World-Class Partnership
Dameron Hospital’s new partnership with Stanford Medicine seeks to ‘re-invent’ cardiothor acic care in the Centr al Valley
Teaching Orthopaedic Surgery in Tanzania New Laws 2018 Holiday Party
Spring 2018
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VOLUME 66, NUMBER 1 • MARCH 2018
{FEATURES}
18 24 32 38
TEACHING ORTHOPAEDIC SURGERY IN TANZANIA NEW LAWS 2018 A WORLD CLASS PARTNERSHIP HOLIDAY PARTY
{DEPARTMENTS} 42 IN THE NEWS
New faces and Announcements
52 PRACTICE MANAGEMENT:
Committed to Improving Quality Health Care
56 PUBLIC HEALTH
WIC Nutrition Program Contributes to a Healthy Start
58 NEW MEMBERS 61 IN MEMORIAM
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PRESIDENT R. Grant Mellor, MD PAST-PRESIDENT Kwabena Adubofour, MD SECRETARY-TREASURER Dan Vongtama, MD BOARD MEMBERS Hyma Jasti, MD, Alvaro Garza, MD, MPH, Mohsen Saadat, DO, Clyde Wong, MD, Peter Garbeff, MD, Sanjay Marwaha, MD, Ramin Manshadi, MD, Benjamin Morrison, MD, Richelle Marasigan, DO, Aliya Gessling, MD
MEDICAL SOCIETY STAFF EXECUTIVE DIRECTOR Lisa Richmond
SAN JOAQUIN PHYSICIAN MAGAZINE EDITOR Lisa Richmond
MEMBERSHIP COORDINATOR Jessica Peluso
EDITORIAL COMMITTEE Grant Mellor MD, Lisa Richmond
ADMINISTRATIVE ASSISTANT Melissa Sanchez
MANAGING EDITOR Lisa Richmond CREATIVE DIRECTOR Sherry Lavone Design
COMMITTEE CHAIRPERSONS DECISION MEDICINE Kwabena Adubofour, MD CMA AFFAIRS COMMITTEE Larry Frank, MD
CONTRIBUTING WRITERS R. Grant Mellor, MD, James Noonan, Karen Furst, MD, MPH, Kimberly Smith, RD, CLE, Peter Salamon, MD
PUBLIC HEALTH TBD SCHOLARSHIP LOAN FUND Matthew Wetstein, PhD
THE SAN JOAQUIN PHYSICIAN MAGAZINE is produced by the San Joaquin Medical Society
CMA HOUSE OF DELEGATES REPRESENTATIVES Robin Wong, MD, Lawrence R. Frank, MD, James R. Halderman, MD, Grant Mellor, MD,
SUGGESTIONS, story ideas are welcome and will be reviewed by the Editorial Committee.
Kwabena Adubofour, MD, Raissa Hill, DO, Ramin Manshadi, MD
PLEASE DIRECT ALL INQUIRIES AND SUBMISSIONS TO: San Joaquin Physician Magazine 3031 W. March Lane, Suite 222W Stockton, CA 95219 Phone: (209) 952-5299 Fax: (209) 952-5298 E-mail Address: lisa@sjcms.org MEDICAL SOCIETY OFFICE HOURS: Monday through Friday 9:00am to 5:00pm Closed for Lunch between 12pm-1pm
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Anterior Hip Replacement
Move at the Speed of Life.
ALIGN WITH THE BEST
Our premier anterior hip specialist is board-certified orthopedic surgeon Dr. Thomas McKenzie, who converted to the anterior total hip replacement approach in 2013. Dr. McKenzie is a Lodi local, offering our community comprehensive orthopedic surgical and sports medicine solutions.
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If your patients are in need of hip replacement, then the anterior method may be the best answer. This minimally invasive surgery utilizes advanced technology and a non-traditional approach, enabling the surgeon to access the hip joint from the front rather than from the side or back, without cutting major muscles. Patients who have this procedure enjoy a shorter hospital stay, better range of motion and find that in the recovery process, the hip precautions outlined for traditional hip replacement are unnecessary. To refer your patient, please call the office at 209-210-4229.
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EXECUTIVE DIRECTOR’S REPORT
STANDING WITH OUR MEMBERS It is not often that SJMS has reason to engage in local politics, with our powerful advocacy largely being handled at a statewide level by CMA. But last year in early December, when two SJMS members, SJ County Chief Medical Examiner Dr. Bennet Omalu and forensic pathologist Dr. Susan Parson, resigned alleging interference in their death investigations by the Sheriff, we knew we had to get involved. The San Joaquin Medical Society and the California Medical Association stand for and protect physician autonomy and independence, so it was crucial that we act swiftly to support our valued members and help shape the discussion regarding this issue in our community.
LISA RICHMOND
With the backing of CMA, a letter by SJMS President Dr. Grant Mellor was sent to the SJ County Board of Supervisors asking for the immediate separation of the Sheriff-Coroner’s offices to create a modern, independent Medical Examiner’s Office stating “that physicians have the unique obligation to put the patient first, and thus must be empowered to work independently to serve the best needs of the patient.” These sentiments were also expressed in person directly to the Board of Supervisors by Dr. Mellor and Past President Dr. Kwabena Adubofour during its meeting in December. Both Drs. Omalu and Parson have expressed a willingness to stay and practice in San Joaquin County if the offices are separated. The ramifications of keeping the current system are far-reaching. As we are keenly aware, there is an acute shortage of clinicians in our region and a nationwide shortage of forensic pathologists. According to the National Association of Medical Examiners (NAME), there are currently only 800 certified forensic pathologists in the United States. NAME has stated that it is imperative that forensic pathologists and medical examiners remain independent officials, and be available for consultation for both prosecuting and defense attorneys outside their governmental employment. In a follow- up letter mailed in February, Dr. Mellor expressed these concerns saying, in part “although, we feel our community is a wonderful place to practice medicine, the city’s reputation, among other factors, make it difficult to recruit physicians to our area who have no previous ties here.” As of the writing of this article, no decision has been made by the Board of Supervisors to separate the offices. The County has hired an outside expert to provide an analysis, which will not be presented to the Board until April, more than one month after both physician’s resignations are final. Additionally, State Senators Richard Pan, MD and Cathleen Galgiani introduced Senate Bill 1303, which would require counties with populations of 500,000 or more residents, like ours to replace the office of the coroner with an office of the medical examiner. On a lighter note, we hope to see you at our 9th Annual Golf Tournament benefitting The First Tee of San Joaquin and SJMS' Decision Medicine program on Sunday, April 29. Please see the enclosed ad for more details. Also, please save the date for our annual Lifetime Achievement Award dinner on Sunday, June 10. More information coming soon! In Solidarity,
Lisa Richmond
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WORLD-CL ASS CARDIAC CARE IN THE HEART OF THE CENTR AL VALLEY
The Stanford Cardiac Surgery Program at Dameron Hospital has partnered with Stanford Health Care and the Stanford School of Medicine to establish a joint cardiothoracic surgery program to enhance its quality of care and the overall patient care experience. Led by Dr. Eric Keyser, an experienced cardiothoracic surgeon and faculty member of Stanford’s Cardiothoracic Surger y Department, this program offers an opportunity for patients with heart and lung disease to receive the highest quality of care available in our community. DR. ERIC KEYSER, MD
“It makes perfect sense to create a presence in the Central Valley with Dameron. It’s an outstanding hospital with a dedicated staff and a great practice environment for our cardiothoracic surgery program. This new program will enhance the standard of surgical care available in the community and leverages the best of what Stanford Health Care and Dameron bring to the table.” – Dr. Joseph Woo, MD Cardiothoracic Surgeon and Chairman of Stanford University School of Medicine’s Cardiothoracic Surgery Department
A N E X T R AO R D I N A RY PA RT N ER S H I P 525 West Acacia Street, Stockton, CA 95203 209-944-5550 DameronHospital.org 10
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A message from our President > R. Grant Mellor, MD
Staying Relevant to the Physicians and the Community We Serve
ABOUT THE AUTHOR R. Grant Mellor, MD- Pediatrician and Chief of Professional Development, Central Valley Service Area, The Permanente Medical Group and current President of the San Joaquin Medical Society
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One overarching goal of the SJMS board of directors is to make sure that the medical society stays relevant to the physicians and the community we serve. We must continue to address, and even anticipate, the needs of our physicians and our medical community. I believe our recent work has shown that we’re doing just that. We are now selecting the 2018 Decision Medicine class, our wellrecognized program that encourages local qualified students to pursue a career in medicine. Decision medicine was started more than a decade ago by members of SJMS. Interest in the program continues to grow. There are now multiple Decision Medicine alumni in college who are planning to attend medical school, some in medical school, and a few alumni physicians in residency programs. We should start to see our Decision Medicine students returning to practice in the Central Valley soon. Our new initiative, the Bridge to Medicine, is designed to offer guidance for interested and qualified students who wish to become physicians. Why do we need the BTM program? Because it’s difficult to get into medical school, even for the well-prepared. For every qualified ten students who go off to college with the intent of becoming doctors, only one gains entrance to medical school. Some colleges are very good at helping students succeed in their quest to become doctors; others (including some with high name-brand recognition) are notorious for dashing their students’ dreams. In other words, some schools are “feeders,” and some schools are “weeders.” We aim to improve our local students’ odds by providing wellinformed advice regarding preparation for college, strategic college choices,
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A message from our President > R. Grant Mellor, MD
application to BS/MD programs, major and course choices in college, choice of resume-building volunteer and research work, med school application advise, interview preparation, and the like. If you’re interested in
alleged interference in medical decision-making by non-medical personnel. We expect a decision by the Supervisors in mid-Spring – hopefully in time to retain our talented Pathology colleagues. I think you’ll agree that the SJMS is addressing the needs of our local physicians and our local medical community. Please help us keep the SJMS and the CMA strong, so that our voices can continue to be heard. Persuade colleagues who aren’t members to join us. Consider serving on our Board of Directors or the House of Delegates. Join the Alliance. Volunteer to help us with Decision Medicine, or Bridge to Medicine. Thank you for supporting our medical society!
"Please help us keep the SJMS and the CMA strong, so that our voices can continue to be heard." serving as a Bridge to Medicine mentor, now is a perfect time to join our group – please contact Lisa soon. As I write this, the SJMS is actively engaged in an attempt to persuade the San Joaquin County Board of Supervisors to establish a separate Coroner’s office, autonomous and independent from the Sheriff ’s office. The recent resignations of doctors Omalu and Parsons from the Coroner’s office raised concerns regarding
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Strong community partnerships lead to happier, healthier people
Celebrate Health Partnering today for a healthier tomorrow
With over 345,000 members and growing, Health Plan of San Joaquin continues to build relationships with health care providers, resource agencies, and local businesses to deliver on our mission to improve wellness throughout the communities we serve.
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FIRST 5 SAN JOAQUIN MEDICAL STIPEND PROGRAM ON ORAL HEALTH ISSUES In 2015, almost 50 percent of dental related Emergency Room visits were for children under the age of five years old1 . These costly visits to ER may be able to be partially avoided as more pediatricians have a better understanding of the oral health needs of young children. Through a grant from the California Department of Health Care Services, First 5 San Joaquin is serving as the lead agency for the San Joaquin Treatment & Education for Everyone on Teeth & Health (SJ TEETH). >>
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Through this grant, medical providers have an opportunity to not only increase their knowledge and practice of oral health, but can also obtain a stipend for their time in taking online courses. Continuing Education hours are also available. The following data from San Joaquin County supports the need for more involvement of the medical field in promoting good oral health:
- The percentage of Medi-Cal enrolled children who have received an annual dental visit and/or a preventive dental service has steadily declined over a three-year period
- Only 62 percent of eligible kindergartners had a mandatory oral health assessment.
- Only 63 percent of children ages 2-11 in San Joaquin County self-reported visited a dental professional compared to 90 percent for California
Through the SJ TEETH program, care coordinators can work with the Emergency Department as well as take referrals from medical clinics for oral health follow up. The community care coordinator agencies and contact info are as follows:
Catholic Charities of the Diocese of Stockton
Family Resource and Referral Center
1106 N. El Dorado Street Stockton, CA 95202 (209) 444-5940 and (209) 444-5934
509 W. Weber Avenue, Suite 101 Stockton, CA 95203 (209) 948-1553 or (209)461-2937
Community Medical Centers, Inc.
Family Resource Network
7210 Murray Drive Stockton, CA 95210 (209) 636-5520 ext. 5535
5250 Claremont Avenue, Suite 148 Stockton, CA 95207 (209) 472-3674
For more information on accessing the stipend program, go to www.sjckids.org/Funding-Opportunities. For information on the SJ TEETH program, call First 5 at 209-953-5437 or visit our website at sjckids.org.
Children Now – from California Department of Health Care Services, Medi-Cal Dental Services Division. Public Records Act request submitted by Children Now. Data received August 2016. Performance measures are based on 11 of 12 months of eligibility with no more than a one month gap. 1
2
Ibid
Of the school that reported assessment. Children Now data from the California Dental Association, AB1433 Reported Data website, www.cda.org/public-resources/communityresources/kindergarten-oral-health-requirement/ab1433-results, accessed on September 25, 2017. 3
California Health Interview Survey, 2014
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TEACHING CHILDREN’S ORTHOPAEDIC SURGERY IN TANZANIA
The Tanzanian Pediatric Orthopaedic Fellows In October and November of 2017 I had the unique opportunity to participate in a program sponsored by The Children’s Orthopaedic Education for Developing Nations foundation in Dar es Salaam, Tanzania (COEDN). The goal of COEDN is to provide fellowship (post-residency) level training in Pediatric Orthopaedic Surgery for Orthopaedic Surgeons in their own country and thereby help bring sustainable Pediatric Orthopaedic care to the developing world. Multiple visiting surgeons from North America and other training centers around the world provided training for 3 doctorate level local surgeons interested in focusing their careers by becoming COEDN Pediatric Orthopaedic sub-specialists. >> www.coedn.org
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The goal of COEDN is to provide training over a long period of time on site in the host country. Over time the local Pediatric Orthopaedic fellows, through daily supervision, gain the knowledge to provide skilled Pediatric Orthopaedic care for the children of their country.
The Need:
Tanzania is located in East Sub-saharan Africa on the Indian Ocean. It has an estimated population of 53 million people with roughly one half the population being under 18 years of age. There is currently one Pediatric Orthopaedic surgeon in Tanzania. Nationwide in Tanzania, two residency programs graduate seven to nine Orthopaedic surgeons each year, but there is very little training in Pediatric Orthopaedics. Our goal is to provide the children of Tanzania with access to expert Pediatric Orthopaedic care provided by local surgeons.
The Program:
I was one of 12 Volunteer Pediatric Orthopaedic surgeons from North America, Europe and Israel to travel to Dar es Salaam, Tanzania. The program is continuing at the Muhimbili Orthopaedic Institute (MOI) over a period of 24 months. MOI provides both basic and tertiary care in the fields of Orthopaedics and traumatology. I spent one month teaching three extremely bright and enthusiastic young Orthopaedic Surgeons who have chosen to pursue a career in Pediatric Orthopaedic surgery. MOI www.moi.ac.tz
Muhimbili Orthopaedic Institute (MOI) MOI is a component part of the Muhimbili Medical Teaching center in Dar es Salaam. It provides both basic and tertiary care in the fields of Orthopaedic surgery and Traumatology. It has more than 300 in-patient beds devoted to the care of Orthopaedic patients. Thousands of patients are seen annually. As more than half the population of Tanzania are under the age of twenty, a large percentage of the patients are children.
Boots on the Ground:
I arrived in Dar es Salaam at 4 AM on a Monday in early October after 40 hours of travel from Stockton. By 8 AM I was being introduced at the morning Orthopaedic triage conference at MOI as the newest faculty from the COEDN program. I met the three Pediatric fellows and began work. Monday morning is the busy twice weekly Pediatric Orthopaedic outpatient clinic. We saw more than 100 children with the entire spectrum of Orthopaedic problems, including congenital and genetic disorders, fractures, musculoskeletal infection, and a myriad of other problems, many of which are not seen in the USA. The clinic was held in a large room with desks around the periphery staffed by the Orthopaedic fellows and residents. The concept of privacy did not seem to be of concern to either patients of staff. Often two of three patients and their parents were gathered around each station. I moved from desk to desk consulting with the residents and fellows, examining patients and offering advice.
The Pediatric Clinic
Tuesday and Friday were our days in the operating theatre. The Pediatric service was assigned two “tables� in the multi-bed operating theatre. The tables were separated by small partitions. The fellows did the operations and I moved back and forth between the two tables to offer assistance and provide direction and teaching.
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Operating Theatre
Wednesdays were devoted to teaching. This included a ward round where the entire Pediatric staff was present. The Pediatric ward is located on the fifth floor of the new hospital and consists of three adjacent open wards, each with about 20 beds. Children often share beds with their parents or other children. There is no division by sex or age. Infants who require traction often share one bed. The duration of hospital stay is never an issue. Almost nothing is done as an outpatient. Patients are frequently kept in the hospital for weeks until they are safe to leave. Social services or follow-up care in local communities is non-existent.
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Ward Rounds: Children sharing beds with parents or other children: The Result: We are now more than one year into the COEDN program at MOI in Tanzania. I was the faculty for month 13 of the program. By the end of this year Tanzania will have three extremely capable young Pediatric Orthopaedic surgeons who will be able to provide skilled Orthopaedic care to the more than 25 million children in Tanzania. These three surgeons will begin to train others so that ultimately the children of Tanzania will no longer be underserved. Peter B. Salamon MD
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AB 210
(SANTIAGO)
AB 133
(COMMITTEE ON BUDGET)
NEW LAWS2018 Significant new California laws of interest to physicians The California Legislature had an active year, passing many new laws affecting health care. On the following pages you will find highlights of the most significant health laws of interest to physicians.
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AB 1048
(ARAMBULA)
AB 242
(ARAMBULA)
AB 841
(WEBER)
ALLIED HEALTH PROFESSIONALS AB 89 (LEVINE) Psychologists: suicide prevention tr aining Requires, effective January 1, 2020, an applicant for licensure or license renewal as a psychologist to complete a minimum of six hours of coursework or applied experience under supervision in suicide risk assessment and intervention.
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AB 1153 (LOW) Podiatry Authorizes a doctor of podiatric medicine with training or experience in wound care to treat ulcers resulting from local and systemic etiologies on the leg no further proximal than the tibial tubercle.
SB 554 (STONE) Nurse pr actitioners: physician assistants: buprenorphine Prohibits construing the Nursing Practice Act, the Physician Assistant Practice Act, or any provision of state law from prohibiting a nurse practitioner or physician assistant from furnishing or ordering buprenorphine to a patient when done in compliance with the provisions of the federal Comprehensive Addiction Recovery Act.
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ANCILLARY SERVICES SB 512 (HERNANDEZ) Health care pr actitioners: stem cell ther apy Requires licensed health care practitioners who perform stem cell therapy that is not approved by the United States Food and Drug Administration (FDA) to communicate to their patients seeking stem cell therapy specified information regarding the provision of stem cell therapies on a specified notice in a prominent display in an area visible to patients in his or her office, posted conspicuously in the entrance of his or her office, and provided in writing to the patient prior to providing the initial stem cell therapy. Does not apply to a health care practitioner who has obtained approval for an investigational new drug or device from the FDA for the use of human cells, tissues, or cellular or tissue-based products.
CONFIDENTIAL INFORMATION AB 210 (SANTIAGO) Homeless multidisciplinary personnel team CMA Position: Support Authorizes counties to establish a homeless adult and family multidisciplinary personnel team, with the goal of facilitating the expedited identification, assessment, and linkage of homeless individuals to housing and supportive services and to allow provider agencies, including those providing health, mental health, and substance abuse services to share confidential information, for the purpose of coordinating housing and supportive services to ensure continuity of care. AB 1119 (LIMÓN) Developmental and mental health services: confidentiality CMA Position: Support Existing law requires all information and records obtained in the course of providing specified developmental and mental services to be confidential and authorizes disclosure only in specified cases. This bill additionally authorizes, during the provision of emergency services and care, the communication of patient information and records between specified individuals, including physicians and surgeons.
SB 241 (MONNING) Medical records: access CMA Position: Support Revises provisions of law governing the right of patients to access and copy their medical records by conforming these requirements to federal Health Information Portability and Accountability Act of 1996 (HIPAA) requirements, including conforming state law regarding charges for clerical costs and requiring health care providers to provide the records in an electronic format if they are maintained electronically and if the patient requests the records in an electronic format. SB 575 (LEYVA) Patient access to health records Expands a provision of law that entitles a patient to a copy, at no charge, of the relevant portion of the patient’s records that are needed to support an appeal regarding eligibility for certain public benefit programs, by including initial applications in addition to appeals, and by expanding the list of public benefit programs to include In-Home Supportive Services, the California Work Opportunity and Responsibility to Kids program, CalFresh, and certain veterans related benefits.
DRUG PRESCRIBING AND DISPENSING AB 40 (SANTIAGO) CURES database: health information technology system CMA Position: Support Requires the California Department of Justice (DOJ) to make electronic prescription drug records contained in its Controlled Substance Utilization Review and Evaluation System (CURES) accessible through integration with a health information technology system no later than October 1, 2018, if that system meets certain information security and patient privacy requirements.
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AB 265 (WOOD) Prescription drugs: prohibition on price discount CMA Position: Support Prohibits, with specified exceptions, a person who manufactures a prescription drug from offering in California any discount, repayment, product voucher, or other reduction in an individual’s out-of-pocket expenses associated with his or her health insurance, health care service plan, or other health coverage, including, but not limited to, a copayment, coinsurance, or deductible, for any prescription drug if a lower cost generic drug is covered under the individual’s health insurance, health care service plan, or other
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health coverage on a lower cost-sharing tier that is designated as therapeutically equivalent to the prescription drug manufactured by that person or if the active ingredients of the drug are contained in products regulated by the federal Food and Drug Administration, are available without prescription at a lower cost, and are not otherwise contraindicated for the condition for which the prescription drug is approved.
AB 720 (EGGMAN) Inmates: psychiatric medication: informed consent CMA Position: Support Extends to an inmate confined in a county jail the protection from being administered any psychiatric medication without his or her prior informed consent, with certain exceptions. Imposes additional criteria that must be satisfied before a county department of mental health or other designated county department may administer involuntary medication. Requires any court-ordered psychiatric medication to be administered in consultation with a psychiatrist who is not involved in the treatment of the inmate at the jail, if one is available. Requires a county that administers involuntary psychiatric medication to file a report with prescribed information to certain committees of the Legislature. AB 1048 (ARAMBULA) Health care: pain management and Schedule II drug prescriptions CMA Position: Sponsor Beginning July 1, 2018, authorizes a pharmacist to dispense a Schedule II controlled substance as a partial fill if requested by the patient or the prescriber. Requires the pharmacy to retain the original prescription, with a notation of how much of the prescription has been filled, the date and amount of each partial fill, and the initials of the pharmacist dispensing each partial fill, until the prescription has been fully dispensed. Authorizes a pharmacist to charge a professional dispensing fee to cover the actual supply and labor costs associated with dispensing each partial fill associated with the original prescription.
DID YOU KNOW CMA’S ONLINE HEALTH LAW LIBRARY IS FREE TO MEMBERS? CMA On-Call, the California Medical Association (CMA) online health law library contains nearly 5,000 pages of up-to-date legal information on a variety of subjects of everyday importance to practicing physicians. One of CMA’s most valuable member benefits, the searchable online library contains all the information available in the California Physician’s Legal Handbook (CPLH), an annual publication from CMA’s Center for Legal Affairs. CMA members can access
SB 17 (HERNANDEZ) Health care: prescription drug costs. CMA Position: Support Requires health plans and insurers that report rate information through the existing large and small group rate review process to also report specified information related to prescription drug pricing to Department of Managed Health Care (DMHC) and California Department of Insurance (CDI). Requires DMHC and CDI to compile specified information into a consumer-friendly report that demonstrates the overall impact of drug costs on health care premiums. Requires drug manufacturers to notify specified purchasers, in writing at least 90 days prior to the planned effective date, if it is increasing the wholesale acquisition cost (WAC) of a prescription drug by specified amounts. Requires drug manufacturers to notify Office of Statewide Health Planning and Development (OSHPD) three days after federal Food and Drug Administration (FDA) approval when introducing a new drug to market at a WAC that exceeds the Medicare Part D specialty drug threshold. Requires drug manufacturers to provide specified information to OSHPD related to the drug’s price.
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On-Call documents free at www.cmanet.org/cmaon-call. Nonmembers can purchase On-Call documents for $2 per page. CPLH, the complete health law library, is also available for purchase in a multi-volume print set or annual online subscription service. To order a copy, visit www.cplh.org or call (800) 882-1262.
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END-OF-LIFE ISSUES AB 242 (ARAMBULA) Certificates of death: veter ans CMA Position: Support Requires a person completing certificate of death to indicate whether the deceased person was ever in the Armed Forces of the United States. Requires the Department of Public Health to access data in the electronic death registration system to compile data on veteran suicides and to provide an annual report to the Legislature and the Department of Veterans Affairs.
HEALTH CARE COVERAGE SB 133 (HERNANDEZ) Health care cover age: continuity of care Requires a health care service plan to include notice of the process to obtain continuity of care in any evidence of coverage issued after January 1, 2018. Requires a health plan to provide a written copy of this information to its contracting providers and provider groups, and a copy to its enrollees upon request. Extends existing continuity of care protections in the Health & Safety Code and Insurance Code to health plan enrollees and insureds whose prior coverage was terminated because the health plan or insurer withdrew from any portion of a market. Requires a health plan or insurer to include notice of the availability of the right to request completion of covered services as part of, to accompany, or to be sent simultaneously with any termination of coverage notice sent under specified circumstances. SB 223 (ATKINS) Health care language assistance services Requires a health care service plan and a health insurer to notify enrollees or insureds upon initial enrollment and in the annual renewal materials of the availability of language assistance services and of certain nondiscrimination protections, and would require this information to be included in the evidence of coverage, on other materials disseminated to enrollees or insureds, and to be posted on the plan or insurer’s website. Requires this written notice to be made available in the top 15 languages spoken by limited-English-proficient (LEP) individuals in California as determined by the State Department of Health Care Services (DHCS). Establishes minimum qualifications for an interpreters providing interpretation services to enrollees and insureds and prohibits the plan or health insurer from requiring an LEP enrollee or insured to provide his or her own interpreter or rely on a staff member who is not a qualified interpreter to communicate directly with the enrollee or insured. Applies to Medi-Cal managed care plans, mental health plans, DHCS in addition to health care service plans and insurers.
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HEALTH CARE FACILITIES AND FINANCING AB 395 (BOCANEGRA) Substance use treatment providers Adds the use of medication-assisted treatment as an authorized service by narcotic treatment programs licensed by the State Department of Health Care Services. Authorizes methadone, LAAM, buprenorphine, or any other medication approved by the FDA for the purpose of medication-assisted treatment to be used by a licensed narcotic treatment program. Authorizes the department to implement, interpret, or make specific this provision by means of plan or provider bulletins, or similar instructions and require the department to adopt regulations no later than January 1, 2021. Authorizes a physician to treat a number of patients specified under the DEA registration instead of a maximum of 20. Specifies that bills for services under Drug MediCal must be submitted within six months. AB 658 (WALDRON) Clinical labor atories CMA Position: Support Directs the California Department of Public Health to temporarily suspend the annual renewal fee for clinical laboratory licenses until January 1, 2020. AB 1102 (RODRIGUEZ) Health facilities: whistleblower protections Increases the maximum criminal fine, from $20,000 to $75,000, for violations of whistleblower protection laws that apply to patients, employees, and other health care workers of hospitals. SB 54 (DE LEÓN) Law enforcement: sharing data CMA Position: Support Limits the involvement of state and local law enforcement agencies in federal immigration enforcement. States that the Attorney General shall publish model policies limiting assistance with immigration enforcement to the fullest extent possible consistent with federal and state law at public schools, public libraries, health facilities operated by the state or a political subdivision of the state, courthouses, Division of Labor Standards Enforcement facilities, the Division of Workers Compensation, and shelters, and ensuring that they remain safe and accessible to all California residents, regardless of immigration status. Requires all public schools, health facilities operated by the state or a political subdivision of the state, and courthouses to implement the model policy, or an equivalent policy. Encourages other entities that provide services related to physical or mental health to adopt the model policy. SB 219 (WIENER) Long-term care facilities: rights of residents CMA Position: Neutral Enacts the Lesbian, Gay, Bisexual and Transgender (LGBT) LongTerm Care Facility Residents’ Bill of Rights and makes it unlawful SPRING 2018
for any long-term care facility to take specified actions on the basis of a person’s actual or perceived sexual orientation, gender identity, gender expression, or human immunodeficiency virus status. Prohibited actions include denying admission to a facility, refusing to make room assignments based on a transgender resident’s gender identity, failing to use a resident’s preferred name or pronouns, and denying or restricting appropriate medical or nonmedical care. Requires each facility to post a nondiscrimination notice.
MEDI-CAL AB 205 (WOOD) Medi-Cal: Medi-Cal managed care plans CMA Position: Support Requires Medi-Cal managed care plans (MCMC) to maintain a network of providers that meet specified time and distance standards, specific to county and provider type. Requires plans that cannot meet the standards to submit a request for alternative access standards. Permits the use of clinically appropriate telecommunications technology as a means of determining annual compliance with the time and distance standards or in approving alternative access to care. Sunsets these requirements on January 1, 2022. Implements changes required by the federal Medicaid managed care rule related to state fair hearings involving MCMC beneficiaries as well as to beneficiary grievances and appeals to MCMC plans. AB 340 (ARAMBULA) Childhood tr auma screening CMA Position: Support Requires the State Department of Health Care Services (DHCS), in consultation with the State Department of Social Services and others, to convene, by May 1, 2018, an advisory working group to update, amend, or develop tools and protocols for screening children for trauma within the Early and Periodic Screening, Diagnosis, and Treatment Program benefit. Requires this group to report its findings and recommendations, as well as any appropriations necessary for implementation to DHCS and to the Legislature’s budget subcommittees on health and human services no later than May 1, 2019. Requires review of the protocols for the screening of trauma in children at least once every 5 years, or upon the request of the department. Authorizes DHCS to implement, interpret, or make specific these provisions by means of all-county letters, plan letters, or plan or provider bulletins. SB 171 (HERNANDEZ) Medi-Cal: Medi-Cal managed care plans CMA Position: Support Implements federal Medicaid managed care regulations. Commencing July 1, 2019, requires a Medi-Cal managed care plan to comply with a minimum 85 percent Medical Loss Ratio (MLR) and to report the MLR for each MLR reporting year as specified. Requires, effective for contract rating periods commencing on or after July 1, 2023, a Medi-Cal managed care plan to provide a remittance to the state if the MLR does not meet the minimum ratio of 85 percent for that reporting year, and specifies how any remittance will be transferred. Requires the Department of Health Care Services (DHCS) to ensure that call covered mental health and substance use disorder benefits comply with federal regulations. Directs DHCS to require Medi-Cal managed care plans to increase certain payments to designated public hospitals, as specified, and to establish a program under which such hospitals may earn performance-based quality incentive payments.
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MEDICAL CANNABIS AB 133 (COMMITTEE ON BUDGET) Cannabis Regulation Makes changes to the Medicinal and AdultUse Cannabis Regulation and Safety Act and repeals prohibition limiting medicinal cannabis manufacturers to only manufactures medicinal cannabis products for sale by a medicinal cannabis retailer. Provides of an exception to the prohibition by an adult use cannabis licensee from allowing persons under 21 years of age on its premises if the licensee holds a medicinal license, as specified. Allows for the sale of medicinal cannabis products to the primary caregiver of a person who possesses a valid recommendation. SB 94 (COMMITTEE ON BUDGET AND FISCAL REVIEW) Cannabis: medicinal and adult use CMA Position: Support Establishes a single system of administration for cannabis laws in California. Contains changes to the Budget Act of 2017 that are necessary for state licensing entities to implement a regulatory framework pursuant to the Medical Cannabis Regulation and Safety Act (MCRSA) and the Adult Use of Marijuana Act (AUMA) of 2016 (Proposition 64). Conforms MCRSA and AUMA into a single system that prioritizes consumer safety, public safety and tax compliance. Creates agricultural cooperatives, a method for collecting and remitting taxes, a process for testing and packaging, and a process for collecting data related to driving under the influence.
MENTAL HEALTH AB 1315 (MULLIN) Mental health: early psychosis and mood disorder detection and intervention Establishes the Early Psychosis Intervention Competitive Selection Process Plus Program and an advisory committee to the Mental Health Services Oversight and Accountability Commission to expand the provision of highquality, evidence-based early psychosis
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and mood disorder detection and intervention. Establishes the Early Psychosis Detection and Intervention Fund and provides that moneys in the fund shall be available, upon appropriation by the Legislature, to the commission for the purposes of the bill.
SB 565 (PORTANTINO) Mental health: involuntary commitment Requires mental health facilities, upon a patient’s completion of a 14-day period of intensive treatment for mental disorder or impairment by chronic alcoholism, to make reasonable attempts to notify family members or any other person designated by the patient at least 36 hours prior to any certification review hearing for an additional 30 days of treatment.
PROFESSIONAL LICENSING AND DISCIPLINE AB 508 (SANTIAGO) Health care pr actitioners: student loans CMA Position: Support Repeals provisions of law authorizing boards to cite and fine, or deny licensure or licensure renewal, to a health care practitioner if he or she is in default on a United States Department of Health and Human Services education loan. AB 1340 (MAIENSCHEIN) Continuing medical education: mental and physical health care integr ation Requires the Medical Board of California to consider including in its continuing education requirements a course in integrating mental and physical health care in primary care settings, especially as it pertains to early identification of mental health issues and exposure to trauma in children and young adults and their appropriate care and treatment. SB 798 (HILL) Healing arts: boards Extends the operation of the Medical Board of California until 2022 and makes various changes to the Medical Practice Act. Includes, among other provisions, elimination of the medical board’s authority to approve ABMS equivalent boards, establishes a post-graduate training license for physicians, requires additional residency training, makes the Board of Podiatric Medicine independent of the Medical Board of California, changes the adverse event reporting requirements for outpatient surgery settings, changes the requirements for use of an expert witness in disciplinary cases, extends the authorization for the Osteopathic Medical Board of California (OMBC), and makes changes to continuing medical education for OMBC-licensed physicians.
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PUBLIC HEALTH AB 643 (FRAZIER) Pupil instruction: abusive relationships Amends the California Healthy Youth Act to require school districts to include information about the early warning signs of adolescent relationship abuse and intimate partner violence in its comprehensive sexual health education and HIV prevention education for all pupils in grades 7 to 12. AB 841 (WEBER) Pupil nutrition: food and bever ages: advertising CMA Position: Support Prohibits, except as provided, a school, school district, or charter school from advertising food or beverages during the school day, and from participating in a corporate incentive program that rewards pupils with free or discounted foods or beverages that do not comply with specified nutritional standards when the pupils reach certain academic goals. Provides that it is the intent of the Legislature that the governing board or body of a school district and a charter school annually review their compliance with these provisions. AB 1221 (GONZALEZ FLETCHER) Responsible Bever age Service Tr aining Progr am Act of 2017 CMA Position: Sponsor Establishes the Responsible Beverage Service (RBS) Training Program Act of 2017, and requires the Department of Alcoholic Beverage Control, on or before January 1, 2020, to develop, implement, and administer a curriculum for an RBS training program. Beginning July 1, 2021, requires an alcohol server to successfully complete an RBS training course offered or authorized by the department. Authorizes the department to charge a fee, not to exceed $15, for any RBS training course provided by the department and require the fee to be deposited in the Alcohol Beverage Control Fund. SB 239 (WIENER) HIV and AIDS: criminal penalties CMA Position: Support Modifies criminal penalties related specifically to human immunodeficiency virus (HIV) that imposed stricter criminal penalties to individuals infected with HIV in comparison to other communicable diseases. Repeals provisions making the intentional exposure to another person by a person who has tested positive for HIV a felony. Eliminates criminal penalties specific to HIV-infected individuals and instead makes the intentional transmission of an infectious or communicable disease a misdemeanor if specified circumstances apply. >>
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SB 536 (PAN) Firearm Violence Research Center: gun violence restr aining orders CMA Position: Support Requires the state Department of Justice (DOJ) to make information related to gun-violence restraining orders that is maintained in the California Restraining Order and Protective Order System or any similar database maintained by DOJ available to researchers affiliated with the University of California’s Firearm Violence Research Center, or, at the discretion of DOJ, any other entity that is concerned with the study and prevention of violence, for academic and research purposes.
WORKERS’ COMPENSATION SB 189 (BRADFORD) Workers’ compensation: definition of employee CMA Position: Sponsor Provides clarification to AB 2883 (Insurance Committee, 2016) which allowed shareholder employees with at least a 15 percent ownership stake in a corporation to exempt themselves from workers’ compensation coverage. This bill reduces the ownership threshold for an officer or member of the board of directors who wishes to waive workers’ compensation coverage to 10 percent. Expands the grounds for waiving workers’ compensation coverage to include owners of a professional corporation if the owner is a practitioner of the professional services for which the professional corporation was created and the owner is covered by a health insurance policy or health care service plan. Expands the grounds for waiving workers’ compensation coverage to board members of worker-owned cooperatives and to closely-held family businesses. SB 489 (BRADFORD) Workers’ compensation: change of physician CMA Position: Support Extends the timeline for submitting claims related to emergency medical treatment to the employer, or its insurer or claims administrator in workers’ compensation system 30 days to 180 days from the date the service was provided to the injured worker.
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WORKFORCE & OFFICE SAFETY ISSUES AB 461 (MURATSUCHI) Personal income taxes: exclusion: forgiven student loan debt CMA Position: Support Excludes from gross income, for taxable years beginning on or after January 1, 2017, and before January 1, 2022, student loan debt, which may include a medical school loan, that is cancelled under specified repayment plans for public service and other employees administered by the United States Secretary of Education. SB 63 (JACKSON) Unlawful employment pr actice: parental leave CMA Position: Support Requires specified employers to allow specified employees to take up to 12 weeks of parental leave within one year of a child’s birth, adoption, or foster care placement. Prohibits an employer from refusing to maintain and pay for coverage under a group health plan for an employee who takes this leave. Does not apply to employees subject to both state and federal laws regarding family and medical leave. SB 179 (ATKINS) Gender identity: female, male, or nonbinary Provides for a third gender option on the state driver’s license, identification card, and birth certificate. Restructures the process for individuals to change their name to conform with their gender identity, and amends procedures for an individual to secure a court-ordered change of gender. The provisions of this bill are effective September 1, 2018. SB 396 (LARA) Employment: gender identity, gender expression, and sexual orientation Requires specified employers to include, as a part of existing required sexual harassment training, training on harassment based on gender identity, gender expression, and sexual orientation. Requires employers to post a poster developed by the Department of Fair Employment and Housing regarding transgender rights in a prominent and accessible location in the workplace.
These are just a sampling of the new laws impacting health care in 2018 and beyond. For a comprehensive list, see “Significant New California Laws of Interest to Physicians for 2018,” in the California Medical Association’s online resource library at www.cmanet.org/resource-library.
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A
World-Class Partnership Dameron Hospital’s new partnership with Stanford Medicine seeks to ‘re-invent’ cardiothor acic care in the Centr al Valley BY JAMES NOONAN
For patients in the Centr al Valley, world-class cardiothor acic care has arrived. Late last year, Dameron Hospital announced a new partnership with Stanford Health Care and the Stanford University School of Medicine to establish a joint cardiothoracic surgery program at the hospital’s campus in Stockton, one that leadership says will bring cutting-edge techniques and procedures to one of the region’s longest serving hospitals. “We’re basically re-inventing the way that cardiac care is delivered in the community,” said Lorraine Auerbach, president and chief executive officer of Dameron Hospital. “This is a tremendously exciting development, and one that re-invigorates our program and helps deliver the best level of care possible to our community.” >>
“Many patients prefer to undergo procedures closer to home, and t his partnership gives t hem t he ability to do t hat,” - Joseph Woo, MD
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Under the new partnership, a team of Stanford Medicine physicians will be performing a variety of cardiothoracic surgical procedures that were previously unavailable at Dameron’s facilities, helping keep Central Valley patients in their community when they seek out complex medical care. According to hospital leadership, the partnership with Stanford has been years in the making, and represents a major step toward increasing the level of care being offered to Central Valley residents. “Starting about three years ago, I reached out to Stanford about their interest in partnering with us, and in bringing their level of healthcare out to the Central Valley,” Auerbach said. “At the time, we were starting to evaluate where our hospital was, and where our patients go for care, and this partnership really arose from that discussion.” In examining the level of care delivered by Dameron Hospital, Auerbach and her team discovered that a large percentage of Central Valley residents, somewhere in the neighborhood of 20 to 30 percent, were choosing to leave the community to meet their health care needs, particularly when their situations required a difficult or complex solution. “We’re mainly talking about university-level, tertiary- or quaternarylevel care,” Auerbach said. “Seeing this data, we began looking for alternatives. We said to ourselves, ‘Instead of people having to leave, why not attempt to bring that level of care here?’” Auerbach notes that, in addition to logistical advantages for the patients, receiving care closer to home can lead to more successful outcomes and a less-stressful healing process after undergoing surgical procedures. “A lot of these procedures that patients were leaving the community to get are things that they should be able to find locally,” Auerbach said. “It’s kind of a given that when people are surrounded by family and friends, sort of in a home environment, that the healing process is better.” In addition to eliminating the inconveniences that come with traveling for medical care, the partnership between the two entities also brings some top-tier medical talent to the 200-bed Stockton facility. The Stanford Cardiac Surgery Program at Dameron Hospital is comprised of surgeons who are members of Dameron’s medical staff and faculty members in the Stanford University School of Medicine’s Cardiothoracic Surgery Department, led by department chairman and world-renowned cardiothoracic surgeon, Joseph Woo, MD. According to Dr. Woo, Stanford Health Care is creating new delivery models to create seamless continuity of care for every patient and is actively working on expanding its services beyond the Bay Area. “Many patients prefer to undergo procedures closer to home, and this partnership gives them the ability to do that,” Woo said. “This new program will enhance the standard of surgical care available in the community and leverages the best of what Stanford Health Care and Dameron bring to the table, respectively, as health care providers.”
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“This new progr am will
enhance t he standard of surgical care available in the community and
lever ages the best of what Stanford Health Care and Dameron bring to the table, respectively, as health care providers.”
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-
Joseph Woo, MD
Woo explained that, under the new partnership, patients needing to undergo advanced cardiothoracic procedures would now be able to do so at Dameron Hospital, where the surgeries would be completed by Stanford surgeons. Should more complex situations arise requiring university-level care, patients can be seamlessly transferred to Stanford’s facilities in Palo Alto. Woo also pointed out that the program will be supported from the main Stanford campus through a combination of clinical research and educational programs, and the Stanford physicians will also be available for tele-medicine consultations with other Dameron-based surgeons. Both sides note that the partnership could yield yet to be discovered benefits for both sides when it comes to physician education, and that teaching opportunities
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“My goal as a surgeon is to provide the safest and best cardiothor acic surgical procedures and techniques for all of my patients, particularly the fr ail elderly. To this end, I have
safest and most advanced approaches to heart and lung surgery
specialized in the
because this is the kind of care I would want members of my own family to receive,” -
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Eric Keyser, MD,
such as sending medical students or other trainees to gain experience at Dameron could be in the cards at some point in the future. Dan Polcyn, Stanford’s executive director of business development, echoed these sentiments, noting that partnerships like these often yield a variety of benefits for both sides. “We are always responsive when inquiries come in from communities. In this situation, given that we have a strong brand name, and leadership who is willing to place collaborating physicians in a community, the partnership made natural sense,” Polcyn said. “We see it as a win-win, both for Stanford and Dameron, as well as for the patients living in the community.” As Polcyn explains, a major component of the new partnership boils down to the placing of Stanford physicians, who can perform these innovative and cutting-edge procedures, in the Central Valley. These physicians live in the community, work in the community and come to call this place their home. The first of these physicians is Eric Keyser, MD, a Stanford clinical assistant professor of cardiothoracic surgery, who located his full-time practice to Dameron Hospital last year. Keyser is an accomplished and decorated surgeon, one who completed his medical training at McGill University Faculty of Medicine in Montreal, Quebec. Keyser went on to complete his residency in cardiothoracic surgery at Long Island Jewish Medical Center in New York, and has undergone specialized fellowships at Massachusetts General Hospital, University of California, San Diego and McGill University. “My goal as a surgeon is to provide the safest and best cardiothoracic surgical procedures and techniques for all of my patients, particularly the frail elderly. To this end, I have specialized in the safest and most advanced approaches to heart and lung surgery because this is the kind of care I would want members of my own family to receive,” said Dr. Keyser. “I’m looking forward to leading the Stanford Cardiac Surgery Program at Dameron and making Stockton my new home.” Leadership at Dameron Hospital is actively recruiting a second physician to join Dr. Keyser, Auerbach said, while pointing out that the partnership, to date, has been rolling out as expected. “The implementation has been very smooth,” she said. “Things like this just take time, and out of respect for what we’re actually doing, when dealing with patients and their care, I think that’s natural.” For a community hospital that has been offering care in the Central Valley for more than 100 years, innovative partnerships such as these are vital to the aim of staying atop of medicine’s leading edge. To that end, Dameron’s leadership remains committed to exploring and implementing relationships that can translate to the desired outcome of increased patient care. “We’re moving in a direction that’s really bringing a much higher level of care to the community,” Auerbach said. “Dameron’s been a fixture in this community for quite some time. We’re here to stay, and we’re committed to bringing the best level of care to the community possible.”
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S A N J OAQ U I N M E D I C A L S O C I E T Y ' S A N N UA L
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S A N J OAQ U I N M E D I C A L S O C I E T Y ' S A N N UA L
T H U R S DAY
DECEMBER 14
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S TO C K TO N G O L F & CO U N T RY C LU B
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In The News
IN THE
NEWS
Lainey Lynn Welcome Lainey Lynn We are excited to welcome the adorable Lainey Lynn Peluso into the SJMS family. Lainey was born to Membership Coordinator, Jessica and her husband Matt Peluso on January 1, 2018. The new, little family is doing great! Brandon May Named CEO of Doctors Hospital of Manteca Brandon May has been named CEO of Doctors Hospital of Manteca, effective Feb. 2, 2018. “Brandon is an accomplished healthcare executive
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Providing staff, physicians, and patients with relevant & up to date information
with significant hospital leadership experience,” said Warren J. Kirk, CEO of Tenet’s Northern California Hospital Group. “He is an outstanding addition to our exceptional team and will help us build upon the great work already taking place at Doctors Hospital of Manteca.” Brandon May May comes to Manteca from Tenet Healthcare’s The Hospitals of Providence, East Campus in El Paso, Texas, where he served as CFO, COO and Interim CEO throughout his tenure. At East Campus, May led hospitalwide labor management initiatives and provided financial, operational and strategic leadership for a $67 million, 72bed tower expansion and 18-bed Emergency Department expansion. Under his leadership the hospital consistently achieved a Safety Score of “A” from The Leapfrog Group. Collectively, the achievements of May and his leadership team resulted in East Campus being named a 2015 Tenet Circle of Excellence recipient. Before that, he served as CFO of Tenet’s Westlake Hospital in Chicago, Illinois. He was also CFO and a compliance officer at Bartow Regional Medical Center in Bartow, Florida. May holds a bachelor of business administration degree in finance and a master of business administration degree from Texas Tech University in Lubbock, Texas. “I am truly excited to be given this opportunity to lead
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the team at Doctors Hospital of Manteca,” May said. “I look forward to working collaboratively with the dedicated employees and physicians at Doctors Hospital of Manteca to fulfill our mission of enriching the health and lives of the patients and the community we serve.” FCPP Welcomes New Pediatrician Princess Dela Pena, M.D. joined the Pediatrics Department of First California Physician Partners in 2017, filling a much needed position in the Manteca area. Her education began at the University Princess Dela Pena, M.D. of Santo Tomas in Manila, Philippines where she completed Medical School and was then certified by the Philippine Pediatrics Society Specialty Board. She then finished her Residency training at St. Joseph’s Regional Medical Center in Paterson, New Jersey in 2017. Dr. Dela Pena is new to California and looks forward to exploring all of its natural wonders. She is very talented musically, as she can play the piano, organ, and guitar. And when it comes to art, she loves to sketch and do scrap booking. Adventist Health Lodi Memorial Awarded Advanced Certification for Primary Stroke Centers Adventist Health Lodi Memorial has earned The Joint Commission’s Gold Seal of Approval® and the American Heart Association/American Stroke Association’s HeartCheck mark for Advanced Certification for Primary Stroke Centers. “Providing quality healthcare for patients and our community is at the center of Adventist Health Lodi Memorial’s mission, and we are honored to be recognized nationally for our ability to treat stroke cases and provide an advanced level of care,” said Adventist Health Lodi Memorial President Daniel Wolcott. “This certification speaks to our healthcare team’s commitment to stroke patients in and around Lodi,
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and has proven our ability to offer effective, timely care to stoke victims and significantly improve outcomes for stroke patients.” Adventist Health Lodi Memorial underwent a rigorous on-site review in November 2017. Joint Commission experts evaluated compliance with stroke-related standards and requirements, including program management, the delivery of clinical care and performance improvement. “Adventist Health Lodi Memorial has thoroughly demonstrated the greatest level of commitment to the care of stroke patients through its Advanced Certification for Primary Stroke Centers,” said Patrick Phelan, executive director, Hospital Business Development, The Joint Commission. “We commend Adventist Health Lodi Memorial for becoming a leader in stroke care, potentially providing a higher standard of service for stroke patients in its community.” A stroke is a medical emergency in which the blood supply is cut off from the brain. It’s best to get to an emergency room immediately – within one hour of experiencing symptoms. The stroke center designation is especially meaningful in Lodi, which has a high incident of stroke. Often, the biggest problem with stroke is people don’t get treatment fast enough, particularly because many don’t know they are experiencing a stroke. “If you think you’re having a stroke, it’s important to remember the acronym F.A.S.T. F is facial weakness, A is for arm weakness, S is for speech impediment and T stands for time – time to call 9-1-1,” said Amanda deNu, Adventist Health Lodi Memorial stroke coordinator. “Though Adventist Health Lodi Memorial has been offering stroke care for years, the community now knows they can count on us for standardized, evidence-based excellence in stroke care close to home.” General surgeon Dr. Lee joins Adventist Health Lodi Memorial Board-certified general surgeon Dr. John Lee, MD, FACS has joined Adventist Health Lodi Memorial. He comes to the Lodi area with more than a decade of experience as a surgeon. Dr. Lee graduated from the University of Buenos Aires, Argentina in 1995 and then completed a general surgery residency at the National Institute of Cancer, Paraguay followed by a minimally invasive surgery fellowship and general surgery residency at the University of Nebraska Medical Center. Most recently, he worked at Marshall Medical Center in Placerville and Riverside County Regional Medical Center in Southern California.
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In The News
IN THE
NEWS Dr. Lee has experience and expertise in roboticassisted surgery and laparoscopic surgery. He has held numerous teaching positions at medical schools in the United States, including University of California, Riverside School of Medicine and Loma Linda University School of Medicine. In addition, he has authored Dr. John Lee, MD, FACS numerous articles and publications about minimally invasive surgery. Fluent in both Spanish and Korean, Dr. Lee takes pride in creating highly individual approaches to caring for patients and finding solutions to complex clinical situations. Outside of work, Dr. Lee enjoys playing tennis and spending time with his wife, son and two daughters. He is seeing patients at Adventist Health Physicians Network Medical Office – General Surgery, 999 S. Fairmont Ave., Suite 100, in Lodi. Call 209-334-8510 to make an appointment. Orthopedic surgeon Dr. Roland Nakata joins Adventist Health Lodi Memorial Orthopedic surgeon Dr. Roland Nakata, MD, has joined Adventist Health Lodi Memorial. Dr. Nakata is board certified, provides comprehensive orthopedic care and specializes in hand surgery. He owned and operated a private orthopedic practice in Lodi for more than 30 years.
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Providing staff, physicians, and patients with relevant & up to date information
Dr. Roland Nakata, MD
Dr. Nakata decided to join Adventist Health Lodi Memorial’s team of orthopedic specialists in 2017. Together, they are proud to deliver consistent and reliable outcomes for their surgical patients, whether they are treating joint conditions, sportsrelated injuries, arthritis or other
conditions. Originally from Hawaii, Dr. Nakata moved to California in 1965. He received an undergraduate degree from Pacific Union College and attended medical school at Loma Linda University School of Medicine, where he also completed a hand surgery fellowship. Outside of work, Dr. Nakata enjoys spending time with his wife, adult son and twin daughters. His hobbies include working on the farm, snow skiing and snorkeling. Dr. Nakata is seeing patients at Adventist Health Physicians Network Medical Office – Orthopedics, 815 S. Fairmont Ave. in Lodi. Call 209-333-1884 to make an appointment. Michael Hurst, DO, joins Dameron Hospital as newest Occupational Medicine and Ambulatory Care Specialist Michael Hurst, DO, MPH, has joined Dameron Hospital as its new Occupational Medicine and Ambulatory Care Specialist.
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Dr. Hurst brings with him years of internal medicine and pediatrics experience to Dameron. He is a graduate of San Diego State University, where he obtained his Masters in Public Health and his Bachelor of Science degree in Microbiology. He also received his Doctorate Michael Hurst, DO of Osteopathic Medicine at the Kirksville College of Osteopathic Medicine in Kirksville, Missouri. Combining both internal medicine and pediatrics, Dr. Hurst continued his education and training serving his residency at Hurley Medical Center in Flint, Michigan. Dr. Hurst is a member of the American Osteopathic Association, the American Academy of Pediatrics and the American College of Physicians/American Society of Internal Medicine. When he’s not at Dameron, Dr. Hurst likes to spend time with his family, refresh himself on the latest Osteopathic techniques and engage in off-road biking. San Joaquin General Hospital Welcomes Neurosurgeon Gowriharan Thaiyananthan, M.D. Dr. Thaiyananthan is seeing patients at the Hospital’s neurosurgery medical office at 2209 N. California Street. He Gowriharan Thaiyananthan, M.D. is joining fellow SJGH neurosurgeons Moris Senegor, MD, Azeem Oladunjoye, MD and Abbas Bahari, MD. He received his medical training at UCSF Medical school and his neurosurgical residency at Yale New Haven Hospital, followed with a fellowship at Cedar Sinai-Institute for spinal
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disorders, minimally invasive spine surgery. He is a member of the American Assoc. of Neurological Surgeons. Palliative Care – Health Plan of San Joaquin’s local partnerships offer head start for new Medi-Cal mandate In September 2016, HPSJ and San Joaquin General Hospital, opened a palliative care program within an SJGH clinic. It continues to provide patient- and family-centered care for HPSJ patients with end-stage liver disease, advanced cancer, end-stage congestive heart failure or end-stage chronic pulmonary disease. HPSJ’s Medical Management team supports SJGH in offering patients four options: home visits from certified nurses, hospital outpatient clinic visits, a telephone care program with a certified social worker, or any combination of these. Building on success, and with grant funding for staff education, outreach, program development, oversight and evaluation, in July 2017, HPSJ launched an outpatient palliative care pilot. Offering in-home consultation and 24/7 telephonic support through SJGH and two newly formed palliative care agency partners, HPSJ supported enhanced local care expertise, capacity and services. HPSJ’s Palliative Care Options agency partners are Transitions Palliative Care, a service of Hospice of San Joaquin (San Joaquin County) and Community Care Choices - Palliative Care Program of Community Hospice (Stanislaus County). As of January 1, 2018, palliative care is a mandated Medi-Cal benefit. With its early, collaborative build up, HPSJ members had a head start for state-mandated palliative care. Now, our wider local community has expanded capacity to provide the kind of palliative care that can support patients during the palliative care phase, and then ease them into eventual hospice care. For more information about Palliative Care Options, contact HPSJ Case Management staff at 209-942-6320. Health Plan of San Joaquin adds triaged physician consults for an enhanced Health Reach 27/7 Advice Nurse/Physician Line HPSJ is excited to introduce this enhanced level of service. Now, when HPSJ patients call Health Reach 24-hour Nurse Advice Line, they also may be eligible to receive a telephone consult with an MD when appropriate. The nurse triages the call, provides advice and, when appropriate, refers the caller for a telephone consult with
SAN JOAQUIN PHYSICIAN
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In The News
IN THE
NEWS a physician. The physician can provide appropriate recommendations and prescriptions for simple conditions, including: cold and flu, or rashes and infections such as sinusitis and conjunctivitis. They will provide prescriptions if needed. The primary care provider receives a summary of the telephone consult. Health Reach – 24-hour Nurse/Physician Advice Line can be reached at 1-800-6558294. This toll free number can be found on each member’s ID card. This is an enhanced service, available through participation in the HPSJ Provider Network. HPSJ patients, at no charge to them, are encouraged to call, whether at home or on the go, when their provider is not available, or in conjunction with their services. SCRUBS for Health Careers Academy Health Plan of San Joaquin continues to have the honor of supporting our next generation of professionals, most recently again donating a set of scrubs to each freshman member of the Health Careers Academy class of 2021. HPSJ Health Articles Library – sound, timely advice each month for patients A growing repository of timely health articles created by HPSJ staff is available on their website, www.hpsj.com/health-articles/. Health care providers are invited to draw from this library and provide to patients, or include these in practice newsletters and other practice social media. Here are a few of the topics: “Curing Colds, do alternative medicines work?” and “Men’s
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Providing staff, physicians, and patients with relevant & up to date information
HPSJ Scrubs for HCA Health Month - Exams and Screenings” and “How to Stop Tooth Decay in Your Baby” and “Women’s Health – Stay informed and be in control.” To receive regular updates on new HPSJ Health Library Articles, subscribe to the monthly CommuniteNews from HPSJ, at hpsj.us13.list-manage2.com/subscribe. There is no charge for the articles. St. Joseph’s Medical Center Recognizes Kwabena O.M. Adubofour, M.D. and Venkata R. Emani, M.D. as 2017 Physician Champions Each year St. Joseph’s medical staff physicians are called upon to nominate their deserving peers to be recognized for the
SPRING 2018
Kwabena O.M. Adubofour, M.D.
Venkata R. Emani, M.D.
annual Physician Champion Awards. The awards recognize a “Champion of Community,” described as a physician who has demonstrated a commitment to improving the health status of the community, and a “Champion of Quality,” a physician who continuously pursues quality improvement through innovation. This year’s awardees are Kwabena O.M. Adubofour, M.D. for Physician Champion of Community and Venkata R. Emani, M.D. for Physician Champion of Quality. Dr. Adubofour has contributed greatly to the education of students through the Decision Medicine program, a two-week program that introduces students to the field of medicine through personal mentoring and site visits with behind the scenes access at local hospitals, clinics, and public health centers. Dr. Adubofour is also known for his continuous work with community diabetes education. As physician champion and leader of the Stroke Committee at St. Joseph’s Medical Center, Dr. Emani has made important contributions to the quality of care for patients with cerebrovascular disease. He has also served in various leadership roles on the medical staff.
physicians to manage heart failure. “This new technology allows us to monitor CHF patients closely from home, greatly reducing the need for hospitalization,” said Dr. Gurinder Grewal, the cardiologist who performed the first procedure at St. Joseph’s. The CardioMEMS HF System features a sensor that is implanted in the pulmonary artery (PA) during a non-surgical procedure to directly measure PA pressure. Once implanted, the wireless sensor sends pressure readings to an external patient electronic system. The CardioMEMS HF System allows the patients to transmit critical information about their heart failure status to a clinician on a regular basis, without the need for additional clinic or hospital visits. This provides clinicians with the ability to detect worsening heart failure sooner, and adjust treatment to reduce the likelihood that the patient will need to be hospitalized. “St. Joseph’s is proud to be a leader in cardiac care, continually bringing new and innovative technology like CardioMEMS to our patients, and elevating the level of care available in our community,” said Joann Marks, MSN, RN, director of Cardiovascular Services for St. Joseph’ s.
It Pays To Be The Best QUALITY • COST • SERVICE
St. Joseph’s Now Offers CardioMEMS Heart Failure Monitoring Solution St. Joseph’s Heart and Vascular Institute is now offering a new miniaturized, wireless monitoring sensor to manage heart failure (HF). The CardioMEMS HF System is the first and only FDAapproved heart failure monitoring device that has been proven to significantly reduce hospital admissions when used by
SPRING 2018
Are You Ready? We Can Help.
The environment of health care is changing—you have the opportunity to not only become sustainable but to succeed. Our team will help you become ADEPTSM at the business of health care. Irv Barnett, MBA, CMPE ibarnett@V2VMS.com 916.747.9611 v2vms.com
SACRAMENTO | ATLANTA | BELLINGHAM | LEWISTON
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In The News
IN THE
NEWS St. Joseph’s to Host Insights in Cardiovascular Care Symposium St. Joseph’s will be hosting a Cardiac Symposium for health care professionals focused on shared care of the cardiovascular patient, including mitral valvular care, cholesterol care, and the effects of relaxation and meditation. The program has been designed for physicians, nurses, and other clinical practitioners involved in the diagnosis, treatment, and care of individuals with cardiovascular diseases. The symposium will be held on Saturday, April 7, 2018, from 8am – 2:30pm at Brookside Golf & Country Club in Stockton. Physicians can attend for free, and earn 5 CME Category 1 credits. To learn more and register, please call St. Joseph’s Education Department at 209.467.6331.
Providing staff, physicians, and patients with relevant & up to date information
St. Joseph’s Awards $227,000 in Community Grants St. Joseph’s Medical Center has awarded over $227,000 in grant funding to three local community benefit organizations that provide critical health and human services to residents in San Joaquin County. Grants were awarded to three community organizations, in partnership with other local agencies, seeking to build healthier communities by improving health and living conditions. Gospel Center Rescue Mission, in partnership with Community Medical Centers/Gleason House Clinic, Hospice of San Joaquin, & Quail Lake Baptist Church was awarded $100,000 for the Recuperative Care Program. This program targets men and woman who are ready to be discharged from a community hospital, but have no home to go to and no trusted family member or friend to care for them during their post-hospital stage of recovery. Community Medical Centers, in partnership with San
HAVE SOMETHING TO SHARE? We welcome submissions to our In-the-News Section from our community healthcare partners. We prefer Word files and .jpg images and may edit for space restrictions. Send your files to lisa@sjcms.org one month prior to publication (February 1st for the Fall issue, May 1st for the Fall issue, August 1st for the Fall issue and November 1st for the Fall issue).
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SPRING 2018
Joaquin County Behavioral Health Services and Sacramento Self Help Housing was awarded $27,749 to provide a Behavioral Health Navigator with behavioral health expertise to help establish a link between the patient, their family and their care team. Sacramento Self Help Housing, in partnership with Catholic Charities of Stockton, & Community Medical Centers was awarded $100,000 to support Respite House, a program designed to assist Hospital and Behavioral Health Center patients who are otherwise ready for discharge but are homeless or have no safe housing to be discharged to. The Community Grants Program was established in 1990 to provide funding to community-based organizations that provide services to individuals in need. Since its inception, the program has distributed nearly $3.2 million in grant funding to deserving nonprofit community benefit organizations. St. Joseph’s annually sets aside revenues from operations to fund the community grant awards.
Available Space to Lease for Medical Office: For Medical office in Weber Ranch Professional park, 1801 East March Lane, Stockton, CA; call today at 209-951-8830 or 951 83 95; 1367 sq. ft. fully finished ready to move in with 4 exam rooms, Doctor's Chamber with separate bath room. Manager's room, work station for MAs, Patient's bath room, storage room, and Reception (waiting room).
Michael R. MoRdaunt PeteR J. Kelly
California Correctional Health Care Services is Hiring California Correctional Health Care Services is seeking 2-3 IM/FP Primary Care Physicians. Up to $327,540 annually plus $50-$60K w/On-Call can be $380-$390K! Benefits include: 4-day workweek; 10 patients per day; generous paid time off; State of CA Pension that vests in 5 years; plus 401(K) and 457 retirement options – tax defer up to $48K; and much more! Contact Danny Richardson, Hiring Analyst, at (916) 691-3155 or danny.richardson@cdcr.ca.gov. EOE.
SPRING 2018
RichaRd J. SoRdello, JR. StePhanie Roundy loRi a. Reihl cuRtiS e. JiMeRSon JaMil R. GhannaM
our firm devotes its practice to civil litigation with decades of experience representing healthcare professionals in: • MEDICAL MALPRACTICE ACTIONS • Medical BoaRd inveStiGationS • HOSPITAL CREDENTIALING PRoceedinGS • PeRSonal inJuRy litiGation
2509 West March lane, Suite 200 Stockton, california 95207 Phone (209) 473-8732 Fax (209) 957-9165 rmktriallawyers.com
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Gail Joseph, M.D.
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SPRING 2018
Sometimes You Just Need a Little Help.
EXCI
RAFFTING PRIZ LE E S
Ninth Annual Golf Tournament Join fellow San Joaquin Medical Society members and invited guests for a relaxing round of golf, BBQ lunch, dinner and after golf party. Exciting and generously donated raffle prizes you don’t want to miss. Plus an opportunity to benefit our local The First Tee of San Joaquin and SJMS’ Decision Medicine programs. Your hosts, Drs. Kwabena Adubofour, George Herron, Prasad Dighe and George Khoury are committed to making this an event to remember!
Sunday April 29, 2018 • Brookside Country Club • 4 Person Scramble $175 per golfer - Price includes green fees, golf cart, lunch, after golf dinner and party! See registration form for details. $50 of every entry fee goes to The First Tee of San Joaquin program Hole Sponsorships benefit SJMS’ Decision Medicine Program
Registration and Range Open 11:00am • Putting Contest Qualifying 11:00am - 12:30pm Buffet Lunch 12:00pm • Shotgun start 1:00pm
To sign up, please call the San Joaquin Medical Society office at 209-952-5299 SPRING 2018
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practice manager Free to SJMS/CMA Members!
resources
The Office Manager’s Forum empowers physicians and their medical staff with valuable tools via expert led educational sessions from industry professionals who are committed to delivering quality health care. For more than 130 years, the San Joaquin Medical Society (SJMS) has been at the forefront of current medicine, providing its physician’s and their staff with assistance and valuable practice resources. SJMS is proud to offer the Office Manager’s Forum, a monthly educational seminar designed to enhance the healthcare environment with professional development opportunities while providing solutions to some of the challenges that come from managing a practice. Attendees gain knowledge on a broad array of topics related to the field of medical staff services, office management, billing and coding, human resources, accounting and back office support. The Office Manager’s Forum is held on the second Wednesday of each month from 11:00AM – 1:00PM at Papapavlo’s in Stockton and includes a complimentary lunch. Attendance is always FREE to our members. Non-members are welcome and may attend for one month at no cost to experience one of the quality benefits that comes with Society Membership ($35.00 thereafter). Registration required. For more information or to be added to the mailing list email Jessica Peluso, SJMS Membership Coordinator, at Jessica@SJCMS.org or call (209) 952-5299.
MARCH 14TH, 2018:
PRACTICE MANAGEMENT 101
11:00AM to 2:00PM
Join us and learn from the expert! CMA’s Physician Advocate Mitzi Young will help you identify opportunities for increased revenue and teach you best practices for implementing effective policies, procedures and processes into your medical office. Topics Covered: • Three Strategies for Better Financial Outcomes • Common Practice Mistakes Costing You Money • Managing Patient Scheduling • Improving Patient Experience • Monthly Reports Every Practice Should Review • Effectively Processing Denied Claims • Marketing Your Practice for Success • Questions Every Office Should Ask Yearly ~ Mitzi Young is the Physician Advocate, for the CMA, RCMA and SBCMS. Mitzi brings 25 years of experience and expertise in the health care industry. Mitzi started her career working for a third party administrator as a claim and eligibility processor for San Bernardino county hospital’s medically indigent adult program. She went on to further her education and worked as operations and business manager for a specialty practices and for an ambulatory surgery center. Overseeing all personnel and business operations. She brings with her a vast knowledge of medical billing and collections, contracting, accreditation, and personnel and business management. She understands the needs of physicians and their staff, the challenges that face medical practices, and is very passionate about advocating on behalf of providers on succeeding in the ever-changing challenges of the healthcare landscape.
ARE YOU READING CPR? CPR contains the latest in Practice Management Resources, Updates and Information.
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MAY 9TH, 2018:
THE PATIENT EXPERIENCE
11:00AM to 1:00PM
CMA Practice Resources (CPR)
Welcome to the Age of Consumerism! The breakthroughs we’ve enjoyed from companies such as Amazon, Apple, Uber, YouTube, and Yelp have simplified our lives in countless ways; offering customers choice, information, speed, and a world-wide platform. It’s wonderful when you’re the customer. It’s overwhelming when you’re the vendor.
is a free monthly e-mail bulletin
For many years, healthcare was immune to this sweeping phenomenon, but not anymore. Customers, consumers, patients – people - now expect all businesses to operate like these pioneering companies. Even the government has gotten onboard and begun setting higher standards for hospitals and healthcare providers.
tips and tools to help physicians
So how can you possibly match the uniquely important, complex, and intimate nature of healthcare with that of buying a pair of shoes online or ordering a ride downtown? The Patient Experience team from Hill Physicians Medical Group will help guide you in their upcoming presentation. You’ll learn why Patient Experience matters, how it is measured, and what you can do for your own practice. You’ll leave with specific tools and ideas you can use in your practice that afternoon. ~The Patient Experience team from Hill Physicians Medical Group
from CMA’s Center for Economic Services. This bulletin is full of and their office staff improve practice efficiency and viability.
SUBSCRIBE NOW
Sign up now for a free subscription to our e-mail bulletin, at www.cmanet.org/news/cpr
MEMBER BENEFITS AND RESOURCES
EMPOWERING PHY SICIANS
CMA gives me the sens e that I am not alone in the fight to protect my patients and ensure that they get the best and highest qu ality of care.
C. Freeman, M.D. Psychiatrist, Member Since 2006
YOUR PRACTICE
YOUR PROFESSION
YOUR VOICE
Access to practice management experts
Valuable tools and resources
Legislative advocacy
Free CME webinars
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News and updates you need to know
Free access to the most comprehensive health law library
WE GET YOU
WE KEEP YOU UP-TO-DATE
WE ARE YOUR VOICE
Direct payor intervention
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www.cmanet.org/benefits
SAN JOAQUIN PHYSICIAN
SPRING 2018
SPRING 2018
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Public Health
Update
The WIC Public Health Model: Low-Income Women, Infants, and Children
Public Health Problem • Higher rates of low and very low birthweight babies • Higher rates of stunted growth and development of children • Higher rates of infant mortality • Lower breastfeeding rates
Behavioral and Environmental Risk Factors
Public Health Program • Nutrition education
• I nadequate intake of nutritious food • I nability to afford nutritionally adequate food • L ack of nutrition and health education and support
• Breastfeeding education and support • Health care and social services referral services • Nutritious food prescription (package)
Short-term Outcomes
Long-term Outcomes
• Improved nutritional intake/diets
• Decreased rates of anemia
• Increased health knowledge, especially about nutrition and breastfeeding
• Reduced risk for pre-term, low birthweight, and very low birth-weight babies
• Increased use of health care and social services
• Reduced infant mortality rates
• L ack of regular access to health care and social services
• Adequate physical growth and cognitive development • Increased breastfeeding rates • Reduced risk for child abuse and neglect • Reduced long-term health care costs
WIC Nutrition Program Contributes to a Healthy Start Kimberly Smith, RD, CLE, WIC Program Coordinator Karen Furst, MD, MPH, Interim Health Officer San Joaquin County Public Health Services The human cost and financial burden resulting from poor birth outcomes begins at delivery and often carries over into adulthood. According to the San Joaquin County 2016 Community Health Needs Assessment (CHNA) Data Book 1, the incidence of preterm births, low and very low birth weights, as well as infant mortality exceeded the state benchmark. Data revealed 10% of infants born in the County in 2011 were preterm (<37 weeks gestation), 7% low birth weight, 1.3% very low birth weight, and 5.8 infants per 1,000 births did not reach their first birthday. Infants born early or low birth weight are more likely to experience cognitive and developmental delays as well as struggle with disabilities during childhood in addition to facing higher risks of chronic disease as adults.
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Causes of preterm birth may be multi-factorial making prevention challenging. According to the Centers for Disease Control and Prevention, factors may include being a teen or woman over age 35, of the black race, low income, under stress, and a smoker or substance user. Though pregnancy is often anticipated as a joyous time in life, any one or more of these factors can affect the outcome. Women may therefore require additional support beyond their trusted and valued physician, family, and friends to assist in mitigating the possibility of poor birth outcomes. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides targeted support for moderate to low income women who are pregnant or recently had a baby, in addition to infants and children up to age five who are at nutritional risk. The effectiveness of WIC in improving birth outcomes is well documented. In a recent study conducted by the California Department of Public Health (CDPH)1, scientists found WIC participation was associated with reductions in the risk of premature birth by 29 to 48%, low birth weight by 23 to 36%, and perinatal death by 22 to 31%. Women were less likely to experience adverse birth outcomes specifically beginning in the third trimester compared to women eligible but not on the program. The impact of WIC participation was significant and greater near delivery suggesting a cumulative effect. WIC Services The WIC program provides screening for a variety of risk factors such as inadequate growth, excessive weight gain, iron deficiency anemia, and high lead levels. The program promotes regular medical care including immunizations and links participants with community resources, and encourages utilization of adjunct services like CalFresh to help stretch food dollars and reduce the risk of food insecurity. WIC also works with retailers in low-income neighborhoods towards becoming WIC authorized vendors by stocking more fruits, vegetables, and whole grains.
Program where moms receive support via phone or in-person. To ease access, WIC clinics are available throughout the county. WIC eligibility is based on California residency and income according to family size. For example, families with two individuals (including unborn baby) qualify with an annual income of $30,044. California applicants automatically qualify if they receive Medi-Cal, CalFresh or Temporary Aid to Needy Families (TANF). San Joaquin County provides WIC services to approximately 26,000 residents; however, many more qualify who are not being identified and referred. Data collected by CDPH in March 2016 revealed over 6,000 infants and children were WIC eligible in our County, yet not on the program. This is a statewide issue. Data from the CDPH 2010-2012 California Maternal and Infant Health Assessment Survey2 found that many women did not apply during pregnancy because 40% assumed they would not qualify and 35% did not think they needed WIC. The Physician’s Role A woman’s trusted practitioner learning of her pregnancy or when caring for her infant or children presents an excellent opportunity to provide information about WIC, either directly or through an office staff member knowledgeable of our services. Fathers, grandparents, legal guardians, and foster parents are also welcome to apply on behalf of an infant or child under age five. A referral is not necessary. Physicians need only to encourage their patients to call (209) 468-3280 for an appointment. At that first appointment, WIC staff will help to determine eligibility and enroll patients so they can start taking advantage of the benefits of this cost-effective, family-centered program designed to help families thrive. For more information on the WIC program, please call: (209) 468-3280. Harder + Company Community Research. (2016). San Joaquin County 2016 Community Health Needs Assessment, Data Book, published online November 4, 2016. Available from: www.sjcphs.org/Disease/Epidemiology.aspx. 1
Nutrition education is central to the program. Registered Dietitians work with participants at higher risk such as women with gestational diabetes, preterm and low birth weight infants, and overweight children. Nutrition Assistants encourage and support healthy habits of lower risk participants. WIC promotes breastfeeding, and their International Board Certified Lactation Consultants provide hands-on breastfeeding assistance. WIC agencies may also offer a Breastfeeding Peer Counseling
SPRING 2018
Carlson, Steven, Neuberger, Zoe. WIC Works: Addressing the Nutrition and Health Needs of LowIncome Families for 40 Years. Center on Budget and Policy Priorities, published online March 29, 2017. Available from:www.cbpp.org/research/food-assistance/wic-works-addressing-the-nutrition-and-healthneeds-of-low-income-families 2
Making Connections: Understanding Women’s Reasons for Not Enrolling in WIC during Pregnancy, California 2010-2012. Sacramento: California Department of Public Health, Center for Family Health; 2016. Available from: www.cdph.ca.gov/Programs/CFH/DMCAH/MIHA/CDPH Document Library/MIHA-MakingConnections-2010-2012.pdf.1 3
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New Members
26 NEW
SJMS MEMBERS THIS FALL!
...and even more on the way.
Abdulbaset Abdulgader, MD
Parvinder Bola, MD
Internal Medicine
OB/Gyn
7373 West Lane Stockton, CA 95210 University of Al Fateh Faculty of Medicine
7373 West Lane Stockton, CA 95210 Odessa Medical Institute of N. I. Pirogova
Randeep Bajwa, MD
Daniel Cooper, MD
Nephrology
Family Medicine
2350 N California St Stockton, CA 95204 Guru Nanak Dev University Medical College
2505 W Hammer Ln Stockton, CA 95209 College of Osteopathic Medicine of the Pacific
Vipul Bhagat, MD Family Medicine 1777 W Yosemite Ave Manteca, CA 95337 University of Debrecen Medical & Health Sciences Centre
Mark Bitgood, MD Otolaryngology 7373 West Lane Stockton, CA 95210 UCSF School of Medicine
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SAN JOAQUIN PHYSICIAN
Andrea Dalve-Endres, MD OB/Gyn 1777 West Yosemite Ave Manteca, CA 95337 Medical School: Harvard Medical School
Philip Ding, MD General Surgery 445 E Eaton Ave Tracy, CA 95376 University of Alberta Faculty of Medicine
SPRING 2018
Thomas Field, MD
Hesham Kamel, MD
Dung Pham, MD
General Surgery
Pediatrics
Internal Medicine
7373 West Lane Stockton, CA 95210 Johns Hopkins School of Medicine
2505 W Hammer Ln Stockton, CA 95209 Faculty of Med Alexandria University
1777 West Yosemite Ave Manteca, CA 95337 Ross University School of Medicine
Ryan Finlayson, MD
Samuel Ko, MD
Michael Rehbein, MD
Emergency Medicine
Internal Medicine
Pediatrics
1777 West Yosemite Ave Manteca, CA 95337 Creighton University School of Medicine
600 Coffee Rd Modesto, CA 95355 Institute of Medicine (I) Rangoon
7373 West Lane Stockton, CA 95210 University of Minnesota Medical Center
Rami Georgies, MD
Dermatology
Family Medicine 8001 Lorraine Ave Stockton, CA 95210 Faculty of Medicine University of Aleppo
Ali Gohari, MD Ophthalmology 7373 West Lane Stockton, CA 95210 University of Alberta Faculty of Medicine
Yanina Greenstein, MD OB/Gyn 2185 W Grant Line Rd Tracy, CA 95377 Boston University School of Medicine
Wenji Jiang, MD Diagnostic Radiology 7373 West Lane Stockton, CA 95210 Jiangxi Medical College
SPRING 2018
Lauren Lomax, MD 2545 W Hammer Ln Stockton, CA 95209 Morehouse School of Medicine
Michael Mequio, MD Ophthalmology 1630 W Yosemite Ave, Ste 3 Manteca, CA 95337 Wayne State University School of Medicine
Sundar Natarajan, MD Internal Medicine 1800 N California St Stockton, CA 95204 New York Medical College
Ashish Patel, MD Critical Care Medicine 1777 W Yosemite Ave Manteca, CA 95337 Gujarat University, B. J. Medical College
Eileen Sicangco, MD Family Medicine 445 W Eaton Ave Tracy, CA 95376 University of Santo Tomas Faculty of Medicine and Surgery
Lakshminarayana Tadimeti, MD Critical Care Medicine 1777 West Yosemite Ave Manteca, CA 95337 Stanley College, Madras University
Inna Tarasula, MD OB/Gyn 2185 Grant Line Rd Tracy, CA 95377 State University of New York at Stony Brook Health Sciences Center
Linnea Williams, MD Family Medicine 7373 West Lane Stockton, CA 95210 Kansas City University of Medicine & Biosciences
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Introducing the San Joaquin Medical Society MemberCard! As part of your membership with San Joaquin Medical Society you will receive quality discounts on dining, attractions and more with the brand new SJMS Membercard! • Enjoy discounts on dining at more than a dozen local restaurants. • Save when visiting participating area attractions and wineries! DIRECTORY RSHIP OF MEMBE BENEFITS
• Earn reward points at over 11,000 online retailers nationwide.
Merchants honoring the SJMS MemberCard: • Midgley’s Public House • Papapavlo’s Bistro & Bar • Ben Mackie Fitness • Mettler Family Vineyards • ...and many more! Plus gain access to the MemberCard Mobile App available for both Android and iPhone devices. The App allows you to find available discounts, map to participating businesses and redeem benefits directly on your phone! 60
SAN JOAQUIN PHYSICIAN
SPRING 2018
In Memoriam
In Memoriam THOMAS ANTHONY THOMAS, MD August 13, 1936 – January 15, 2018
Tom was a Toastmaster, an avid golfer and member of Stockton Golf and Country Club, a volunteer mentor at California Youth Authority, and a member of St. Bernadette’s Catholic Church.
SPRING 2018
Dr. Tom Thomas passed away on January 15, 2018. He was born to the late Maroun Thomas and Wadeha Ezzie Thomas on August 13, 1936 in Canton, Ohio. Tom attended Central Catholic High school and graduated from Notre Dame University. He pursued his medical degree from Georgetown University. He served as a Lieutenant Commander in the Navy Medical Corps and was stationed in Chelsea, Massachusetts at the United States Naval Hospital. He moved to Stockton, California in 1968, became a partner in private practice at Stockton Radiology Medical Group, and worked as a staff radiologist and Chairman of Radiology at St. Joseph’s Hospital. He was a member of the San Joaquin Medical Society for 38 years. Tom was a Toastmaster, an avid golfer and member of Stockton Golf and Country Club, a volunteer mentor at California Youth Authority, and a member of St. Bernadette’s Catholic Church. Tom loved his profession, family, friends and faith. He was kind, generous, thoughtful and loved to tell stories and jokes. He could be found most
mornings at 8 am mass at St. Bernadette’s and then onto the golf course where prayer did not always help his hook. Not many events could interfere with mass on Sundays or his Saturday golf game. He was predeceased by his brother, Dr. John Thomas; and sister, Mary Esber. He is survived by his brother, Dr. Joseph Thomas; and sisters, Margaret Thomas and Rose Fleck of Canton, Ohio. Tom was predeceased by his first wife of 25 years, Carole Pedrotty Thomas. Carole fell in love with Tom on the dance floor at a high school dance. They married in 1962 and had six children together. Tom is survived by his second loving wife of 25 years, Donna Yarborough Thomas. She graciously put up with his six children and graced Tom with another 25-year romance. He is survived by his children: Cathy Waheed, Janet Sanders, Betsy Hodson, Daniel Thomas, Michael Thomas and Amy Jo Giebel; 15 grandchildren and two great-grandchildren. We will miss our loving patriarch and are grateful to be part of his clan.
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experience of over 125 years in medical practice operations. Our goal is to empower physician practices by providing resources and guidance to improve the success of your practice.
CALIFORNIA MEDICAL ASSOCIATION
Assistance ranges from coaching and education to direct intervention with payors or regulators.
Fresno Madera MedicalPAID? Society TROUBLE GETTING 66th Annual Yosemite Postgraduate Institute CMA CAN HELP! March 24 - 26, 2017 I’VE RECOVERED
CMA members can call on CMA’s practice management experts for one-on-one help with payment, billing and contracting issues. If you answer “yes” to any of the following questions, it might be time to call for help.
70,000
$
In the past nine years, CMA’s Center for • Are your claims being denied after obtaining prior • Do you have questions about the new law on payment Economic Services has recovered over authorization? from my payors using and billing for out of network services (Assembly Bill 72)? CMA’s Center for $15.5 million from payors on behalf of Economic Services •CMA Do you members. have questions about Covered California? • Do you need help with Medicare-related issues? CMA’s Center for Economic Services is staffed by practice management experts with a combined experience of over 125 years in medical practice •operations. Are you not Our being paidisaccording to your contract? goal to empower physician practices by providing resources and guidance to •improve Are you receiving untimely requests for refunds or is a the success of your practice. • Are your claims not being paid in a timely manner?
payor recouping money from your check without
• Have you been presented with a managed care contract and you’re not sure if the terms are consistent with California law? • Have you done everything you can to resolve an issue with a payor, but have hit a brick wall?
Assistance ranges coaching andrequest? education to first notifying you infrom writing of a refund Registration is now open direct intervention with payors or regulators.
Call (559) 224-4224 ext. 118 for more information or visit www.FMMS.org
Access to CMA’s reimbursement experts is a FREE, members-only benefit. help? Call 786-4262 or email economicservices@cmanet.org. CMANeed members can call on (800) CMA’s practice management experts for one-on-one help with payment, billing and contracting issues. If you answer “yes” to any of the following questions, it might be time to call for help.
• Do you have questions about the new law on payment and billing for out of network services (Assembly Bill 72)?
• Are your claims being denied after obtaining prior authorization?
• Do you have questions about Covered California?
• Do you need help with Medicare-related issues?
• Are your claims not being paid in a timely manner?
• Have you been presented with a managed care contract and you’re not sure if the terms are
• Are you not being paid according to your contract? • Are you receiving untimely requests for refunds or is a payor recouping money from your check without
consistent with California law? • Have you done everything you can to resolve an issue with a payor, but have hit a brick wall?
first notifying you in writing of a refund request?
Access to CMA’s reimbursement experts is a FREE, members-only benefit. Need help? Call (800) 786-4262 or email economicservices@cmanet.org.
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SAN JOAQUIN PHYSICIAN
SPRING 2018
Secured over $1 billion annually to improve provider payments and graduate medical education funding.
ONEBILLION
Defended medical staff independence in “existential threat” lawsuit against the Tulare Regional Medical Center.
ONEMILLION Recouped nearly $1 million from payors on behalf of physician members.
Expanded member insurance program with state-approved workers comp coverage, new cyber liability program and personal insurance products.
CMA executive awarded “CFO of the Year” for fiscal responsibility and innovative strategic investments.
Defeated irresponsible federal legislation that would have harmed patient access to physicians and decreased health care coverage.
Stood in solidarity with California’s “Dreamers” and in support of diversity and inclusion.
Reaffirmed staff commitment to CMA’s mission by developing a credo.
Developed AB 72 and MACRA resource centers to educate members on rights and responsibilities.
Convinced CMS to further reduce 2018 MACRA reporting burdens.
Debuted a Mother’s Room at CMA headquarters for breastfeeding staff and members.
Declared firearm violence “violates the fundamental human right” to “live safely without fear in a free society.”
@cmaphysicians www.cmanet.org SPRING 2018
CMA Member Service Center Just one number to call for all your CMA needs! (800) 786-4CMA (4262) SAN JOAQUIN PHYSICIAN
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San Joaquin Medical Society 3031 W. March Lane, Suite 222W Stockton, California 95219-6568 RETURN SERVICE REQUESTED
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