SAN FRANCISCO-Federal officials have begun a probe into a California policy that allows developmentally disabled patients to be transferred from state institutions to community group homes and other facilities, the San Francisco Chronicle reported. Reports of problems with such transfers prompted HCFA to begin its investigation June 16, said Richard Chambers, federal Medicaid chief of California. "The concern that's been raised is that patients in the community have a higher death rate than those in the state's institutions," Chambers said. "Certainly we will take that up as part of the review . . . as well as any quality-of-care issues that might impact that." The probe will focus on fiscal practices and medical care in the statewide system that provides services and care to the mentally retarded and developmentally disabled. Medicaid investigators will examine programs in the east San Francisco Bay Area, Los Angeles and possibly the Sacramento area. They will meet this summer with administrators, staff and disabled clients, and conduct on-site audits of group homes and other facilities. For two decades, patients have been transferred from state institutions to group homes. But the state in late 1993 stepped up the transfer of extremely disabled patients, including those with fragile or violent conditions, after a lawsuit settlement required it to move 2,000 patients out of its hospital-style facilities. The Chronicle reported that top officials in the Department of Developmental Services were warned the transfers would endanger lives. But they pushed ahead with the re-settlements, sometimes coercing patients' parents and doctors to accept the transfers, the Chronicle reported. Medical researchers have found that, in the wake of such transfers, dozens of patients have died or suffered serious medical problems, the paper reported. The state's program sets aside $250 million per year in Medicaid funds for 35,000 disabled people, most of whom are transferred to community care. The Department of Developmental Services provides services for 140,000 Californians with mental disorders.
ALBUQUERQUE-A joint venture proposed by a group of orthopedic specialists can go ahead without a challenge from the U.S. Justice Department. The department's antitrust division said Southwest Orthopedic Specialists meets the "safety zone" for nonexclusive joint ventures. A risk-bearing arrangement, the group plans to start with 10 specialists, then recruit more to cover third-party payers with enrollees throughout the state. The group won't exceed 30% of the market. The government usually won't challenge a nonexclusive physician network if the doctors share substantial financial risk and constitute less than 30% of the market. The Justice Department said the proposed joint venture would be a competitive alternative to another group.
OAKLAND, Calif.-Mercy Retirement and Care Center and Salem Lutheran Home, both in Oakland, said they have agreed to affiliate and form a new not-for-profit corporation called Elder Care Alliance. Under their agreement, the long-term-care facilities will share a common management team, purchasing and consulting services. The facilities will retain their individual identities, assets and liabilities, and religious affiliations. Together, the facilities care for more than 400 older adults, providing housing, assisted living, dementia care and more than 100 skilled-nursing beds. The facilities said they decided to partner to help face increased costs as the frailty level of their patients increases and the reimbursement environment continues to change. "There is an urgent need for nonprofit, long-term-care providers to join forces in order to meet both internal and external challenges," said Janeane Randolph, president and chief executive officer of the alliance. "Elder Care Alliance hopes to develop as an umbrella for other long-term-care, nonprofit facilities and community-based programs and services for the elderly."