California Task Force on Family Caregiving
The California Chapters of the National Multiple Sclerosis Society are thrilled that Bob Lesh has been selected as a member of the California Task Force on Family Caregiving, pursuant to ACR 38 (Resolution Chapter 200, 2015). Bob has been a caregiver to his wife, Alice, for almost 30 years and has been a committed advocate for the needs of patients, family members, and caregivers affected by multiple sclerosis. Bob would bring a distinctive and much needed perspective to the work of the Task Force.
The Caregiving Task Force is charged to meet and report to the Legislature findings by January 1 of 2018, on challenges faced by family caregivers, opportunities to improve caregiver support, and to review the current network and the services and supports available to caregivers. Calls for a 12-member task force of experts to meet without compensation, under open-meeting standards, consult with stakeholders, partner with the California Commission on Aging, and report to the Legislature and the Governor by January 1, 2017, and January 1, 2018.
The general public, and even social service agencies and political decision makers often believe that the need for caregiving and long-term care is an exclusively geriatric need. Bob Lesh will represent a different viewpoint and different challenges facing family caregivers. He will bring to the Task Force a considerable amount of experience, skill, constructive thinking, and perspective necessary to improve caregiver support.
MS-CAN Successful in 2015 Legislative Advocacy Efforts
MS-CAN was successful in advocating for three bills that were adopted by the Legislature and signed by the Governor; AB 339 (Gordon) Out-Patient Prescription Drug Costs, AB 374 (Nazarian) Health Care Coverage: Prescription Drugs and SB 137 (Hernandez, Ed) Provider Directories.
These bills will provide people living with MS better access to their prescription drugs and greater transparency of their overall health care coverage. MS-CAN used its statewide volunteer network to call, write, and meet with legislators and their staff, sharing their personal stories and urging support for the legislation as it progressed through the legislative process. Upon passage by the Legislature, MS-CAN advocates turned their attention to the Governor, writing letters emphasizing the importance of each bill to people living with a chronic disease, and asking that he sign the legislation. Kudos to the MSCAN volunteers for their success!
The three bills went into effect on January 1, 2016. Below is a brief description of each of the bills:
AB 339 (Gordon) Out-Patient Prescription Drug Costs
AB 339 would reduce cost barriers to consumers accessing prescription drugs by 1) requiring insurers to cover medically necessary prescription drugs, including those for which there is no therapeutic equivalent; 2) requiring formularies to be based on clinical guidelines and peer-reviewed scientific evidence first and not only on cost 3) prohibiting placing most or all of the drugs to treat a condition on the highest cost tiers of a formulary; and, 3) capping out of pocket drug costs at no more than $275 for a 30 day prescription, 1/24th the annual out of pocket limit.
AB 374 (Nazarian) Health Care Coverage: Prescription Drugs
AB 374 creates a process for prescribers to request an override of a health plan or health insurer's step therapy requirement. The bill aligns the process with the current prior authorization procedures and grievance process for prescription drugs.
SB 137 (Hernandez, Ed) Provider Directories
SB 137 creates standards for provider directories and requires regular updates so directories are accurate and people know which doctors and hospitals are in their network when they shop for coverage or when they seek care. SB 137 requires health plans/health insurers to make updated provider directories available on-line and to include the following:
Information about their contracting providers, including those who are accepting new patients.
Information on whether there is access for persons with disabilities.
Information on whether the provider or staff speaks any non-English languageIn addition, SB 137 will require health plans to update specific information on their online directories weekly and to have them accessible through a clearly identifiable link or tab and in a manner that is searchable by name, practice address, California license number, National Provider Identifier (NPI) number, admitting privileges to an identified hospital, product, tier, provider language, medical group, independent practice association, hospital name, facility name, or clinic name. Health plans and insurers are required to update their printed directories quarterly and the entire provider directory must be updated annually.
Legislative session 2014 – SB 1052
Enactment of our #1 Legislative Priority in 2014 was Senate Bill 1052 which requires insurers and health plans to post their drug formularies on their websites and update the postings within specified time periods of making a change in the drug formulary. While we are thrilled this important legislation was signed into law last year, currently, MS-CAN is engaged in stakeholder meetings with the California Department of Managed Care to ensure that the web page meets the needs of persons living with MS and the greater disability community at large.