On Leap Day, the South Los Angeles Collaborative for Specialty Care Access met for the first time, deciding how to proceed in using a recently awarded $150,000 grant from Kaiser Permanente. An offshoot of the South Los Angeles Collaborative, the group comprises the Los Angeles County Medical Association and six other organizations, and stands to gain as much as $300,000 in a second Kaiser grant, should the health giant approve of its plan to get specialty medical care to South Los Angeles residents who have little access.

During its inaugural meeting, collaborative members decided how to best study the state of specialty care in South Los Angeles, and they divided duties for collecting data. In this phase, the group will focus on patients who are uninsured or who have coverage through Medi-Cal, including its managed care and fee-for-service programs.

"The barrier for me to send people to specialists in county [facilities] is much higher for uninsured patients than those within Medi-Cal Managed Care," says Deborah Lerner, chief medical officer of Eisner Pediatric and Family Medical Center, which participates as a member of the Southside Coalition. Dr. Lerner cited Medi-Cal Managed Care's legal obligation to find specialty care for its members as a main reason for their advantage over the uninsured.

On the other hand, Medi-Cal fee-for-service patients "are not under the managed care umbrella, so they don't have coverage under an IPA," says Nina Vaccaro, director of the Southside Coalition. "Those patients have a particularly hard time accessing specialty care as well, because the reimbursement is really low."

To get a better idea of the specialty referral situation in South Los Angeles, the collaborative formed two task groups. One will gather data from referral centers serving Los Angeles County facilities, while the other will draw information from the companies serving the Medi-Cal Managed Care market. Both groups plan to have data to present at the collaborative's next meeting in late March.

Ultimately, the collaborative hopes to develop both short- and long-term plans for improving South Los Angeles patients' access to medical care. "One of the things that we need to do--once we have the data--is to start advocating to our elected officials at the local, state and federal levels, trying to get changes in terms of reimbursement for specialty care," says Vaccaro.

One of 11 such planning grants that Kaiser awarded in January, the collaborative's recent award is intended to fund a 12-month planning process. It would then apply for a multi-year implementation grant from Kaiser of as much as $300,000 a year.