Monday Rx | February 4, 2019 | Addressing the Health Care Workforce Shortage February 4, 2019 Tag 911 Busy week that was as LACMA physician leaders like Dr C. Freeman, Dr. Jerry Abraham and Dr. Sion Roy attended the L.A. Care Health Plan Provider Recognition Awards Dinner. L.A. Care recognized the area's top performing practitioners, IPAs and clinics that help strengthen the provider safety net in Los Angeles County. One of the areas L.A. Care, through its innovative "Elevating the Safety Net' initiative, and LACMA are looking at closely is the workforce shortage impacting the state and most specifically, Los Angeles County. Physicians for a Healthy California Loan Repayment Program Another aligned organization is CMA's Physicians for a Healthy California (PHC) which is looking for people interested in California's health care workforce to serve on the advisory council for PHC's new loan repayment program. The program—which aims to increase access to care for California's 13 million Medi-Cal patients—has been made possible by Proposition 56, which was sponsored in 2016 by CMA, the California Hospital Association and Service Employees International Union-United Healthcare Workers West. Prop. 56 provides a one-time allocation of $220 million for state loan repayment programs to incentivize providers to increase their Medi-Cal patient population. Another aligned organization is CMA's Physicians for a Healthy California (PHC) which is looking for people interested in California's health care workforce to serve on the advisory council for PHC's new loan repayment program. The program—which aims to increase access to care for California's 13 million Medi-Cal patients—has been made possible by Proposition 56, which was sponsored in 2016 by CMA, the California Hospital Association and Service Employees International Union-United Healthcare Workers West. Prop. 56 provides a one-time allocation of $220 million for state loan repayment programs to incentivize providers to increase their Medi-Cal patient population. PHC will be administering the program on behalf of the California Department of Health Care Services (DHCS). Eligible physicians and dentists may receive up to $300,000 in loan repayments in exchange for a five-year service obligation. Email advisory council nominations to lrp@phcdocs.org by Feb. 8! Assembly to Vote on Security Prescription Fix This Week I've communicated extensively about the uber-flawed implementation of a new state law that requires all security prescription forms to have a uniquely serialized number and has left pharmacies unable to fill prescriptions and patients being refused necessary medications. CMA is currently working on a legislative fix to address this issue immediately to ensure no patient goes without the essential medicine and care they need. This week, the Assembly will be voting on AB 149 (Assemblymembers Cooper, Arambula and Low) to correct the flawed implementation of the new law, which was intended to improve the security of physician prescription pads as a solution to the opioid crisis. Click here to contact your legislators now to encourage their support of AB 149. Talking points and sample letters are provided. The California Board of Pharmacy recently said it would "not make enforcement a priority" if pharmacists choose to fill prescriptions written on security prescription forms that were compliant prior to January 1 but are not compliant with the new serialization requirement. The pharmacy board has urged pharmacists and pharmacies to exercise their best professional judgement when handling these situations, to determine if it is in the best interest of the patient or public health or safety to nonetheless fill such prescriptions. Similarly, the Medical Board of California has also recently issued a memorandum emphasizing the pharmacy board's decision not to aggressively enforce the new requirement. Prescribers should, however, expect to receive calls from pharmacies seeking to validate prescriptions written on non-compliant forms. Reordering security prescription forms presents a great expense for many physician practices and CMA is working to ensure that physicians are able to comply with this new requirement in a way that does not adversely affect patient care. Let me know if you need more information. Task Force Outlines Strategy To Address California's Shortfall Of Health Workers Gov. Gavin Newsom has proposed bold steps to ensure more Californians have health coverage, but a new report underscores that his success may depend in part on large-scale investments to expand the state's health care workforce. A coalition of health, labor and education leaders, in a report released Monday, cited a dearth of health care workers in many regions of the state and recommended spending up to $3 billion over 10 years to address the shortfall. It's not clear where that money would come from, though the report cited several possible sources. The proposals of the group, the California Future Health Workforce Commission, include: creating more primary care and psychiatric residency slots; increasing the use of nurse practitioners; boosting scholarships for low-income students who agree to work in under served areas; and expanding the supply — and training — of home care workers. The commission also recommended building a more culturally and linguistically diverse pool of health care professionals to better match California's demographics. To meet the needs of an aging population, the commission recommended training home care workers and putting them on a more defined career path. In addition, the report focuses on shortages in mental health care, with proposals to create a new training program for psychiatric nurse practitioners and expand the use of mental health peer counselors. An estimated 7 million Californians live in shortage areas, and the problem is expected to worsen as older physicians retire, baby boomers age and more people live with chronic diseases. About 45 percent of psychiatrists and 37 percent of psychologists in the state are over 60 years old, according to research from the University of California-San Francisco. The report comes less than a month after Newsom unveiled his ambitious health care agenda. As I referenced previously, L.A. Care Health Plan is already working to expand the primary care workforce by offering full scholarships to certain medical school students and loan repayment for physicians recruited to practice in under served areas. Investing in more health care professionals — especially primary care providers — can help reduce the overall cost of health care. The state is expected to need an estimated 4,100 more primary care clinicians in 2030. New Partner Announcements I continue to look for products, services and organizations that can help our members thrive. We are in negotiations with Town & Country Travel (yes, travel agencies still exist) since they provide exotic and total immersive destinations for physicians. We should have our agreement completed this week! I'm also in conversations with Argus Medical Management, a respected management services model that has been in business for almost 25 years and serves a variety of needs for private practice physicians so they can maintain autonomy and independence. The LACMA Marketplace continues to progress as the goal is to "go live" by March. Discounted pricing on vaccines, medical supplies, credit card services, medical liability, office supplies, in addition to concierge assistance for physician buying needs will be available for members only. Current list of partners includes: Sanofi, Merck, Pfizer, Henry Schein ProficientRx, McKesson, VaxServe, ClearGate Merchant Services and Staples Advantage to name a few. There is Still Time to Renew Your Membership Many of you have already renewed your 2019 membership with LACMA and CMA and we thank you for your continued support! Whether advocating on behalf of physicians and patients at the Capitol, offering you free reimbursement assistance, connecting you to practice resources, or supporting public health initiatives, no other organizations represent the best interests of physicians, regardless of their specialty or practice setting, like LACMA and CMA. If you have not yet renewed your dues, you may do so online by clicking below or by calling 213-226-0393. Gustavo Friederichsen Chief Executive Officer Los Angeles County Medical Association "If it matters to our LACMA members, it matters to me." EVENTS AND COMMUNITY CME Programs HOW THE EXPERTS TREAT HEMATOLOGIC MALIGNANCIES WHEN: March 21 to 23, 2019 WHERE: Waldorf Astoria, Las Vegas 3752 S. Las Vegas Blvd. Las Vegas, NV 89109 Click here for more information. This two-and-a-half-day symposium has been designed by experts in the field of hematologic malignancies and affords the conference attendee specialized educational tracks for both physicians and nurses, providing an opportunity to learn about the most recent advances in the treatment of bone marrow transplant, multiple myeloma, lymphoma, and leukemia. For questions contact: cme@coh.org or 626-218-5622.