September 2008

• Sharps Can No Longer Be Placed in Household Waste
• Free Directory Photo Sessions Scheduled
• Reminder: SCMA 150th Anniversary on Nov. 11
• Magazine To Publish Special Commemorative Issue for 150th
• Number of Local Kaiser Physicians Up 30% Since 2005
• Coalition Posts Online Survey for Mental Health Providers
• Medicare Posts Interim Study for Revising Payment Localities
• Court Halts 10% Medi-Cal Cut
• Doctors Affected by State Budget Can Apply for Loans
• Physicians Spared from New Reporting Requirements
• Obesity Prevention Advocacy Workshop in Oakland Sept. 13
• End-of-Life Conference in Petaluma Oct. 24-25
• "Silent PPO" Guide Available from CMA
• Dr. Emily Keram Testifies at Hamdan Trial
• Center for Well-Being Honors Several SCMA Physicians
• New Physician Leaders at West County Health Center

Sharps Can No Longer Be Placed in Household Waste

Effective Sept. 1, home-generated sharps waste can longer be placed in household trash, recycling or yard-waste containers. The ban applies to lancets, needles and other sharps used for administering medications to humans or animals.

The new state law will primarily affect about one million Californians who self-inject medications at home. Instead of disposing of sharps in their household waste, they will now have to use one of the methods listed below. Physicians should inform their self-injecting patients about the new procedures.

Deputy Health Officer Dr. Mark Netherda urged compliance with the new law, noting, “It is an important way to prevent accidental exposure to serious infections such as HIV and hepatitis B and C.” Improperly disposed sharps pose a significant health risk to anyone who comes into contact with them.

Free Directory Photo Sessions Scheduled

Free portrait sessions for the 2009 SCMA Physician Directory have been scheduled for Sept. 30 to Oct. 3. Members who need new or updated photos for the directory are urged to take advantage of this complimentary service from RCL Portrait Design. Coat and tie are requested.

Sessions will be held at the following locations and times:

Life Learning Center, 1144 Montgomery Dr. (across from Memorial Hospital), rooms 2 and 3:
* Tuesday, Sept. 30: 7 a.m. to 1 p.m.
* Friday, Oct. 3: 7 a.m. to noon

Sutter Medical Center, 3325 Chanate Rd., rooms to be determined:
* Wednesday, Oct. 1: 7 a.m. to 2 p.m.
* Thursday, Oct. 2: 7 a.m. to 2 p.m.

To make an appointment, call RCL toll-free at 800-951-8712.

Reminder: SCMA 150th Anniversary on Nov. 11

SCMA will soon be mailing invitations to all members for the association’s 150th anniversary celebration on Nov. 11 at the Vintner’s Inn in Santa Rosa. Tickets, which include dinner, are free to SCMA members and $75 for a member’s spouse or guest.

The invitations include an RSVP postcard. You can also reserve a spot by contacting SCMA at 525-4359 or scma@scma.org. See you at the celebration!

Magazine To Publish Special Commemorative Issue for 150th

The Fall issue of Sonoma Medicine, SCMA’s award-winning magazine, will commemorate the association’s 150th anniversary, with articles by Gaye LeBaron, local historian Jeremy Nichols, and Drs. Joseph Clendenin, Allan Bernstein, James Gude and Colin Kopes-Kerr. Photos and documents from SCMA’s archives will be included as well.

Physician groups, hospitals and other providers interested in placing commemorative ads in this special issue should contact Nan Perrott at nperrott@rhscommunications.com or 525-4226. The deadline is Sept. 9. Ad rates are posted on the SCMA website at http://www.scma.org/magazine/advertising.html.

Number of Local Kaiser Physicians Up 30% Since 2005

The number of physicians working full-time at Kaiser facilities in Santa Rosa and Petaluma increased by almost 30% in the past three years, from 211 to 273, according to SCMA’s physician database. During the same time period (2005 to 2008), the total number of physicians working in the county increased by just 5%, from 976 to 1026, even as the number of non-Kaiser physicians declined by 2%, from 765 to 753.

The newest numbers confirm long-term trends in Sonoma County health care, with Kaiser gaining an ever-bigger share of local physicians and patients. The Permanente Medical Group now employs about 30% of the primary care physicians and 23% of the specialists in the county.

Coalition Posts Online Survey for Mental Health Providers

Physicians and other mental health providers are encouraged to complete a brief online survey posted by the Mental Health Coalition of Sonoma County. The anonymous survey will be used to improve mental health services throughout the community.

The survey, located on the coalition’s website at http://www.mentalhealthcoalitionsc.org, includes 22 multiple-choice questions and a box for comments. All told, it should take only a few minutes to complete.

The coalition’s website also includes a survey for the general public. Both surveys will remain posted until a sufficient number of comments are received. Results will published shortly thereafter.

Medicare Posts Interim Study for Revising Payment Localities

Medicare has posted an interim study of different options for revising its GPCI payment localities. The study, “Review of Alternative GPCI Payment Locality Structures,” is available for download at http://www.cms.hhs.gov/PhysicianFeeSched/downloads/ReviewOfAltGPCIs.pdf.

Medicare is asking doctors and other interested parties to submit comments about the study to MPFS@cms.hhs.gov by Oct. 20. By statute, Medicare is required to adjust physician fee schedules periodically to account for geographic differences in cost. Eighty-nine payment localities across the country, including several in California, have not been adjusted since 1997.

CMA’s own study of possible alternative payment locality configurations is in the early stages of development. CMA will communicate proposed changes to the locality configurations after the study is completed.

Court Halts 10% Medi-Cal Cut

A federal court in Los Angeles has enjoined the 10% cut in Medi-Cal reimbursement rates that took effect July 1, finding that the cuts would irreparably harm access to health care for nearly 7 million Californians. The California Medical Association hailed the decision as an important step for health care in California, and for the health and lives of the millions of Californians who benefit from the state’s safety net.

“This is the third court in five years to find that the state of California has put at risk the access to health care for millions of Californians by underfunding the Medi-Cal program,” said CMA President Dr. Richard Frankenstein. “Hopefully, lawmakers get the message that they cannot balance the budget on the backs of the state’s poor or those who provide their health care. The state safety net needs to be strengthened, not weakened.”

Even prior to the cuts, California ranked at the bottom of the country in Medi-Cal funding, and spent less per beneficiary than any other state. Since the cuts took effect, many providers have been forced to reduce or completely stop services for Medi-Cal beneficiaries.

Doctors Affected by State Budget Can Apply for Loans

As the state budget gridlock drags on, physicians affected by the delay can apply for loans from community banks or from CMA’s endorsed line of credit with the Bank of America. The latter--which offers credit-line amounts up to $250,000 and rates as low as Prime plus 1%--requires a Bank of America business checking account. To apply, visit a Bank of America center or call 888-600-4000.

CMA estimates that 2,000 of its 35,000 members could be adversely affected financially by the budget delay. The California Dept. of Health Services will be issuing Voucher of Claim letters to Medi-Cal providers outlining the exact amount owed by the state. Providers will be paid that amount by the state controller’s office when the budget is resolved.

For more details, call the CMA member helpline at 800-786-4842.

Physicians Spared from New Reporting Requirements

In response to months of persistent lobbying by CMA, a bill that could impose unlimited data reporting requirements on health care providers (AB 2967) has been amended to exclude physicians and physician groups.

CMA has long supported efforts to improve medical outcomes, the stated intent of AB 2967. However, prior to being amended, the bill would have required physicians to give a newly created state agency as much patient data as the agency demanded. This new bureaucracy would be in addition to the current outcomes reporting program under the Office of Statewide Health Planning and Development.

By being excluded from AB 2967, physicians are also saved from paying the tens of millions of dollars in costs related to the legislation.

Obesity Prevention Advocacy Workshop in Oakland Sept. 13

End-of-Life Conference in Petaluma Oct. 24-25

"Silent PPO" Guide Available from CMA

CMA’s Center for Legal Affairs has published a free “Silent PPO Action Guide” to help physicians understand the complexities of health plan contracting and protect themselves from unlawful or unauthorized leasing of their health plan contracts. The revised guide incorporates new case law that gives physicians more power to extricate themselves from “silent PPOs.”

Health plans often lease their networks of contracted physicians to other third-party payors, such as self-insured employers. These “silent PPOs” allow third-party payors to take advantage of discounted rates that health plans have negotiated with their contracted physicians. Health plans, which make a great deal of money by leasing their physician networks, often conceal silent PPO clauses in lengthy contracts and use language that applies in perpetuity.

CMA’s guide helps physicians detect and prevent silent PPO activity. The guide is available through CMA ON-CALL (document #1907) in the members-only section of CMA’s website at http://www.cmanet.org. Or contact Samantha Pellon at 916-551-2872 or spellon@cmanet.org.

Dr. Emily Keram Testifies at Hamdan Trial

Santa Rosa psychiatrist Dr. Emily Keram served as a defense expert witness in the recent Guantanamo Bay trial of Salim Hamdan, the former driver for Osama bin Laden. Keram, who has spent more than 120 hours evaluating Hamdan since March 2005, testified that he only took the job to support his family and that he “feels dead inside” after several years of detention, including solitary confinement and sleep deprivation.

Although Hamdan was convicted by a military tribunal of providing support to Al-Qaeda, he was acquitted of the more serious charge of conspiracy in Al-Qaeda attacks against the United States. He will be eligible for release in December.

“I have great respect for the neutrality of the military commission members,” said Keram, who specializes in forensic psychiatry. “Given the constraints of the process, they applied the law fairly.”

Center for Well-Being Honors Several SCMA Physicians

The Northern California Center for Well-Being will honor Drs. Kirk Pappas, Mary Maddux-González and John Shearer at its Celebration of Dreams event on Friday, Sept. 19. The three SCMA members are among several community leaders receiving awards from the Center. The keynote speaker, Dr. JoDean Nicolette, will discuss medical ecology.

Tickets for the event, which runs from 11:30 a.m. to 1:30 p.m. at the Santa Rosa Country Club, cost $65 each. To purchase, call 575-6043.

New Physician Leaders at West County Health Center

Allison Bacon, MD
Family Medicine
3320 Chanate Rd.
Santa Rosa 95404
576-4100 Fax 576-4185
bacona@sutterhealth.org
Loma Linda Univ 2008


Annemieke de Lange, MD
Family Medicine
3320 Chanate Rd.
Santa Rosa 95404
576-4100 Fax 576-4185
Loma Linda Univ 2008

Anne French, MD
Family Medicine*
PO Box 1493
Eldridge 95431
938-6787
St. Louis Univ 1996

Mark Netherda, MD
Family Medicine*
625 Fifth St.
Santa Rosa 95404
565-4599 Fax 565-7627
mnetherd@sonoma-county.org
George Washington Univ 1988

* board certified

OFFICE FOR SALE OR LEASE
Fully equipped medical office, 1,000 square feet, $285,000. Doctors Park, Santa Rosa. Or: lease for $2,000/month. Very competent medical staff looking for work. 707-577-0768.

MEDICAL OFFICE SPACE
Suite available. Perkins Medical Center, Sonoma. 1800+/- square ft. $2,890/month. 707-996-4519.

FOR LEASE
Prime medical/dental office suite near Memorial Hospital. Call owner at 707-576-0777.

HOW TO SUBMIT AN AD
To submit a classified ad for News Briefs or Sonoma Medicine, contact Nan Perrott at nperrott@rhscommunications.com or 707-525-4226. The cost is one dollar per word.