David Richfield

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 also 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, and she said she only handles federal issues, so could not be of help regarding this. I next contacted Assemblyman Sam Blakslee, who has always been a great help in this sort of issue, and he said Blue Shield of California is a private entity, and the State of California has no voice in their ways of doing business. But it seems to me that someone in the state government, or CalPERS (which provides retirement and health benefits 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? Approximately none.

On a separate note: At least in San Luis Obispo County, patients on the way out of Community Health Clinics—where Medicaid patients can be seen by doctors—are being handed brochures and told by staff to use “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 the 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 employees. All of this information is available on opensecrets.org, which provides public records showing where 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-Cal benefits. )

Again, this is all public record—but is anyone watching these guys? Next up, CenCal too is about to try to go 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, and not 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. It’s called Escalante Services and is based out of Nevada. If the current trend is to outsource pharmacy services, why not start outsourcing city and state employees, and politicians?

My next step was back to Assemblyman Blakslee, who said I could write a good “There ought to be law” letter voicing the need to get rid of mandatory mail order. Well, here it is!


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