Political Pulse Coming Out of the Dark! Carla Kakutani, MD

political pulse

Carla Kakutani, MD Chair, CAFP Legislative Affairs Committee

Coming Out of the Dark!

As our state and nation are on the brink of reopening and rebounding from the COVID-19 pandemic, we are all taking stock of the past year, the challenges we faced as physicians (and, at times, patients), and the opportunities and optimism we see for the future. This same assessment is happening at the legislative level. At this time last year, CAFP was fighting (successfully) against the Governor’s May Revise budget proposal to cut almost all funding ($33 million) for the Song-Brown Primary Care Physician Training Program, a state-run program that provides tens of millions of dollars annually to primary care physician residency programs in underserved areas serving underserved populations. Now, CAFP is on the verge of securing not only $33 million in ongoing funding, but an additional $50 million over six years to create and sustain NEW primary care residency programs in underserved areas. At this time last year, CAFP was having difficulty convincing the Governor and his administration to take executive action to create financial security for small primary care physician practices hit hard by COVID-19. This year, our sponsored bill, SB 402 (Hurtado), has no opposition and hasn’t received a single ‘No’ vote as it moves from the Senate to the Assembly. The bill would create a primary care payment reform collaborative that would establish multipayer payment reform pilots to help small primary care practices in areas hit hardest by COVID to move away from fee-forservice to a payment model that truly supports primary care delivery. At this time last year, legislators were preparing a State Budget under the assumption that the California’s tax revenue would be several billion dollars short of early projections due to the COVID-19 pandemic. This year, California is preparing to fully replenish its Rainy Day Fund, pay down debt, and make significant investments in our long-neglected public health care infrastructure. Finally, in my last Political Pulse article, I let you know about several bills on which the CAFP Legislative Affairs Committee would likely act. Here is an update on CAFP’s action surrounding a few of those bills: • SB 428 (Hurtado) would require health plans and insurers to provide coverage and payment for adverse childhood experience (ACE) screenings. This CAFPsupported bill is still alive and headed to the Assembly. • AB 97 (Nazarian) would prohibit health plans and insurers from imposing a deductible on an insulin prescription drug. This CAFP-supported bill is still alive and headed to the Senate. • SB 48 (Limón) would have required all general internists and family physicians to complete at least four hours of mandatory continuing education on the special care needs of patients with dementia. We informed legislators that family physician residency training already includes significant training in geriatric care, and worked with the author and sponsors of the bill to remove our opposition. The author and sponsors agreed to an amendment that removed the mandatory CME requirement, and instead allowed physicians already required to complete CME on the care of older patients to have courses on “the special care needs of patients with dementia” also satisfy the requirement. • SB 316 (Eggman) would allow federally qualified health centers and rural health clinics to be paid for a patient who has two visits in the same day at a single location if the patient has a medical visit and a mental health visit or dental visit. This CAFP-supported bill is still alive and headed to the Assembly.

If you’d like to be involved in family medicine advocacy, I encourage you to visits CAFP’s Get Involved webpage: www.familydocs.org/advocacy/get-involved.