Advocacy: How your CSA delegates champion our #1 priority

by
  • Zakowski, Mark, MD
| Jun 15, 2017

Zakowski_crop_7.2011_cropCSA membership surveys consistently rank advocacy as members’ #1 priority. 

At the House of Delegates meeting on June 4 in Irvine, CSA took important steps to provide greater value to our members, and strengthen our voices as advocates:

  • Formulating a long-term strategy to grow our political action “war chest”;
  • Strengthening legislative affairs participation at the grassroots level;
  • Setting up a new Committee on Practice Management to develop practice management resources and partnerships for our members in a time of radical healthcare change.

Having seen the ebb and flow of events as a member of the Board of Directors over the last 17 years, I am convinced CSA will be much better positioned soon than we have ever been before, as a result of these actions.

First, we want to thank all the individual members and groups who donated to our spring GASPAC campaign, and helped us achieve our ambitious goal of $100,000 in 100 days. This is the grassroots support that makes advocacy succeed, since (as we all know) money really is the mother’s milk of politics!

New resources for managing your practice

The House acted to modify the current Legislative and Practice Affairs Division and create two individual committees – a Committee on Practice Management, chaired by Keith Chamberlin, MD, MBA, and a Committee on Legislative Affairs, chaired on an interim basis by former CSA President Narendra Trivedi, MD.  The Division will continue to be guided overall by current chair Jeff Poage, MD.

The separate practice management committee will allow CSA leaders to develop and deliver content to help our members grow their practices and advance their careers. The new legislative affairs committee, combined with district-based advocacy workshops and a revitalized Committee on Resident Representation, will allow CSA leaders to focus even more intently on CSA’s critical legislative priorities and improve our grassroots advocacy efforts.

CSA’s voice heard in Sacramento

capitolOver the last several years, working in partnership with our lobbying firm, KP Public Affairs, CSA’s voice has been increasingly recognized in Sacramento – by the State Legislature, by regulatory agencies, and by our partner, the California Medical Association (CMA). As a recent example, when the issue of pediatric dental sedation deaths was discussed in the Assembly last year, several Assembly members spontaneously asked, “Where are the anesthesiologists on this issue?” and “Why isn’t there a physician anesthesiologist present during these procedures?”  

As advocates, we consistently champion CSA members’ top policy priorities, including:

  • Maintaining MICRA (the cap on non-economic damages in medical malpractice)
  • Fair negotiation with insurance companies
  • Safe, physician-led anesthesia care for our patients.

In 2015, CSA played a key role in the narrow defeat of AB 533 (Bonta) on the final day of session, which sought to reimburse out-of-network bills equal to Medicare reimbursement. In 2016, CSA helped shape the successor bill, AB 72 (Bonta), to be as physician-friendly as possible. The final bill, supported by large majorities in both houses, pegged out of network bills at 125 percent of Medicare or at the average contracted rate. In 2017, CSA along with CMA continues to work diligently (and quietly) to help define the out-of-network independent resolution process and network adequacy.

The “GASPAC fix”

gaspac_largeAdvocacy in all our arenas – legislation, regulation, patient safety, and practice affairs – requires a combination of engaged physician leaders, professional staff, and a source of adequate, sustainable, political action committee dollars.  

One unintended consequence of CSA’s agreement with ASA to administer “unified billing” has been our inability to continue to offer members a “check-off” opportunity on the dues renewal invoice as a convenient method of contributing to GASPAC – CSA’s political action fund. While never robust, the “check-off” method generated approximately $100,000 per year for GASPAC from less than 20 percent of the CSA membership. 

With no dues check-off on renewal notices, GASPAC contributions plunged this fall and winter. Despite our diligent work to obtain contributions, the GASPAC balance fell to $8,000 at one point early this year. 

At CSA’s Board of Directors planning session in January, board members unanimously resolved to make advocacy CSA’s top priority for the year, establishing a set of objectives to position CSA among the top healthcare interests in Sacramento.  The board set a goal of raising $400,000 per year: $200,000 for direct campaign contributions, and $200,000 directed toward building a $1 million “war chest” over five years. 

After investigating best practices of similar professional societies (California Dental Association, California Orthopaedic Association), and consulting with attorneys and experts in the field, CSA leadership prepared a detailed position paper – aptly named the “GASPAC fix” – endorsed by the Executive Committee and the Board of Directors for presentation to the House of Delegates in June.

The House unanimously approved a four-step action plan:

  • Annual dues allocation of $125 per member to GASPAC, effective January 1, 2018, to raise approximately $300,000 per year for GASPAC. (Members whose dues are paid directly by a public agency or a nonprofit 501c3 will have the same amount automatically directed instead to the CSA general fund, in compliance with state law.)
  • Annual dues increase of $99 for active members, effective January 1, 2018.  The dues allocation to GASPAC will be a shared expense between individual members and CSA’s general fund. Once GASPAC funds have reached their goal, the dues assignment and dues increase may be revisited.
  • Annual event to raise funds for GASPAC, to be held at CSA’s Annual Meeting in March, allowing individuals, practices groups, and others to contribute more than the minimum amount to GASPAC and to obtain visibility and recognition for their investment.
  • A one-time allocation of $49,999 from CSA’s general fund to GASPAC to boost the short-term balance.

What was especially heartening about the discussion among the House of Delegates was the unanimous recognition that for us to be effective advocates on behalf of CSA and the practice of anesthesiology, a best-in-class political action fund is essential. 

These actions, combined with changes to enhance member value in practice management and legislative affairs, will benefit CSA and our members for years to come.

We all face a brighter future together!

For our patients, for our practices, for our society – Always Be Advocating

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