CalPERS adopts 6.3-percent health care premium increase
Written by Editor
Saturday, 23 June 2007
SACRAMENTO – The CalPERS Board of Administration on Wednesday approved the lowest health benefit rate increase in a decade. The 2008 rate package will increase overall premiums by 6.3 percent. Basic HMO premiums will increase 7.4 percent.
Rob Feckner, chair of CalPERS Board of Administration, said the benefit package was the result of months of hard work and a great deal of effort in striking the right balance for the entire risk pool of members.
“This 2008 benefits program is substantially lower than what consultants are anticipating for U.S. employers next year,” he said. “More importantly, it is strategically aligned to deliver high standards of efficient health care and disease prevention, and achieve rate increases well below the average in today’s marketplace.”
For the large majority of CalPERS members, the 2008 program will bring new health plan choice, ensure a standardized disease management program, and save the State money in the last half of the current fiscal year.
The 2008 health care program will include:
• A $5 increase in HMO co-pays for office visits, standardized urgent care co-pays to $15 for HMOs and an annual out-of-pocket maximum ($1500 single, $3000 family) for Blue Shield. (Kaiser already had this maximum in place.)
• Free (no co-pay) office visits for many preventive care services.
• The addition of two new high performance health plans (Blue Shield NetValue and PERS Select) that will be less expensive in premium than the standard plans from Blue Shield and PERS Choice. (Current Blue Shield members who move to Blue Shield NetValue will pay a lower premium than they did in 2007. For example, a family moving from Blue Shield’s standard HMO plan into NetValue next year will save over $180 in premiums.)
• An HMO Medicare rate that is 1.6 percent less than last year.
• Withdrawal of Blue Shield’s HMO from the four costliest rural counties – Lake, Napa, Plumas and parts of El Dorado – and elimination of Sacramento-region based Western Health Advantage (WHA) because of WHA’s expressed inability to meet CalPERS requirement for data and disease management, and expressed reluctance to modify its business model to expand into more regions of the State.
All efforts to develop the 2008 health care program shaved $144 million off of initial plan proposals. The overall increase of 6.3 percent is less than one-half the average of increases in the previous five years.
Overall, CalPERS plans to spend $5.3 billion to purchase benefits for more than 1.2 million state and local government employees, retirees, and their families next year, up from $4.9 billion this year.
“We recognize that in this tough health care marketplace, a combination of approaches is necessary to keep rate hikes low and quality high. We have strategic health plan partners who share our vision, and are committed to helping us make that vision a reality,” said George Diehr, Chair of the Health Benefits Committee. “We will continue to pursue innovative, aggressive approaches with our health plans to get better value for our dollars, and provide our members with opportunities and incentives to obtain the highest quality of care at the most affordable price.”
The package benefits employers, who will have new high performance network offerings for many of their employees. The State of California, which had projected a 9.5-percent increase for health care costs, would also see some relief in its budget forecast for 2007-08. Based on a 6.3 percent hike, the State’s projection would be about $65 million less than anticipated.
This year’s rate package will also have an effect on the state’s retiree health benefits projection. In April, actuaries for the State Controller used a 10- percent increase assumption in the rise of health care costs. Staff estimated that the 6.3 percent rate increase would reduce the state’s long-term liability by roughly $1 billion to $1.6 billion, depending on how the state funds the liability in the future.
CalPERS is the nation’s third largest purchaser of employee health benefits and the largest in California, with 1.2 million state and public agency employees, retirees, and their dependents.
LAKE COUNTY – Older adults will receive free health screenings at local senior centers during the last two weeks of June.
The Area Agency on Aging is partnering with Health Screens Gerontology Research Foundation to bring a mobile health screening service to senior centers in Lakeport, Clearlake Oaks, Clearlake, Ukiah, Willits, Fort Bragg and Point Arena.
Screenings are available to people of any age, but only those aged 60 or over who have low incomes will qualify for the free screenings.
Many diseases do not cause noticeable symptoms until a heart attack, stroke or other life-threatening event occurs. Health screenings can detect early disease processes before symptoms appear.
The screenings use ultrasound imaging, Doppler and CardioVision to check for plaque deposits, blockages, aneurysms, cysts, stones, nodules, masses, enlargements and bone density. The tests are safe and use no x-rays or radiation. The Health Screen staff of registered sonographers and technicians documents results that are recorded in a report and given to the participant that day.
Because they are considered “preventive health care,” Medicare and most insurance companies do not cover screenings, which cost between $40 and $50 each or $275 for all nine tests.
Lake and Mendocino County residents aged 60 or over who cannot afford to pay for screenings are encouraged to take advantage of a limited number of FREE screening packages (a $130 value) sponsored by the Area Agency on Aging.
The free package includes any four of the nine basic screenings: stroke, aneurysm, gall bladder, liver, kidney, thyroid, heart, circulation or osteoporosis.
Lake County screenings:
– Highlands Senior Center in Clearlake – June 21.
– Live Oak Senior Center in Clearlake Oaks – June 22.
– Lakeport Senior Center – June 30.
Mendocino County screenings:
– Ukiah Senior Center – June 18 and 19.
– Willits Senior Center – June 26.
– Redwood Coast Seniors in Fort Bragg – June 27 and 29.
– South Coast Seniors in Point Arena – June 28.
All screenings are by appointment only. Please call Health Screens at 877-854-4735 to make your reservation. Spaces are currently available.
Sutter Lakeside launches pilot program to improve children's health
Written by Editor
Monday, 11 June 2007
LAKEPORT – Moist squares of chocolate brownies sat irresistibly on a tray of free samples at the grocery store. But the fifth-grader refused to give in to temptation and walked off to buy an apple instead. The reason for making that decision, she later told her teacher, was simple: "I really care about myself so I won't eat things that aren't good for me."
The idea of a fifth-grader making such a self-respecting health choice is becoming more and more common in one northern California school district, thanks to a unique education program developed by Sutter Lakeside Hospital.
The program is called Healthy Kids Are Contagious, and has just completed its first pilot in schools throughout Lake County, the primary region served by Sutter Lakeside's main facility in Lakeport, located about two hours north of San Francisco.
Health Kids are Contagious stems from Sutter Lakeside's Wellness Center program and its hallmark, The Five Keys to Wellness, which identifies and promotes five aspects of healthful living, including self-love, breathing, positive choices, balance and trust. The Five Keys are infused through all hospital wellness programs.
"To improve health and lower healthcare costs in our county, we are reaching the kids," said Kelly Mather, CEO of Sutter Lakeside. "The Healthy Kids Are Contagious program not only educates students about nutrition and exercise, but it also addresses mental and emotional issues from our Five Keys to Wellness principals, so they will be motivated to make healthier choices for a lifetime.
Mather turns hospital staff into healthy role models
The dismal health status of Lake County – ranked 56 out of 58 California counties by the state's Department of Health & Human Services – prompted Sutter Lakeside's Mather to develop a series of wellness programs for hospital staff and the adult community.
Mather had required Sutter Lakeside's staff members to improve their own health through a wellness program that included weight-loss support groups, exercise programs and stress-management classes.
More importantly, using the Five Keys to Wellness, members of Mather's wellness team guided the staff to develop healthier thoughts, feelings, beliefs and habits – the issues that drive poor life-style choices and lead to chronic illness.
Collectively, the staff saw their average blood pressure and cholesterol levels drop ten percent in one year – and the cost of their medical insurance premiums went down as well. Mather then established the Wellness Center at Sutter Lakeside to offer the community a place to get support for making lifestyle changes and used those same principles to educate children, morphing the adult program into Healthy Kids Are Contagious.
"We're offering 'wellness care' and not only illness care,'" Mather said. "Once we saw the results among staff members and patients we wanted to promote the idea of wellness beyond the hospital walls. Since children have not yet formed decades of bad habits we felt we could reach them in the classroom instead of the doctor's waiting room."
A healthy curriculum
Healthy Kids Are Contagious offers school presentations that cover a variety of subjects ranging from avoiding the flu on the playground to preventing bacterial outbreaks in the locker room.
The "Healthy Mascots," however, are by far the most popular ambassadors for the program because they feature Sutter Lakeside staff members dressed in costumes representing characters such as "Healthy Mr. Heart," "Healthy Mr. Spine" and "Mr. Tissue."
"I've seen kids sit up straight because that's what 'Mr. Spine' says to do," reports Chris Veenstra, a first-grade teacher at Upper Lake Elementary School whose class enjoyed one of Sutter Lakeside's presentations. "I've also heard them say things like 'We should go exercise because it's good for our hearts.'"
Gail Marshall who teaches sixth grade at Minnie Cannon Middle School in Middletown says, "I saw a huge transformation in the kids. They now speak the vocabulary of the five keys to wellness. One boy actually stood up in front of the entire class and said, 'I love myself!'"
Mather writing children's books
To give parents a tool to understand and support what their children are learning about good health choices, Mather has written the book, The 5 Keys to Wellness for students to take home with them.
The full-color illustrated hardback describes the five aspects of healthful living, and provides characters and illustrations to educate readers about self-love, breathing, positive choices, balance and trust.
For more information contact Shelly Gordon, 650-856-1607, e-mail
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or visit www.sutterlakeside.org.
CLEARLAKE – Sutter Lakeside needs your thoughts on how our community can create healthier children.
Childhood obesity is a national epidemic. One in three children in California is overweight or at risk for being overweight.
We can turn this around by coming together in community focus groups, called “World Cafés,” to share ideas and make recommendations for programs throughout Lake County.
Sutter Lakeside Hospital and the Health Leadership Network (HLN) are inviting all interested community members to a series of “World Cafés” to do just that.
The Health Leadership Network, a network of Lake County service provider agencies, has received a grant from the California Endowment to develop countywide obesity prevention programs.
Partners in this project include our school systems, hospitals and clinics, physicians, public health, early childhood development agencies, food and agricultural programs, and concerned citizens.
The next “World Café” will be conducted in Clearlake at the Best Western El Grande Inn on Lakeshore Blvd. on Thursday, June 14, from 5:30 p.m. to 7 p.m.
If you live in Clearlake, Clearlake Park or Lower Lake, plan to attend this fun evening. Refreshments will be served. Seating is limited so please call and reserve your space!
For more information about the “World Café” call Leslie Lovejoy at the Wellness Center, 263- 2998 or e-mail
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.
To reserve your space or find out when a World Café is coming to your community, contact Jill Mills, administrative assistant to the HLN, at 245-5745.
Bill enables audiologists to serve on Work Comp appeals board
Written by Editor
Wednesday, 30 May 2007
SACRAMENTO – The State Senate on Tuesday voted 35-0 to approve a bill by Sen. Patricia Wiggins (D-Santa Rosa) to allow doctors of audiology or practicing clinical Ph.D. audiologists to serve as qualified medical evaluators on the state Workers’ Compensation appeals board to consider cases involving hearing-impaired workers.
Existing law requires the administrative director of the state Division of Workers' Compensation to appoint physicians to two-year terms as qualified medical evaluators in each of the respective specialties, for the evaluation of medical-legal issues that may arise in disputed workers compensation cases.
In asking her colleagues to approve her bill (SB 557) Tuesday, Wiggins said that “audiologists are the most qualified professionals to determine whether hearing loss would impair a worker’s ability or whether hearing loss was secondary to noise exposure on the job.”
The California Academy of Audiologists, which is sponsoring SB 557, notes that other allied health professionals, even those without doctorates such as acupuncturists, can serve as qualified medical examiners (they also cite chiropractors, optometrists and psychologists. The academy asserts that “it stands to reason that audiologists should be able to do the same for hearing loss.”
“Including audiologists as experts in Workers' Comp cases will improve consumer access to professionals with special training in the assessment of hearing loss,” Wiggins said, “as well as a detailed understanding of the effects of damaging influences on the auditory mechanism that may occur in various work settings.”
Now that it has been approved by the full Senate, SB 557 next heads to the Assembly for consideration.
Wiggins represents the 2nd Senate District, which includes parts or all of Humboldt, Lake, Mendocino, Napa, Solano and Sonoma counties. Visit her Web site at http://dist02.casen.govoffice.com/.
