On March 22, Ralph W. Nobbe, CPO, president of the California Orthotic and Prosthetic Association (COPA) released a statement regarding COPA’s struggle to prevent California Governor Arnold Schwarzenegger from eliminating O&P services from Medi-Cal, the state’s Medicaid program. Nobbe’s statement appears in edited form below:
The California Orthotic and Prosthetic Association (COPA) has embarked upon an aggressive campaign to vigorously oppose the elimination of orthotic and prosthetic services in the state’s Medi-Cal program.
Governor Arnold Schwarzenegger’s budget for the fiscal year beginning July 1, 2010, includes the elimination of all optional Medi-Cal benefit categories. The following benefits are slated for elimination: hearing aids, physical therapy, occupational therapy, orthotics, independent rehabilitation facilities, outpatient heroin detoxification, medical supplies, prosthetics, durable medical equipment. This benefit elimination earmarks approximately $552 million in total payment reductions for all optional benefit categories.
Medi-Cal payments to O&P providers represented approximately $20 million dollars in 2008. This represents .05 percent of the overall Medi-Cal budget of $40 billion. This also includes the federal matching dollars received. Lastly, the orthotic and prosthetic benefit portion represents only 3.6 percent of the savings from the proposed eliminated benefits (i.e. $20 million of $552 million).
The California Department of Health Care Services (CDHCS) fact sheet states, “California is facing a multibillion-dollar shortfall, and Medi-Cal, as the second largest General Fund expenditure after education, must be part of the effort to reduce state costs. These actions will reduce the services provided under these programs and will therefore reduce Medi-Cal expenditures.”
The CDHCS continues, “There would be opposition to this proposal by advocates, provider groups, and welfare rights organization. The opposition may indicate that this eliminates critical care for beneficiaries, may cause complications with existing medical conditions, and may cause additional expense if beneficiaries seek these services in an emergency room setting. Opposing groups may also indicate that the elimination of the disposable medical supply benefit will cause a significant number of patients, currently managing conditions such as ostomies, diabetes, tracheostomy, and/or IV therapy at home, to shift the management of these chronic conditions to acute or long-term care facilities, thus overburdening the resources of these systems of care. Eliminating access to medical supplies from pharmacies and medical supply providers may likely result in a cost shift to emergency rooms, acute care facilities, and nursing facilities to the extent that beneficiaries exhaust their ability to purchase and replenish the disposable supply items.” The CDHCS fact sheet will be available shortly on www.oandp.com/copa
In addition to COPA’s individual efforts to prevent elimination of O&P in Medi-Cal, we are also part of a larger coalition representing all affected optional benefit medical providers and stakeholders. This coalition has hired a high-profile public affairs and media firm to coordinate the overall outreach and media campaign. This effort will be expensive and has just begun.
The response of O&P national organizations has been unprecedented. The Amputee Coalition of America (ACA), the American Orthotic and Prosthetic Association (AOPA), and the American Academy of Orthotists and Prosthetists (the Academy) have all provided immediate access to their resources and their assistance to battle the elimination of orthotic and prosthetic benefits under Medi-Cal.
Individual COPA members and board members have already initiated personal and vital outreach to key legislators, media, advocacy groups, consumers, and other medical associations. These members and board members include Jeff Collins of Cascade Orthopedic Supply; COPA board member Harry JR Brandt, BOCO; COPA board member Kel Bergmann, CPO, of SCOPe; COPA Board member Bob Jensen, CPO, with Lawrence Orthopedic; and Jeff Zeller, CP, with Spectrum Prosthetics.
The national healthcare debate has consumed significant attention and driven the recent health agenda. The national legislative decisions will not impact California’s immediate dilemma. More importantly, it is felt that many of the unfunded federal mandates may exacerbate California’s crisis.
COPA anticipates an initial legislative hearing before the respective Assembly and Senate Budget Subcommittees on Health shortly-perhaps as soon as March 25. Other pertinent committee hearings will rapidly follow and will be determined by the outcomes of the Health Subcommittees hearings. COPA is targeting key legislators for direct, personal appeals. All COPA efforts will be coordinated by its executive director, Bryce Docherty. He was instrumental in the successful 2006 campaign for and passage and implementation of AB2012, California’s parity legislation. His past positions at the California Medical Association have served COPA well in building dialogue and rapport with other key medical association groups.
Recent tragic events have focused considerable recent media attention upon the orthotic and prosthetic community and its potentials to restore function and individual dignity. However, our industry’s limited resources remain in constant, heavy demand. Your PAC contributions are now truly needed and vital to this effort in California. COPA’s resources are limited and every single dollar helps. A contribution form is available at: www.oandp.com/resources/organizations/copa/pdf/pledge_form_bus.pdf. Several COPA member firms have already answered the immediate, urgent call for additional COPA PAC contributions. These firms include Hanger Prosthetics & Orthotics ($5,000), Nobbe Orthopedics ($1,500), and Breakey Prosthetics ($1,000). This will continue to be an “all hands on deck” effort that has only just begun.
Your ongoing support and interest are vital to the successful retention of orthotic and prosthetic benefits under California’s Medi-Cal program. COPA will need a grassroots effort in the near future, and you can further assist us by signing up for and responding to e-mail alerts here:
www.oandp.com/resources/organizations/copa/flashnews.asp
A final and important note: California at present is not a licensed state. Under California’s Health and Safety Code, Medi-Cal payments for orthotic and prosthetic services can only be rendered to providers certified by the American Board for Certification in Orthotics and Prosthetics (ABC) or the Board of Certification/Accreditation, International (BOC).
