives in the community, especially among the most vulnerable populations such as children, seniors, and socioeconomically disadvantaged. Healthcare Districts also have an obligation to give back through improving the health of their community members.
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