Health, Doctors and Common Sense

California State Controller John Chiang released a new survey Monday that criticizes counties as too slow to act after they learn that in-home care payments may be going to pay for care for dead recipients.

As much as $11.5 million in state payments in 2008 may have been lost because of inaction to ensure the validity of payments to providers of care, Chiang’s survey showed. Some care providers’ names and Social Security numbers have also been found in federal and state records of the deceased.

The problem could be the result of fraud, with someone using the Social Security number of a deceased person, or clerical errors.

The California Department of Social Services administers the in-home care program for the disabled and elderly.

Counties process timesheets filled out by in-home care workers and recipients. The sheets are sent to the state Department of Social Services.

The controller’s office issues the checks to pay the wages and runs names of providers and recipients through death files.

Social Services notifies counties of inconsistencies, and counties are responsible for investigating and recouping losses.

In Fresno and San Diego counties, according to the survey, about $464,000 and $538,700 in questionable payments were issued in 2008.

Of the 129 cases in question in those counties, only a quarter of individual files contained documentation showing that counties had taken sufficient action to resolve inconsistencies, Chiang’s report said.

“Many of these cases were referred for fraud investigation with inconclusive results,” according to a letter about the survey Chiang sent to Social Services.

Frank Mecca, executive director of the County Welfare Directors Association, said counties are funded for only about eight hours of social work oversight per case per year. He called the funding “inadequate.” Mecca said officials should be able to speed up comparing death records against names of in-home care providers and recipients with a new state payroll system that’s under construction.

State Department of Social Services spokeswoman Lizelda Lopez said officials “don’t agree with the controller’s contention,” but that “there’s always more work to be done, and we are working with our county partners to strengthen these reporting requirements.”

Gov. Arnold Schwarzenegger, who urged reforms to fight fraud last year, responded to Chiang’s report with a press statement.

“Any fraud in our system is too much,” the governor said. “Now more than ever, every dollar must count so that we can save money and focus this important program for Californians that rely on these resources.”

Tags: California Department Of Social Services, California State Controller, Care Payments, Clerical Errors, County Welfare Directors Association, Death Files, Death Records, Deceased Person, Department Of Social Services, Fraud Investigation, Home Care Providers, Inconclusive Results, Inconsistencies, New Survey, Questionable Payments, San Diego Counties, Social Security Number, Social Security Numbers, State Controller John Chiang, State Payments

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El Dorado County public health officials say it’s not too late to get the H1N1 flu vaccine.

The county’s Health Services Department will offer the vaccine free to county residents of all ages at two community clinics this month.

The first is scheduled from 3 to 6 p.m. Wednesday in the multipurpose room at South Lake Tahoe Middle School, 2940 Lake Tahoe Blvd., South Lake Tahoe. The second will be from 1 to 3 p.m. Feb. 18 in the fellowship hall at Light of the Hills Lutheran Church, 3100 Rodeo Road, Cameron Park, behind Burke Junction.

The H1N1 vaccine also is available by appointment at the El Dorado County Health Services Department by calling (530) 621-6100 in Placerville or (530) 573-3155 in South Lake Tahoe.

During February, South Lake Tahoe residents may also receive the vaccine through one of the walk-in clinics held from 1 to 4 p.m. each Wednesday at the Health Services Department, 1360 Johnson Blvd., Suite 103, in South Lake Tahoe.

Health officials say children 9 years old and younger should receive two doses of the vaccine, administered at least four weeks apart, to have the best protection. Some individuals, such as people who are severely allergic to eggs and infants younger than 6 months old, should not receive the H1N1 vaccine.

Updated information on the H1N1 flu is available on the Web site at www.edcgov.us/publichealth.

Tags: Cameron Park, Community Clinics, County Health Services, County Public Health, County Residents, El Dorado County, Fellowship Hall, Flu, Flu Vaccine, Flu Vaccines, Health Services Department, Hills Lutheran Church, Lake Tahoe, Lake Tahoe Blvd, Multipurpose Room, Placerville, Public Health Officials, Rodeo Road, South Lake Tahoe, Walk In Clinics

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Second-graders, from the left, Anaya Basurto, Destiny Cervantes and Jonathan Salsbury jump rope Caleb Greenwood School in River Park on Monday as part of a statewide attempt to break the world record for the “Most People Jumping/ Skipping Rope at the Same Time.”

This morning, students at Bowling Green Charter School in Sacramento were extra careful to double knot their shoes and tie their belts tight. They had a Guinness World Record to break.

Mayor Kevin Johnson counted down.

At exactly 9 a.m., a thousand neon-colored jump ropes undulated. A thousand kids and adults hopped up and down in the school’s playground.

Van Halen’s guitar cadences roared from the loudspeakers: “I get up and nothing gets me down… Might as well jump. Jump!”

The scene was replicated across 40 schools in the Sacramento region and 550 schools in California, the event’s organizers said.

Bowling Green Charter School served as the event’s headquarters, its activity broadcasted live to rope skippers everywhere from a Rancho Cordova National Guard unit in Iraq to members of the California congressional delegation in Washington.

All told, 88,000 Californians broke the Guinness World Record for “Most People Jumping/Skipping Rope at the Same Time.”

The record was previously held by 59,000 jumpers in Australia.

Ten minutes later, it was over.

The students lined up with their classes, getting strawberry and peach flavored Jamba Juice as a reward.

The event was about more than breaking a record, said sponsors, the Jamba Juice Company and the California Association for Health, Physical Education, Recreation and Dance (CAHPERD).

“You don’t need to be an elite athlete or have fancy equipment to be fit,” said Drisha Leggitt, CAHPERD’s executive director. “These jump ropes were $2.50.”

Next year, she plans to organize the same event around the world.

Second-grader Tyler Burnham, center, shows his exuberance while jump roping in an attempt at a world record at Caleb Greenwood School in River Park on Monday.

Tags: Cadences, Cahperd, Caleb Greenwood School, California Association, California Congressional Delegation, Charter School, Drisha, Elite Athlete, Fancy Equipment, Guinness World Record, Health Physical Education, Jamba Juice Company, Jump Rope, Jump Ropes, Jump Roping, Jumping Rope, Leggitt, Morning Students, Physical Education Recreation, Rope Skippers, Sacramento Region, Schools In California, Skipping Rope

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ANNE CHADWICK WILLIAMS Bee file, 2009
Max Villalobos, left, senior vice president at Kaiser’s south Sacramento facility, greets colleague William Muha.

Max Villalobos has never taken care of a patient, yet a big part of Kaiser Permanente’s South Sacramento Medical Center bears his mark.

Bespectacled and balding, he’s the hospital’s Mr. Fix-it in a suit. He walks the halls holding doors for patients and asking staff about their families. He’ll even stop to pick up a stray bit of trash from the floor.

Villalobos has been the highest-ranking non-physician at Kaiser’s south Sacramento hospital for just four years and already has won acclaim for the hospital’s advances.

And, as health care executives go, he’s probably traveled further than most to get to this point in his career.

Villalobos is one of 11 children in an immigrant family, and he lived through an impoverished childhood in Chihuahua, Mexico, and then in Los Angeles. His father was a day laborer and, later, a butcher.

It took Villalobos 13 years – studying part time and working full time – to finish his education. He’s the only one of his siblings to finish college; he also earned a master’s degree in health care administration from the University of Southern California.

People who have watched his rise say Villalobos understands his hospital’s diverse patient population. The Kaiser center is in an area with one of the region’s richest mixes of ethnic cultures and languages.

Under his leadership, Kaiser South Sacramento became the first Kaiser hospital to fully implement a new electronic medical records system and the first to open a Level II trauma center. And Villalobos is overseeing a $300 million expansion.

But what really sets Villalobos apart, observers said, is his commitment to improving the patient experience.

“When we talk about improving patient care, it’s not just the medical care,” Villalobos said. “Can they find where to park? Are they able to figure out where to go? I try to focus on the little things as well as the big things.”

Several years ago, he began a campaign to make all of Kaiser South Sacramento’s signs bilingual.

“Imagine you’re a Latino patient who’s coming into the hospital and not doing well, and you need to find where you’re going,” he said.

In the Sacramento region, nearly 60 percent of the insured Latino population are Kaiser Permanente members.

Bilingual signs were a simple idea but a huge undertaking. It took three years to replace thousands of signs at the 1 million-square-foot hospital.

Villalobos is no stranger to hard work.

His younger sister, Patricia Appleby, says Villalobos was always serious about work and school. She recalled that his high school job was at a McDonald’s, where in 1976 he received $2.15 per hour. As a teenager, he was promoted to supervisor, and helped Patricia get a job.

“When he got me the job at McDonald’s, he would say, ‘Don’t stand around, you need to sweep or mop if you have free time,’ ” she said.

In 1996, Kaiser Permanente recruited him to be director of sourcing and logistics, and he began working his way up.

Even as a senior vice president, no task seems beneath Villalobos. He’s been known to personally mediate confrontations between patients and staff.

If he has a spare minute, he doesn’t sit in his office. Instead, he is out doing “rounds,” which for this non-doctor means walking around the hospital, checking on staff and patients.

When he was in charge of implementing the hospital’s electronic health records pilot program, he spent countless hours on such rounds.

“I wore out three pairs of shoes walking around then,” he said.

The electronic medical records program is now so successful that every Kaiser hospital is using it or converting to it. In the process, Kaiser has become the second-largest health care system to use electronic medical records, after the Department of Veterans Affairs hospitals.

It hasn’t been easy, though. Some staffers said they just couldn’t ever get used to computers. Some cried, and a few even quit over the conversion.

One of those who found it difficult to convert was Nazanin Hassan, a nurse who said Villalobos visited her every day during the process.

“Now I don’t think I could go without the electronic system,” she said, recalling that because she struggled to learn English as adult, she feared having to learn a new computer language. “But back then, I thought I couldn’t do it. Max made me feel like I could.”

Because English was his second language, Villalobos says, he understood Hassan’s fear.

“I’m sensitive to that,” he said. “When I moved to America at age 12 I didn’t speak of word of English, and it was just very challenging.”

Tags: Chihuahua Mexico, Day Laborer, Electronic Medical Records, Health Care Administration, Health Care Executives, Immigrant Family, Improving Patient Care, Kaiser Center, Kaiser Hospital, Kaiser Permanente, Level Ii Trauma Center, Medical Records System, Muha, Patient Experience, Patient Population, S South, Sacramento Medical Center, South Sacramento, University Of Southern California, Villalobos

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