By VIVIENNE AGUILAR l November 3, 2023 CVJC email@example.com
San Joaquin County taxpayers will continue to pay for managerial and administrative changes made within the General Hospital in French Camp.
The Board of Supervisors unanimously voted on Oct. 24 to spend another $4.5 million to extend a Management Services Agreement partnership with Dignity Health, according to a county press release.
Millions of dollars have already gone into making San Joaquin General Hospital (SJGH) more efficient since 2022.
Last year, the county partnered with Dignity Health to boost SJGH’s financial and quality performance, Board of Supervisors Chair Robert Rickman said in the release. The sprawling Dignity Health hospital chain has owned St. Joseph’s Medical Center in Stockton since 1996.
The board vote confirms its previous plans for 10-year initial period option for the Management Services Agreement. The new agreement will expire on June 30, 2025.
Since the services agreement began, Richard Castro was appointed as CEO of San Joaquin General Hospital, through Common Spirit Health (a partnership between Dignity Health and Catholic Health Initiatives). Castro held a similar leadership position for another Dignity Health facility in Arroyo Grande.
The CommonSpirit Group was instrumental to achieving pharmacy and supply savings during the first phase of the services agreement, according to county documents.
Abe Nuñez was hired as chief financial officer in December 2022, the hospital told CVJC in a statement.
Many of the financial improvements noted by the county involve optimizing how the facility bills its patients. These revamped practices have since saved the hospital an estimated $30 million.
For example, SJGH contracted with an outside vendor to pursue small balance accounts that were neglected in the past, the hospital said in an email statement.
The hospital also began using the 3M CodeAssist tool that examines physician reports to assign more accurate codes for billing, according to the press release.
“3M CodeAssist will save the hospital money,” SJGH told CVJC. “In addition to a revenue lift, SJGH expects to realize productivity improvements by leveraging the 3M computer-assisted coding technology.”
The release lists eight “Quality Improvement Items,” including the hiring of a new deputy director of nursing. Zainab Wardak was appointed to the position, SJGH wrote in a statement.
The county reported a significant decrease in “all SJGH-acquired infections” as one of the hospital’s improvements.
“The Standards and Compliance department, which includes Infection Control, Quality and Risk Management, are responsible for these improved results, as are the nursing unit managers and staff who implemented clinical best practices,” SJGH told CVJC in an email statement.
Catheter-associated urinary tract infections dropped from 10 to a single infection over the course of a year, the hospital said. Thirteen central line associated bloodstream infections were tallied in 2022; so far this year, only six have been noted. Surgical site infections lowered from 53 to 27 since last year.
During the management transitions, SJGH implemented a hospital-wide quality reporting system, MIDAS.
“Staff are adjusting to the transition with the new MIDAS reporting system. As with any new system, staff are on a learning curve and adjusting to the changes,” the hospital told CVJC in an email statement. MIDAS deals with Ongoing Professional Practice Evaluation (OPPE) and Focus Professional Practice Evaluation (FPPE).
“All core measures reported to the Centers for Medicare and Medicaid Services (CMS) are also now performed through MIDAS,” the hospital wrote. SJGH will keep old OPPE/FPPE reviews on paper, and utilize a shared drive for core measures, along with the new system.
San Joaquin General Hospital’s quality improvement is measured through a series of surveys, according to the county. Most notably, the CMS LeapFrog Hospital Survey rating is expected to “improve to an ‘A’ by the end of calendar year 2024, breaking the seven-year ‘F’ rating,” the release said.
Today, the SJGH has a “high C” score, the hospital told CVJC.
LeapFrog currently ranks SJGH high in most of the 12 categories surveyed, such as Maternity Care and Medication Safety. The public hospital has low rankings in the Pediatric and Patient-Centered Care categories.
SJGH in French Camp’s Billing Ethics rank low in LeapFrog’s Patient-Centered Care survey, because the hospital has been found to sue its patients.
In 2020, the San Joaquin County General Hospital filed two civil cases against patients represented by Health Care Services Corporation’ and Blue Cross/ Blue Shield for lack of payments of over $100,000, according to court documents. The Health Care Services Corporation case was moved to a federal court in August 2022, and the other was dismissed.
“San Joaquin County is not aware of any pending lawsuit (sic) filed by Health Care Services Corporation or any San Joaquin General Hospital (SJGH) related litigation that is pending in Federal court,” the hospital wrote in a statement to CVJC.
SJGH was established in 1857, and its post-graduate residency has trained over 3,000 physicians since 1932. The facility and its related clinics are the basis of San Joaquin County’s safety-net health care system, according to the press release. Eighty-percent of SJGH patients rely on Medicare or Medi-Cal.
Vivienne Aguilar is the health equity reporter for the Central Valley Journalism Collaborative, a nonprofit newsroom based in Merced, in collaboration with the California Health Care Foundation (CHCF).
Zhaozhou Dai, data reporter with The Center for Public Integrity & Central Valley Journalism Collaborative, contributed to this report.
Aging Californians: Relaxing the State’s Public Meeting
By Tanu Henry and Antonio Ray Harvey |California Black Media |August 28, 2023
During the COVID-19 pandemic, Gov. Gavin Newsom issued an executive order that temporarily suspended some of the requirements of the California’s public meeting law, the Bagley Keene Act.
Newsom’s executive order allowed elected boards, commissions and other state “bodies” to hold remote meetings via teleconference without posting each official’s teleconference location (which in some cases were private homes); posting agendas at each location; or making those locations accessible to the public, as required by law.
A bill is currently being considered by the California legislature that would extend some of the changes to the Bagley-Keene Open Meeting Act until Jan. 1, 2026.
Senate Bill (SB) 544, which was amended Aug. 14 and is currently being reviewed by the Assembly Appropriations Committee, was introduced by Sen. John Laird (D-Santa Cruz) in February.
Supporters of the legislation argue that the bill saves taxpayer money by driving down the costs associated with in-person meetings by up to 90%, and that virtual meetings give access to vulnerable populations who may not be able to attend meetings in person.
One of those vulnerable populations is aging Californians.
“For many citizens, this was a way to stay active in the community,” says former Assemblymember Cheryl Brown, who is now the chair of the California Commission on Aging.
“Once we got them trained, they fall in love with it. They become engaged with their government,” said Brown.
“They want more communication, and they don’t want to be isolated,” Brown says referring to the changes SB 544 is proposing. She wants people to have permanent access to public meetings. During the pandemic, there was record participation in meetings because they were broadcast online, and people could access them by teleconference.
However, SB 544 has its share of opponents. Groups such as the First Amendment Coalition (FAC), the California Newspaper Publishers Association, California Common Cause, The Society of Professional Journalists, and other groups committed to
holding government accountable have spoken out against the bill. They believe that if SB 544 passed, it would lead to more government secrecy and turn state government boards and commissions into “faceless bureaucracies.”
The FAC was one of several civic groups that co-signed a letter critical of SB 544.
“This rewriting would ensure that a state body would never again have to meet in person. This would fundamentally undermine one of the law’s key protections for public access and participation — the guarantee that the press and public can be physically present in the same room as those sitting on the dais and making decisions. Such physical presence has been a constant hallmark of democratic institutions,” according to the letter.
David Loy, legal director at the FAC, told California Black Media (CBM) he is concerned SB 544 would allow more online meetings and it would diminish elected officials’ face-to-face contact with their constituents.
He added that the governor’s executive orders about online meetings were established during the COVID pandemic – and that the health crisis is over.
According to Loy, elected officials decide public policy in these meetings. And he feels that needs to be done in-person.
“Public officials should be meeting face-to-face with the people they serve,” he said.
Sedalia Sanders, former mayor of El Centro who is currently active with her city’s local agency on aging and is active with the California Commission on Aging, disagrees with Loy.
Sanders told CBM since many of the Commission’s meetings are held in Sacramento, she participates through video conferencing.
“I don’t think anything is lost,” she said.
Sanders says participants can still see and interact with their representatives through video cameras.
“For an elected official to participate in a meeting online, the majority of the board members still have to meet in person to form a quorum,” she added.
Although born during World War II, Sanders has embraced modern technology. She has a cell phone and navigates the Internet. However, she said that not all senior citizens are as tech savvy as she is.
Many of them don’t know you have to pay for the Internet. And this can be a problem, especially if you’re on a fixed income.
Brown says that the bill’s opponents are conflating the issues, boards, and commissions are different than elected leaders voting on public policy matters, and seniors and disabled communities support this bill because it’s about inclusion, not exclusion.
“Seniors don’t want to sit back and just play pickleball,” she said. “They want to have a say in the decisions that affect their lives and remote access allows them to do that.”
California Cities are Pilot Testing Guaranteed Basic Income Programs
Manny Otiko | California Black Media | Posted: September 19, 2022
Guaranteed basic income isn’t a new idea. Dr. Martin Luther King Jr talked about the idea of low-income people receiving regular checks from the government in the 1960s. It was brought up again during the 2020 presidential campaign when Democratic candidate Andrew Yang, a technology entrepreneur, made it a major part of his platform.
However, Yang was advocating for Universal Basic Income (UBI), which guarantees payments to everyone.
Guaranteed basic income only targets low-income people.
According to Yang, some kind of guaranteed basic income program is going to be necessary for the future when technology makes many jobs obsolete. A 2020 World Economic Forum study predicted that technologies such as artificial intelligence and robotics would eliminate 85 million jobs by 2025. However, guaranteed basic income programs are gaining steam across California as poverty alleviation. Several cities are carrying out pilot programs.
Los Angeles County is conducting a guaranteed basic income pilot program called Breathe. The program provides $1,000 to 1,000 LA County residents over a three-year period. The program will be evaluated by researchers at the University of Pennsylvania’s Center for Guaranteed Income Research.
Breathe is overseen by the county’s Poverty Alleviation Initiative. 180,000 residents applied to take part in the program.
On a single day during the that process, 95,000 people submitted applications, according to a county press release.
To qualify for Breathe funds, the applicants had to be at least 18 years old, have a single-person household income under $56,000 or $96,000 for a family of four, and have experienced negative impacts due to COVID-19.
One motivation behind the Breathe program was the COVID-19 pandemic, which laid bare the problems of poverty and income inequality.
“The course of this pandemic has revealed the large number of County residents who are living on the brink of the financial crisis, with insufficient savings to weather a job loss, a medical emergency, or a major car repair. This guaranteed income program will help give residents the breathing room they need to better weather those crises,” said Supervisor Sheila Kuehl.
Other guaranteed basic income programs are being pilot-tested in California.
Miracle Messages, an outreach program for the unhoused in San Francisco, started to pilot test a program called Miracle Money last year. Miracle Money provided $500 to homeless people. And the initial program seemed to be a success. According to Miracle Messages, about 50% of the people in the test group were able to find housing after they received the cash payments. Miracle Money was funded by a GoFundMe campaign.
Oakland Resilient Families is a Bay Area program that provides a $500 grant to families for 18 months. The program stresses it
is different from universal basic income. “Guaranteed income is meant to provide an income floor but not meant to be a replacement for wages. Guaranteed income can also be targeted to those who need it most,” according to the organization’s website. Oakland Resilient Families is funded by donations.
Mountain View, another Bay Area city is setting up a new guaranteed basic income pilot program called Elevate MV. The pilot program promises to give, for two years, $500 a month to 166 low-income families with at least one child or who are currently pregnant. Elevate MV is operated through the Community Services Agency, a non-profit organization.
In San Diego County a guaranteed income pilot program was launched in March 2020. One hundred and fifty households with young children residing in one of the four priority ZIP codes in the county – Encanto, Paradise Hills, National City and San Ysidro — are receiving $500 a month for two years. The $2.9 million program is run by Jewish Family Service of San Diego with funding from Alliance Healthcare Foundation and from the state’s budget surplus.
These programs, including LA County’s Breathe program, are modeled after a universal basic income program that was tested in the city of Stockton. The Stockton Economic Empowerment Demonstration (SEED) provided $500 to 125 low-income residents for 24 months.
And the research showed that the SEED program worked, according to a National Public Radio (NPR) article.
“Among the key findings outlined in a 25-page white paper are that the unconditional cash reduced the month-to-month income fluctuations that households face, increased recipients’ full-time employment by 12 percentage points, and decreased their measurable feelings of anxiety and depression, compared with their control-group counterparts,” said NPR.
As Stockton Mayor Michael Tubbs launched the SEED program in 2019. Following the promising results of the pilot program, in 2020 Tubbs launched Mayors for Guaranteed Income, a coalition of 60 mayors who are advocating for a guaranteed income program to ensure that all Americans have an income floor.
Tubbs lost his bid for re-election in 2020 and is now an adviser to Gov. Gavin Newsom who is a proponent of guaranteed income.
Make Room, Gas and Food: Insurance Payments Might Go Up, Too
Tanu Henry | California Black Media March 15, 2022
As gas and food prices continue to shoot up at a rapid clip, Californians might be hit with sticker shock from another bill that skyrockets later this year: their health insurance premiums.
According to officials at Covered California, monthly premiums for insurance coverage could jump by as much as 100% — or an average of about $70 — for more than 2 million Californians if federal government subsidies provided by the American Rescue Plan are allowed to expire at the end of 2022.
An estimated total of 14 million Americans could be affected by the price increase.
“The American Plan built on the Affordable Care Act and provided more financial help than ever before to help people get covered and stay covered largely in response to the pandemic,” said Peter V. Lee, former Executive Director of Covered California.
Lee was speaking during a press briefing held earlier this month to inform the public about what he sees as an impending crisis if the federal government does not take action.
As a side note during that virtual meeting, Lee announced that he was stepping down from Covered California.
In February, the agency’s Board of Directors announced Jessica Altman, former Commonwealth Insurance Commissioner of Pennsylvania, as Covered California’s new Chief Executive Officer. Lee said funds the federal government currently provides to states to help lower health care premiums for Americans led to record numbers in enrollment across the country, including about 1.8 million new signups in California.
The largest increases in enrollment in California were among African Americans and Latinos.
About 90% of Covered California enrollees have received discounts on their premiums through the program. “The American Rescue Plan increased affordability by paying a bigger share of consumers’ monthly premiums. As a result, the portion that consumers pay dropped significantly by 23 % nationally and 20 % here in California,” said Lee.
“Those are big drops. That meant that two-thirds of our consumers were eligible for a plan that cost $10 or less,” Lee continued. “For a lower income consumer, low cost is a critical ingredient for getting and keeping coverage.”
Covered California is the Golden State’s federally subsidized public insurance marketplace where individuals and businesses can purchase health care plans.
Lee said nearly $3 billion from the American Rescue plan allowed California to subsidize the insurance costs of more middle-income people. The eligibility window expanded to include Californians earning up to $52,000 as a single person or $106,000 as a family of four.
Before help from the American Rescue Plan kicked in there were hundreds of thousands of Americans paying up to 30 % of their income for insurance, according to Covered California.
If the federal supplement expires, “those who can least afford it would be hit the hardest,” warned lee. Lee says the program is helping more middle-income people than ever before.
“In California today, about one out of 10 of our subsidized enrollees earn above 400% of the poverty level. They are getting financial help that is needed and meaningful,” said Lee. “Without the extension of the American Rescue Plan, those gains would be wiped away and consumers would be faced with staggering cost increases.”
Lee says if the federal subsidies expire, the loss of funding will also hurt people who do not qualify for the subsidies and pay for insurance at market rates.
He estimates, for Californians earning more than $52,000 a year, there premiums could increase by an average of more than $270 per month or nearly $3,000 annually.
“As people drop their coverage, the rising premiums would be felt by everyone. When you price people out of coverage, people that drop coverage first are healthy people. If you’re sicker, you keep your coverage,” said Lee.
“What does that mean? If the American Rescue Plans subsidies are not continued, we are very likely to see a premium spike. As health plans say, ‘next year will be the year we have fewer insured people, they are going to be sicker on average, we are going to have to boost our premiums,’” Lee emphasized.
If the U.S. Congress does not act to make the subsidies permanent – or at least to extend them — Californians will first see the new increased amount of their monthly premiums in the fall when they receive their renewal notices for 2023.