SACRAMENTO, Calif.—A Democratic California state lawmaker introduced a package of bills to address an expected doctor shortage as the state prepares to insure millions of new patients under federal healthcare reforms. State Sen. Ed Hernandez said his bills would expand services that can be provided by nurse practitioners, optometrists and pharmacists in order to help alleviate a shortage of primary-care physicians, particularly in rural areas and inner cities dominated by minorities. Hernandez, an optometrist, said his bills would allow nurse practitioners to see Medicaid and Medicare patients even if the doctors they work for do not. Optometrists could check for high blood pressure, and pharmacists could order laboratory testing to detect diabetes. “Here in the state of California, we have a capacity issue,” he said. “We have a workforce shortage.” The California Medical Association opposes the bills, said spokeswoman Molly Weedn. The group representing 35,000 doctors believes the state should focus on building more medical schools, adding residency slots and expanding programs that help doctors pay off student loans in exchange for working in underserved communities. Hernandez, who unveiled his bills at a safety net clinic in Sacramento, said the measures are not meant to replace doctors but to increase access to care for ethnic and poor communities as California's healthcare system braces for a huge influx. Hernandez isn't the only lawmaker trying to tackle the provider gap. State Sen. Fran Pavley, a Democrat, has put forth a bill seeking to expand services that physician assistants can provide.

—Associated Press

SAN DIEGO—A California judge has dismissed a lawsuit stemming from a turf war between two San Diego-area healthcare providers. In an order that ended a four-year legal fight, Judge Earl Maas of the Superior Court of California threw out the 2009 lawsuit that Tri-City Medical Center filed against competitor Scripps Health. Tri-City Medical, a 330-bed public hospital in Oceanside, about 40 miles north of San Diego, filed suit against Scripps Health after the four-hospital system based in San Diego acquired the former Sharp Mission Park medical group and subsequently hired 65 Tri-City physicians. The decision to go to court came as Tri-City faced mounting challenges, including decreasing revenue, increasing debt, declining patient volume and allegations of mismanagement. Maas in his order said that Tri-City had not shown that Scripps engaged in unfair competition. Tri-City did not respond to a request for comment by deadline. In a news release, Scripps President and CEO Chris Van Gorder said the system is “pleased with the judge's decision” but blasted the “significant” resources that had been expended on both sides. “The time and money Tri-City has spent pursuing this case is a waste of public funds,” he said.

—Beth Kutscher

OLYMPIA, Wash.—Workers at Providence St. Peter Hospital Providence SoundHomecare, Olympia, went on strike last week to protest increased costs to employee health plans. The 530 striking workers included nearly all employees except nurses and doctors. Both strikes, scheduled to last until March 16, were triggered by changes to the health plan that went into effect Jan. 1, said officials from Service Employees International Union Local No. 1199NW. The changes raise the cost of deductibles by an average of $3,100, union officials said. Providence officials disagreed with the union's assessment over how much deductibles would increase. Providence officials said they've been upfront with the union that health insurance costs could rise, according to a statement, and that the net deductible grew from $250 to $450 for individuals and from $750 to $900 for families. “The combination of declining healthcare reimbursement and our desire to provide affordable and sustainable health benefits to employees means we must find ways to control our costs,” the statement read. One union member, Abbey Bruce, a certified nursing assistant at St. Peter for the past year and a half, said the policy forced her to take a second job as a home-care aide. Her husband, who suffers from cystic fibrosis, saw his prescription copayment increase from zero to $300 a month under the new plan, Bruce said. The union gave Providence officials notice last month of their intention to strike, allowing the hospital time to schedule replacement workers.

—Ashok Selvam