Why is CALPERS hurting local pharmacies?
April 27, 2010
CALPERS (State of California employees) are about to be forced, by Blue Shield of California, to use only a mail-order pharmacy in New Mexico to receive prescription benefits. Several of the patients from my store that are going to be affected by this are approaching 90 and now they are expected to mail off for their prescriptions to New Mexico?
It is bitterly ironic that a move like this, which will hurt small businesses like myself throughout California, is being made at the same time that our governor, Arnold Schwarzenegger, is traveling around the state promoting small businesses. This shift of about 25 percent of my business to New Mexico means I’m probably going to have to lay off several employees. Multiply that effect by all the pharmacies in California that will likely undergo similar layoffs, and it adds up to a lot of people going on unemployment in the next couple months.
I contacted Congresswoman Lois Capps about the issue. Capps said she only handles federal issues, so could not be of help regarding this. Next, I contacted Assemblyman Sam Blakslee, who has always been a great help in this sort of issue. Unfortunately he said Blue Shield of California is a private entity thus the State of California has no voice in their ways of doing business. But it seems to me that someone in the state government, CALPERS(which provides retirement and healthbenefits for public employees), or somewhere, had to OK this idea. I was told I could try to contact Insurance Commissioner Steve Poizner, but communication efforts to that office have gone unreturned.
I would like to point out to someone that for every $100 spent in independently owned business, $68 returns to the community through taxes, payroll, and other expenditures. How much of the money going to New Mexico will return to California? None.
On a separate note, the Community Health Clinics across the county are medical clinics where Medicaid patients can be seen by doctors. On their way out of these clinics patients are being handed brochures and told by staff to use their “preferred” pharmacies like Ralph’s grocery store in order to get “expedited” services (Their refills are authorized in a more timely manner).
When CenCal,the regional Medicaid agency, and these CHC clinics are partnering together to stonewall small independent business like myself, that is a huge hurdle to overcome. When I called CenCal, all of the representatives I talked to said they couldn’t comment on the issue—they didn’t want to “misspeak”—and my calls to the CenCal Director of Pharmacy have gone unreturned.
CenCal and the Community Health Clinics are state-funded by taxpayers like myself, and I want all people in our community to know about this issue. It might also be noted that CenCal has been allocated an increase of $800-900,000, though not all of that has been disbursed yet. This was without an increase in employee FTE (full time equivalents). All of this information is available on opensecrets.org, which provides to the public CenCal records showing where their money (our money) is going. Also of note is the fact that CenCal contributes $10,000 per quarter towards lobbying, as well as $80,000 yearly in dues to a COHS, which is deducted out of the “per Medi-Cal patient” allocations. (A COHS, which stands for County Organized Health System, is an agency that contracts with the state to administer Medi-Calbenefits. )
Again this is all public record—but is anyone watching these guys? Next up, CenCal (like CALPERS) is about to try to force mandatory mail order, but many CenCal patients that I have are homeless, and I’m wondering: How you are going to mail them a 90-day supply, much less expect them to hang on to it and take correctly for 90 days?
The value of a local pharmacy/pharmacist needs to be recognized, andnot brushed aside for the dollars of lobbyists who are pushing for mandatory mail order. We know the CALPERS mail order facility is in New Mexico: Would the CenCal mail order facility be located in California, at least? No its called Escalante Services and is based out of Nevada. If the current trend is to outsource pharmacy services, we should start outsourcing city/state employees, as well as our politicians. Surely they work for less and provide the same service.
Based on the above, I am hoping that only Doctors, Nurses, Pharmacists, and other Health Care practitioners are consulted for this Health Care Reform that is in the works.
Jason Tewell is the pharmacist for Los Osos Rexall.