WeeklyFinancingNewsPulsefinal200900720.pdf (PDF | 374.88 kb)
SAMHSA222s Weekly Financing News Pulse July 20, 2009 7/20/09 1 National Health Financing News House Democrats Release Health Care Reform Bill, Senate HELP Committee Approves Bill, and Senate Finance Committee Nears Bi- Partisan Agreement Obama Administration Proposes Changes to Medicare Payment Oversight President Obama Nominates Benjamin as Surgeon General HELP Committe e Approves 12 - Year Exclusivity Period for Biologics CMS Awards MAC Contract for Jurisdiction 7 to TrailBlazer Aetna and UnitedHealth Win DoD Contract, Replace Humana and Health Net Virgin Islands Delegate Sponsors Legislation Requiring the CBO to Consider Broader Implications of Preventative Health Care UnitedHealth and Cisco Partner to Create Virtual Clinics Unions Appeal Decision Limiting GM Health Care Support to UAW Montana, Wyoming Tribes Receive Grant to Curb Alcohol Abuse USA Today/Gallup and McClatchy - Ipsos Release Health Care Reform Polls PWC Survey Shows Rising Healt h Care Costs for U.S. Companies SCAN Foundation Report Considers Options for Long- Term Care Commonwealth Fund Report Examines Administrative Cost Savings in Health Reform ACAP Report Says Medicaid Eligibility Tests Lead to Higher Costs Families USA Report Provides State - Level Estimates of Health Insurance Loss US News & World Report Releases Hospital Rankings Around the Hill: Hearings on Health Financing Around the States: State and Local Behavioral Health Financing News Alaska California Illinois Indiana Massachusetts Michigan Minnesota Mississippi New Hampshire New Jersey New Mexico New York North Carolina Ohio Oregon Pennsylvania Utah Washington West Virginia For questions or comments, please contact Sarah Wattenberg (sarah.wattenberg@samhsa.hhs.gov). SAMHSA222s Weekly Financing News Pulse July 20, 2009 7/20/09 2 National Health Financing News House Democrats Release Health Care Reform Bill, Senate HELP Committee Appro ves Bill, and Senate Finance Committee Nears Bi -Partisan Agreement : On July 14, House Democrats released their health care reform bill , America222s Affordable Health Choices Act ( HR 3200 ), that House aides say will cost $1.2 trillion over ten years and insure 97 percent of Americans by 2015. The bill also includes an individual health care mandate, an employer health care mandate coupled with a penalty clause and an exception for busines ses with payrolls under $250,000, and an expansion of Medicaid for all individuals earning up to 133 percent of the federal poverty level (FPL). The bill is financed with a surtax on individuals earning over $280,000 or families earning over $350,000 and through cost reductions in federal programs including Medicare. About half of the cost of the bill is expected to come from federal savings while another $544 billion is expected from the new tax. The Congressional Budget Office ( CBO ) has only released a partial score of the bill but House Democrats say costs are fully offset over the benchmark 10 - year period. The bill, which is backed by the American Medical Association (AMA), was approved by the House Ways and Means Committee on July 17 ( Kaiser Health News, 7/17 ; Kaiser Health News, 7/17 ) and is still pending approval in the House Education and Labor Committee and the House Energy and Commerce Committee where the Blue Dogs intend to offer amendments and have threatened to stall the bill over costs and other issues ( Kaiser Health News, 7/16 ; Kaiser Health News, 7/16 ). In the Senate, the Senate Health, Education, Labor and Pensions (HELP) Committee passed its version of health care reform legislation on July 15 with a party - line vote ( CQ Politics, 7/15 ). The HELP Committee222s bill, now estimated to cost $600 billion ove r 10 years , also includes an amendment offered by Sen. Tom Coburn (R - OK) that would require members of Congress to join any public health plan created by health reform legislation ( California Healthline, 7/15 ; Kaiser Health News, 7/15 ). Meanwhile, Senate Finance Committee Chair Max Baucus (D - MT) announced on July 16 that his committee was hoping to release a bipartisan health reform deal by the end of the day; however, talks have been postponed until July 20. The Fi nance Committee222s proposal is of special importance because it represents the only bill currently seeking bipartisan compromise, it must be merged with the Senate HELP Committee222s bill, and because recent statements by CBO Director Douglas Elmendorf regard ing the House and HELP Committee bills call into question the viability of those plans ( Kaiser Health News, 7/17 ). Elmendorf said that the House and Senate HELP Committee proposal s would increase the country222s long- term health care costs, referring to expenses outside the official 10 - year CBO estimation period( CQ Politics, 7/16 ; Kaiser Health News, 7/15 ; CQ Politics, 7/14 ). Details of the current health care reform bills are available from the Kaiser Family Foundation222s (KFF) health care reform tracker . Obama Administration Proposes Changes to Medicare Payment Oversight : On July 15, the Obama Administration sent two proposals to Congress designed to change the way Medicare payment rates are set. Both proposals would strip Congress of the power to set Medicare rates; however, one would give the power to the Medicare Payment Advisory Commission (MedPAC) and the other would create a new entity to govern payment rates. Under the second proposal, President Barack Obama would nominate five individuals for Senate confirmation to serve on a Medicare Advisory Council responsible for setting Medicare rates. Congress could block the council222s recommendations with a resolution withi n 30 days of a council decision; however, final veto authority would rest with the President ( Kaiser Health News, 7/16 ; Washington Post, 7/16 ). SAMHSA222s Weekly Financing News Pulse July 20, 2009 7/20/09 3 President Obama Nominates Benjamin as Surgeon General : On July 13, President Obama nominated Dr. Regina Benjamin as U.S. Surgeon General. Benjamin founded and subsequently rebuilt the Bayou La Batre Rural Health Clinic after its destruction by hurricanes Georges and Katrina. Benjamin also served as president of the Alabama Medical Association an d as associate dean for rural health at the University of Alabama College of Medicine ( Kaiser Health News, 7/13 ; Kaiser Health News, 7/14 ). HELP Committee Approves 12 -Year Exclusivity Period for Biologics : On July 13, the Senate HELP Committee voted to give 12 years of market exclusivity to high - tech biologic drugs before allowing generic versions to compete. The Obama Administration and AARP had both pushed for 7 years of exclusivity and the biotech companies had sought 14 years. The decisio n still requires agreement from the full Senate and House where Energy and Commerce Committee Chair Henry Waxman (D - CA) supports a shorter exclusivity period ( Kaiser Health News, 7/14 ; AP, 7/14 ). CMS Awards MAC Contract for Jurisdiction 7 to TrailB lazer : On July 15, TrailBlazer Health Enterprises, LLC announced that the Centers for Medicare & Medicaid Services (CMS) has awarded it the Medicare Administrative Contract (MAC) for Jurisdiction 7, which includes Arkansas, Louisiana, and Mississippi. The contract is for one base year and four option years. As MAC, TrailBlazer is responsible for provider enrollment, customer service, and auditing. TrailBlazer also serves as MAC for the Indian Health Services (IHS) and for Jurisdiction 4, which includes Texas, Oklahoma, New Mexico, and Colorado ( PRNewswire, 7/15 ). Aetna and UnitedHealth Win DoD Contract, Replace Humana and Health Net : On July 13, the Department of Defense (DoD) selected Aetna Inc. to run the northern region of the TRICARE health care plan and UnitedHealth Group Inc. to run the southern region. Aetna replaces Health Net and UnitedHealth Group replaces Humana . Aetna222s contract is for $2.8 billion with five one - year option years for a potential total of $16.7 billion and UnitedHealth222s contract is for $3.7 billion with the same structure and a potential total of $21.8 billion. The new contracts are set to begin April 1, 2010 ( Reuters, 7/13 ). Virgin Islands Delegate Sponsors Legislation Requiring the CBO to Consider Broader Implications of Preventative Health Care : U.S. Rep. Donna Christensen (D - VI) introduced Preventative Health Savings Act on July 9 that would require the CBO to consider the impact of preventative health care measures beyond the current 10 - year window ( Caribbean Net News, 7 /13 ). UnitedHealth and Cisco Partner to Create Virtual Clinics : UnitedHealth Group Inc. and Cisco Systems Inc. announced that they will collaborate to create a network of virtual clinics to facilitate the delivery of medical care in offices, stores, and rural areas. UnitedHealth would reportedly spend 223tens of millions224 of dollars to invest in the plan and the companies would seek to partner with states in spending the $6 billion in 223telehealth224 funds allocated through the American Recovery and Reinvest ment Act (ARRA) ( Kaiser Health News, 7/16 ; Bloomberg, 7/15 ). Unions Appeal Decision Limiting GM Health Care Support to UAW : As part of the General Motors (GM) bankruptcy proceedings, the United Auto Workers (UAW) will receive a partial share in the company to fund retiree health care benefits through the Voluntary Beneficiaries Retiree Association (VEBA) (Financing News Pulse 6/1, 5/26, 4/20, 3/13, 3/20 editions). However, over 50,000 retirees represented by three unions 227 the IUE - CWA , the United Steelworkers, and the International SAMHSA222s Weekly Financing News Pulse July 20, 2009 7/20/09 4 Union of Operating Engineers 227 will receive no GM m oney to fund $3 billion in retiree health care obligations. The court has ruled that GM and the U.S. Department of the Treasury are within their rights to refuse to fund the obligations. The unions, known as the splinter unions, are appealing the decisio n. If the appeal is lost, splinter union members must accept the health plans with high out - of - pocket costs that they have been offered under the Treasury/GM deal ( Workforce Management , 7/ 14 ). M ontana, Wyoming Tribes Receive Grant to Curb Alcohol Abuse : The Montana - Wyoming Tribal Leaders Council has received $5 million in grants from SAMHSA to fund underage drinking prevention programs and help recovering alcoholics in the council222s 11 member tribes ( AP via Great Falls Tribune, 7/14 ). USA Today/Gallup and McClatchy -Ipsos Release Health Care Reform Polls: A USA Today/Gallup poll conducted between July 3 and July 5 found that 56 percent of Americans want major health care changes this year with 52 percent of people citing cost control as the most important factor and 42 percent citi ng expanded coverage. However, 90 percent of respondents opposed placing limits on the tests and treatments that they and their doctors deemed appropriate. Sixty percent of respondents favor an employer mandate and 58 percent support a surtax for wealthy Americans; however, only 43 percent support taxing health benefits. Finally, the poll found a strong partisan divide, with 79 percent of Democrats favoring reform this year compared with 23 percent of Republicans and 55 percent of independents ( USA Today, 7/14 ; Kaiser Health News, 7/14 ; CQ Politics, 7/14 ). In addition, a McClatchy - Ipsos poll, conducted between July 9 and July 13, found that 40 percent of Americans believe a public plan would lower the quality of health care, 21 percent thought it would improve quality, and 36 percent thought it would have no effect on quality. The McClatchy survey also found that Americans were divided over the financial effects of a government - run plan, with 38 percent believing it would bring down their h ealth care costs, 27 percent believing it will raise their health care costs, and 31 percent thinking it will have no effect ( Detroit Free Press, 7/16 ). PWC Survey Shows Rising Health Care Costs for U.S. Companies : On July 9, PricewaterhouseCoopers (PWC) released a survey, 223Behind the Numbers: Medical Cost Trends for 2010,224 that found that health care costs have risen 9.2 percent in 2009 and that employers plan to shift rising costs of health care expense to employees. The survey showed that 42 per cent of employers plan to increase workers222 share of health care costs and 41 percent plan to increase medical cost sharing through plan changes. In addition, though 67 percent of companies had wellness programs in place; however, few reported that they w ere effective at lowering health care costs ( Reuters, 7/13 ; Kaiser Health News, 7/14 ). SCAN Foundation Report Considers Options for Long - Term Care : On July 16, the SCAN Foundation and Georgetown University released a report , 223Long - Term Care in Health Care Reform: Policy Options to Improve Both,224 which examines four options for improving long - term care. Two options focus on improving long- term care for the poor by improving and modernizing Medicaid and two options focus on improvin g long - term care more broadly through Medicare changes and by establishing long - term care insurance for all Americans ( Kaiser Health News, 7/16 ; SCAN Foundation, 7/16 ). C ommonwealth Fund Report Examines Administrative Cost Savings in Health Reform : On July 16, the Co mmonwealth Fund released a report , 223How Health Care Reform Can Lower the Cost of SAMHSA222s Weekly Financing News Pulse July 20, 2009 7/20/09 5 Insurance Administration,224 examining three health care reform plans to determine their level of administrative savings. Commonwealth found that including a public plan in an insurance exchange would save $265 billion in administrative costs over 10 years and an insurance exchange with only private plans would save $32 billion over the same period ( Kaiser Health News, 7/16 ). AC AP Report Says Medicaid Eligibility Tests Lead to Higher Costs : The Association for Community Affiliated Plans (ACAP) released a report arguing that states222 Medicaid eligibility tests, which often cause families to un - enroll and re - enroll in Medicaid programs, often cost Medicaid more because of poor management of chronic conditions than would allowing individuals to remain in the program over small periods of ineligibility. The ACAP report advocates passing a Medicaid Continuous Quality Act to establish 12 - month continuous Medicaid eligibility and calculates that the move will cost more in the short- term but save in the long- term because continuously enrolled patients have lower average costs ( Fierce Healthcare, 7/14 ). Families USA Report Provides State - Level Estimates of H ealth Insurance L oss : A report by Families USA uses 2008 U.S. Census Bureau data to estimate the number of Americans who will lose health care coverage through 2010. The report provides state and national estimates. US News & World Report Releases Hospital Rankings : U.S. News & World Report has rel eased its annual hospital rankings , which grade hospitals based on the most complex and demanding procedures. The rankings cover 16 specialties, including psychiatry, and feature a search tool to identify scores for specific hospitals ( U.S. News & World Report, 7/15 ). Around the Hill: Hearings on Health Financ ing Senate Health, Education, Labor and Pensions Committee: Health Care Overhaul July 14, 9 a.m. 325 Russell July 15, TBA, 325 Russell House Appropriations Committee: Fiscal 2010 Appropriations: Labor - HHS - Education July 17, 9 a.m. 2350 Rayburn House Veterans222 Affairs Subcommittee on Oversight and Investigations: VA/DOD Coordination of Health Records July 14, 10 a.m. 334 Cannon Senate Commerce, Science and Transportation Subcommittee on Consumer Protection, Product Safety, and Insurance: Health Care Competition July 16, 10 a.m. 253 Russell Around the States: State and Local Behavioral Health Financing News Alaska State Receives $11.5 Million SAMHSA Grant for M/SU Prevention : SAMHSA awarded a five - year $11.5 million grant to Alaska222s Department of Health and Social Services Division of Behavioral Health . The grant, which comes through SAMHSA222s Strategic Prevention Framework State Incentive Grant program, SAMHSA222s Weekly Financing News Pulse July 20, 2009 7/20/09 6 targets rural Alaskans for behavioral health prevention. The first year of the contract is devoted to data analysis and program planning and in the following years grant funds will be available to communities for specific projects ( KTVA, 7/10 ). California Legislators, Governor Yet to Reach Budget Deal, Expected to Cut Health Care: Though Governor Arnold Schwarzenegger (R) and the California Legislature have yet to reach a budget deal to close the state222s $26 billion deficit, sources close to the negotiations say that lawmakers have resolved all but $400 million of the deficit. Any budget passed will include cuts to Medi - Cal, the state222s Medicaid program, and in - home health care; however, Democrats in the Legislature are fighting further health care cuts proposed by Governor Schwarzenegger ( California Healthline, 7/15 ; New York Times , 7/16 ). In addition, Healthy Families, the state222s insurance program for low - income children is expected to face a $90 million cut and is already facing an enrollment freeze which is expected to prevent 350,000 children from obtaining health coverage ( Kaiser Health News, 7/17 ; California Public Radio, 7/17 ). Governor Replaces Most Members of Nursing Board: Following a Los Angeles Times/ProPublica investigation that found it takes the California Board of Registered Nursing an average of three years and five months to investigate and close complaints made against one of its 350,000 nurses ( ProPublica, 7/11 ), Governo r Arnold Schwarzenegger (R) replaced the majority of the board members on July 13. Governor Schwarzenegger fired three of the six sitting members and an additional member resigned. The governor222s appointments fill the four newly vacated seats and two of three previously vacant seats ( Los Angeles Times, 7/14 ; Kai ser Health News, 7/14 ). Mental Health Clinic Closes Because of Budget Cuts : San Bernardino County222s Hesperia clinic must close because of state budget cuts. Staff and clients of the Hesperia clinic will report to Victor Valley Behavioral Health Center ( Daily Press, 7/12 ). Illinois Governor Signs Budget : On July 15, Governor Pat Quinn (D) signed a $26 billion state budget that solves part of the state222s $9.2 billion deficit by borrowing $3.5 billion to pay workers222 pensions. The governor222s office reports that, because of the borrowed funds, the state222s budget actually has a $4.5 billion deficit despite being technically 223balanced224 and warns that future tax increases may be necessary. The budget also cuts $2.1 billion in state expenses and designates another $1 billion as 223reserve fund224 to be taken from agencies that do not spend their entire budgets at Governor Quinn222s discretion. Among the cuts, the budget cuts human services by about 10 percent. ( AP via Forbes, 7/16 ; New York Times, 7/16 ; Chicago Public Radio, 7/16 ; Chicago Tribune, 7/17 ) . AARP Survey Finds Seniors Delay Purchasing Prescription Drugs : A survey conducted between October and December 2008 found that 21 percent of AARP members reported not filling or delaying filling their prescriptions because of cost and 18 percent reported taking less than the required amount of medication to make it last longer. Twenty percent of respondents reported cutting back on food to SAMHSA222s Weekly Financing News Pulse July 20, 2009 7/20/09 7 afford medical costs and 63 percent reported being 223concerned224 about the affordability of prescription drugs ( UPI, 7/13 ; Kaiser Health News, 7/13 ). Kane County Extends Line of Credit to Health Department : Because of the delay passing the Illinois state budget, which funds $4.35 million or 40 percent of the Kane County Health Department budget, Kane County has extended the department a $500,000 line of credit to ensure continued operation and prevent layoffs ( Courier News, 7/16 ). Madison County Constructing New Behavioral Health Center: Madison County222s Community Counseling Center currently provides behavioral health services to county residents from four locations; however, a $4.5 million construction project, funded by a Community Development Block Grant from Madison County and the state of Illinois, will create a single building for the Center222s services. The Illinois Departments of Human Services and Children and Family Services , the Madison County Mental Health Board, and Area Agency on Aging of Southwestern Illinois will fund the center ( St. Louis Business Journal, 7/14 ). Indiana State Seeks Corrective Action Plan from Contractors Operating Medicaid Program : The Family and Social Services Administration is seeking a corrective action plan from IBM Corp. and Affiliated Computer Services Inc. , the companies operating a 10 - year $1.16 billion contract to modernize the state222s Medicaid system. Medicaid enrollees report long delays on the phone, mismanagement of paperwork, and uninformed staff. In addition, since the contractor222s responsibility was expanded in May 2008, backlogged cases have increased 86 percent. To respond to some of the complaints, the contractors have hired an additional 350 staff members, including 160 for county offices, 150 for service centers, and 40 for management. The state says it may cancel the contract if the changes are not made by the end of September ( Journal and Courier, 7/15 ; Fort Wayne Journal Gazette, 7/12 ). Senator Announces Funding for State Programs in Labor -HHS- Education Appropriations Bill : Rep. Pete Visclosky (D - IA) announced that programs in northwest Indiana will split $1 million under the Fiscal Year 2010 Labor, HHS, and Education bill approved by the House Appropriations Subcommittee on Labor, HHS and Education this week. One program would receive $550,000 to construct a behavioral health center, one would receive $200,000 for nursing equipment, one would receive $150,000 to expand social and extracurricular activities for clients with life challenges, and another would receive $100,000 to expand a family literacy program ( Office of Congressman Pete Visclosky via Indiana Business, 7/15 ). Massachusetts Panel Recommends Shift in Health Care Payment Model : As the second phase of the st ate222s health care reform effort, which began in 2006 when the state instituted an individual health care mandate along with a subsidy program, a state commission has recommended that Massachusetts move from a fee - for - service model to a 223global payment224 mod el for health care payments. If adopted by the governor and the Legislature, the plan would group doctors, hospitals and other health care providers into networks and pay them flat monthly fees for each client rather than paying for individual services re ndered. The SAMHSA222s Weekly Financing News Pulse July 20, 2009 7/20/09 8 commission recommends implementing the change over five years and obtaining permission from the federal government to apply the change within Medicaid and Medicare as well as in the private sector ( New York Times, 7/16 ; Kaiser Health News, 7/17 ). Budget Eliminates State - Sponsored Coverage for Legal Immigrants : The state budget signed by Governor Deval Patrick (D) on June 29 (Financing News Pulse 7/6 edition) eliminates health care coverage for 30,000 legal immigrants through the state222s Commonwealth Care program, established in the state222s health reform package of 2006. The cuts, which affect immigrants that have been permanent green - card - holding residents for less than five years, will save the state $130 million. Governor Patrick has proposed restoring $70 million to the program to restore some the coverage; however, legislative leaders have opposed the plan. If the governor222s proposal is not passed, the cuts will take effect in August ( New York Times, 7/14 ; Kaiser Health News, 7/15 ). Rep. Moore Introduces Small Business Health Insurance Legislation: State Rep. Richard Moore (D) and the Massachusetts Association of Health Plans introduced legislatio n to allow business with fewer than 50 employees and self - employed residents to purchase medical coverage with lower premiums and higher out - of - pocket costs. Under the plan, health care providers would be reimbursed up to 110 percent of the Medicare rate for services and insurers222 profits would be capped at 2 percent. Proponents of the bill estimate it could cut premium costs for enrollees by 22 percent ( Boston Globe, 7/15 ). Boston Hospital Sues State Over Funding : On July 15, Boston Medical Center sued the state of Massachusetts alleging that the state222s 2006 universal health care law is forcing the hospital to pay an unfair portion of care for the poor. Initially in favor of the law, Boston Medical reports that, though the percentage of uninsured clients it treats has dropped from 20 percent to 10 percent since the law was implemented, reimbursement rates for Medicaid and th e state222s Commonwealth Fund have dropped as enrollment has increased. The hospital says the state currently pays 64 cents for every dollar the hospital spends treating the poor and that, as a result, the hospital faces a $38 million current year deficit and will lose over $100 million next year ( New York Times, 7/15 ; Kaiser Health News, 7/16 ) . School - Based Substance Abuse Prevention Program Loses Grant Funding : As part of the state budget signed by Governor Patrick (D) (Financing News Pulse 7/6 edition), a school - based substance abuse prevention program 227 New Beginnings 227 lost a $200,000 state g rant that allowed it to offer services to local schools free of charge. The program visits about 300 schools annually and estimates that, without the grant, it will be forced to charge schools a total of $187,000 for program services ( Framingham Tab, 7/10 ). Michigan House Speaker Unveils Plan to Create Single Public Health Insurance Plan: House Speaker Andy Dillon (D) proposed l egislation that would cover all of Michigan222s public employees, including both state and local employees as well as retirees, under a single 400,000 - person health plan. The state222s cumulative health insurance costs for public employees totals between $4.5 billion and $7 billion annually; SAMHSA222s Weekly Financing News Pulse July 20, 2009 7/20/09 9 however, Dillon says that consolidating the numerous health plans 227 including plans negotiated by unions 227 would save an estimated $700 to $900 million annually. However, the plan has faced criticism from unions, notably the teachers union, who feel that such a move reduces union power and forces union members to 223give back224 benefits that they have fought to maintain ( Detro it Free Press, 7/15 ). Minnesota Four - County Mental Health Agreement to Continue Through 2016 : An agreement between Anoka, Carver, Hennepin, and Scott Counties to provide mental health crisis services for adults has been extended through June 30, 2016 as long as funding from the Minnesota Department of Human Services lasts. Funding from the agreement allowed each county to hire care coordinators, expand mental health crisis care, improve access to care, and reduce hospitalization ( ABC Newspapers, 7/15 ). Mississippi Governor, DMH Director Seek Mental Health Clinic Funding : After Governor Haley Barbour (R) vetoed $7 million in funding for community health centers because it exceeded the $95 million limit he had placed on 223rainy day fund224 transfers (Financing News Pulse 7/13 edition), the Director of the Department of Mental Health (DMH) announced plans to fund 15 community mental health centers with $30 million in department money from the general fund. The centers need the money to meet the Medicaid match requirement and DMH plans to ask the Mississippi Legislature for a deficit appropriation in January to eliminate the resulting shortfall ( AP via Sun - Herald, 7/14 ; Clarion - Ledger , 7/14 ). New Hampshire Medicaid Roles on Pace to Cause Shortfall : Only weeks after Governor John Lynch (D) signed New Hampshire222s budget on June 30, state Medicaid officials report that Medicaid funding is already in jeopardy. The state222s new budget assumes a 1 percent Medicaid growth rate between July 2009 and July 2010; however, the Medicaid caseload in creased 9 percent between May and June and state officials report that the Medicaid budget will be insufficient if 39 additional residents enroll after June 30 ( Kaiser H ealth News, 7/15 ). Governor Signs Law to Expand Children222s Health Insurance Program to Young Adults : On July 16, Governor Lynch (D) signed a bill that will allow adults up to age 26 with incomes up to $43,000 annually to purchase insurance through Health y Kids, the state222s health insurance program for low - income children. Roughly 22,000 young adults in New Hampshire would be eligible for the program that is not expected to begin for another year. Under the law, adults would pay the full cost of their pr emiums ( Kaiser Health News, 7/17 ; Concord Monitor, 7/17 ). New Jersey New Jersey Awards PerformCare the System Administrator Contract for Children222s Behavioral Health: PerformCare , a managed behavioral health care organization (MBHO), has been selected as the contract systems administrator for the New Jersey Department of Health222s Division of Child Behavioral Services . Under the contract, which has three base years and two option years, PeformCare will handle customer service, care coordination, management, and outcomes measurement ( Business Wire, 7/14 ). SAMHSA222s Weekly Financing News Pulse July 20, 2009 7/20/09 10 Legislature Passes Involuntary Commitment Law : The New Jersey Legislature has passed AB 1618 , which would allow the state to commit individuals to psychiatric hospitals for outpatient treatment against their will if they are deemed dangerous to themselves or others ( WAFF, 7/10 ). New Mexico Legislators Seek Audit of Behavioral Healt h Contractor : Thirteen members of the New Mexico Legislature have asked State Auditor Hector Balderas for a special audit of ValueOptions New Mexico. ValueOptions has operated the New Mexico Behavioral Health Collaborative for four years but was replaced by OptumHealth New Mexico , a UnitedHealth Group subsidiary, on July 1. The contract award process was marred with lobbying controversies and groups have accused ValueOptions of improperly rendering treatment decisions after losing its bid for future state business (Financing News Pulse 6/8, 5/26, 2/20, 2/13, 1/30 editions). Balderas will submit an official audit proposal to the legislature to obtain funding ( AP via KBDC ). New Yo rk Study Finds Kendra222s Law Successful : A study conducted by the Duke University Medical School found that Kendra222s Law , which provides court - assisted outpatient treatment to people with mental illness, is effective at reducing hospitalizations, arrests, substance abuse, and other negative consequences of mental illness while greatly increasing access to mental health treatment ( Business Wire via PR Inside, 7/10 ). Chemung County Legislature Approves Medicaid Resource Center : On July 13, the Chemung County Legislature approved a plan to construct a Medicaid Medical Home in the county222s Human Resources Center (Financing News Pulse 5/26 edition). The home, which is slated for completion by the end of the year, will provide case management for the county222s 4,000 Medicaid enrollees to save money and improve care. The county legislature has agreed to borrow up to $400,000 to finance construction ( WETM, 7/13 ). Niagara County Sues State Over Funding for Medicaid Mental Health Services : Niagara County has filed a second lawsuit against the state, demandin g that the state pay $668,193 for mental health treatment provided under the Medicaid program. In New York, the federal government pays 50 percent of Medicaid costs, the state pays 25 percent, and counties pay 25 percent; however, Niagara County contends the rule does not apply to mental health services. In March, the Appellate Division of the state Supreme Court ruled that upheld a ruling from a lower court, which ruled that Niagara County was correct in its interpretation of the Medicaid law and that the state owed Niagara $425,000. The county discovered additional Medicaid mental health billings and is now suing the state over those funds as well ( Buffalo News, 7/ 12 ). North Carolina Legislators Fail to Pass Permanent Budget, Pass Continuing Resolution: Failing to pass a two - year budget for FY2010 and FY2011, the North Carolina General Assembly passed a continuing resolution on July 15 to fund the state at 84 per cent of FY2009 funding for two weeks, allowing the legislature more time to pass a permanent budget ( WECT, 7/16 ). SAMHSA222s Weekly Financing News Pulse July 20, 2009 7/20/09 11 East Carolina Behavioral Health Enters Cooperative Agreement to Increase Access to Care : Facilitated by the North Carolina Division of Mental Health, East Carolina Behavioral Health , East Carolina University, and the Beacon Center will partner to hire three additional psychiatrists to rotate through 13 underserved counties in Eastern North Carolina ( WNCT, 7/14 ). Ohio Legislature Passes Budget, Governor Signs Interim Budget : On July 13, the Ohio Legislature p assed a $52 billion budget that Governor Ted Strickland (D) has been reviewing to prepare his line - item vetoes. In the mean time, Governor Strickland approved a third interim budget on July 14 to fund the state through July 21 while he reviews the final b udget and makes changes ( Business First of Columbus, 7/14 ; WBNS, 7/17 ). If Governor Strickland approves the final budget as it was passed, it would cut community mental health services by 34 percent and cut nursing home funding by 10 percent, or $184 million. In addition, the budget contains provisions to expand access to private health care by limiting the fees that state insurance companies may charge people with chronic conditions in individual health plans, mandating that employer - sponsored insurance cover children up to age 28, and requiring employers to offer uninsured employees the opportunity to purchase health coverage with pre - tax earnings ( Columbus Dispatch, 7/13 ; Dispatch Politics, 7/16 ). Forum Health to Close Behavioral Health Center, Layoff Staff : On July 14, Forum Health announced that it will close the adult behavioral health unit at Northside Medical Center, laying off the full time equivalent of 50 employees to save $2.7 million. The behavioral health unit will be moved to Forum222s Trumbull Memorial Hospital in Warren where the company operates its geriatric mental health ward. The moves come as part of a reorganization plan that Forum must file with U.S. Bankruptcy Court by September 15 ( Vindicator, 7/15 ). Grant Money Funds Job Program for Mentally Ill : A $28,850 grant from the Greater Cincinnati Foundation will help the Linder Center for HOPE fund and support employment services for the mentally ill. The grant money will expand the current program, funding additional staff and technology ( WCPO, 7/13 ). Oregon State Passes Prescription Drug Monitoring Legislation: At the end of the 2009 legislative session, the Oregon Legislature passed SB 355 to establish a prescription drug monitoring program in the state beginning July 1, 2010. Under the program, doctors and pharmacists must enter information about patients to whom they prescribe Schedule 2 - 4 drugs; however, doctors and pharmacists are not required to run patients222 names through the database prior to prescribing medication. The police may only access the program222s information with a search warrant and an 11 - mem ber panel containing no law enforcement personnel will govern it. The program222s startup costs are funded via federal grant and a $25 annual fee paid by medical practitioners and pharmacists will maintain it ( South Lincoln County News, 7/14 ). SAMHSA222s Weekly Financing News Pulse July 20, 2009 7/20/09 12 Pennsylvania Update: Legislature Yet to Pass Budget : On July 16, the Democratic - controlled Pennsylvania House rejected a $27.3 billion GOP budget and is expected to pass a $29.1 billion Democratic budget July 17 that would then head to the Republican - controlled Senate ( AP via Forbes, 7/17 ). Update: Westmoreland Completes Mental Health Services Transition After Excela Cancels Services : After Excela Health announced plans to eliminate outpatient mental health services because of cost, Westmoreland County Mental Health, Mental Health America of Westmoreland, Westmoreland Case Supports Inc. , and Va lue Behavioral Health formed a team to help transition former Excela clients (Financing News Pulse 3/27, 3/20 editions). The transition plan went into effect July 1, with numerous providers expanding services, one agency opening a new clinic in Greenberg, and a new private firm assuming responsibility for court - ordered mental health evaluations ( Pittsburgh Tribune - Review, 7/13 ). Utah Medicaid Cuts Affect Dental B enefits : Cuts to Utah222s Medicaid program (Financing News Pulse 5/11 edition) have left 40,000 Medicaid enrollees in Utah without dental coverage. Those individuals are now seeking care predominantly at free clinics that lack staffing and funding to treat the influx of newly uninsured patients ( Salt Lake Tribune, 7/11 ). Washington King County Council Approves Measure Cutting Spending to Fund Safety Net : The King County Council approved a measure to cut $875,000 from its 2009 allocation, $900,000 from executive branch agencies, and $110,000 from the Elections Office and Department of Assessment to fund the human services safety net in 2009. The plan preserves reserves designed to close the 2010 budget gap ( West Seattle Herald, 7/14 ). West Virginia PEIA Tells Legislators it Will Eliminate Retiree Health Insurance Subsidies for New State Employees : The executive director of the Public Employees Insurance Agency (PEIA) told legislators on July 15 that the PEIA will eliminate retiree health insurance subsidies for state employees hired after January 1, 2010 (Financing News Pulse 6/15 edition). The st ate currently has a $7 billion retiree health care obligation that would increase to $18 billion by 2030 without the policy change. Retirees would still be eligible to pay for benefits; however, they could cost as much as $2,000 monthly for a non - Medicare eligible family. The PEIA will vote on the issue later in July ( Charleston Gazette, 7/15 ). Huntington VA Facility Expanding : The Huntington VA Medical Center is undergoing $20 million in facility improvements that will include the creation of a mental health complex and the renovation of existing departments. About $5 million of the funding comes from the Omnibus Appropriati ons Act of FY2009 and funding for numerous projects comes from the ARRA ( Herald - Dispatch, 7/14 ).
