Keeping patients safe, maintaining access and improving quality of care

• Signed legislation that provides access to $540 million in new federal funds for health care services for uninsured Californians. Using increased federal funding secured through a renewed hospital financing waiver, California will be able to test innovative strategies to provide health care coverage to low-income uninsured residents.
• Protected access and eligibility for more than seven million at-risk Californians who rely on Medi-Cal and the Healthy Families Program for health coverage.
• Fortified access to health care and ensured that organized systems of care/managed care plans continue to serve 3.2 million Medi-Cal beneficiaries by providing $143.5 million to fund rate increases for Medi-Cal health providers.
• Established a state emergency prescription drug program to ensure access to essential prescription drugs for low-income seniors and persons with disabilities who were dually eligible for Medi-Cal and Medicare and could not obtain life-saving medications during the transition to federal Medicare prescription drug coverage in January.
• Demonstrated his strong commitment to protect HIV/AIDS patients and curb the spread of the disease by:
  • Providing nearly $300 million to fully fund the projected caseload for the AIDS Drug Assistance Program, which provides lifesaving medications to low-income persons living with HIV/AIDS.
  • Funding HIV/AIDS prevention education programs at nearly $40 million per year.
  • Targeting innovative strategies to address the epidemic in disproportionately affected ethnic communities.
  • Expanding clean needle programs and allowing pharmacies to sell clean needles.
  • Implementing a names-based HIV reporting system to increase the accuracy of HIV data and align the reporting of the disease with federal funding requirements.
  • Piloting innovative strategies to improve health outcomes of HIV/AIDS patients by better serving patients’ pharmaceutical drug needs.
• Supported expanding research for diseases by signing legislation to:
  • Allowing taxpayers to donate to prostate cancer and Alzheimer’s research through income tax forms.
  • Creating a Parkinson’s disease registry to collect information about the disease.
• Provided assistance to consumers on issues related to health plans through the Department of Managed Health Care’s (DMHC) 24-hour, seven-day-a-week HMO Help Center.
• Began the Provider Complaint Unit (PCU) within the HMO Help Center to ensure prompt and fair payment of claims. Since it was established in 2004, the PCU has recovered more than $600,000 in additional payments owed by health plans to doctors and hospitals.
• Saved California consumers more than $1.1 million in disputes with an HMO through the HMO Help Center in 2005. This amount is attributed to medical claims that consumers did not have to pay after DMHC intervened with an HMO on their behalf.
• Launched a new Web site to provide consumers with expanded health information, help them file formal complaints against HMOs and educate them about health care options and other important rights for California consumers.
• Ensured that consumers retain health care coverage if a health plan leaves their service area.
• Convened a Secretary’s Roundtable on Health Care Quality to gain consensus on quality measurements among consumers, health plans, health policy experts, state agencies and providers and develop an action plan to improve quality of care delivered to Californians.
• Secured charitable contributions from health plans to provide $200 million in investments in rural and underserved communities, such as San Benito, Salinas, Mariposa, Lake Tahoe, Tehachapi and Yuba City/Marysville. Funding was also provided for premium subsidies of dual-eligible Medicare and Medi-Cal recipients. An additional $200 million was secured for other investment purposes, which will largely focus on expanding health information technology.
• Approved new product designs that contain reduced premium costs for consumers and narrowed networks to help employers save money; health savings account-compatible benefit designs to reduce premiums for consumers; and products with greater cost-sharing features that preserve and promote the managed care model, which has been shown to contain costs and offer lower premiums.
• Opposed new benefit mandates, such as increased maternity services, duplicative reporting obligations and requirements on pharmacy benefit managers, to keep health care costs affordable.
• Signed legislation to increase Medi-Cal reimbursement rates in skilled nursing facilities, which will result in better wages for nursing home employees, compensation for facility improvement and better quality of care for residents.
• Provided $6 million to improve access to health services in rural areas and loan repayment for doctors serving rural or low-income communities.
• Enhanced funding for community clinics for bilingual primary medical and dental care services, nutrition counseling and health education for seasonal and migrant workers.
• Collaborated with Mexican counterparts to implement cross-border surveillance projects that protect border and binational communities against infectious diseases, such as West Nile virus, tuberculosis and HIV/AIDS, and to work together on a binational guide for emergency response.
• Augmented the Department of Health Services’ (DHS) licensing and certification programs by more than 150 new staff in 2006-07 to support DHS’ efforts to rebuild these programs, strengthen oversight of health facilities and better protect vulnerable Californians.
• Fully automated the licensing process for health plans, making it easier and faster for new and innovative health insurance products to be brought to the marketplace.
• Licensed the first two California HMO products that satisfy federal Health Savings Account requirements. These plans from Blue Shield and Kaiser offer consumers a lower premium and the ability to make their own health care choices.
• Reduced the review time of certain health plan documents from a median of 147 days to 27 days. This helps keep down costs for health plans, allowing the plans to pass savings on to consumers.
• Protected funding for low-income, uninsured men needing prostate cancer treatment. Enacted program reforms to treat more than a third more men at nearly half the cost.
• Signed legislation to protect women’s immediate access to emergency contraception, carefully balancing patient’s rights with a pharmacist’s personal beliefs and a business' right to choose what products it makes available.
• Signed legislation to protect Californians, particularly women of childbearing age, from exposure to harmful chemicals by requiring cosmetic companies to list any ingredients known to cause cancer or reproductive harm.
• Established a voluntary program for counties to distribute surplus medications at no cost to the poor and uninsured.
• Translated materials and public health messages into multiple languages to communicate to diverse communities statewide.

Maximizing federal funds

• Secured an $18.4 billion federal waiver, with more than $3 billion in new federal funds, for safety net hospitals to support vital health care services for Medi-Cal beneficiaries and the uninsured. The last Administration negotiated only $250 million in additional funds under the prior waiver, compared with more than $3 billion secured by Governor Schwarzenegger.
• Secured a federal waiver of Medicaid rules that allows thousands of In-Home Supportive Services recipients (seniors and persons with disabilities) to receive services and avoid unnecessary institutionalization by allowing federal funds to support care given by loved ones. The waiver is expected to provide $1.7 billion in additional federal funds over five years, resulting in savings of $1.1 billion for the state and $0.6 billion for counties. The Governor also invested more than $5 million in increases to support services that allow medically frail seniors to continue living at home.
• Secured over $400 million in new federal funds to support critical pregnancy-related health care services for 110,000 low-income pregnant women. Previously, these services were funded solely by the state. Addressing waste, fraud and abuse
• Protected the fiscal integrity of Medi-Cal by calling for program improvements that include increasing claims review; conducting onsite reviews of pharmacies; using new, customized anti-fraud technology; working with the Legislature to reform Adult Day Health Care centers; and developing a joint plan of action with regulatory boards and provider associations to address provider claim errors.
• Boosted the state Department of Justice’s ability to crack down on fraud and abuse in the Medi-Cal system in order to ensure taxpayer funds are used appropriately and valuable health care dollars are protected so they serve those with legitimate health needs.
• Protected victims of fraudulent discount health plans through aggressive investigations into at least 50 companies since 2004, resulting in seven cease and desist orders to stop companies from marketing deceptive products.
• Fined health plans more than $1.5 million in 2005, nearly double the amount from 2004.
• Signed a measure prohibiting taxpayer-subsidized erectile dysfunction drugs for sex offenders. Recognizing children as a priority investment
• Rebuilt enrollment and outreach efforts that had previously been eliminated for Medi-Cal and the low-cost Healthy Families program. Provided more than $80 million to identify, enroll and retain all children eligible for state health coverage programs.
• Increased enrollment for children’s health care in the Healthy Families Program by roughly 12 percent since taking office. Under the Governor’s leadership, more than four million low-income California children currently have state health coverage.
• Secured $15 million to increase enrollment efforts of children into the Healthy Families Program.
• Expanded California’s nation-leading, state-of-the-art Newborn Screening Program, which serves more than 99 percent of all newborns, to increase screenings for genetic disorders from 39 to 74 and to provide access to treatment for any identified conditions.
• Signed legislation to remove mercury from vaccines administered to pregnant women and children under age 3.
• Continued efforts to prevent childhood lead poisoning, particularly among Latino children, by prohibiting the sale of imported candies with high levels of lead and strengthening the state’s oversight to monitor lead content in candy.
• Expanded local community health center grants for children’s asthma control programs by $3 million and required health plans to cover pediatric asthma equipment.
• Provided $10 million for the Early Mental Health Initiative, which offers services to students in kindergarten through third grade who are experiencing mild to moderate school adjustment difficulties.
• Supported county efforts to offer low-cost health coverage to children not eligible for the Healthy Families Program or Medi-Cal by providing technical assistance to counties and allowing county programs to buy into the Healthy Families Program.
• Obtained federal approval of an innovative pilot program that enabled four Bay Area counties to access federal money to expand health care coverage to an estimated 3,000 more low-income children through the Healthy Families Program.
• Received national recognition for the BabyBIG® infant botulism antidote being a safe and highly effective tool in reducing the severity of illness for babies in California and across the nation.

Encouraging healthy habits

• Yielded immediate results at the Governor’s Summit on Health, Nutrition and Obesity that will improve the health and fitness of Californians and combat the state’s obesity crisis. Businesses and community groups answered the Governor’s challenge and announced changes in business practices so Californians would have healthier options and more opportunities for physical activity. The Governor and First Lady have continued to work with participants and others to build upon the momentum created at the Summit and develop new private and public sector commitments to get California healthy.
• Signed legislation making the state’s school nutrition standards the most progressive in the nation, extending the ban of sugary soft drinks in elementary and middle schools to high schools and investing more than $18 million to put more fruits and vegetables into California schools’ menus.
• Provided $40 million for incentive grants to hire more credentialed physical education teachers in elementary and middle schools. Also provided $500 million in grants for schools to purchase physical education, arts and/or music equipment.
• Secured a $30 million commitment from California health plans to develop innovative and healthy lifestyle programs, including routine measurement of body mass index, weight program subsidies, fitness programs and school educational efforts.
• Launched the Council on Physical Fitness and Sports, a non-profit organization established to promote making California the nation's “Fitness State” with all Californians striving to meet their personal physical fitness and health goals.
• Cracked down on the use of performance enhancing drugs in high schools by prohibiting the sale or distribution to students and requiring coaches to complete a training program to spot the signs of steroid abuse.
• Increased funding for tobacco control and prevention and smoking cessation and expanded California’s tough anti-tobacco laws by signing legislation to:
  • Prohibit the use of tobacco products at California prisons and youth authority facilities.
  • Increase fines for not properly posting safety information at locations that sell tobacco products.
  • Broaden the Stop Tobacco Access to Kids Enforcement (STAKE) Act by prohibiting the sale of tobacco related products by self-service display.

Strengthening the nursing and physician workforce

• The Nursing Education Initiative has invested more than $130 million in public and private funds and will add nearly 14,000 nurses in California by 2010, reducing the shortage by 30 percent.
• The Nursing Education Initiative has expanded nursing enrollment in state colleges and universities, provided incentives for nurses to practice in rural and medically underserved areas, expanded efforts to recruit and retain nursing faculty and developed new avenues to nursing careers.
• Provided $20 million in additional funding to directly address California’s health care workforce shortage by addressing recruitment, education and retention.
• Provided more than $1 million to expand nursing enrollment at the University of California and California State University systems and $2 million for community colleges to increase nursing faculty and expand clinical training opportunities for students.
• Expanding the Assumption Program of Loans for Education (APLE) for nursing, increasing nursing faculty by forgiving student loans.
• Invested nearly $5.5 million through the Song-Brown Family Physician Training Program to increase the capacity at registered California nursing schools. These funds allow for the expansion of nursing education programs throughout California and will increase the annual number of nursing graduates.
• Implemented regulations establishing first-in-the nation nurse staffing ratios. The fragility of California’s health care system, coupled with a statewide nursing shortage, demanded a cautious approach in the implementation of the ratios.

Making California safer than ever before

• Provided $214 million to strengthen the state’s ability to respond to the significant health care demands created by earthquakes, floods, pandemic flu or other natural and man-made disasters. The proposal provides medical supplies for alternate care sites, creates mobile field hospitals and stockpiles ventilators, masks for health care workers and antiviral medications sufficient to treat 25 percent of California’s population.
• Provided $58 million to bolster state and local public health capacity to prevent and respond to disease outbreaks and natural or manmade disasters.
• Invested more than $1 million in federal funding to improve bioterrorism readiness and communications efforts.
• Enhanced California’s Medical Mutual Aid Response System with rapid ambulance strike teams and trained regional and local disaster medical managers. This system is a national model in ensuring resources get to first responders more quickly in an emergency.
• Convened a pandemic influenza summit with U.S. Department of Health and Human Services Secretary Mike Leavitt that encouraged and promoted preparedness at all levels of government, communities and businesses.
• Created a new state-of-the-art Department of Health Services Emergency Operations Center with primary and back up communications capacity to facilitate rapid response and deployment of the state’s public health and medical actions and assets. This center is activated for testing and surveillance of avian flu.
• Conducted a pandemic flu satellite broadcast and tabletop exercise that was downloaded by 1,500 sites worldwide.
• Provided a $1.3 million funding increase to ensure that seismic assessments of health facilities are conducted in a timely fashion by well-trained staff using the latest technology.
• Purchased personal protective equipment for thousands of California emergency medical services first responders.
• Released the California Pandemic Influenza Preparedness and Response Plan.
• Coordinated with federal and state agencies in Mexico on planning and response to public health emergencies, developing a binational guide and risk communication plan for emergency response.
• Developed an award-winning Crisis and Emergency Risk Communication Tool Kit and provided regional trainings for state and local health departments on its use.

Combating West Nile Virus (WNV)

• Invested a total of $15 million in 2005-06 and 2006-07 to enhance and expand mosquito control efforts. Mosquito control is the best defense against WNV. During the 2005 season, WNV was detected in 54 of California’s 58 counties. In addition, there were 894 human WNV infections, including 19 deaths, in the state.

Information provided by the California Health and Human Services Agency and the Department of Managed Health Care.