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February 2009


Recommendations for Use of Influenza Antiviral Medications


By Dep. Health Officer Mark Netherda, MD

Although influenza activity is low in Sonoma County andthroughout the United States to date, preliminary data from a limited number ofstates indicate that the prevalence of influenza A subtype (H1N1) virusresistant to the antiviral medication oseltamivir (Tamiflu) is high. Therefore,CDC is issuing interim recommendations for antiviral treatment andchemoprophylaxis of influenza during the current flu season.

When influenza A (H1N1) virus infection or exposure issuspected, zanamivir (Relenza) or a combination of oseltamivir and rimantadineare more appropriate options than oseltamivir alone. Most labs in SonomaCounty, including the Public Health Department, do not differentiate betweenspecific subtypes of Type A influenza virus (e.g., H1N1 vs. H3N2). The CDC willupdate their recommendations as more information is gained through furthertesting of more viral isolates across the United States.

Both (1) people providing medical care for patients with suspectedinfluenza and (2) people who are candidates for chemoprophylaxis againstinfluenza should consider the following:

Consider use of influenza tests that can distinguishinfluenza A from influenza B.

Patients testing positive for influenza B may be giveneither oseltamivir or zanamivir (no preference) if treatment is indicated.

People who are candidates for chemoprophylaxis should beprovided with medications most likely to be effective against the influenzavirus that is the cause of the outbreak, if known. Respiratory specimens fromill patients during institutional outbreaks should be obtained and sent fortesting to determine the type and subtype of influenza A viruses associatedwith the outbreak and to guide antiviral therapy decisions.

Zanamivir should be used when people requirechemoprophylaxis due to exposure to influenza A (H1N1) virus and considered foruse when subtyping of Influenza A is unavailable and local/regional data suggesta prevalence of H1N1 activity. Rimantadine can be used if zanamivir use iscontraindicated. People whose need for chemoprophylaxis is due to potentialexposure to a person with laboratory-confirmed influenza A (H3N2) or influenzaB should receive oseltamivir or zanamivir (no preference).

For complete recommendations, visitwww.cdc.gov/flu/professionals/antivirals/index.htm.

 

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SCMA Board Reaffirms Position Statement on Sutter Proposal


In response to Sutter’s latest proposal to build a newhospital in Santa Rosa, the SCMA board of directors has reaffirmed an earlierposition statement that emphasizes access to care, support for community healthdirectives, and availability of physicians.

The statement says, in part, that SCMA’s paramount concernis to “ensure that patients will continue to have access to care and to theirphysicians. We continue to express concerns that short-term capacity needs willbe insufficient.”

SCMA’s position statement is among many comments that thecounty’s Department of Health Services is analyzing in response to Sutter’sproposal, including those received at public hearings on Jan. 13 and 14. DHSofficials are expected to report their findings to the Board of Supervisors inthe spring.

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Physician Directory Set for Delivery


The annual Sonoma County Physician Directory published bySCMA is back from the printer and will be delivered to all members free ofcharge in the first week of February. This year’s directory includes detailedspecialty and contact information for SCMA members, along with alphabeticallistings and specialty indexes for virtually all physicians in Sonoma County.

Additional copies are $30 for members ($40 for nonmembers)and can be ordered at www.scma.org or by contacting Rachel Pandolfi at 525-4375or rpandolfi@scma.org.

Several dozen physicians have joined SCMA during the pastyear, bringing the latest membership count to 666, about two-thirds of thepracticing physicians in Sonoma County. For more information on joining SCMA,visit www.scma.org.

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Volunteer Needed for SCMA Health Careers Scholarship Committee


SCMA needs a physician volunteer for its Health CareersScholarship Committee, which recommends recipients for scholarships and studentloans. The committee meets only twice a year at lunchtime.

Interested physicians should contact Cynthia Melody at525-4359 or cmelody@scma.org.

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Nominations Needed for SCMA Elections


Nominations for the following SCMA positions are due by March 20:

*     SCMA president-elect

*     Individual SCMA board representatives from Healdsburg (1), Petaluma (1), and Santa Rosa (2)

*     Two CMA delegates

*     Two CMA alternate delegates

All positions require a three-year commitment, beginning July 1. Nominations can be e-mailed to cmelody@scma.org, faxed to 525-4328, or mailed to SCMA, 3033 Cleveland Ave. #104, Santa Rosa, CA 95403. Each nomination should include a brief statement about the nominee's qualifications.

For more details, contact Cynthia Melody at cmelody@scma.org or 525-4359.

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Local Health Groups Can Apply for PFMC Community Grants


Nonprofit health organizationsin Sonoma County are encouraged to apply for Community Grants from the PacificFoundation for Medical Care. The grants, generally in the $10,000 range, areawarded twice a year by the nonprofit foundation to support local projects thatenhance health services.

The application deadline for thenext round of grants is April 1. For application materials, contact MarilynFlowers at 800-548-7677, Ext. 120, or mflowers@rhs.org. For more information,visit www.pfmc.org.

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Meetings on Health Care Reform Set for Feb. 11 and 21


At least two meetings on healthcare reform will be held in Santa Rosa during February.

Newly elected county supervisorsShirlee Zane and Efren Carrillo will host a Feb. 11 forum on the role of countygovernment in health care delivery. The forum will be held from 6 to 8 p.m. atthe Veterans Building, 1351 Maple Ave. To RSVP, contactSonomaSolutions@seiu1021.info.

On Feb. 21, Dr. John Shearerwill moderate a discussion of single-payer plans from 3 to 4:30 p.m. at theGlaser Center, 547 Mendocino Ave. Panelists include Drs. Richard Quint andClaudia Chaufan. No RSVPs are required.

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Obama Community Discussion Group Recommends Finance Reform


On Dec. 30, nearly 50 localphysicians and other health care leaders attended a Health Care CommunityDiscussion in Santa Rosa sponsored by the Obama-Biden Transition Project.According to a summary of the meeting provided by RCHC and Health Action, thegroup identified financing as the biggest problem in the health system.

“The health care financing modelis the underlying problem in the system,” the group concluded, “because it iswasteful, does not provide equal access to care, and does not reflect a valueof health care as a civil right equal to education and public safety.”

The group also recommendeduniversal coverage, medical homes, and increased emphasis on preventive care.Their recommendations, along with those from similar groups around the country,will be considered as part of a health care reform package to be unveiled bythe Obama Administration later this year.

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BBR Needs Blood Donations


Blood Bank of the Redwoods’blood supply is being depleted by limited donations. They are in great need ofblood donors for all blood types.

Blood may be donated at the BBRoffice, 2324 Bethards Dr., Santa Rosa. The office is open from noon to 7 p.m.Monday to Thursday and 9 a.m. to 3 p.m. on Friday and Saturday.

For details, call 545-1222 or visit www.bbr.org. book


Medi-Cal Claims with Patient SSNs Will Be Denied as of Feb. 1


Beginning on Feb. 1, physicianscan no longer bill Medi-Cal or the Child Health and Disability PreventionProgram using patients’ Social Security numbers as identifiers. All providersmust use the 14-character Medi-Cal identification number from recipients’Benefits Identification Cards (BIC) or paper ID cards when submitting claims.The ID number is located on the front of the card and consists of a 9-digitclient index number, a check digit, and a 4-digit issue date. (The issue dateis used to deactivate cards that have been reported as lost or stolen.)

The only exemption to this ruleis for Medicare crossover claims. Physicians may continue to bill Medicarecrossover claims using the recipient’s SSN/Medicare number as it appears on beneficiaries’Medicare identification cards.

Physicians are also urged to useMedi-Cal identification numbers when verifying eligibility or submittingtreatment authorization requests. In an emergency or in the event a Medi-Calpatient does not bring his or her BIC to an appointment, physicians may (withthe patient’s permission) use a SSN to verify eligibility via the Medi-CalEligibility Verification System.

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Physicians Urged to Complete Balance Billing Survey on CMA Website


CMA is conducting a survey togauge the impact of the recent ban on balance billing by the California SupremeCourt and by the Department of Managed Health Care’s regulation definingbalance billing as an “unfair billing pattern.” CMA also is gathering evidenceconcerning other, broader industry practices by health insurers to underpay forout-of-network services.

The survey is located on thehome page of the CMA website at www.cmanet.org. Physicians are urged tocomplete the survey as fully as possible. The information will be used by CMAin its advocacy efforts and will not be used in a manner that reveals anyphysician’s identity.

To request a paper copy of thesurvey, contact Samantha Pellon at 916-551-2872 or spellon@cmanet.org.

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CME Events at Sonoma Developmental Center


Two CME events will be held atthe Sonoma Developmental Center in February. Both are scheduled for McDougallHall from 1 to 2 p.m.

On Feb. 5, Drs. Ken Christensenand David Gray will discuss ICD-9 coding. On Feb. 26, Dr. Gopa Green willdiscuss renal osteodystrophy. For details, call JoAnne Rawles at 938-6419.

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Charles Amezcua, MD
Anatomic & Clinical Pathology
401 Bicentennial Way
Santa Rosa 95403
393-4684 Fax 393-4291
Univ Southern California 1993

Santiago Centurion, MD
Dermatology
106 Lynch Creek Way #8
Petaluma 94954
763-6816 Fax 763-1730
New Jersey Med Sch 1999

Julie Clark, MD
Obstetrics & Gynecology*
1550A Professional Dr. #100
Petaluma 94954
792-2229 Fax 792-1072
Cornell Univ 2001

Randall Hrabko, MD
Dermatology*
6880 Palm Ave.
Sebastopol 95472
823-7628 Fax 823-1521
Univ Miami 1976

Daciana Iancu, MD
Internal Medicine
401 Bicentennial Way
Santa Rosa 95403
393-4104 Fax 393-4146
Univ North Carolina 1997

Francesca Manfredi, DO
Family Medicine
144 Stony Point Rd.
Santa Rosa 95401
521-4635 Fax 544-4626
Western Univ 2000

Margaret Marquez, MD
Internal Medicine*
Geriatric Medicine*
3559 Round Barn Blvd.
Santa Rosa 95403
571-3953 Fax 571-3941
UC Davis 1994

David Pastran, MD
Family Medicine
401 Bicentennial Way
Santa Rosa 95403
393-4300 Fax 393-4558
Univ Colorado 2003

Carina Quezada, MD
Pediatrics
3925 Old Redwood Hwy.
Santa Rosa 95403
393-4000 Fax 566-5292
Univ Southern California 1994

Mitchell Savitsky, MD
Emergency Medicine
401 Bicentennial Way
Santa Rosa 95403
393-4000 Fax 393-4741
George Washington Univ 1978

Regina Sullivan, MD
Obstetrics & Gynecology*
401 Bicentennial Way
Santa Rosa 95403
393-4696 Fax 393-4299
New Jersey Med Sch 1994

Michael Tsao, MD
Pediatrics
3925 Old Redwood Hwy.
Santa Rosa 95403
393-4000 Fax 566-5929
Northwestern Univ 2003

Jamie Weinstein, MD
Family Medicine
5900 State Farm Dr.
Rohnert Park 94928
206-3000 Fax 206-3042
Oregon Health Sciences Univ 2000

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