Page 8 • ANA\C The Nursing Voice
Should Registered Nurses Home Address be Posted on the BRN Website?
SB 1111, a Department of Consumer Affairs legislation, introduced by Senator Negrete McCloud would require the Board of Nursing to post all nurses address of record on the website. The argument is that this is a consumer protection measure. The Department would like to have rules for all licensing boards that are the same. The California Medical Board was mandated to provide address’s of record a number of years ago. SB 1111 would now require this of all licensees.
ANA\C is opposed to this measure in the bill and working with the author to have the language removed. Unlike physicians, nurses do not usually have offices to have as their address of record. Additionally, many nurses cannot get mail at their workplace. A nurse has the option of getting a P.O. Box at their own expense. We do not believe this is a fair or safe measure. We also believe posting a home address of a nurse could be dangerous. We do not believe an irate or dysfunctional patient should be able to get our home address.
Please let your Assemblyperson or Senator know how you feel about this measure. The bill should be heard in April or May! Your voice counts!
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WHICH IS THE DOCTOR AND WHICH IS THE NURSE?
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April, May, June 2010
California Regulators Adopt Rules On Timely Access to Non-Emergency Care
SACRAMENTO, Calif.—Seven years after the enactment of legislation (A.B. 2179) directing it to do so, the California Department of Managed Health Care (DMHC) announced Jan. 20 it adopted regulations aimed at ensuring plan enrollees have timely access to health care services. According to DMHC Director Cindy Ehnes, the new rules make California the first state to shorten the time a patient has to wait to see a doctor by requiring that managed care plans ensure member appointments with medical providers be scheduled within certain time frames. “California patients are literally sick of having to wait weeks to see a doctor,” Ehnes said in a Jan. 20 statement. DMHC said it receives complaints from managed care plan members having difficulty getting appointments with doctors, noting a 2009 study found that new patients in preferred provider organizations and health maintenance organizations wait an average of 59 days to see a family practice physician in Los Angeles.
The adoption of the rules follows multiple rounds of public comment from managed care plans, providers, and consumers through most of last year. The state’s Office of Administrative Law (OAL), which oversees regulatory agency rulemaking, rejected a previous version of the
regulations issued Jan. 9, 2009, on the grounds that it provided too little time for public comment. In March 2008, OAL also disapproved an earlier set of proposed rules after OAL concluded that by allowing plans to develop their own standards for patient wait times, they failed to comply with California administrative law requiring regulations to set uniform standard governing all plans.
Time Frames for Appointment Scheduling The regulations require managed care plans meet the following appointment scheduling time frames:
urgent care appointments for services that do not require prior authorization within 48 hours of the request for appointment;
urgent care appointments for services that require prior authorization within 96 hours of the request for appointment;
nonurgent appointments for primary care within 10 business days of the request for appointment;
nonurgent appointments with specialist physicians within 15 business days of the request for appointment;
nonurgent appointments with a nonphysician mental health care provider within 10 business days of the request for appointment; and
nonurgent appointments for ancillary services for the diagnosis or treatment of injury, illness, or other health condition within 15 business days of the request for appointment.
However, the regulations permit these time frames to be extended if a provider has determined a longer waiting time will not have a detrimental impact on the health of the patient. The rules also contain an exception for nonurgent services including preventive care and periodic follow- up care. Plans must also provide 24/7 triage or screening services by telephone with wait times not exceeding 30 minutes. Telephone triage or screening services can be provided through plan-operated telephonic triage or medical advice services, the plan’s contracted primary care and mental health care provider network, or other means.
Must Ensure Sufficient Numbers of Providers
ANA\C member Bonnie Faherety and Assemblyman Perez at a CAPP Event in LA
Madigan Army Medical Center, Fort Lewis, Washington is seeking Psychiatric Nurse Practitioners, Neonatal, Case Managers for RNs, Pediatric Intensive Care Unit ($3,000 Relocation Offered) and Psychiatric RNs, LPNs and RNs of various specialties to join our growing staff of civilian employees. You will work in a professional environment with the following benefits: flexible schedules, 10 paid federal holidays, plus 12 days vacation and 13 days sick leave per year, a choice of affordable health, dental & vision plans, life insurance, the Federal Employees Retirement Program, and the Thrift Savings Plan with the employer matching up to 5%. Your starting salary will incorporate your experience and you may be eligible for recruitment and retention allowances, Student Loan Repayment Program, as well as evening, night, weekend, and on-call differential pay. Degree accreditation through CCNE or NLNAC required.
Please email your resume to: Sandra.Jones1@us.army.mil or www.mamc.amedd.army.mil
Under the regulations, managed care plans are required to adopt written quality assurance standards ensuring they have enough contracted providers to comply with the rules. Plans must draw up compliance monitoring policies and procedures for DMHC review and approval that accurately measure the accessibility and availability of contracted providers and document network capacity. Plans must also survey providers and enrollees annually to assess compliance with timely access to care standards.
Managed care plans that use a preferred provider organization network may demonstrate compliance with network provider availability requirements by monitoring at least annually the number of PPO primary care and specialty physicians under contract with the plan in each county of the plan’s service area, enrollee grievances and appeals regarding timely access, and the rates of compliance with the timely access to care standards.
The rules also require managed care plans to implement “prompt investigation and corrective action” when their compliance monitoring determines their provider network is not sufficient to ensure timely member access to care.
Groundbreaking Consumer Protections
Health Access California, a consumer advocacy coalition that sponsored A.B. 2179 in 2002, noted that while the concept of timely access to health care was one of the “cornerstones” of the original Knox-Keene Act of 1975 that established and regulated managed care plans in California, it remained largely unrealized and unenforced. “These groundbreaking consumer protections will help ensure that HMO patients get the care they need, when they need it,” Anthony Wright, executive director of Health Access California, said in a Jan. 20 statement. “Care delayed is often care denied, leading to worse health outcomes or unnecessary visits to the emergency room,” Wright said. “These new first-in-the-nation patient rights will provide consumers with clear expectations about how quickly they should get in to see a doctor or specialist.”