Attachment A
Part II - Legislative Priorities
Expanded Health Coverage
In Pasadena, one in ten residents do not have health insurance. People who are uninsured and underinsured face significant barriers in obtaining needed health services, often leading to needless death, disability, and increased costs of care. Social, economic, racial and ethnic factors also contribute to significant health disparities. To address these issues, the City supports legislation to improve health coverage in a comprehensive manner provided adequate funding and cost controls are in place. Expansion in health insurance programs would also help to reduce the burden of unreimbursed care provided by local emergency services, which has led to a crisis in the emergency medical system in Los Angeles County.
The City supports enhancement to state sponsored health care mechanisms consistent with the set of principles approved in October 2009 by the Pasadena City Council to guide comprehensive health care reform:
• Reduce long-term growth of health care costs for families, individuals, businesses and government; • Retain coverage for behavioral health services (mental health and substance abuse treatment); • Protect families from bankruptcy or debt because of health care costs; • Guarantee choice of doctors, hospitals and health plans and the choice of a private or public health care plan;
• Invest in prevention and wellness;
• Improve patient safety and quality of care for all Americans; • Maintain coverage when someone changes or loses a job; • Assure affordable, quality health coverage for all Americans; • End barriers to coverage for people with pre-existing medical conditions; • Eliminate fraud, waste, and abuse in government health programs; • Hold insurance and drug companies accountable by ensuring that people are not overcharged for prescription drugs, or discriminated against for pre-existing conditions; • Support public hospitals and other providers in the health care safety net so that those who fall through the cracks of expanded health coverage may still receive care, and so that surge capacity is available in case of public health emergencies; and so that the cultural competencies achieved by providers serving diverse populations are preserved and enhanced in a reformed health care system.
Mental Health and Behavioral Health
The World Health Organization defines mental health as: "A state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community." Several barriers to mental health care, including stigma, cost or access to appropriate care make it difficult for many individuals to achieve their best mental health. To address these issues, the city supports legislation to improve access to programs and services for mental and behavioral health. Additionally, the City supports legislative efforts that puts mental health on par with physical health services and offers frameworks and tools that can help people with mental health and substance use disorders get care and support.
The City supports efforts for reforming state policies and enhancing programs that improves mental health and behavioral health services, including substance use disorders, by:
• Improving crisis care support systems
• Ensuring mental health benefit parity with physical health services • Creating new frameworks, support structures, and other innovative programs, including court ordered services, to help people with mental health and substance use disorders get the support and care they need
Modernizing and updating mental health definitions
• Supporting and expanding the mental health and behavioral health workforce • Training for first responders to engage safely with people living with mental illness • Encouraging age-appropriate mental health education
Skilled Nursing Facilities
Although the City of Pasadena does not license, regulate, or operate primary care, long-term care, or acute care hospital facilities, healthcare access and quality are key factors in improving quality of life for Pasadena residents. As such, the City is committed to exploring ways to hold federal and state regulatory agencies accountable to fulfilling their roles, as well as identifying local mechanisms to support healthcare quality.
The City does operate limited healthcare services that interact with the larger private and public health care system: pre-hospital emergency medical services in the Fire Department and immunization, HIV testing and tuberculosis treatment services in the Health Department.
The City supports legislation to enhance protections and care for skilled nursing facility ("SNF") residents by strengthening state regulation of SNF oversight, financial transparency and accountability. The City opposes legislation that would lead to a decline in SNF resident health outcomes and experiences.
Additionally, the City believes state policy reform should better protect SNF residents, and improve the working environment for individuals who care for them.
There are 1,201 licensed beds in the 15 skilled nursing facilities located in Pasadena that are licensed and regulated by the California Department of Public Health. The health and safety of this medically frail population is entirely dependent on the quality of health care provided by privately-owned skilled nursing facility operators and their staff, and the ability of the California Department of Public Health to inspect, cite, and regulate them. The City supports legislation that assures the quality of health care provided at these facilities meets or exceeds state and federal (US Centers for Medicare and Medicaid) regulatory standards and is delivered ethically, responsibly, and equitably. The City supports enhancement of state mechanisms to promote skilled nursing facility accountability, increase state capacity to investigate complaints, and improve state capability to respond to crises through:
• Enhanced resident and family education to promote understanding of their legal rights; • Provision of adequate medical oversight by a licensed physician in each skilled nursing facility; • Expanded requirements for professional qualifications to ensure facilities are operated by skilled individuals with a commitment to serving our aging population; • Strengthened State regulatory authority over management and contracting practices to ensure residents receive the services and resources they pay for at a fair price; • Improved accountability by increasing fines and penalties for violations of state requirements; • Increased liability for poor quality of care that causes harm or death to residents; • Improved State capacity to investigate complaints and capability to respond to crises.