SAMHSA222s Weekly Financing News Pulse : State an d Local Edition September 22, 2009 9/22 /09 1 SAMHSA222s Weekly Financing News Pulse: State and Local Edition Around the States: State and Local Behavioral Health Financing News Arizona California Florida Georgia Hawaii Illinois Iowa Kansas Louisiana Massachusetts Michigan Minnesota New Hampshire New Jer sey New Mexico North Carolina Oklahoma Pennsylvania Texas U tah Vermont Washingt on Washington D.C. West Virginia Wisconsin Beginning this w eek, SAMHSA will deliver the Weekly Financing News Pulse as two documents 227 a National edition and a State and Local Edition. This is the first issue of the State and Local edition, which SAMHSA will deliver on Wednesdays. SAMHSA will deliver the National Edition on Mondays . For quest ions or comments, please contac t Kevin Hennessey ( kevin.hennessy@samhsa.hhs.gov ). SAMHSA222s Weekly Financing News Pulse : State an d Local Edition September 22, 2009 9/22 /09 2 Around the States: State and Local Behavioral Health Financing News Arizona Update: Governor Receives Extension for Maricopa County Behavioral Health Care Report : The Maricopa County Superior Court has granted Governor Jan Brewer (R) additional time to prepare a status report on Maricopa County222s behavioral health system. In her request, Go vernor Brewer said that she needed the extension because the state budget battle (Financing News Pulse 7/13, 7/6 editions) had consumed most of her time . The report, now due for presentation in court Octob er 20, stems from a nearly thirty - year - old lawsuit over the county222s treatment of individuals with serious mental illness (Financing News Pulse 9/14, 5/26, 1/30 editions). Because of the extension, the governor must submit a 223specific plan with structural reforms224 rather than a broader action plan ( AP via KSWT, 9/17 ). State Eliminates Benefits for Unmarried Partners of State Employees : By signing the state222s budget package ( HB 2013 ), Governor Jan Brewer (R) approved a change in state empl oyees222 benefits that will limit health insurance coverage to spouses and dependent children. Though implementation is still under consideration at the Arizona Department of Administration , the change is slated to take effect October 1 and is estimated to save $3.3 million annually and affect about 800 people ( Arizona Republic, 9/13 ). California State Opens Electronic Prescription Drug Monitoring Program : On September 15, California Attorney General Edmund Brown Jr. announced that the state is launching a web - based database for doctors, pharmacists, and law enforcement officials to track prescriptions for schedule II, III, and IV drugs for suspicio us and illegal behavior. The new site, funded through state funds and $1.1 million federal grant, replaces a paper - based system with the Controlled Substance Utilization Review and Evaluation System (CURES), containing over 100 million entries of controlled substance prescriptions ( AP via Examiner, 9/15 ; Los Angeles Daily News, 9/15 ). State to Cut Substance Abuse Services in Prisons : As a result of the $1.2 billion reduction in Department of Corrections and Rehabilitation (DOCR) funding in the state budget (Financing News Pulse 8/3 edition), DOCR plans to cut $250 million from prison rehabilitation programs and layoff staff. Among the cuts, DOCR plans to cut substance abuse treatment programs for inmates and layoff 600 - 900 employees, including contractors that provide substance abuse services ( AP, 9/18 ). Republican Gubernatorial Candidate Releases State Health Reform Plan: On September 17, Republican gubernatorial candidate Tom Campbell released a plan to cover California222s uninsured if Congress fails to pass national health care reform. Campbell222s plan, which he says would cover 9.6 million Californians, would seek a Centers for Medicare & Medicaid Services (CMS) waiver to use federal and state Medicaid and State Children222s Health Insurance Program ( SCHIP ) money to create a $42 billion fund that would provide $4,375 per person to cover benefits and administrative overhead. Campbell222s plan would create regional providers and allow insurers from all states to compete for those contracts. In addition, SAMHSA222s Weekly Financing News Pulse : State an d Local Edition September 22, 2009 9/22 /09 3 Campbell222s plan would require insurers to provide coverage for all pre - existing conditions ( San Francisco Chronicle, 9/17 ; Kaiser Health News, 9/18 ). Santa Cruz County Reaches Phase Out Agreement with Hospital Over Psychiatric Facility : Dominican Hospital has reached an agreement with the Santa Cruz County Health Services Agency to phase out the hospital222s psychiatric unit over four years and replace it with a county facility. Under the deal, Dominican will continue to operate the unit for four years and contribute $5 million of the $8 million needed to construct the new 16 - bed facility. Hospital officials said that the current unit loses money and welcomed a solution that preserved the continuum of care ( San Jos e Mercury News, 9/12 ). Florida State Uses Pfizer Settlement Funds for Medicaid Whistle Blower Payments : Florida officials announced plans to use $1 million of the $58 million that Florida will receive as a result the $3.2 billion settlement that the U. S. Department of Justice (DOJ) reached with Pfizer Inc. on September 2 (Financing News Pulse 9/8 edition), to fund a Medicaid whistle blower program established this Spring. Florida will use $1 million to fund incentive payments to individuals providing i nformation leading to fines, legal charges, or property forfeitures in Medicaid fraud cases ( Tampa Bay Online, 9/17 ; Kaiser Health News, 9/18 ). State Settles Medicaid Nursing Home Lawsuit : The state of Florida has agreed to spend up to $27 million to settle a 2008 lawsuit in which Med icaid recipients alleged that the state illegally forced them from community - based programs into nursing homes . Under the agreement, the Florida Agency for Health Care Administration and the Florida Department of Elder Affairs must provide community - based services to those who want them and improve the way they inform nursing home residents of their community - based options. The court found that Florida222s system constituted discrimination under the Americans with Disabilities Act ( AP via Miami Herald, 9/18 ). Progress Slow on State Insurance Exchange : The Florida Health Choices program, approved in 2008 and championed by GOP House leaders, has yet to begin operation. The program lacks a CEO and has yet to attract any insurers or consumers for eventual participation. Designed to provide Florida residents with a market in which to select private health coverage, the program will free insurers from minimum cover age mandates but still subject them t o other requirements, including minimum adequate networks and sufficient plan finances ( AP via Miami Herald, 9/16 ; Kaiser Health News, 9/16 ). Jackson Health System to Cut Primary Care Clinics and Nursing Homes : After obtaining approval from the Miami - Dade County Commissioners on September 18, the Jackson Health System began implementing a $1.9 billion FY2010 budget that spends about $50 million less than Jackson222s FY09 budget. Among other reductions, Jackson will eliminate two primary care clinics and two nursing homes on January 1 and seek competitive bi ds to take over the Miami- Dade jail health services ( Miami Herald, 9/18 ). SAMHSA222s Weekly Financing News Pulse : State an d Local Edition September 22, 2009 9/22 /09 4 Georgia Board Raises Employee Health Insurance Contributions : The Georgia Board of Community Health voted to ra ise state employee222s contribution to their health insurance premiums by 10 percent beginning January 2010. The move is designed to close part of a projected $500 million deficit in the reserve fund that pays employee claims but is expected to leave a $75 million deficit that will require action in the next legislative session ( Georgia Public Broadcasting, 9/11 ). Hawaii Mental Health America to Launch Program Examining Returning Guardsman and Reservists : Mental Health American of Hawaii (MHA- H) is launching a study of the mental health of national guardsman and reservists returning from combat. In conjunction with theStrategist, a consulting firm, MHA - H wil l examine the impact of deployment on soldiers222 marriage s, children, employment, and mental health ( Honolulu Star Bulletin, 9/13 ). Illinois DOC P roposes Reforms for Tamms Correctional Center , Including Inmate Mental Health Screenings : On September 17 , Illinois Department of Corrections (DOC) Director Michael Randle announced a 10 - point plan to reform the state222s super - max facility, Tamms Correctional Center. The plan includes a full mental health evaluation within 30 days of an inmate222s referral to Tamms and weekly rounds to identify inmates whose mental health conditions have deteriorated because of the transfer to Tamms . The move comes after conditions at Tamms were discussed at a September 15 hearing in the U.S. Senate Judiciary Subcommittee on Human Rights and the Law ( BND, 9/17 ). Iowa DHS Proposes Budget With No Cuts : The Io wa Department of Human Services (DHS) has proposed a $5 billion budget for the coming fiscal year that would not cut reimbursement rates, services, or staff. The proposal, which would spend about $18 million more than the current - year budget despite losin g American Recovery and Reinvestment Act (ARRA) funding, has been seen by several legislators as unrealistic. The proposal would fully fund the state222s four mental health institutes, though the state is considering closing one. The Council of Human Servi ces , which oversees DHS, will assess the prop osal and make recommendations to Governor Chet Culver (D). The governor will then make recommendations to the Iowa Legislature ( Des Moines Register, 9/15 ). Poll Finds Iowans Want Sen. Grassley to Compromise on Health Reform : A poll conducted by the Des Moines Register found that 52 percent of Iowans woul d rather that Senate Finance Committee Ranking Member Charles Grassley (R - IA) compromise with Democrats on health care reform than walk away from bipartisan negotiations. Thirty - nine (39) percent of respondents would prefer that Sen. Grassley withdraw of negotiations rather than support positions with which he does not agree . The poll als o found a strong political gap, with 70 percent of Democrats wanting Sen. Grassley to compromise and only 35 percent of Republicans ( Des Moines Register, 9/18 ). SAMHSA222s Weekly Financing News Pulse : State an d Local Edition September 22, 2009 9/22 /09 6 Government awarded the Massachusetts222 Commonwealth Health Insurance Conne ctor Authority an Innovations in American Government award in recognition of the program222s role in the state222s 2006 health care reform. The connector braids funding from Medicaid and private insurers to create a public - private pool from which residents can choose their health plan. The honor, which Harvard also awarded to programs in Idaho, Illinois, Tennessee, Washington D.C., and Wisconsin, comes with a $100,000 grant to publicize the innovation ( Stateline, 9/15 ; Kaiser Health News, 9/16 ). Michigan State Legislators Say MI Likely to Forfeit Additional SCHIP Funds : Facing a $2.8 billion deficit for the fiscal year beginning October 1, state legislators say the Michigan Legislature is unlikely to allocate the $33 million needed to draw down $100 million in supplemental federal SCHIP funding approved when President Obama re authorized SCHIP in February (Financing News Pulse 2/6 edition) ( Detroit News, 9/15 ; Kaiser Health News, 9/15 ). Senate Democrats Propose Mental Health Bills : Democratic senators are introducing bills to increase access to public mental health treatment in Michigan. The bills would clarify state law to allow treatment for those who do not know they need it and streamline the system by reducing the number of local community health agencies ( AP via Chicago Tribune , 9/16 ). State Workers Receive Notification of Possible Layoffs : Roughly 52,000 state employees will receive letters informing them of temporary layoffs that will take effect October 1 if the state fails to pass a budget. Governor Jennifer Granholm222s ( D) spokesperson says that the governor anticipates reaching a budget deal before the deadline and that the letters are precautionary rather than predictive. U nion contracts dictate that state employees receive advance notice of layoffs ( Detroit Free Press, 9/15 ). Minnesota HMS Wins DHS Third Party Liability Contract : The Minnesota Department of Human Services (DHS) has awarded HMS a contract to provide additional third - party liability services for Minnesota health care programs, including Medicaid. Under the contract, HMS will supplement the state222s third - party liability services, including performing data matches with private insurance carriers and employers to ensure that state programs remain 223payers of last resort.224 With the addition of Minnesota, HMS now provides third party liability services to Medicaid agencies in 39 states ( PR Newswire via Reuters, 9/16 ). New Hampshire State Receives ARRA Funding for Infection Reporting Program : After the New Hampshire Legislature passed a law three years ago which requires hospitals to report the number of infections that patients acquire while under their care, the state was awarded $760,000 in ARRA funding to manage the reporting program and audit the data. The legislation requires hospitals to report both hospital- acquired infections and infection prevention compliance measures and mandates that the state make the data available to the public. The state began collecting a more limited dataset from hospitals earlier in 2009 ( Concord Monitor, 9/15 ; Kaiser Health News, 9/15 ). SAMHSA222s Weekly Financing News Pulse : State an d Local Edition September 22, 2009 9/22 /09 7 New Jersey Rutgers University Opens New Behavioral Health Center : Rutgers University opened a new $5 million building to house the Counseling, Alcohol and Other Drug Assistance Program and the Psychiatric Services program. The new building will serve as a central location for services previously provided at five sites ( My Central Jersey, 9/14 ). New Mexico Sandoval County Approves Health Contracts, Behavioral Health Unit Funded: On September 17, the Sandoval County Commissioners unanimously approved contracts with UNM Sandoval County Regional Medical Center and Presbyterian Healthcare Services , using $13.8 million slated to come from a 4.25 - mil pr operty tax for health services. P resbyterian222s facility is scheduled to open in 2011 while the UNM plans to open its facility in 2012. Under the terms of the contract, UNM will receive 20 percent of the funding for an inpatient behavioral health unit with a minimum of eight beds ( Rio Rancho Observer, 9/20 ). North Carolina Governor Announces Federal Grant to Fund Health Care Access Pilot : On September 14, Governor Beverly Perdue222s (D) office announced that North Carolina will receive a $17 million five - year State Health Access grant from HHS . The funding will support a new pilot program to provide health care to 1,500 low - income working parents with family incomes at or below 125 perce nt of the federal poverty level (FPL). To qualify for the program , parents must demonstrate that their children are enrolled in or have applied for health insurance through Medicaid, SCHIP, or a private insurer. North Carolina is one of 13 states to recei ve a State Health Access grant ( Media General News Services via Go Dan River, 9/15 ; News Observer, 9/15 ; Kaiser Health News, 9/15 ). State Employee Health Care Costs Increase : Despit e increasing out - of - pocket expenses and using 223rainy day224 funds to close budget gaps, North Carolina222s State Health Plan paid out 8 percent more than was budgeted for July and August. Non - governmental actuaries now estimate the plan will lose $54 million this year rather than making a small profit as they predicted a few months ago ( AP via Reflector, 9/20 ). Local Behavioral Health Management Entity Loses Funding From State Budget Cuts : As a result of the $40 million cut to mental health in North Carolina222s budget (Financing News Pulse 8/10 edition ), local management entities (LMEs) th roughout the state will receive reduced state funding. The Southeastern Center for Mental Health, Developmental Disabilities and Substance Abuse Services, the LME for Brunswick, New Hanover, and Pender counties, will receive $17.3 million for the current fiscal year, a $227,000 loss in operations funding and a $1 .7 million reduction in client services funding. However, the center222s director says that the reduced funding will not result in reduced services ( Star News Online. 9/18 ). Local Mental Health Management Entity Receives State Grant for Wellness Management Program : Crossroads Behavioral Healthcare, the LME for behavioral health in Iredell, Sur ry, and Yadkin coun ties, received a $9,000 grant to develop a wellness management recovery program. The program aims to put SAMHSA222s Weekly Financing News Pulse : State an d Local Edition September 22, 2009 9/22 /09 8 patients in charge of their own illness es and involve them in treatment decisions. Crossroads and two other LMEs received the funding from the North Carolina Council of Community Programs and the Governor222s Institute on Alcohol and Substance Abuse ( Mooresville Tribune, 9/16 ; Mount Airy New, 9/12 ). Oklahoma State Officials Continue Across - the- Board Agency Cut : Because of falling revenues, Oklahoma Finance Director Mike Clingman elected to continue a 5 percent across - the - board cut to state agency budgets for the second consecutive month. The reductions save the state $21 million monthly and may remai n in place every month until the end of Oklahoma 222s fiscal year in June 2010. State leaders are also examining tapping the state222s 223rainy day224 fund, using ARRA funds previously set aside for FY2011, or convening a special session of the Oklahoma Legislatur e to modify the current - year budget ( Norman Transcript, 9/16 ). If the 5 percent reduction continues through the end of the year, the Department of Mental Health and Substanc e Abuse Services would lose $15.8 million ( Oklahoman, 9/12 ). Pennsylvania Update: Governor and State Legisla tors Reach Budget Compromise : On September 18, Governor Ed Rendell (D) and Pennsylvania lawmakers reached an agreement on a $28 billion state budget. The state has been without a permanent budget for nearly 3 months (Financing News Pulse 8/10, 7/6 edition s; Bloomberg, 9/19 ). Human Service Providers Sue State to Recoup Funding Lost in Budget Impasse: A group of behavioral health care providers are suing Pennsylvania, allegin g that Governor Ed Rendell 222s (D) veto of human services funding in the state222s stopgap budget (Financing News Pulse 8/10 edition) cut funding for essential services while maintaining funding for state employees. The plaintiffs hope the law will release th e state and federal funding for human services, including behavioral health care ( WHYY, 9/ 10 ). Montgomery County Opens Mental Health Court : In July, Montgomery County launched a mental health court to increase access to mental health treatment and reduce incarceration time for criminal defendants with serious mental illness . The court recei ved a one - year $64,000 planning grant from the state and an additional $140,000 implementation grant. The majority of offenders commit non - violent crimes; however, violent offenders are permitted to on a case - by - case basis ( Bucks County Courier Times, 9/18 ; KYW, 9/18 ; Mercury News, 9/18 ). Philadelphia Health Centers to Charge Sliding Scale Fees : On September 15, the Philadelphia Board of Health voted to impose a $5 to $20 sliding scale fee for the city222s eight primary care health centers. Though the city has yet to set an effective date for the fees, officials estimate they will generate $1 million annually. A spokesperson for the Philadelphia Department of Public Health says the fees are unrelated to the city222s budget r esolution under consideration in the Pennsylvania Legislature ( Philadelphia Inquirer, 9/16 ). SAMHSA222s Weekly Financing News Pulse : State an d Local Edition September 22, 2009 9/22 /09 9 Texas HHS Office of the Inspector General Finds State Violated Medicaid Reimbursement Rules, CMS Demands Reimbursements : On September 14, the HHS Office of the Inspector General released a report, which found that the Texas Health and Human Services Commission allowed legal and illegal immigrants access to non- emergency health services in violation of CMS policy. CMS, which defines emergency procedures sufficiently narrowly as to include an appendectomy but not a subsequent prescription for antibiotics, has requested that Texas refund the $286,427 federal s hare of the unauthorized payments. The audit covered the $314.2 million in claims that Texas processed during FY2005 ( Star - Telegram, 9/14 ; Kaiser Health News, 9/15 ). North Texas Mental Health Agency to Decrease Funding Despite Increased Demand: Under a plan approved by the Texas Department of State Health Services , ValueOptions of Tex as Inc. 227 the managed care company that runs mental health care in Collin, Dallas , Ellis, Hunt , Kaufman, Navarro , and Rockwall counties 227 will reduce its funding by $10 million annually despite increasing demand for mental health services . After the state den i ed ValueOptions additional funding, ValueOptions elected to reduce the program 222 s annual budget from $146 million to $136 million despite a 17 percent increase in demand since July 2008. Local mental health providers believe that the reduction will result in lower reimbursement rates and, in turn, force them to lay off staff and limit program admission ( Dallas Morning New s, 9/16 ; Kaiser Health News, 9/16 ). Update: Appeals Court Overturns Dallas County Judge222s Ruling in Legal Payments Case : The 5th District Court o f Appeals has blocked Probate Judge Michael Mille r222s ruling that Green Oaks, a private psychiatric hospital, must pay court costs and attorneys222 fees for poor patients who are involuntarily committed due to severe mental illness. The fees apply only to pr ivate facilities; however, Green Oaks only admits the patients because no public facility exists to treat the patients in Dallas County (Financing News Pulse 6/1 edition). The appeals court found that a trial court cannot order a non - party to pay court co sts and that, even if Green Oaks had been a party to the lawsuit, Miller222s court would not have had authority to assess the costs. The majority of the costs were incurred because Miller ordered private attorneys for the defendants instead of relying on pu blic defenders ( Dallas Morning News, 9/11 ). Henderson County to Use State Funds for Inmate Mental Health Screenings: The Henderson Count y Commissioners Court adopted a memorandum of understanding (MOU) with the Andrews Center to provide mental health screenings through the Texas Correctional Office of Offenders with Medical and Mental Impairments (TCOOMMI) program. Henderson County pays t he Andrews Center $30,000 annually for behavioral health screenings ( Athens Review, 9/15 ). Utah Dentists Withdraw from Medicaid Over Rate Cut Error : In the last legislative session, the Utah Legislature rolled back Medicaid dental providers222 4.5 percent cost of living increase to 2007 levels but intended to exclude a one - time 30 percent increase the providers received in 2008 to ensure 223break - even224 payment rates. However, because the final legislative language was presented as a dollar amount rather a percentage reduction, legislators mistakenly cut the one - time increase as well. As of September SAMHSA222s Weekly Financing News Pulse : State an d Local Edition September 22, 2009 9/22 /09 10 18, 24 dentists had withdrawn from the state222s Medicaid program to protest the c uts. Lawmakers are currently working to resolve the issue, which requires an additional $2 million in state funds ( Salt Lake Tribune, 9/18 ). Dey Settles Medicaid Overcharging Suit : Utah Attorney General Mark Shurtleff announced that the state has settled a Medicaid fraud suit with Dey L.P. over Dey222s alleged inflation of drug prices to increase the price s paid by the state Medicaid program. Under the terms of the settlement, Dey agreed to pay Utah $1 million but admitted no wrongdoing ( Legal Newsline, 9/18 ). Vermont State Passes Reduced Hospital Rate Increases : After state hospitals requested an average commercial rate increase of 6.4 percent for 2010, the Vermont Department of Banking, Insurance, Securities and Health Care Administration elected to grant a 5.9 percent average rate increase. Hospitals rates are requested and asse ssed individually, so requested rates were reduced by different amounts for different hospital systems ( Rutland Herald, 9/16 ; Kaiser Health News, 9/16 ). Washington State Begins Eligibility Audit for Employee Health Care Plan : Following the recommendation of the State Auditor222s Office, the Washington Health C are Authority sent letters to 330,000 individuals currently enrolled in the state222s public employee health benefits program requiring them to prove eligibility by November 30 or lose coverage. The move is designed to eliminate ineligible dependents from t he state222s program ( News Tribune, 9/17 ). H ealth District to Lay O ff Eight , Eliminate Department : Effective October 1, the Benton Franklin Health District in Kennewick will lay off eight employees and eliminate the Environmental Health Education Department. Health district officials say the cuts are the result of unstable funding and not the recession and expect that the cuts will affect services ( KVEW, 9/16 ). Washington D.C. Unions Sue District Over Privatization of Mental Health Treatment : Six (6) unions, led by the D.C. Nurses Association , are suing the District of Columbia Department of Mental Health (DM H), alleging that the department222s plan to privatize mental health treatment (Financing News Pulse 7/27 edition) forces patients to choose from private providers that are ill226 equipped to handle the influx of new patients. On August 1, DC laid off 120 empl oyees because of the privatization, which government offic ials say will save $14 million. H owever, union representatives contend that DMH has little evidence to support the $14 million figure ( Washington Business Journal, 9/18 ). West Virginia Senator Byrd Announces SAMHSA Prevention Grant : On September 16, Senator Robert Byrd (D - WV) announced that the Substance Abuse and Mental Health Serv ices Administration222s ( SAMHSA) Center for Substance Abuse Prevention (CSAP) has awarded $915,000 to Marshall University222s West Virginia Prevention Resource Center in Charleston, WV. The funding, which Byrd secured though the FY2009