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Legislative Update:  January 20, 2016


Help AAFP Grassroots Effort to Protect Coverage

AAFP President John Meigs, Jr., MD, urges all CAFP members to send a message to elected officials to demand they preserve Americans’ health care coverage. With more than 4,000 letters sent so far, this has become one of the most widely utilized Speak Out campaigns in recent AAFP history. Please join your fellow family physicians in this effort.


CAFP Secures Significant Song-Brown Changes

For the last several months, CAFP engaged in an effort to ensure the new $100 million state investment in the Song-Brown Health Care Workforce Training Program is distributed in a way that reflects the mission of the program: to train and place primary care physicians in underserved areas, delivering primary care services to underserved populations. All of this work culminated in a crucial meeting this week of the Healthcare Workforce Policy Commission, the public body that determines the operations of Song-Brown. The Commission made decisions on application scoring criteria and grant amounts, among other decisions. After numerous letters, testimony and outreach by CAFP and the family medicine California Residency Network, the Commission adopted proposals to significantly increase the grant amounts and ensure distribution of funds properly awards programs that produce true primary care physicians.


In-Depth Analysis
Historically, Song-Brown grant application scoring criteria did not measure a program’s ability to produce primary care physicians because only family medicine programs, whose graduates remain in primary care at least 95 percent of the time, were allowed to apply. With the addition of applicants from internal medicine, pediatric and obstetric and gynecological residency programs, CAFP pursued an aggressive effort to ensure the scoring criteria was amended to ensure state funds were being spent as intended – to produce primary care physicians. Below you will see the scoring criteria questions (in bold red) added to the application by the Healthcare Workforce Policy Commission as a result of CAFP’s advocacy in collaboration with the California Medical Association and CaliforniaHealth+ Advocates.


The Commission also instructed its staff, working with advocacy groups and programs, to form a working group to examine metrics that reliably measure exclusivity to primary care and bring recommendations to the Commission. CAFP has already begun to reach out to stakeholders with expertise in tracking primary care for their input.


Another of CAFP’s major concerns was that the tradition Song-Brown grant amount was inadequate to truly support residency program sustainability and growth, particularly in light of the more than $55 million in cuts programs have faced over the last two years. Our coalition successfully advocated for nearly tripling the grant amount from $51,000 to $125,000 per existing resident over a period of three years. For a program that adds a resident to an existing class, that slot is eligible for a $150,000 grant.


As detailed in last week’s Legislative Update, Governor Brown has proposed reallocating the $100 million appropriation to Song-Brown as part of his 2017-18 State Budget proposal. CAFP has already begun working with our partners in the advocacy community to protect those funds and much can happen between now and the finalized budget in June. Please be alert to action alerts on this item in the coming weeks and months.


Statutory Criteria Points available
Placement of graduates in medically underserved areas 20
Attracting and admitting underrepresented minorities and/or economically disadvantaged groups to the program: graduates 20
Location of the program and clinical training sites in medically underserved areas 20
Additional criteria Points available
Do residents spend at least an average of eight hours per week after the first year of training in a primary care continuity clinic? 10
Placement of graduates in primary care ambulatory settings in areas of unmet need five years post residency 15

Attracting and admitting underrepresented minorities and/or economically disadvantaged groups to the program: current residents


Describe the primary care continuity clinics’ payer mix (Medi-Cal, Medi-Medi, County Indigent Programs and Uninsured)

Total Points 115


CAFP Signs Letter Urging Support for Vaccinations

CAFP joined a broad coalition this week on a letter directed to key Senators overseeing the confirmation hearing of Representative Tom Price as Health and Human Services Secretary, urging them to ascertain Rep. Price’s commitment to vaccines, in light of recent comments by President Trump. More than 90 organizations signed the letter that warns that while immunization rates remain high for children, pockets of undervaccinated communities remain at risk of deadly vaccine-preventable diseases. Immunization rates for adolescents and adults remain woefully low, leaving them vulnerable to diseases and to serving as vectors for the transmission of deadly diseases, such as pertussis to young children. It has been reported that the U.S. spends nearly $27 billion annually treating four vaccine-preventable diseases that afflict adults over 50 years of age: influenza, pertussis, pneumococcal disease and shingles. As the nominee for the Secretary of Health and Human Services it is our hope that Representative Tom Price will support our nation’s public health infrastructure by investing in the science and technology that informs our national immunization policy, providing a safety net to uninsured, poor adults for vaccine purchases, monitoring the safety of vaccines, educating providers and performing community outreach, and conducting surveillance, laboratory testing, and epidemiology to respond to disease outbreaks.

Join CAFP’s Health Care Reform Fight

Are you concerned about how the recent election affects you and your patients? Do you want to take action but don’t know how? Join CAFP and family physicians from across the state in a week of action beginning March 4! The first step is to register for CAFP’s All Member Advocacy Meeting March 4-5, followed by Family Medicine Lobby Day on March 6, at The Citizen Hotel in Sacramento. Be sure to reserve your room at The Citizen Hotel soon to get the CAFP rate of $169 plus tax per night.

Learn about health care policies being proposed at the state and federal level
Receive insider advice on how to inform legislators and influence policy decisions
Learn tricks and tips for honing your message
Network with like-minded colleagues from your community and around the state
Engage in face-to-face dialogue with legislators about issues affecting family medicine

Learning effective ways to advocate on behalf of family medicine and patients is more important than ever as our country is confronted with the unprecedented potential for change. Be sure to register today!

Save the Date for the 2017 Coding Teleconference

The “Strategies for Coding and Reimbursement: 2017 CPT Updates” teleconference with coding and practice management expert Mary Jean Sage is scheduled for Tuesday, January 31, 2017 from 12:15 pm to 1:45 pm. Register today to ensure you and your staff understand the new, edited and deleted CPT codes and rules for 2017 and get fair payment for the care you provide. Learning objectives for the event are:

Enhance understanding of changes to CPT codes, including additions, deletions and edits;
Improve practice documentation of visits and procedures;
Discuss MACRA and related shifts towards value-based care; and
Improve documentation of medical decision-making.


Also available is CAFP’s coding monograph update with brand new content for 2017. Registration is at a low price of $49 for CAFP members and $79 for nonmembers. Additionally, all participants will receive 1.5 hours of CME credit. Sign up online today or contact Sonia Kantak at 415-345-8667 for more information.