Pharmacists Have Expanded Duties in CA

California may have found one solution to the primary-care physician shortage. On October 1, Gov. Jerry Brown signed Senate Bill No. 493 that will expand the ability of pharmacists to serve patients and collaborate with other healthcare providers.  The result will be an increase in access to care and efficiency, as patients without primary-care providers can now receive treatment from their local pharmacist, instead of trying to find a doctor in their network or waiting until their condition worsens to visit the emergency department.

The legislation authorizes pharmacists to administer drugs and routine vaccinations, as well as order and interpret tests to monitor drug therapies.  Advanced-practice pharmacists will gain board recognition to perform additional functions normally performed by a physician or nurse practitioner, such as patient assessments.

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The bill, in its original form, allowed pharmacists to perform these duties without the collaboration of a physician. However amendments were put in place to include integration with a physician and create the advanced-pharmacist designation, with appropriate education and training.

The primary-care provider shortage in California is expected to worsen as the ACA expands coverage to millions of uninsured Californians. The goal of this legislation is to create another avenue of access to healthcare for patients who are unable to access a primary-care provider.

Friday Variety: College Student Healthcare, An Arizona Law Bites the Dust, & Texas and California Agree on ACA

So Many Health Plans for College Students

Under the ACA, college students have many health plans to choose from.  First, if you're under 26 years old, the law allows you to stay on your parents plan if they have health insurance that offers coverage for family members.  Whether you're financially independent, single, or married, a person under 26 can stay on their parents' plan.

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Second, students can elect to purchase a health plan offered by their college.  However college students should be aware that self-insured schools -- that is, schools who who pay claims directly, instead of hiring an insurance company to do so -- do not have to meet the ACA's essential benefits requirement that otherwise mandates health plans to provide the full menu of "essential" health benefits.

Third, recent federal government regulations clarified that even if students who are eligible for student health plans at self-insured schools, they may still qualify for subsidized coverage on a state Marketplace, or exchange. Coverage purchased on the exchange would start in January, however, so college students would need to obtain coverage elsewhere for the Fall 2013 semester.

Finally, an even lower-cost option for college students may be Medicaid - the federal-state insurance program for low-income people.  Prior to the ACA, Medicaid coverage was reserved for children, pregnant women, and people with disabilities. However since the passage of federal healthcare reform, some states have expanded Medicaid coverage to include low-income adults, including college students.

Arizona Cannot Cut Planned Parenthood out of its Medicaid Program

The 9th Circuit struck down struck down an Arizona law that attempted to bar Medicaid patients from receiving care from medical providers who perform elective abortions, such as Planned Parenthood. The three-judge panel ruling was unanimous.

Texas and California Agree: Long Live the ACA

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Elected officials from both Texas and California traveled throughout their respective states yesterday to tout the ACA.  Rep. Lloyd Doggett (D-TX) sang the ACA's praises to constituents in East Austin.  Doggett also took time to criticize Texas Senator Ted Cruz for his attempts to defund the law.

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Simultaneously, CA Sen. Barbara Boxer spoke to a health center in North Hollywood about the importance of spreading the word about the ACA.  She emphasized that insuring CA's 7 million uninsured residents will have a big effect on the success of the law.  "California is key." Boxer said.  "As California goes, I think so goes the Affordable Care Act."

Doctors Delivering Pizza, Not Patient Care

In a country with a shortage of primary care physicians, there are too many doctors not practicing medicine. And with Obamacare potentially adding 25 million to 30 million people to the health system, the doctor shortage is going to get worse before it gets better.

But it turns out that this country is ripe with doctors itching to return to the practice of medicine.  On the 4th of July, CNN broke a story about the country's most overqualified house painters, McDonald's employees, and construction workers. Surprise -- many of them are doctors.

In Southern California, an estimated 3,000 medically trained Latino immigrant doctors aren't practicing medicine but, rather, cleaning your house, delivering your pizza, or asking "do you want fries with that?"  To help these physicians obtain their licenses to practice medicine in the U.S., UCLA has launched the International Medical Graduates (IMG) program.

The IMG program provides test prep classes and clinical observations with UCLA doctors. It also covers the cost of the U.S. medical board exam and provides a monthly stipend.

Funded by private donors, the program has helped 66 Latino immigrant doctors pass the board exams and get placed into residency programs in California. In return, the doctors commit to working three years in an underserved area.

This program is especially important to have in California where 40% of the population is Latino compared to a mere 5% of doctors of the same ethnic origin. 

Read more about personal stories of these doctors here.