Fresno State researchers seek improvements in health reform proposals to meet region's needs

In a policy brief released Thursday, June 28, by the Central Valley Health Policy Institute at California State University, Fresno, researchers said specific improvements must be made for proposed state health reforms to meet the needs of San Joaquin Valley residents.

“There really are contrasting visions as to what health care should be like,” explained Dr. John Capitman, executive director of the institute and co-author of the report.

The policy brief, “Health Reform 2007 Impact on the Valley,” is the first comprehensive report in the region to analyze the varied health care reform proposals together and to outline potential effects that each could have on this region if implemented.

Capitman and Deborah Riordan, lead author of the report and senior health policy analyst for the institute, developed the brief after multiple meetings and events in the Valley that focused on developing a long-term plan to address health care coverage for all residents.

Highlighted in the brief are:

Gov. Arnold Schwarzenegger’s Health Care Reform Proposal
AB8: Assembly Speaker Fabian Núñez’s Health Care Coverage Legislation
SB48: Senate President Pro-Tem Don Perata’s Health Care Coverage Legislation
SB 840: Senator Sheila Kuehl’s California Universal Health Care Act
SB 236: Senate Republican Caucus Proposal-Cal CARE
Assembly Republican Caucus Health Care Reform Package

Based on responses from key stakeholders at various Valley health care reform events, 10 regional issues surfaced and were further refined into demographics, access issues and resources.

A consistent concern voiced by stakeholders was that the Valley experiences a higher number of poor residents, higher unemployment rates and more unauthorized or undocumented residents than other counties or the state as a whole. This poses many challenges in providing health insurance that is accessible, affordable and efficient for all residents.

The San Joaquin Valley also faces higher rates of asthma and diabetes than any other region in the state. Recent data from the California Department of Health Services, reveals that four of the Valley counties ranked the highest in the state for deaths due to diabetes. In addition, the region experiences a lack of coordinated care and disease management programs, due to health professional shortages, lower reimbursement rates, underfunding of public health services and a lack of long-term care infrastructure.

“The issues that we’re raising are not just Central Valley issues, they apply to other … less-populous, less-urban areas that have different needs,” explained Capitman.

For the region to address some of these complex issues, says the brief, “It’s important that we explore creative models for coverage of agricultural and undocumented workers.” Also important, says the report, is finding ways that Valley health career pipeline programs can continue to receive funding and to demonstrate a community-based long-term care model for the region.

The brief, which recommends other actions, is intended to provide stakeholders and policymakers with a comprehensive picture of the Valley’s health and health care challenges so they can advocate for long-term, comprehensive solutions.

Although a compromise bill including elements of the Núñez and Perata proposals has been proposed in the last few days, most of the San Joaquin Valley concerns have not been addressed, explained Capitman.

“Most of the regional issues and concerns addressed in the brief could be included in any of the proposals without major structural or system changes, noted Capitman.

This brief was funded by a grant from The California Endowment and is available online at http://www.csufresno.edu/ccchhs/documents/CVHPI_brief_062007.pdf.