Governor’s Proposed May Revise Offers No Relief for Healthcare and Significantly Worsens the Situation for California’s Poor and Vulnerable Citizens

Read news releases from CPhA, CMA and CHA and CAPH regarding the May Revise. Below you will find a summary of the details of the May Revise.

On Wednesday, the Governor released a copy of his May Revision of the 2008-09 State Budget. As relayed in the May Revision, the current budget deficit totals approximately $17.2 billion. The Governor asserts that his May Revision fully funds education under Proposition 98, keeps state parks open, does not borrow from transportation or local government and does not provide for early release of felons.

The Governor’s Budget is balanced through cuts and creative fund transfers and loans to the General Fund to cover the projected deficit. The Governor’s May Revision includes no proposal beyond privatizing the lottery to provide additional revenues to the state. The Governor proposes the enactment of a “Rainy-Day Fund,” which would trigger a one-time sales tax increase of one penny if there is not enough money in the projected Rainy-Day Fund to bring the General Fund to a certain level.

The May Revision reflects significant cuts to Medi-Cal eligibility including undocumented immigrants and newly qualified immigrants. The proposed cuts eliminate California's $111-million program of healthcare for legal immigrants, and pares back the healthcare provided to impoverished people who have been in the country for five years or less, for a savings of $87 million. The Revised Budget also allows cuts in rates to non-contract hospitals servicing Medi-Cal beneficiaries. There are no additional cuts in Medi-Cal provider rates beyond the 10% provider rate decrease already proposed by the Governor and enacted by the Legislature in February to be effective July 1, 2008.

Under Medi-Cal pharmacy services there are a couple additions to the program:

(1) $1.5 million increase to establish the Beneficiary Utilization Review Unit to review overuse and abuse of prescription drugs by Med-Cal beneficiaries.

(2) An increase of $324,000 for Medi-Cal’s fiscal intermediary to hire additional pharmacy consultants to handle the current TAR backlog.

(3) Proposed competitive bid process for DME by utilizing a private vendor to negotiate rates to achieve savings in DME costs.

The Governor’s May Revise includes some discussion about high users in the Medi-Cal FFS Program and its intent to address this small segment of enrollees that cost the state a significant amount. In addition, the Governor asserts his interest in continuing his healthcare reform agenda to include those areas that do not include a General Fund cost.

The Governor made some additional significant cuts in human services including:

(1) Restricting full in-home supportive services for seniors and people with disabilities, and cutting the pay of the service workers to the minimum wage. Only the most severely impaired would get aides for household tasks, although in-home medical assistance would continue.

(2) Eliminates cost-of-living increases for disabled people in the supplemental security income program, part of the Social Security system, with the state keeping $109 million the federal government is providing to California.

(3) Cuts welfare grants under the Cal-Works program by 5% instead of providing a cost-of-living increase, saving $187 million.

As you can see, healthcare continues to be the single hardest hit area. The devastation that the cuts and this proposal would wreak on the healthcare infrastructure of California would be of monumental proportions. CPhA is continuing to pull out all the stops and work tirelessly with our healthcare coalition partners to turn this around.

Pharmacy Defense Fund Contributors

Over this last week, we received some very generous contributions to the Pharmacy Defense Fund. Both Leader Pharmacies and United Drugs each contributed $20,000. I just want to extend a huge thank you to these great supporters. We received many generous individual donations as well. I wish I could say that we have more than enough money collected but that is not the case. We still need more help and we need it quickly. Please click here today to donate or call Veronica Van Orman at 916-779-1400 x: 311.

Patients for Access to Medications Coalition

This coalition has produced a tremendous effort on behalf of pharmacy and the patients they serve in California. To date we have collected 760 petitions, which represents 12,920 individuals speaking out on behalf of the needed services provided by pharmacists. This week, many new organizations have joined the coalition. Please visit www.calaccessrx.org to view a full list of our coalition members and to download more petitions. These petitions are having a huge impact at the Capitol.

Heparin Recall

Earlier this month, both the California Department of Public Health and the Board of Pharmacy issued provider notices indicating that certain lots of Heparin have been recalled because of contamination of the raw material used to produce the products. However, state surveyors are still finding the recalled Heparin in nursing facility emergency kits. Please click here to read the CDPH letter and act according to its instructions--be sure to pull all of the recalled Heparin from the emergency supply kits and any automated drug delivery systems.

Disaster Preparedness Committee -cathi

This week, the CPhA Disaster Preparedness Committee & Pharmacy Coalition held a conference call to set priorities for 2008. Chairman Carl Britto led a discussion with 14 committee members on issues ranging from distribution of disaster preparedness materials and disaster preparedness CE courses to ways for pharmacists to engage with both state and local governments during times of disaster. Dana Grau, Pharmaceutical Consultant II in the Emergency Pharmaceutical Services Unit of the state Department of Public Health, urged the committee to undertake an initiative to have as many pharmacists as possible sign up as emergency medical volunteers. Sign up today for this very important effort to become part of the Medical Reserve Corps. We will keep you posted to the critical ongoing effort of this group.

CPhA/CDA Collaboration

On Thursday morning, Cathi Lord, Director of Communications, accompanied our President Paul Lofholm to an interview that was held in San Francisco with Dr. Peter Jacobsen of the California Dental Association to discuss collaborative practice issues and to clarify scope of practice between the two professions. It was an outstanding session and an article will be generated jointly for inclusion in the fall issues of CPhA Journal, California Pharmacist and the California Dental Association Journal. This topic will also be presented at Synergy 2008 and Outlook 2009.

NASPA and SureScripts Collaborative Effort

NASPA and SureScripts have announced a collaborative effort to gather direct input from practicing community pharmacists and technicians about the experiences that they have had with electronic prescriptions. Given the interest nationwide on moving as quickly as possible to full e-prescribing, it is imperative that your experiences be reported and collected so that we can be sure that these initiatives will be constructed in a way that maintains safety and security for our patients. To fill out the questionnaire, click here

Tobacco-Free Pharmacy Push in S.F.

Mayor Gavin Newsom is seeking an ordinance to amend the San Francisco Health Code to ban the sale of tobacco in pharmacies. The ordinance will be heard in the City Operations and Neighborhood Services Committee and, if passed, will go to the full board of supervisors the following week. Because it is a major policy change, it must "sit in committee" for 30 days, so it will not be heard until after May 29th. I will keep you posted as progress is made. It is of note that there are several such initiatives going on around the country.

Drug Suffixes Survey

The National Coordinating Council for Medication Error Reporting and Prevention is asking for your input regarding the use of suffixes in drug names. The intent of the survey is to assess the current use of suffixes in drug names, problems that may arise from the use of suffixes and how those situations are handled. The survey should take approximately 5-10 minutes to complete. Please submit your answers by June 15, 2008. Your answers to the survey will remain anonymous. Please access the survey by clicking here.

UCSF APhA-ASP Annual End-of-the Year Banquet

Theresa Andrews, Director of Membership, attended the UCSF End-of-the-Year and Spring Installation Banquet on Wednesday, May 14, at the Atrium Restaurant in San Francisco. Theresa reports that the UCSF students put on a terrific event and it was such an inspiration to witness how the students and faculty at UCSF really support and applaud one another for all their efforts. Kristin Harter, current APhA-ASP President passed the torch onto Thomas Hong who takes over for the 2008-2009 school year. Many of the past APhA-ASP Presidents were in attendance as well as many supporters of UCSF such as Rite Aid and Walgreens. The students had another reason to celebrate as Dean Mary Anne Koda-Kimble won the 2008 APhA-ASP Dean of the Year Award. Congratulations to Dean Koda-Kimble and to all the UCSF APhA-ASP leadership on your very successful year!

San Mateo Pharmacists Association CE Meeting

On Thursday, Annette Todaro-Smith attended the San Mateo Pharmacists Association CE Meeting. This months topic was “A Community Pharmacist’s Introduction to Medication Therapy Management,” presented by Sam Lee, Pharm.D. This program was the second part of this two-part MTM CE series. Dr. Lee did an outstanding job presenting key MTM skills that are taught through a series of interactive case studies. The program was well attended and the feedback from the members was excellent.

2008-2009 Membership Renewals

Don't forget to renew your 2008-2009 CPhA Membership! The emails have all gone out and you should be receiving a paper renewal invoice in the mail shortly. Please take a few minutes out of your day to renew your membership. Should you have any questions or did not receive the email/paper renewal, contact Theresa Andrews at 916-337-8877 or tandrews@cpha.com. It has never been more important than it is right now to be a member of CPhA to have a voice speaking for you and a team fighting for you in Sacramento. Renew today!

2008 CPhA Elections

Thinking about taking a leadership position in CPhA? Now is the time! We need strong and committed members to step up during these critical times. We are accepting Desire to Serve Forms for various positions open for election. Elections will open in September 2008. If you want to run for a Board of Trustee position or on an Academy Board of Directors, contact Theresa Andrews at tandrews@cpha.com or 916-337-8877.

USP Chapter 797
Just a reminder that the revisions to United States Pharmacopeia Chapter 797 Sterile Compounding guidelines will be in effect on June 1, 2008

Medicare Training Program Audio Conference Call – May 20

The next presentation in the My Health. My Medicare. series of audio-conference training sessions sponsored by the Centers for Medicare & Medicaid Services (CMS) will be held on May 20, 2008. The call will take place from 11:30 a.m. to 12:30 p.m. (PST). The call in number is 800-475-0456 and the pass code is NMTP. To learn more, please visit the CMS web site.

In the News:

Mindy Rasmussen from the Arizona Pharmacy Alliance was interviewed on CBS 12 in Arizona. She spoke about knowing your pharmacist and how pharmacists can help patients save money on prescription medications. You can watch the interview by clicking here.

Last Sunday, an opinion editorial regarding the ten percent Medi-Cal cuts was printed in the North County Times. I co-authored the editorial with Bill Dombrowski from CRA and Steve Anderson from NACDS. This OpEd is also expected to run in the coming weeks in the San Jose Mercury News and Capitol Weekly.

Question of the Week

Over the last few weeks, we have had questions from a number of pharmacists regarding the tamper resistant prescription pads.

Answer

We have provided many links and answers in previous messages about the tamper resistant prescription pads. You can also visit the BNE website of approved security printers. Please visit the Office of the Attorney General’s website to check the list of pre-approved printers.

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