| San Diego Education Report |
DOMHC Leadership Team
Shelley Rouillard,
Chief Deputy Director
Shelley Rouillard was appointed by Governor
Brown as the chief deputy director for the
Department of Managed Health Care (DMHC)
on September 1, 2011. She is responsible for
overseeing all of the day-to-day operations
of the DMHC, working with the director to
improve the operation of California’s
managed care system and ensure that
consumers get the right care at the right time.
Prior to her appointment to the DMHC,
Rouillard was the deputy director for
benefits and quality monitoring at the
California Managed Risk Medical
Insurance Board, where she oversaw the
contractual and clinical quality performance
of 33 health, dental, and vision plans and a
contracted third party administrator.
She previously was the founder and director
of the Health Rights Hotline, an independent
consumer advocacy program. She has also
held the positions of chief of health policy at
the California Public Employees Retirement
System, director of network development for
a national preferred provider organization,
and legislative advocate working on health
and long term care issues affecting low
income seniors and persons with disabilities.
She has a bachelor of arts degree in social
work from Rutgers University.
Holly Pearson [school attorney]
Deputy Director, General Counsel
Holly Pearson serves as the DMHC General
Counsel. In this capacity, she advises the Director
and Chief Deputy Director on general legal matters,
coordinates legal activities among the various office
divisions, and acts as liaison to the Business,
Transportation and Housing Agency, the Governor’s
Office, and major stakeholder organizations.
Pearson has been with the DMHC since
2006, most recently serving as acting
Assistant Deputy Director of the Office
of Legal Services (OLS), where she
contributed significantly to major policy development.
She joined the DMHC as Chief of Personnel and
Employment Litigation and Appellate Defense.
Following a brief period as Staff Counsel III in the
Office of Provider Oversight, she returned to OLS as
Assistant Chief Counsel, where she quickly gained
the confidence and support of the Executive team.
While in OLS, she developed a high level of
understanding of the Knox-Keene Act and its
corresponding regulations including administrative
and civil litigation, analyzing requests for public
records and claims payment issues. She developed
and organized a comprehensive in-house training
program on all aspects of the Knox-Keene Act for
DMHC staff counsels.
With a focus on public agency law throughout
her career, she served as general counsel to
K-12 school districts and community colleges
prior to joining the DMHC, and most recently
as a shareholder and manager of the
Education Practice Group at Kronick,
Moskovitz, Tiedemann & Girard of
Sacramento.
Pearson received her juris doctorate at
McGeorge School of Law, where she was
a member of the Traynor Honor Society and
received several American Jurisprudence
Awards. She received her bachelor’s degree
at the University of Southern California, and
is conversant in Spanish and Arabic.
Anthony Manzanetti,
Assistant Deputy Director, Office of
Enforcement
Tony Manzanetti is the Assistant Deputy Director and
Chief Counsel in the Office of Enforcement for the
Department of Managed Health Care (DMHC),
responsible for handling the litigation needs of the
DMHC and representing it in actions to enforce the
managed health care laws, in referrals from other
DMHC divisions that review the activities of health
care service plans for compliance with the managed
health care laws, and in actions that are brought
against the DMHC. He previously served as a senior
counsel at the Help Center, assisting enrollees in
resolving difficult and challenging complaints. Prior
to joining the Help Center, he served in the Office of
Enforcement representing the DMHC in a variety of
areas, including rescission litigation, unlicensed
discount plans, solicitors selling fraudulent
Medicare policies, and grievance system failures.
Manzanetti came to the DMHC from the City of Elk
Grove as its first city attorney, where as general
counsel to the city council and executive staff he
developed strategies regarding complex litigation
and directed external law firms on various specialty
issues for the City. Prior to that, he was in private
practice with Kronick, Moskovitz, Tiedemann &
Girard, representing businesses and public entities
in litigation, litigation avoidance, and strategic
planning on their behalf.
He received his juris doctorate from the
University of the Pacific’s McGeorge
School of Law and is admitted to practice
before the United States Supreme Court,
California State Supreme Court, and all trial
and appellate courts of the State of California.
Dennis Balmer,
Deputy Director, Financial Solvency
Standards Board
Dennis Balmer serves as the Deputy Director
of the Financial Solvency Standards Board,
interfacing between the DMHC and
stakeholder groups to address matters of
financial solvency that affect the delivery of
health care services. He also advises the
Director on current issues and potential
solutions to enhance the economics of
healthcare delivery for Californians. He
brings more than 28 years of both public and
private sector experience in finance, senior
management, and healthcare to the DMHC.
Prior to his appointment, Balmer worked as
an auditor in the DMHC’s Office of Provider
Oversight. Previous positions included
serving as the Director of Finance for the
Americas Channel Sales at Hewlett-Packard
Company, where he led the worldwide
integration of the Hewlett-Packard and
Compaq channel finance organizations, as
well as the implementation of Sarbanes-Oxley
compliance reporting for the Americas
Partner Sales organization, and provided
financial leadership for more than $10 billion
in annual sales and expenses.
He has a bachelor of arts in economics and a
master of administration from Willamette
University in Salem, Oregon.
Maureen McKennan,
Deputy Director, Plan and Provider Relations,
Maureen McKennan is the Acting Deputy
Director, Plan and Provider Relations, at the
California Department of Managed Health
Care, responsible for fostering proactive and
effective relations between the DMHC and its
licensed health plans, while serving as
primary advisor to the Director on critical plan
and provider issues and providing strategic
planning and policy direction on emerging
issues and industry trends.
She previously served as the Assistant
Deputy Director, Office of Health Plan
Oversight, where she directed all activities of
the 60 staff in the Division of Financial
Oversight and the Division of Licensing. After
joining the DMHC in 2005, she first worked in
the Office of Legal Services and the
Licensing Division of Health Plan Oversight.
McKennan is uniquely qualified to work in the
health care field, having extensive
experience as both an attorney and a nurse.
She came to the DMHC from the Office of the
Attorney General, where she had
worked as an attorney in both the
correctional law section and the
licensing section. She has also worked
as an attorney at the Department of
Health Services and in private practice
at Porter, Scott, Weiberg and Delehant.
In addition to her juris doctorate at
McGeorge School of Law, she has a
master of science degree in nursing from the
University of California, San Francisco, and
worked as a registered nurse and an adult
nurse practitioner for 14 years at the
University of California, Davis Medical Center.
Andrew George,
Assistant Deputy Director, Help
Center
As Assistant Deputy Director of the Help Center,
George is responsible for overseeing the operations
of the Help Center, which assists consumers with
health care issues and ensures that managed
health care patients receive the medical care and
services to which they are entitled.
George has been a practicing attorney in state
government for the past eleven years and served as
a senior staff counsel in the Help Center for eight
years. Throughout these years, he has developed a
strong commitment to Help Center customers, staff
and the public in general. He has played a
prominent leadership role in the development of the
Help Center while acquiring broad operational
knowledge of all five of its divisions.
He then moved to the Office of Provider Oversight
where he was instrumental in streamlining the
provider complaint process and enhancing efficiency.
Previously, he served at Department of Corporations
where he investigated and resolved consumer
complaints regarding health plan compliance with
the Knox-Keene Health Care Service Plan Act.
Additional prior experience has included serving as
an attorney in private practice performing all phases
of civil litigation including representation of clients
before state appellate courts, federal courts, trial
courts and administrative agencies.
George received his bachelor of science in
finance from University of Massachusetts at
Dartmouth, and a Juris Doctorate from
University of the Pacific, McGeorge School of
Law.
Carol Massey-McCants, manager, Complaint
Resolution Branch
Barbara Garrett,
Assistant Deputy Director, Office of
Technology & Innovation
Barbara Garrett serves as the Assistant
Deputy Director for the Office of Technology
and Innovation and as the Chief Information
Officer for the Department of Managed
Health Care. She manages a staff of 20
technical professionals dedicated to the
support of the information technology
infrastructure and systems that support the
delivery of mission critical services provided
by the DMHC.
Prior to her appointment at the Department
of Managed Health Care in June 2005, she
spent 17 years at the Stephen P. Teale Data
Center, where she held a number of
management positions in support of the data
center's network and help desk services. She
has also held positions in information
technology at the State Controller's Office
and the Department of Motor Vehicles. She
brings to the position extensive experience in
the planning, implementation, operation, and
management of information technology
solutions, and has a strong commitment to
customer service with an innate ability to
motivate and lead people.
She is a graduate of the Information
Technology Manager's Academy, is Vice
Chairman of the Board for the California
Association of Information Technology
Managers (CAITM), and is certified in IT
Service Management.
Debbie McKinney,
Assistant Deputy Director, Office of
Administrative Services
Debbie McKinney was appointed as Assistant
Deputy Director for Administrative Services of
the Department of Managed Health Care in
January 2008. She has more than 25 years
of state agency budget experience, and
manages a staff of 44 who provide
accounting, budgeting, personnel, contracts,
and business services to the Department.
Prior to her current appointment, she was the
Chief of Budget Operations for the
Department of Corrections and
Rehabilitation, after serving as the Fiscal
Officer. Prior to that, she was the Fiscal
Officer for the Department of Personnel
Administration, where she managed the
accounting, budget, and contracts
administrative offices. She has also held
management positions in the administrative
offices at the California Workforce Investment
Board, where she established statewide work
programs for the program's participants, and
the Department of Consumer Affairs, where
she was a team leader and coordinated the
transition of the administrative activities for
the Bureau for Private Postsecondary and
Vocational Education to the Department of
Consumer Affairs.
She holds a bachelor of science degree in
business administration, with a concentration
in accounting.
Shelley Rouillard,
Chief Deputy Director
Shelley Rouillard was appointed by Governor
Brown as the chief deputy director for the
Department of Managed Health Care (DMHC)
on September 1, 2011. She is responsible for
overseeing all of the day-to-day operations
of the DMHC, working with the director to
improve the operation of California’s
managed care system and ensure that
consumers get the right care at the right time.
Prior to her appointment to the DMHC,
Rouillard was the deputy director for
benefits and quality monitoring at the
California Managed Risk Medical
Insurance Board, where she oversaw the
contractual and clinical quality performance
of 33 health, dental, and vision plans and a
contracted third party administrator.
She previously was the founder and director
of the Health Rights Hotline, an independent
consumer advocacy program. She has also
held the positions of chief of health policy at
the California Public Employees Retirement
System, director of network development for
a national preferred provider organization,
and legislative advocate working on health
and long term care issues affecting low
income seniors and persons with disabilities.
She has a bachelor of arts degree in social
work from Rutgers University.
Holly Pearson [school attorney]
Deputy Director, General Counsel
Holly Pearson serves as the DMHC General
Counsel. In this capacity, she advises the Director
and Chief Deputy Director on general legal matters,
coordinates legal activities among the various office
divisions, and acts as liaison to the Business,
Transportation and Housing Agency, the Governor’s
Office, and major stakeholder organizations.
Pearson has been with the DMHC since
2006, most recently serving as acting
Assistant Deputy Director of the Office
of Legal Services (OLS), where she
contributed significantly to major policy development.
She joined the DMHC as Chief of Personnel and
Employment Litigation and Appellate Defense.
Following a brief period as Staff Counsel III in the
Office of Provider Oversight, she returned to OLS as
Assistant Chief Counsel, where she quickly gained
the confidence and support of the Executive team.
While in OLS, she developed a high level of
understanding of the Knox-Keene Act and its
corresponding regulations including administrative
and civil litigation, analyzing requests for public
records and claims payment issues. She developed
and organized a comprehensive in-house training
program on all aspects of the Knox-Keene Act for
DMHC staff counsels.
With a focus on public agency law throughout
her career, she served as general counsel to
K-12 school districts and community colleges
prior to joining the DMHC, and most recently
as a shareholder and manager of the
Education Practice Group at Kronick,
Moskovitz, Tiedemann & Girard of
Sacramento.
Pearson received her juris doctorate at
McGeorge School of Law, where she was
a member of the Traynor Honor Society and
received several American Jurisprudence
Awards. She received her bachelor’s degree
at the University of Southern California, and
is conversant in Spanish and Arabic.
Anthony Manzanetti,
Assistant Deputy Director, Office of
Enforcement
Tony Manzanetti is the Assistant Deputy Director and
Chief Counsel in the Office of Enforcement for the
Department of Managed Health Care (DMHC),
responsible for handling the litigation needs of the
DMHC and representing it in actions to enforce the
managed health care laws, in referrals from other
DMHC divisions that review the activities of health
care service plans for compliance with the managed
health care laws, and in actions that are brought
against the DMHC. He previously served as a senior
counsel at the Help Center, assisting enrollees in
resolving difficult and challenging complaints. Prior
to joining the Help Center, he served in the Office of
Enforcement representing the DMHC in a variety of
areas, including rescission litigation, unlicensed
discount plans, solicitors selling fraudulent
Medicare policies, and grievance system failures.
Manzanetti came to the DMHC from the City of Elk
Grove as its first city attorney, where as general
counsel to the city council and executive staff he
developed strategies regarding complex litigation
and directed external law firms on various specialty
issues for the City. Prior to that, he was in private
practice with Kronick, Moskovitz, Tiedemann &
Girard, representing businesses and public entities
in litigation, litigation avoidance, and strategic
planning on their behalf.
He received his juris doctorate from the
University of the Pacific’s McGeorge
School of Law and is admitted to practice
before the United States Supreme Court,
California State Supreme Court, and all trial
and appellate courts of the State of California.
Dennis Balmer,
Deputy Director, Financial Solvency
Standards Board
Dennis Balmer serves as the Deputy Director
of the Financial Solvency Standards Board,
interfacing between the DMHC and
stakeholder groups to address matters of
financial solvency that affect the delivery of
health care services. He also advises the
Director on current issues and potential
solutions to enhance the economics of
healthcare delivery for Californians. He
brings more than 28 years of both public and
private sector experience in finance, senior
management, and healthcare to the DMHC.
Prior to his appointment, Balmer worked as
an auditor in the DMHC’s Office of Provider
Oversight. Previous positions included
serving as the Director of Finance for the
Americas Channel Sales at Hewlett-Packard
Company, where he led the worldwide
integration of the Hewlett-Packard and
Compaq channel finance organizations, as
well as the implementation of Sarbanes-Oxley
compliance reporting for the Americas
Partner Sales organization, and provided
financial leadership for more than $10 billion
in annual sales and expenses.
He has a bachelor of arts in economics and a
master of administration from Willamette
University in Salem, Oregon.
Maureen McKennan,
Deputy Director, Plan and Provider Relations,
Maureen McKennan is the Acting Deputy
Director, Plan and Provider Relations, at the
California Department of Managed Health
Care, responsible for fostering proactive and
effective relations between the DMHC and its
licensed health plans, while serving as
primary advisor to the Director on critical plan
and provider issues and providing strategic
planning and policy direction on emerging
issues and industry trends.
She previously served as the Assistant
Deputy Director, Office of Health Plan
Oversight, where she directed all activities of
the 60 staff in the Division of Financial
Oversight and the Division of Licensing. After
joining the DMHC in 2005, she first worked in
the Office of Legal Services and the
Licensing Division of Health Plan Oversight.
McKennan is uniquely qualified to work in the
health care field, having extensive
experience as both an attorney and a nurse.
She came to the DMHC from the Office of the
Attorney General, where she had
worked as an attorney in both the
correctional law section and the
licensing section. She has also worked
as an attorney at the Department of
Health Services and in private practice
at Porter, Scott, Weiberg and Delehant.
In addition to her juris doctorate at
McGeorge School of Law, she has a
master of science degree in nursing from the
University of California, San Francisco, and
worked as a registered nurse and an adult
nurse practitioner for 14 years at the
University of California, Davis Medical Center.
Andrew George,
Assistant Deputy Director, Help
Center
As Assistant Deputy Director of the Help Center,
George is responsible for overseeing the operations
of the Help Center, which assists consumers with
health care issues and ensures that managed
health care patients receive the medical care and
services to which they are entitled.
George has been a practicing attorney in state
government for the past eleven years and served as
a senior staff counsel in the Help Center for eight
years. Throughout these years, he has developed a
strong commitment to Help Center customers, staff
and the public in general. He has played a
prominent leadership role in the development of the
Help Center while acquiring broad operational
knowledge of all five of its divisions.
He then moved to the Office of Provider Oversight
where he was instrumental in streamlining the
provider complaint process and enhancing efficiency.
Previously, he served at Department of Corporations
where he investigated and resolved consumer
complaints regarding health plan compliance with
the Knox-Keene Health Care Service Plan Act.
Additional prior experience has included serving as
an attorney in private practice performing all phases
of civil litigation including representation of clients
before state appellate courts, federal courts, trial
courts and administrative agencies.
George received his bachelor of science in
finance from University of Massachusetts at
Dartmouth, and a Juris Doctorate from
University of the Pacific, McGeorge School of
Law.
Carol Massey-McCants, manager, Complaint
Resolution Branch
Barbara Garrett,
Assistant Deputy Director, Office of
Technology & Innovation
Barbara Garrett serves as the Assistant
Deputy Director for the Office of Technology
and Innovation and as the Chief Information
Officer for the Department of Managed
Health Care. She manages a staff of 20
technical professionals dedicated to the
support of the information technology
infrastructure and systems that support the
delivery of mission critical services provided
by the DMHC.
Prior to her appointment at the Department
of Managed Health Care in June 2005, she
spent 17 years at the Stephen P. Teale Data
Center, where she held a number of
management positions in support of the data
center's network and help desk services. She
has also held positions in information
technology at the State Controller's Office
and the Department of Motor Vehicles. She
brings to the position extensive experience in
the planning, implementation, operation, and
management of information technology
solutions, and has a strong commitment to
customer service with an innate ability to
motivate and lead people.
She is a graduate of the Information
Technology Manager's Academy, is Vice
Chairman of the Board for the California
Association of Information Technology
Managers (CAITM), and is certified in IT
Service Management.
Debbie McKinney,
Assistant Deputy Director, Office of
Administrative Services
Debbie McKinney was appointed as Assistant
Deputy Director for Administrative Services of
the Department of Managed Health Care in
January 2008. She has more than 25 years
of state agency budget experience, and
manages a staff of 44 who provide
accounting, budgeting, personnel, contracts,
and business services to the Department.
Prior to her current appointment, she was the
Chief of Budget Operations for the
Department of Corrections and
Rehabilitation, after serving as the Fiscal
Officer. Prior to that, she was the Fiscal
Officer for the Department of Personnel
Administration, where she managed the
accounting, budget, and contracts
administrative offices. She has also held
management positions in the administrative
offices at the California Workforce Investment
Board, where she established statewide work
programs for the program's participants, and
the Department of Consumer Affairs, where
she was a team leader and coordinated the
transition of the administrative activities for
the Bureau for Private Postsecondary and
Vocational Education to the Department of
Consumer Affairs.
She holds a bachelor of science degree in
business administration, with a concentration
in accounting.
California Department of Managed Health Care
(DOMHC)
(DOMHC)
People
Diagnostic Imaging
Diagnosis
Medical Records
Other
Doctors
Kaiser Papers.org
LIST OF WEB SITES THAT
SPECIFICALLY STUDY KAISER
PERMANENTE AND PROVIDE
ADVOCACY AND OFFER
SUGGESTIONS FOR THE
PATIENT
LIST OF WEB SITES THAT
SPECIFICALLY STUDY KAISER
PERMANENTE AND PROVIDE
ADVOCACY AND OFFER
SUGGESTIONS FOR THE
PATIENT
Conahan v. Sebelius and Kaiser
Foundation Health Plan, Inc.
Foundation Health Plan, Inc.
Cases and news
Patient advocates
Doctors who cause death
Doctors who go along
with Kaiser tactics
with Kaiser tactics
Doctors in charge of
cover-ups
cover-ups
[The DOMHC has a remarkably large number of
executives who are lawyers who studied at
McGeorge School of Law.]
executives who are lawyers who studied at
McGeorge School of Law.]
Kaiser Permanente
administrator on
DOMHC Clinical
Advisory Panel
Dr. Bernadette C. Loftus
Otolaryngology
Stanford University School of
Medicine; Physician-inChief,
Kaiser Permanente Santa
Clara Medical Center
(Clinical assistant professor;
practicing physician)
(Loftis regulates herself.
I wonder if she thinks
this is appropriate
medical practice.)
administrator on
DOMHC Clinical
Advisory Panel
Dr. Bernadette C. Loftus
Otolaryngology
Stanford University School of
Medicine; Physician-inChief,
Kaiser Permanente Santa
Clara Medical Center
(Clinical assistant professor;
practicing physician)
(Loftis regulates herself.
I wonder if she thinks
this is appropriate
medical practice.)
August 11, 2011
Governor Brown Announces
Appointments
SACRAMENTO – Governor Edmund G.
Brown Jr. today announced the following
appointments.
Brent Barnhart, 68, of Danville, has
been appointed director of the Department of
Managed Health Care. Barnhart was
senior counsel at Kaiser
Foundation Health Plan from 1996 to
2009 and a policy committee consultant to the
California State Assembly from 1993 to 1996.
He was the legislative affairs director at
Blue Cross of California [lobbyist] from
1991 to 1993 and senior attorney and
legislative advocate from 1983 to 1987.
Barnhart served as counsel and secretary
at the Association of California Life and
Health Insurance Companies from 1987 to
1991 and was the California legislative
director of the American Civil Liberties Union
from 1975 to 1983. This position requires
Senate confirmation and the compensation is
$142,965. Barnhart is registered decline-to-
state.
Shelley Rouillard, 55, of Sacramento has
been appointed chief deputy director of the
Department of Managed Health Care.
Rouillard has served as deputy director of the
Benefits and Quality Monitoring Division at
the Managed Risk Medical Insurance Board
since 2007. She was program director at the
Health Rights Hotline for Legal Services of
Northern California from 2006 to 2007 and
from 1996 to 2004. Rouillard was chief of
health policy at the Office of Health Policy and
Plan Administration at the California Public
Employee Retirement System in 2005. She
was the principal at Rouillard Consulting from
2001 to 2004 and served as director of
Network Operations at HealthCare Compare
Corporation from 1991 to 1996. Rouillard was
a legislative advocate at the California Rural
Legal Assistance Foundation from 1987 to
1991. This position does not require Senate
confirmation and the compensation is
$125,000. Rouillard is a Democrat.
John Shen, 61, of Berkeley, has been
appointed chief of the Long Term Care
Division at the Department of Health Care
Services. Shen was the executive director of
the Marin Community Clinic from 1997 to
2011. He was a health care consultant from
2003 to 2007, working for Marin County
Health and Human Services, Southwest
Community Health Center, and Contra Costa
County Health Plan. Shen held multiple
positions at On Lok Senior Health Services
from 1997 to 2003 and 1979 to 1995,
including health plan director from 2001 to
2003. He served as the geriatric planning
director at Mount Sinai Medical Center in New
York from 1995 to 1997. This position does
not require Senate confirmation and the
compensation is $122,196. Shen is a
Republican.
Colonel Keith Tresh, 49, of Sacramento,
has been appointed director of the Office of
Information Security at the California
Technology Agency. Tresh has served as
chief information officer at the California
National Guard since 2006, after serving in
multiple positions from 1993 to 2005. He
served in the United States Army in Iraq as a
brigade communications officer from 2005 to
2006. This position does not require Senate
confirmation and the compensation is
$156,000. Tresh is a Republican.
Governor Brown Announces
Appointments
SACRAMENTO – Governor Edmund G.
Brown Jr. today announced the following
appointments.
Brent Barnhart, 68, of Danville, has
been appointed director of the Department of
Managed Health Care. Barnhart was
senior counsel at Kaiser
Foundation Health Plan from 1996 to
2009 and a policy committee consultant to the
California State Assembly from 1993 to 1996.
He was the legislative affairs director at
Blue Cross of California [lobbyist] from
1991 to 1993 and senior attorney and
legislative advocate from 1983 to 1987.
Barnhart served as counsel and secretary
at the Association of California Life and
Health Insurance Companies from 1987 to
1991 and was the California legislative
director of the American Civil Liberties Union
from 1975 to 1983. This position requires
Senate confirmation and the compensation is
$142,965. Barnhart is registered decline-to-
state.
Shelley Rouillard, 55, of Sacramento has
been appointed chief deputy director of the
Department of Managed Health Care.
Rouillard has served as deputy director of the
Benefits and Quality Monitoring Division at
the Managed Risk Medical Insurance Board
since 2007. She was program director at the
Health Rights Hotline for Legal Services of
Northern California from 2006 to 2007 and
from 1996 to 2004. Rouillard was chief of
health policy at the Office of Health Policy and
Plan Administration at the California Public
Employee Retirement System in 2005. She
was the principal at Rouillard Consulting from
2001 to 2004 and served as director of
Network Operations at HealthCare Compare
Corporation from 1991 to 1996. Rouillard was
a legislative advocate at the California Rural
Legal Assistance Foundation from 1987 to
1991. This position does not require Senate
confirmation and the compensation is
$125,000. Rouillard is a Democrat.
John Shen, 61, of Berkeley, has been
appointed chief of the Long Term Care
Division at the Department of Health Care
Services. Shen was the executive director of
the Marin Community Clinic from 1997 to
2011. He was a health care consultant from
2003 to 2007, working for Marin County
Health and Human Services, Southwest
Community Health Center, and Contra Costa
County Health Plan. Shen held multiple
positions at On Lok Senior Health Services
from 1997 to 2003 and 1979 to 1995,
including health plan director from 2001 to
2003. He served as the geriatric planning
director at Mount Sinai Medical Center in New
York from 1995 to 1997. This position does
not require Senate confirmation and the
compensation is $122,196. Shen is a
Republican.
Colonel Keith Tresh, 49, of Sacramento,
has been appointed director of the Office of
Information Security at the California
Technology Agency. Tresh has served as
chief information officer at the California
National Guard since 2006, after serving in
multiple positions from 1993 to 2005. He
served in the United States Army in Iraq as a
brigade communications officer from 2005 to
2006. This position does not require Senate
confirmation and the compensation is
$156,000. Tresh is a Republican.
Meet Bernadette Loftus,
Kaiser Permanente
Joint Venture Silcon Valley
Network
2009
Dr. Bernadette Loftus
Physician-in-Chief
Kaiser Permanente Santa
Clara Medical Center
Joint Venture Board of
Directors
“I was honored when Joint
Venture asked me to join
their board because of the
very important work they were
doing in the health care
arena.”
On the wall behind Dr.
Bernadette Loftus’ desk
hangs a poster-sized
photo collage of her in
three different snapshots
– one with Permanente
Medical Group CEO Dr.
Robert Pearl, another
standing beside Governor
Arnold Schwarzenegger and
a third of her embracing a
colleague’s husband decked
out in full Elvis Presley regalia.
“Three men in my life that I
call Kings of Quality,” she
says, gesturing to the frame
with an outstretched arm and
a wide smile. “Dr. Pearl, my
boss, is the ‘king’ of the
medical center and a
mentor to me; Arnold is
the ‘king’ of California;
and everyone knows Elvis
as ‘The King.’ [Maura
Larkins' note: California has a
king? If so, is Arnold still king
even after Jerry Brown got
elected governor?]
“My co-workers presented
this to me as a gift to
recognize the improvements
in the quality of care we have
achieved here. In their own
way, these men all symbolize
quality.”
Indeed, it’s a fitting
connection to the
professional and personal
standards of Dr. Loftus,
Physician-in-Chief of
Kaiser Permanente’s
sprawling Santa Clara
Medical Center and a
member of the Joint
Venture Board of
Directors.
In her association with Joint
Venture she has participated
on the Smart Health Task
Force, hosted board
meetings and assisted with
health-related panels at the
annual State of the Valley
conference.
“I was honored when Joint
Venture asked me to join
their board,” she said,
“because of the very
important work they were
doing in the health care
arena.”
In her present role since
1998, Dr. Loftus oversees
medical services for more
than 330,000 Kaiser
Permanente patients
throughout the region and a
staff of 585 doctors, the latter
number having doubled
under her watch and nearly
triple that of ten years ago.
She was instrumental in the
conception, planning, design,
construction and startup
operations of the $750
million, 1.4-million-square-
foot medical center she
overlooks from her fourth-
floor office on the campus.
“It’s a huge sense of
accomplishment,” she says of
the process that culminated
late last summer. “Moving in
hundreds of patients and
everything that goes along
with relocating a major facility
is an enormous undertaking,
and there are still a few kinks.
Even if you’re just moving
your home you still end up
misplacing a box somewhere.”
The analogy is apt because
the campus has become a
professional home to Dr.
Loftus, who began her career
as a head and neck surgeon
but gravitated to the
administrative side because
she was drawn to the notion
of providing quality care for
thousands of patients
collectively rather than one at
a time.
“My mother was a nurse and
my father was an engineer,
and I went into medicine
because I thought I wanted to
cure cancer. It seemed
simple. I figured if you had
something bad inside of you I
could just cut it out.”
Sitting at a small conference
table, she gazes around her
office at the clutter of
memorabilia - photos,
plaques, coffee mugs,
inspirational quotes by the
likes of Disraeli, Dr. Martin
Luther King, Jr., Eleanor
Roosevelt and others.
She points out a picture of
her favorite cow from her
grandfather’s farm. It’s clear
she is a long way from her
original home, and not just
geographically.
“I came to California as a
reluctant trailing spouse when
my husband was recruited to
a job here, but I soon fell in
love with the mission of
Kaiser. There is nothing like it
on the East Coast.”
When she became the
elected representative to
the board at KPMG in
1996, she said, “it opened
up a whole new world, the
world of health care policy
and improving the quality of
care on a larger scale. I
became fascinated with the
idea that you could put policy
into action. It was a breath of
fresh air.”
Dr. Loftus earned her
undergraduate degree in
biochemistry at the University
of Pennsylvania and her M.D.
at the Case Western Reserve
University School of Medicine
in Cleveland. She performed
her residency with the
Columbia University College
of Physicians and Surgeons
in Otolaryngology and Head
and Neck Surgery.
“I still maintain a small
practice today, but I traded
most of it in for
administration – something I
never dreamed I’d wind up
doing,” she confessed.
Sue Murphy, the medical
center’s chief operating
officer, says Dr. Loftus is
exceptionally well-suited to
her role as physician-in-
charge.
“She is very focused, driven
by excellence and devoted to
her job,” said Dr. Murphy. “I
really appreciate her passion
and involvement in
understanding what it takes
to make the medical center
the best that it can be.”
Dr. Murphy added that Dr.
Loftus is not only “remarkably
attentive to detail and has a
phenomenal memory,” but
that she excels at debating
and negotiating, and
possesses a vocabulary that
frequently sends Dr. Murphy
to the dictionary. “The other
day she used the word
‘pusillanimous.’ I had to go
look it up.”
She did not say in what
context Dr. Loftus used the
word, but it certainly could not
have been in reference to
herself. The definitions of
“cowardly,” or “lacking in
courage or resolution” hardly
apply to Dr. Loftus, who is
seen by many of her
colleagues and others in the
community as indefatigable in
her pursuit of quality health
care in the community.
Among her accomplishments
in connection with the medical
center project, she added
such new clinical services as
radiation oncology and cardio-
vascular surgery, oversaw
major improvement in
member in-patient and out-
patient satisfaction
measurement, and led the
implementation of a highly
successful e-consult/direct
scheduling access system.
She also elicited and aligned
leadership support at multiple
levels to acquire a donation
of land on the medical center
campus for construction of
the JW House – housing for
families of long-stay patients
– the first facility of its kind for
Kaiser Permanente.
In addition to her work on
several TPMG board
committees and the Joint
Venture board, Dr. Loftus has
also served on the Joint
Venture Smart Health Task
Force, the clinical advisory
panel of the California
Department of Managed
Health Care and California
Health Care Foundation
Leadership Fellowship.
She has been a member of the
Santa Clara County and
California Medical Associations
since 1991, and since 2001
she has been a clinical
assistant professor in the
department of
otolaryngology/head and neck
surgery at the Stanford
University School of Medicine.
Dr. Loftus was named Silicon
Valley Business Woman of
the Year in 2003 and was
honored as the 2007 Woman
of the Year in California State
Senate District 13, the seat of
Sen. Elaine Alquist.
“She’s brilliant, one of the
more intelligent people in
our medical center,” says
Dr. Mark DuLong, the
assistant physician-in-chief
and chief of plastic surgery
for the Santa Clara facility.
“What she does takes a wide
range of talents that most
people don’t have.
“Key among them is
communication – she knows
how to keep her audience in
mind when she is speaking.
Over time I have become
more and more appreciative
of how many things she has
to deal with in her current
role. And she does them with
good humor and poise.”
Dr. Loftus acknowledges that
her field and her individual
role both require political
savvy and the courage to
voice opinions and build
consensus.
“We need to inspire and
motivate people about the
future. And I have to learn
which battles to fight, what
phrases and code words to
use in order to get things
done.”
While Dr. Pearl, the governor
and Elvis may be Kings of
Quality to her, there are three
other more significant men in
her life – her husband, Marty
McKenzie, now a physics and
chemistry teacher at
Bellarmine Preparatory
School in San Jose, and her
sons, Tim, 18, a freshman at
the University of
Pennsylvania in Philadelphia,
and Connor, 14, a freshman
at Bellarmine.
“They are the three most
important men in my life,” she
says. “Being a parent is the
most rewarding job I have
ever had, and I try to be
involved in the boys’ lives as
much as possible.”
When she has time, Dr.
Loftus finds joy in gardening
around their Los Altos Hills
home and is a voracious
reader, which may help
explain all those big words.
But one word that means a
great deal to her is quality. In
fact, if one were to ask Dr.
Pearl, the governor or any
number of other “kings of
quality” in her circle, they
might say they think of Dr.
Loftus as a “Queen of Quality.
Kaiser Permanente
Joint Venture Silcon Valley
Network
2009
Dr. Bernadette Loftus
Physician-in-Chief
Kaiser Permanente Santa
Clara Medical Center
Joint Venture Board of
Directors
“I was honored when Joint
Venture asked me to join
their board because of the
very important work they were
doing in the health care
arena.”
On the wall behind Dr.
Bernadette Loftus’ desk
hangs a poster-sized
photo collage of her in
three different snapshots
– one with Permanente
Medical Group CEO Dr.
Robert Pearl, another
standing beside Governor
Arnold Schwarzenegger and
a third of her embracing a
colleague’s husband decked
out in full Elvis Presley regalia.
“Three men in my life that I
call Kings of Quality,” she
says, gesturing to the frame
with an outstretched arm and
a wide smile. “Dr. Pearl, my
boss, is the ‘king’ of the
medical center and a
mentor to me; Arnold is
the ‘king’ of California;
and everyone knows Elvis
as ‘The King.’ [Maura
Larkins' note: California has a
king? If so, is Arnold still king
even after Jerry Brown got
elected governor?]
“My co-workers presented
this to me as a gift to
recognize the improvements
in the quality of care we have
achieved here. In their own
way, these men all symbolize
quality.”
Indeed, it’s a fitting
connection to the
professional and personal
standards of Dr. Loftus,
Physician-in-Chief of
Kaiser Permanente’s
sprawling Santa Clara
Medical Center and a
member of the Joint
Venture Board of
Directors.
In her association with Joint
Venture she has participated
on the Smart Health Task
Force, hosted board
meetings and assisted with
health-related panels at the
annual State of the Valley
conference.
“I was honored when Joint
Venture asked me to join
their board,” she said,
“because of the very
important work they were
doing in the health care
arena.”
In her present role since
1998, Dr. Loftus oversees
medical services for more
than 330,000 Kaiser
Permanente patients
throughout the region and a
staff of 585 doctors, the latter
number having doubled
under her watch and nearly
triple that of ten years ago.
She was instrumental in the
conception, planning, design,
construction and startup
operations of the $750
million, 1.4-million-square-
foot medical center she
overlooks from her fourth-
floor office on the campus.
“It’s a huge sense of
accomplishment,” she says of
the process that culminated
late last summer. “Moving in
hundreds of patients and
everything that goes along
with relocating a major facility
is an enormous undertaking,
and there are still a few kinks.
Even if you’re just moving
your home you still end up
misplacing a box somewhere.”
The analogy is apt because
the campus has become a
professional home to Dr.
Loftus, who began her career
as a head and neck surgeon
but gravitated to the
administrative side because
she was drawn to the notion
of providing quality care for
thousands of patients
collectively rather than one at
a time.
“My mother was a nurse and
my father was an engineer,
and I went into medicine
because I thought I wanted to
cure cancer. It seemed
simple. I figured if you had
something bad inside of you I
could just cut it out.”
Sitting at a small conference
table, she gazes around her
office at the clutter of
memorabilia - photos,
plaques, coffee mugs,
inspirational quotes by the
likes of Disraeli, Dr. Martin
Luther King, Jr., Eleanor
Roosevelt and others.
She points out a picture of
her favorite cow from her
grandfather’s farm. It’s clear
she is a long way from her
original home, and not just
geographically.
“I came to California as a
reluctant trailing spouse when
my husband was recruited to
a job here, but I soon fell in
love with the mission of
Kaiser. There is nothing like it
on the East Coast.”
When she became the
elected representative to
the board at KPMG in
1996, she said, “it opened
up a whole new world, the
world of health care policy
and improving the quality of
care on a larger scale. I
became fascinated with the
idea that you could put policy
into action. It was a breath of
fresh air.”
Dr. Loftus earned her
undergraduate degree in
biochemistry at the University
of Pennsylvania and her M.D.
at the Case Western Reserve
University School of Medicine
in Cleveland. She performed
her residency with the
Columbia University College
of Physicians and Surgeons
in Otolaryngology and Head
and Neck Surgery.
“I still maintain a small
practice today, but I traded
most of it in for
administration – something I
never dreamed I’d wind up
doing,” she confessed.
Sue Murphy, the medical
center’s chief operating
officer, says Dr. Loftus is
exceptionally well-suited to
her role as physician-in-
charge.
“She is very focused, driven
by excellence and devoted to
her job,” said Dr. Murphy. “I
really appreciate her passion
and involvement in
understanding what it takes
to make the medical center
the best that it can be.”
Dr. Murphy added that Dr.
Loftus is not only “remarkably
attentive to detail and has a
phenomenal memory,” but
that she excels at debating
and negotiating, and
possesses a vocabulary that
frequently sends Dr. Murphy
to the dictionary. “The other
day she used the word
‘pusillanimous.’ I had to go
look it up.”
She did not say in what
context Dr. Loftus used the
word, but it certainly could not
have been in reference to
herself. The definitions of
“cowardly,” or “lacking in
courage or resolution” hardly
apply to Dr. Loftus, who is
seen by many of her
colleagues and others in the
community as indefatigable in
her pursuit of quality health
care in the community.
Among her accomplishments
in connection with the medical
center project, she added
such new clinical services as
radiation oncology and cardio-
vascular surgery, oversaw
major improvement in
member in-patient and out-
patient satisfaction
measurement, and led the
implementation of a highly
successful e-consult/direct
scheduling access system.
She also elicited and aligned
leadership support at multiple
levels to acquire a donation
of land on the medical center
campus for construction of
the JW House – housing for
families of long-stay patients
– the first facility of its kind for
Kaiser Permanente.
In addition to her work on
several TPMG board
committees and the Joint
Venture board, Dr. Loftus has
also served on the Joint
Venture Smart Health Task
Force, the clinical advisory
panel of the California
Department of Managed
Health Care and California
Health Care Foundation
Leadership Fellowship.
She has been a member of the
Santa Clara County and
California Medical Associations
since 1991, and since 2001
she has been a clinical
assistant professor in the
department of
otolaryngology/head and neck
surgery at the Stanford
University School of Medicine.
Dr. Loftus was named Silicon
Valley Business Woman of
the Year in 2003 and was
honored as the 2007 Woman
of the Year in California State
Senate District 13, the seat of
Sen. Elaine Alquist.
“She’s brilliant, one of the
more intelligent people in
our medical center,” says
Dr. Mark DuLong, the
assistant physician-in-chief
and chief of plastic surgery
for the Santa Clara facility.
“What she does takes a wide
range of talents that most
people don’t have.
“Key among them is
communication – she knows
how to keep her audience in
mind when she is speaking.
Over time I have become
more and more appreciative
of how many things she has
to deal with in her current
role. And she does them with
good humor and poise.”
Dr. Loftus acknowledges that
her field and her individual
role both require political
savvy and the courage to
voice opinions and build
consensus.
“We need to inspire and
motivate people about the
future. And I have to learn
which battles to fight, what
phrases and code words to
use in order to get things
done.”
While Dr. Pearl, the governor
and Elvis may be Kings of
Quality to her, there are three
other more significant men in
her life – her husband, Marty
McKenzie, now a physics and
chemistry teacher at
Bellarmine Preparatory
School in San Jose, and her
sons, Tim, 18, a freshman at
the University of
Pennsylvania in Philadelphia,
and Connor, 14, a freshman
at Bellarmine.
“They are the three most
important men in my life,” she
says. “Being a parent is the
most rewarding job I have
ever had, and I try to be
involved in the boys’ lives as
much as possible.”
When she has time, Dr.
Loftus finds joy in gardening
around their Los Altos Hills
home and is a voracious
reader, which may help
explain all those big words.
But one word that means a
great deal to her is quality. In
fact, if one were to ask Dr.
Pearl, the governor or any
number of other “kings of
quality” in her circle, they
might say they think of Dr.
Loftus as a “Queen of Quality.
Maryland Health
Services Cost
Review Commission
Bernadette C. Loftus, MD
Dr. Loftus joined The
Permanente Medical Group
(TPMG) in 1991 and has
served in a number of
leadership capacities,
including TPMG Board
Member and Physician in
Chief of the Santa Clara
Medical Center, the largest
Kaiser Permanente (KP)
medical center in Northern
California. Currently, she is
charged with accomplishing
the merger of the
MidAtlantic Permanente
Medical Group (MAPMG)
with TPMG. Accordingly,
she has medical group
accountability for the
performance and
operations of the KP
delivery system in the
MidAtlantic region. The KP
MidAtlantic Region currently
serves approximately
500,000 members in D.C.,
Maryland, and Northern
Virginia, with 1,000
physicians, 5,000
employees, and $2 billion in
revenue.
Dr. Loftus was born and
raised on the East Coast
and graduated from the
University of Pennsylvania
with a Bachelor of Arts
degree in biochemistry
before attending Case
Western Reserve University
School of Medicine. After
earning her medical degree
Dr. Loftus completed a
six-year otolaryngology
residency in New York City
at Columbia University
College of Physicians and
Surgeons.
Dr. Loftus is Board-certified in
Otolaryngology/Head and Neck
Surgery, and serves on the
Research Advisory Board of the
American Academy of
Otolaryngology. She has been an
invited speaker/consultant on a
variety of health care topics for
such entities as the Wharton
School of Business of the
University of Pennsylvania, the
Bloomberg School of Public Health
of Johns Hopkins University, The
Commonwealth Fund, the National
Association of Commissions for
Women, the North American
Bengali Association, and others.
Her broader health care interests
lie in technology-enabled
population care management.
(Term Expires July, 2015)
Services Cost
Review Commission
Bernadette C. Loftus, MD
Dr. Loftus joined The
Permanente Medical Group
(TPMG) in 1991 and has
served in a number of
leadership capacities,
including TPMG Board
Member and Physician in
Chief of the Santa Clara
Medical Center, the largest
Kaiser Permanente (KP)
medical center in Northern
California. Currently, she is
charged with accomplishing
the merger of the
MidAtlantic Permanente
Medical Group (MAPMG)
with TPMG. Accordingly,
she has medical group
accountability for the
performance and
operations of the KP
delivery system in the
MidAtlantic region. The KP
MidAtlantic Region currently
serves approximately
500,000 members in D.C.,
Maryland, and Northern
Virginia, with 1,000
physicians, 5,000
employees, and $2 billion in
revenue.
Dr. Loftus was born and
raised on the East Coast
and graduated from the
University of Pennsylvania
with a Bachelor of Arts
degree in biochemistry
before attending Case
Western Reserve University
School of Medicine. After
earning her medical degree
Dr. Loftus completed a
six-year otolaryngology
residency in New York City
at Columbia University
College of Physicians and
Surgeons.
Dr. Loftus is Board-certified in
Otolaryngology/Head and Neck
Surgery, and serves on the
Research Advisory Board of the
American Academy of
Otolaryngology. She has been an
invited speaker/consultant on a
variety of health care topics for
such entities as the Wharton
School of Business of the
University of Pennsylvania, the
Bloomberg School of Public Health
of Johns Hopkins University, The
Commonwealth Fund, the National
Association of Commissions for
Women, the North American
Bengali Association, and others.
Her broader health care interests
lie in technology-enabled
population care management.
(Term Expires July, 2015)
FOR IMMEDIATE RELEASE
October 4, 2011
(916) 445-7442
DMHC ANNOUNCES SENIOR STAFF
APPOINTMENT
(Sacramento) – Brent Barnhart, Director of
the Department of Managed Health Care
(DMHC),
has announced the appointment of
Maureen McKennan as Deputy
Director for Plan and Provider Relations.
“Maureen has long been a great asset to the
DMHC and we are very pleased that she will
be overseeing the DMHC’s role in regulating
the California managed care industry and
ensuring
that consumers continue to receive the care
they need and deserve,” said Barnhart. “She
is wellqualified to help lead the DMHC as
national health care reform efforts are
implemented and
expanded to benefit California enrollees.”
As Deputy Director of Plan and Provider
Relations, McKennan is responsible for
fostering proactive and effective relations
between the DMHC and its licensed health
plans,
while serving as primary advisor to the
Director on critical plan and provider issues
and providing strategic planning and policy
direction on emerging issues and industry
trends.
She has served as the Acting Deputy
Director of Plan and Provider Relations since
February 2011, having previously been the
Assistant Deputy Director, Office of Health
Plan
Oversight, where she directed all activities of
the 60 staff in the Division of Financial
Oversight
and the Division of Licensing. After joining
the DMHC in 2005, she first worked as a staff
counsel in the Office of Legal Services, and
later in the Licensing Division.
McKennan is uniquely qualified to work in the
health care field, having extensive experience
as both an attorney and a nurse. She came
to the DMHC from the Office of the
Attorney General, where she worked in both
the correctional law section and the licensing
section. She has been an attorney at the
Department of Health Services, and in
private practice at
Porter, Scott, Weiberg and Delehant.
DMHC announces “Right Care Initiative” award
recipients
FOR IMMEDIATE RELEASE
CONTACT: Lynne Randolph
October 6, 2011
(916) 445-7442
Health plan and medical groups honored for work to fight diabetes and heart disease
among HMO patients
(Sacramento) -- The California Department of Managed Health Care (DMHC) has
announced recipients of the fourth annual Right Care Initiative (RCI) awards.
This year’s top award goes to Kaiser Health Plans of
Northern and Southern California for ranking in the 90th percentile of
national performance in controlling blood pressure and cholesterol for cardiovascular,
hypertensive and/or diabetic patients, among the nation’s most prevalent and
devastating chronic
diseases. Awards are given annually to California health plans meeting the goals of the
DMHC’s
Right Care Initiative, a public-private collaborative effort launched in 2008, to improve
clinical
quality in three key areas: heart disease, diabetes, and hospital-acquired infections, and
to rank
among the best in the nation.
“When the DMHC launched the Right Care Initiative in 2008, not one California health
plan ranked in the 90th percentile in controlling many of the factors which lead to heart
attacks
and strokes,” said Shelley Rouillard, Chief Deputy Director of the DMHC. “But this effort
shows that with health plans, medical groups and the community working together, we
can
achieve dramatic improvements in health plan quality measures.”
Eight of the nine largest health plans in California have made overall improvements on
heart and diabetes quality measures since 2007, the year which was used as the Right
Care
Initiative’s baseline level of performance. The data is from HEDIS (Healthcare
Effectiveness
Data and Information Set) scores, which measures American health plan performance on
important dimensions of care and service. According to national quality experts,
meeting the
90th percentile by the largest health plans in heart and diabetes scores could save the
lives of
more than 2,000 Californians annually through the prevention of heart attacks and
strokes.
In addition, 11 medical groups in California have reached the 90th percentile of clinical
control measures in blood sugar and cholesterol. This is the first year in which the
DMHC has
included medical groups, not only health plans, in its Right Care Initiative awards. The
medical
groups include:
Arch Health Partners - Poway
Edinger Medical Group - Fountain Valley/Huntington Beach
John Muir Physicians Network - Concord
Mercy Medical Group/CHW Medical Foundation - Sacramento
Palo Alto Medical Foundation – Mills Peninsula Division - Palo Alto
Scripps Medical Group - San Diego
Sharp Rees-Stealy Medical Group - San Diego
St. Joseph Heritage Medical Group - Orange County
St. Jude Heritage Medical Group - Fullerton
Sutter Gould Medical Group - San Joaquin/Stanislaus County
UCLA Medical Group - Los Angeles
The statewide goal of the Right Care Initiative is to reach the 90th percentile in heart and
diabetes HEDIS control measures of blood pressure, blood sugar and cholesterol for the
prevention of heart attacks and strokes, and to cut the rate of death from hospital
acquired
infections through concerted action. Key partners include California health plans and
medical
groups, the California Chronic Care Coalition, University of California, Stanford
University,
RAND, American Diabetes Association, American Heart/Stroke Association, California
Hospital
Association, California Medical Association Foundation, California Pharmacy Foundation
and
other disease-based and community organizations throughout the state. The annual
awards were
presented at the fourth annual Right Care Initiative Dean’s Summit, held on October 3 at
UC San
Diego.
For more information on the Right Care Initiative visit www.rightcare.dmhc.ca.gov . The
California Department of Managed Health Care is the only stand-alone HMO watchdog
agency
in the nation, touching the lives of more than 21 million enrollees. The DMHC has
assisted
more than one million Californians to resolve their health plan problems through its Help
Center,
educates consumers on their health care rights and responsibilities, and works closely
with health
plans to ensure a solvent and stable managed health care syste
recipients
FOR IMMEDIATE RELEASE
CONTACT: Lynne Randolph
October 6, 2011
(916) 445-7442
Health plan and medical groups honored for work to fight diabetes and heart disease
among HMO patients
(Sacramento) -- The California Department of Managed Health Care (DMHC) has
announced recipients of the fourth annual Right Care Initiative (RCI) awards.
This year’s top award goes to Kaiser Health Plans of
Northern and Southern California for ranking in the 90th percentile of
national performance in controlling blood pressure and cholesterol for cardiovascular,
hypertensive and/or diabetic patients, among the nation’s most prevalent and
devastating chronic
diseases. Awards are given annually to California health plans meeting the goals of the
DMHC’s
Right Care Initiative, a public-private collaborative effort launched in 2008, to improve
clinical
quality in three key areas: heart disease, diabetes, and hospital-acquired infections, and
to rank
among the best in the nation.
“When the DMHC launched the Right Care Initiative in 2008, not one California health
plan ranked in the 90th percentile in controlling many of the factors which lead to heart
attacks
and strokes,” said Shelley Rouillard, Chief Deputy Director of the DMHC. “But this effort
shows that with health plans, medical groups and the community working together, we
can
achieve dramatic improvements in health plan quality measures.”
Eight of the nine largest health plans in California have made overall improvements on
heart and diabetes quality measures since 2007, the year which was used as the Right
Care
Initiative’s baseline level of performance. The data is from HEDIS (Healthcare
Effectiveness
Data and Information Set) scores, which measures American health plan performance on
important dimensions of care and service. According to national quality experts,
meeting the
90th percentile by the largest health plans in heart and diabetes scores could save the
lives of
more than 2,000 Californians annually through the prevention of heart attacks and
strokes.
In addition, 11 medical groups in California have reached the 90th percentile of clinical
control measures in blood sugar and cholesterol. This is the first year in which the
DMHC has
included medical groups, not only health plans, in its Right Care Initiative awards. The
medical
groups include:
Arch Health Partners - Poway
Edinger Medical Group - Fountain Valley/Huntington Beach
John Muir Physicians Network - Concord
Mercy Medical Group/CHW Medical Foundation - Sacramento
Palo Alto Medical Foundation – Mills Peninsula Division - Palo Alto
Scripps Medical Group - San Diego
Sharp Rees-Stealy Medical Group - San Diego
St. Joseph Heritage Medical Group - Orange County
St. Jude Heritage Medical Group - Fullerton
Sutter Gould Medical Group - San Joaquin/Stanislaus County
UCLA Medical Group - Los Angeles
The statewide goal of the Right Care Initiative is to reach the 90th percentile in heart and
diabetes HEDIS control measures of blood pressure, blood sugar and cholesterol for the
prevention of heart attacks and strokes, and to cut the rate of death from hospital
acquired
infections through concerted action. Key partners include California health plans and
medical
groups, the California Chronic Care Coalition, University of California, Stanford
University,
RAND, American Diabetes Association, American Heart/Stroke Association, California
Hospital
Association, California Medical Association Foundation, California Pharmacy Foundation
and
other disease-based and community organizations throughout the state. The annual
awards were
presented at the fourth annual Right Care Initiative Dean’s Summit, held on October 3 at
UC San
Diego.
For more information on the Right Care Initiative visit www.rightcare.dmhc.ca.gov . The
California Department of Managed Health Care is the only stand-alone HMO watchdog
agency
in the nation, touching the lives of more than 21 million enrollees. The DMHC has
assisted
more than one million Californians to resolve their health plan problems through its Help
Center,
educates consumers on their health care rights and responsibilities, and works closely
with health
plans to ensure a solvent and stable managed health care syste
UCLA physicians control
40% of the DOMHC CLINICAL
ADVISORY PANEL
Membership (as of January 1, 2005)
All members of the Clinical Advisory Panel
are appointed by the Director, Department of
Managed Health Care
PANEL MEMBERS ORGANIZATION
Dr. John F. Alksne
Neurosurgeon
University of California, San Diego School of
Medicine;
UCSD Medical Center (Professor; practicing
physician)
Dr. Herbert A. Berkoff
Cardiovascular surgeon
University of California, Davis School of
Medicine
(Professor Emeritus)
Dr. Mark S. Grossman
Pediatrician/Internist
University of California, Los Angeles School of
Medicine,
UCLA, Community Physicians Network
(Clinical assistant professor; practicing
physician)
Dr. Bernadette C. Loftus
Otolaryngology
Stanford University School of Medicine;
Physician-inChief, Kaiser Permanente Santa
Clara Medical Center
(Clinical assistant professor; practicing
physician)
Dr. Edward W. Salvage, Jr.
Obstetrics/Gynecology
Charles R. Drew University of Medicine &
Science/UCLA
Center for Health Science King/Drew Medical
Center
(Professor; practicing physician)
40% of the DOMHC CLINICAL
ADVISORY PANEL
Membership (as of January 1, 2005)
All members of the Clinical Advisory Panel
are appointed by the Director, Department of
Managed Health Care
PANEL MEMBERS ORGANIZATION
Dr. John F. Alksne
Neurosurgeon
University of California, San Diego School of
Medicine;
UCSD Medical Center (Professor; practicing
physician)
Dr. Herbert A. Berkoff
Cardiovascular surgeon
University of California, Davis School of
Medicine
(Professor Emeritus)
Dr. Mark S. Grossman
Pediatrician/Internist
University of California, Los Angeles School of
Medicine,
UCLA, Community Physicians Network
(Clinical assistant professor; practicing
physician)
Dr. Bernadette C. Loftus
Otolaryngology
Stanford University School of Medicine;
Physician-inChief, Kaiser Permanente Santa
Clara Medical Center
(Clinical assistant professor; practicing
physician)
Dr. Edward W. Salvage, Jr.
Obstetrics/Gynecology
Charles R. Drew University of Medicine &
Science/UCLA
Center for Health Science King/Drew Medical
Center
(Professor; practicing physician)
DOMHC Director Brent
Barnhart, former lawyer for
Kaiser
Earlier, he was an attorney and lobbyist for
the health insurance industry in
Sacramento – as legislative affairs director
for Blue Cross of California, and as counsel
and secretary to the Association of
California Life and Health Insurance
Companies.
Barnhart, former lawyer for
Kaiser
Earlier, he was an attorney and lobbyist for
the health insurance industry in
Sacramento – as legislative affairs director
for Blue Cross of California, and as counsel
and secretary to the Association of
California Life and Health Insurance
Companies.
| SDER |
San Diego
Education Report
Education Report
| SDER |
| SDER |
| SDER |
Former Calif. Regulator Agrees to Fine for Assisting
Kaiser in Audit
California Healthline
January 13, 2016
An attorney who previously worked at a state regulatory agency has agreed to a fine
after admitting she acted improperly during an audit of Kaiser Permanente, according to
court documents released Monday, the Los Angeles Times reports (McGreevy, Los
Angeles Times, 1/11).
In September 2013, National Union of Healthcare Workers filed a
complaint against Kaiser alleging that the company hired Marcy
Gallagher to impede an investigation into its practices.
Gallagher previously served as an attorney with the California
Department of Managed Health Care's enforcement division.
NUHW filed the complaint with the California Fair Political Practices Commission.
Kaiser hired Gallagher in 2012 while she was investigating the organization's
health plan for issues related to mental health services access. She later served as a
practice leader in Kaiser's regulatory response business unit (California Healthline,
9/19/13).
Details of Decision
According to the state FPPC, Gallagher during the six months she worked on the audit:
"Helped pick" the audit team;
Developed the scope of work;
Counseled the audit analysts;
"Advised on documents to be requested from Kaiser"; and
Reviewed and edited the preliminary report.
The state FPPC concluded that after leaving DMHC, Gallagher helped Kaiser defend
itself against the investigation's findings...
Kaiser in Audit
California Healthline
January 13, 2016
An attorney who previously worked at a state regulatory agency has agreed to a fine
after admitting she acted improperly during an audit of Kaiser Permanente, according to
court documents released Monday, the Los Angeles Times reports (McGreevy, Los
Angeles Times, 1/11).
In September 2013, National Union of Healthcare Workers filed a
complaint against Kaiser alleging that the company hired Marcy
Gallagher to impede an investigation into its practices.
Gallagher previously served as an attorney with the California
Department of Managed Health Care's enforcement division.
NUHW filed the complaint with the California Fair Political Practices Commission.
Kaiser hired Gallagher in 2012 while she was investigating the organization's
health plan for issues related to mental health services access. She later served as a
practice leader in Kaiser's regulatory response business unit (California Healthline,
9/19/13).
Details of Decision
According to the state FPPC, Gallagher during the six months she worked on the audit:
"Helped pick" the audit team;
Developed the scope of work;
Counseled the audit analysts;
"Advised on documents to be requested from Kaiser"; and
Reviewed and edited the preliminary report.
The state FPPC concluded that after leaving DMHC, Gallagher helped Kaiser defend
itself against the investigation's findings...