WeeklyFinancingNewsPulsefinal200900908.pdf (PDF | 340.99 kb)
SAMHSA222s Weekly Financing News Pulse Sept ember 8, 2009 9/08/09 1 National Health Financing News President Obama to Address Congress on Health Care Reform; Senate Finance Committee Negotiators Hold Conference Call; Democrats Remain Optimistic Rep. Waxman Seeks Information From Health Insurers on 223Purging224 Practices HHS Officials Provide Details on ARRA Health IT Exchange Grants ONDCP Announces Drug Free Communities Grants Pfizer to Pay $3.2 Billion in Medicare/Medicaid Settlement CNN, Mellman, and CBS Release Health Care Reform Polls; Thomson Reuters Releases Health Care Cost Poll Segal Releas es 2010 Health Plan Cost Trend Survey GW Policy Brief Examines the Impact of Health Center Expansions on Health Care Costs Study Concludes that Retail Health Clinics are Well-Positioned to Supply Simple C are for Urban Populations Study Examines Long-Term Illness Costs and Potential Changes to the Federal Budget Process Study Compares Medicare FFS with Medicare Advantage Plans RAND Study Assesses Medicare Part D Update: GM Agrees to Pay Additional $50 Million for Retiree Health Care Health IT Companies Announce the First Personal Health IT Tool with Cost Savings Applicati on KFF Releases Reports Examining the Impacts and Implications of Massachusetts222 Health Care Reform Around the Hill: Hearings on Health Financing Around the States: State and Local Behavioral Health Financing News Alaska Arizona California Colorado Connecticut Florida Georgia Hawaii Illinois Indiana Iowa Kansas Kentucky Louisiana Maryland Massachusetts Michigan Nebraska North Carolina Ohio Texas Washington Wyoming This issue of SAMHSA222s Financing News Pulse will be published Tuesday September 8, 2009 because of the Labor Day holiday. For quest ions or comments, please contact Sarah Wattenberg (sarah.wattenberg@samhsa.hhs.gov). SAMHSA222s Weekly Financing News Pulse Sept ember 8, 2009 9/08/09 2 National Health Financing News President Obama to A ddress Congress on Health Care Reform; Senate Finance Committee Negotiators Hold Conference Call; Democrats Remain Optimistic : President Barack Obama plans to meet with House Speaker Nancy Pelosi (D -CA) and Senate Majority Leader Harry Reid (D -NV) at the W hite House on September 8 to discuss health care reform. The following day, President Obama will address a joint session of Congress in prime time to provide more specifics about his desired health reform legislation. President Obama222s address will mark the first time since President George W. Bush 222s terrorism address on September 20, 2001 that a president has addressed a joint session of Congress outside of a State of the Union or traditional first address ( CQ Politics, 9/3 ). The address comes before the scheduled September 15 deadline for Senate Finance Committee negotiators to reach a bipartisan health care compromise; however, media outlets report that the prospects of that agreemen t have dwindled as the politics surrounding health care reform have increased over the August recess ( The Hill, 9/4 ). Nonetheless, the Finance Comm ittee negotiators has continued negotiations and held a conference call to discuss health care reform legislation on September 4 ( Kaiser Health News, 9/4 ) . Still, numerous democrats including Vice President Joe Biden, Senate Finance Committee Chair Max Baucus (D), and members of the Blue Dog Coalition have voiced confidence that health care reform legislation will pass in the current legislative session, t hough possibly on a partisan vote ( CQ Politics, 9/3 ; New York Times, 9/1 ; AP via Examiner, 8/31 ). I n related news, new information is available regarding the effects of the House health care reform legislation ( HR 3200 ). Kaiser Health News has obtained documents from the House Ways and Means Committee outlining the maximum premium and out -of -pocket expenses that lower income Americans might face under HR 3200. The Congressional Budget Office (CBO) also has published estimates of the change in Medicare Prescription Drug Benefit (Part D) costs under the same legislation ( New York Times, 8/30 ). Rep. Waxman Seeks Information From Health Insurers on 223Purging224 Practices : On August 31, House Energy and Comm erce Committee Chair Henry Waxman (D -CA) sent letters to numerous insurers, including Aetna Inc. , UnitedHealth Group Inc. , WellPoint Inc. , Humana Inc. , Medica , and Wellmark Blue Cross Blue Shield , requesting information on how they determine coverage for s mall businesses. The requests, which ask the insurers to provide the information by September 14, come after Rep. Waxman alleged that the insurers engage in a process known as 223purging,224 eliminating coverage for individuals after they become sick or raising group premiums until the policies become unaffordable. America222s Health Insurance Plans (AHIP) said that Waxman222s investigation is designed to smear the insurance companies and increase support for a public insurance plan ( Kaiser Health News, 9/1 ; AP, 8/31 ). HHS Officials Provide Detail s on ARRA Health IT Exchange Grants: After Vice President Joe Biden announced $1.2 billion in American Recovery and Reinvestment Act (ARRA) health IT funding on August 20 (Financing News Pulse 8/31 edition), U.S. Department of Health and Human Services (HH S) officials held a teleconference to clarify the use of $598 million in grants to help establish 70 health IT regional exchange centers. HHS officials said that the $598 million will fund about 70 four -year grants to non-profit organizations to run the health exchange centers. The health IT exchanges will help doctors, primarily at smaller primary care offices, select appropriate electronic health record (EHR) systems, implement those systems, and achieve 223meaningful use224 through those systems. In addit ion, the exchanges will provide 223in - depth224 technical support for select EHR vendors222 systems ( Kaiser Health SAMHSA222s Weekly Financing News Pulse Sept ember 8, 2009 9/08/09 3 News, 8/31 ). An HHS -appointed panel of experts will evaluate the regional centers every two years and the first round of grants are slated to begin on a rolling basis in FY2010 ( American Medical News, 8/31 ). O NDCP Announces Drug Free Communities Grants : On August 27, Director of the Office of National Drug Control Policy (ONDCP) Gil Kerlikowski announced $21 million in new Drug Free Communities (DFC) grants to 161 communities across the U.S and 10 new DFC mentoring grants. The DFC program, directed by ONDCP in collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA), distributes grants of up to $625,000 over five years to facilitate citizen participation in drug prevention. In addition to the $21 million in new grants, ONDCP released $60 million in continuation grants earlier this month to 565 community coalitions and 10 DCF mentoring programs. ONDCP awarded grants to communities in every state, the District of Columbia, and Puerto Rico ( ONDCP, 8/27 ). Pf izer to Pay $3.2 Billion in Medicare/Medicaid Settlement : On September 2, U.S. Department of Justice (DOJ) officials announced that they had reached a deal with Pfizer Inc. to settle allegations that the company illegally marketed numerous drugs including, Bextra, a pain medication that has been withdrawn from the market; Geodon, an antipsychotic; Zyvox, an antibiotic; and Lyrica, a medication used to treat nerve pain. Under the de al, which includes every U.S. state except South Carolina, Pfizer will pay civil and criminal penalties totaling $3.2 billion227 the largest health care settlement and the largest criminal fine of any kind. Forty -nine (49) states and the District of Columbia will collect $331 million and six whistle-blowers will collect $102 million from the federal share of the settlement and additional funds from the states222 shares ( New York Times, 9/2 ; Baltimore Sun, 9/3 ; AP, 9/2 ; Kaiser Health News, 9/3 ). C NN, Mellman, and CBS Release Health Care Reform Polls; Thomson Reuters Releases Health Care Cost Poll: A CNN/Opinion Research poll , conducted August 28 -31, found that 51 percent of respondents oppose President Obama222s health reform plan while 45 percent favor it. The poll also found that 45 percent of respondents believe the health care system requires 223a great deal224 of reform, 46 percent believe it requires 223only some,224 and 7 percent believe it requires none. Finally, the poll found that 55 percent of respondents favored a 223public plan option224 and 41 percent opposed it ( CQ Politics, 9/2 ). In addition, in a poll conducted by the Mellman Group August 21 -24 and released by the American Health Care Association (AHCA), respondents indicated that Medicare nursing home cuts were the least desirable method for financing health care reform, favoring increased taxes on wealthy individuals, insurance companies, and generous health care benefits ( PRNewswire via Reuters, 8/31 ). However a CBS News poll , conducted August 27 -31, found that 67 percent of respondents reported that health care reform was confusing and that only 31 percent had a 223clear understanding224 of the proposed changes. In addition, the poll found that 60 percent of respondents do not believe that President Obama has clearly explained his health care reform plans. The confusion cut across party lines, with 69 percent of Republicans and 58 percent of Democrats reporting that health care reform was unclear ( CBS News, 9/1 ; Kaiser Health News, 9/1 ). Meanwhile, a related poll released by Thomson Reuters August 31, that found that fewer Americans are concerned about their ability to pay for health care, with confidence in the ability to pay rising 12 percent betwee n March and July ( Reuters, 8/31 ; Kaiser Health News, 8/31 ). Segal Releases 2010 Health Plan Cost Trend Survey : On September 3, the Segal Company released its 2010 Segal Health Plan Cost Trend Survey , surveying 80 health insurers, managed care SAMHSA222s Weekly Financing News Pulse Sept ember 8, 2009 9/08/09 4 organizations, pharmacy benefit managers, and third -party administrators to develop trends to apply to actual medical claims to yield 2010 health plan cost estimates. Segal estimates that expenses will increase 13.3 percent for fee -for-service (FFS) indemnity plans, 11.9 percent for high deductible health plans, 10.8 percent for open access preferred provider organizations (PPOs) and point of service (POS) plans, 10.2 percent for HMOs, 9.8 percent for Medicare Advantage (MA) FFS plans, and 7.7 percent for MA HMOs ( PRNewswire via Reuters, 9/3 ; U.S. News & World Report, 9/2 ). GW Policy Brief Examines the Impact of Health Center Expansions on Health Care Costs : A policy brief , released by researchers at the George Washington University (GW) School of Public Health and Health Services , estimates that expanding health centers to treat an additional 20 million patients would save $212 billion between 2010 and 2019, including a $59 billion savings for Medicaid. Furthermore, the brief authors stress that the value of the savings vastly exceeds the $38.8 billion health center investment called for in HR 3200 ( PRNewswire via Reuters, 9/1 ). S tudy Concludes that Retail Health Clinics are Well - Positioned to Supply Simple Care for Urban Populations : A study published in the Annals of Internal Medicine examined retail health clinics in the U.S., finding that, as of August 2008, 42 operators ran 982 clinics in 33 states with 84 percent of clinics located in urban areas. The study found that all clinics offered sore throat treatment and at least 95 percent offered treatment of skin conditions, immunizations, pregnancy testing, and lipid or diabetes screening . In addition, the study found that 97 percent accepted private insurance and 93 percent accepted Medicare FFS. The auth ors conclude that retail health clinics are 223well positioned to provide immunizations and care for simple acute conditions for a substantial segment of the urban U.S. population 224 ( Kaiser Health News, 9/1 ). S tudy Examines Long- Term Illness Costs and Potential Changes to the Federal Budget Process : A study , published September 1 in Health Affairs , examined the federal costs of type 2 diabetes under alternative policies, finding that the current CBO projections do not allow for considerations of the long- term effects of improvements in treating chronic conditions. The authors also discuss the broader implication of these findings for health care reform ( Health Care Finance News, 9/1 ). S tudy Compares Medicare FFS with Medicare Advantage Plans: A study conducted by Johns Hopkins University professor Gerard Anderson and sponsored by the Alliance of Community Health Plans (ACHP) compares hospital readmissions and preventable hospitalizations under Medicare FFS plans and Medicare Advantage (MA) plans offered by ACHP organizations. The study found that, for 2007, 12 of 13 ACHP plans had readmission rates lower than the national average of 18.6 percent, ACHP plans had 86 percent fewer preventable emergency admission th an the national average, and ACHP plans had preventable inpatient hospitalization rates that were 13 percent of the national average. Anderson also calculated potential savings that Medicare could realize if Medicare FFS plans had rates proportional to AC HP222s plans ( Kaiser Health News, 9/3 ; Business Review West Michigan, 9/2 ). R AND Study Assesses Medicare Part D: A RAND study published in the American Journal of Managed Care assessed the impacts of th e Medicare Prescription Drug Benefit Program (Part D), finding that, by 2008, 90 percent of seniors had coverage that was at least as generous as the standard Part D benefit. The study also found that poorer beneficiaries have made the greatest gains in a ccess and out - SAMHSA222s Weekly Financing News Pulse Sept ember 8, 2009 9/08/09 5 of -pocket savings under Part D. The authors conclude most coverage under Part D is comparable to non-Part D plans; however, drug pricing issues and coverage gaps remain ( Reuters via ABC, 9/2 ). U pdate: GM Agrees to Pay Additional $50 Million for Retiree Health Care: After settling its retiree health care obligations with the United Auto Workers (UAW) (Financing New Pulse 6/1 edition), General Motors (GM) and the U.S. Department of the Treasury initially gave no money to fund $3 billion in retiree health care costs for the IUE -CWA, the United Steelworkers , and the International Union of Operating Engineers (Financing News Pulse 7/20 edition). However, GM has now agreed to pay $50 million to fund health benefits for 50,000 hourly retirees represented by those unions ( Kaiser Health News, 9/2 ; Detroit News, 9/1 ). Hea lth IT Companies Announce the First Personal Health IT Tool with Cost Savings Application: MediKeeper Inc. and Change:Healthc are Inc. have partnered to create the first personal health information tool with an embedded cost savings application. The companies will initially introduce the tool to large employer groups and health plans and have scheduled a consumer -level launch fo r later in 2009 ( PRNewswire, 8/31 ). K FF Releases Reports Examining the Impacts and Implications of Massachusetts222 Health Care Reform : On September 1, the Kaiser Family Foundation (K FF) released two new reports examining Massachusetts222 health care reform law. 223 Consumers222 Experience in Massachusetts: Lessons for National Health Reform 224 examines the impact of the law with special focus on affordability and accessibility of care and 223 In Pursuit of Affordable Health Care: On the Ground Lessons from Families in Massachusetts 224 highlights state residents222 experiences in obtaining coverage, accessing services, and managing out -of - pocket expenses. KFF also updated its Massachusetts health care reform factsheet . Around the Hill: Hearings on Health Financing Congress is out of session for the August recess and will reconvene Tuesday, September 8. Around the States: State and Local Behavioral Health Financing News Alaska Update: CMS Lifts Moratorium on State Medicaid Waiver Programs : In a letter date d August 27, the Centers for Medicare & Medicaid Services (CMS) lifted a moratorium that the agency had previously placed on enrollment in Alaska222s Medicaid waiver programs for home and community -based care. CMS had imposed the moratorium because the stat e failed to assess and reassess eligibility in a timely manner, resulting in a large backlog of unprocessed claims (Financing News Pulse 8/31, 7/13 editions). The Alaska Department of Health and Social Services (DHSS) has not yet submitted its final corrective action plan to CMS; however, CMS officials elected to lift the moratorium early in recognition of the state222s ongoing progress ( Juneau Empire, 8/30 ). Detox Center Expects to Reopen by October : After the Alaska Division of Behavioral Health shut down Fairbanks Native Association222s (FNA) Gateway to Recovery Enhanced Detoxification Center on August 17 over safety concerns, center officials announced that they expect to reopen the facility in October. FNA222s leadership met with state officials to discuss improvements to the facility222s procedures and FNA222s SAMHSA222s Weekly Financing News Pulse Sept ember 8, 2009 9/08/09 6 CEO reports that a new round of staff training is set to culminate by September 15 in advance of the October opening. The detox center also provides some mental health services ( Daily News Miner, 8/29 ). Arizona State Medicaid Director Expects Medicaid Enrollment and Cos ts to Balloon: Arizona222s Medicaid program, the Arizona Health Care Cost Containment System (AHCCCS), covers about 20 percent of Arizona222s residents and AHCCCS Director Tony Rodgers predicts that, instead of the usual 60,000 enrollees per year, the program will have an additional 300,000 members by the end of the year. The state222s ballooning Medicaid enrollment and associated costs have contributed to a standoff between Governor Jan Brewer (R) and the Arizona Legislature over a $3 billion budget gap ( NPR, 9/1 ; Kaiser Health News, 9/1 ). California Legislature Passes Measure to Increase SCHIP Funding, Insure 700,000 Children : On September 3, the California Legislature passed a measure to increase funding for California222s State Children222s Health Insurance Program (SCHIP), Healthy Families, by $196 million. The move, which comes after the state budget cut the program by over $100 million (Financing News Pulse 7/27 edition), will include a 2.35 percent tax on health insurers that will draw down $97 million in federal matching funds. State legislators note that the insurers will ac tually get a tax reduction because the current tax rate, set to expire in October, is 5.5 percent. In addition to the tax, the bill enacts several other measures to direct funding to Healthy Families. The $196 million is expected to keep 700,000 children enrolled in the program and Governor Arnold Schwarzenegger (R) has said he will sign the bill ( Los Angeles Times, 9/3 ; Los Angeles Times, 9/3 ). State to Regulate Wait Times for Medical Care : Under new state regulations that will take effect this fall, California will set ma ximum wait times for patients in managed care plans. The regulations will require appointments for non -urgent primary care visit s within 10 business days, non -urgent appointment s with specialist s within 15 business days, and most urgent - care appointments within two days. The regulations also stipulate that all after - hour emergency calls to a doctor must be returned within 10 minutes . California is the first state to impose such guidelines ( NPR, 8/31 ; Kaiser Health News, 9/1 ). Report Finds Large California Insurers Reject 22 Percent of Claims: On September 3, the California Nurses Association released a report that found that the major California health insurers rejected 22 percent of claims between 2002 and June 30, 2009. Using data submitted to the state, the report shows that PacifiCare denied 39.6 percent of c laims, Cign a Corp. denied 33 percent, Health Net denied 30 percent, Anthem Blue Cross and Kaiser each denied 28 percent, and Aetn a Inc. denied 6.5 percent. The report prompted California Attorney General Jerry Brown to announce plans to join state regulat ors in bringing increased scrutiny to the state222s HMO claims decisions ( Los Angeles Times, 9/4 ; Kaiser Health News, 9/4 ). SAMHSA222s Weekly Financing News Pulse Sept ember 8, 2009 9/08/09 7 Survey Finds Small Business Owners Favor Health Care Reform : In a survey conducted by the Small Business Majority , a research and advocacy group for small businesses, 61 percent of 700 Califor nia small business owners believe health care reform is needed to right the economy. In addition, 53 percent believe that employers should pay some percentage of their payroll to cover employee health care if they do not offer a plan. The poll also found that 55 percent of businesses polled do not provide health insurance and that 86 percent of those cited cost as the reason ( San Francisco Chronicle, 9/2 ; Kaiser Health News, 9/2 ). Sacramento County Behavioral Health Funding Affected by State Budget Cuts : As a result of cuts included in the budget signed by Governor Arnold Schwarzenegger (R) July 28 (Financing News Pulse 8/3 edition), Sacramento County expects to lose $10 million in state funding for behavioral health services. To compensate for the loss in funding, county departments plan to shut do wn a crisis stabilization unit and eliminate 50 of the 100 beds at the Sacramento County Mental Health Treatment Center ( Sacramento Press, 9/2 ). Transitional Youth Facility to Open in Santa Monica: On September 11, Step up on Second, an adult mental health recovery center, will open a transitional youth facility in Santa Monica. The new facility, known as Daniel222s Village, will have seven beds ( Los Angeles Times, 9/2 ). Colorado State to Receive Federal IT/Infrastructure Funding for Medicaid : The Colorado Department of Health Care Policy and Financing will receive $42 million from the Health Resources and Service Administration222s (HRSA) State Health Access Program to invest in health care technology and infrastructure over five years ( Denver Post, 9/3 ; Denver Business Journal, 9/2 ). Governor222s Health Clinic Cuts Affect Mental Health: Governor Bill Ritter 222s (D) FY2010 budget cut $32.9 million from health clinics this year. The cuts will close several mental health clinics to save the state $1.3 million in FY2010 and $4.2 million in FY2011 but forfeit $976,000 in federal Medicaid matching funds. The mental health cuts w ill eliminate a 16 - bed children222s unit, an 18 -bed adolescent unit, and a 25-bed geriatric from the Mental Health Institute at Fort Logan during this fiscal year, and an additional 20-bed facility in FY2011 ( Denver Post, 9/2 ; Kaiser Health News, 9/2 ; Denver Post, 9/3 ; Kaiser Health News, 9/3 ). Connecticut Update: State Budget to Become Law Without Governor222s Signature : After a seven-month battle that included an executive veto (Financing News Pulse 7/6 edition), the Connecticut Legislature passed a budget on September 1 that Governor M. Jodi Rell (R) will allow to become law without her signature. However, Governor Rell line -item vetoed $8.3 million in spending that had been strongly opposed by Republican legislators. The two -year $37.6 billion budget relies largely on tax increases to close the state222s $8.5 billion deficit ( Bloomberg, 9/1 ; Hartford Courant, 9/2 ). SAMHSA222s Weekly Financing News Pulse Sept ember 8, 2009 9/08/09 8 Florida UF Study Finds Medicaid Pilot Shows Savings: A study , conducted by the University of Florida (UF) and released in June, examined cost savings under Florida222s Medicaid pilot program. Under the pilot, which began in 2006 under Former Governor Jeb Bush (R), Medicaid enrollees in Duval and Broward Counties were transferred from traditional FFS Medicaid to private managed care plans. The pilot program has previously drawn extensive criticism from advocates and the Florida Legislature (Financing News Pulse 6/22, 6/8, 5/11, 3/6, 2/27 editions). The study analyzed the two years before and after the program222s 2006 launch, comparing Broward and Duval Counties to Hillsborough and Orange Counties, and found that the pilot reduced patient bills compared to traditional Medicaid. However, critics of the study highlight that it does address the cause of the savings, noting that both poor care and quality management can yield cost savings. A future UF study is slated to explore the cause of the spending reductions ( Jacksonville News, 9/1 ; Kaiser Health News, 9/1 ). Georgia Department of Human Services to Close 12 Days Because of Budget Cuts : As a result of Governor Sonny Perdue222s (R) order for state agencies to reduce their budgets by 5 percent (Financing News Pulse 7/27 edition), the Georgia Department of Human Services (DHS) has scheduled 12 furlough days between September and June to cut costs by $23 million. DHS will retain core emergency staff throughout the furlough ( Atlanta Journal Constitution, 8/28 ). Hawaii District Court Judge Halts State222s Migrant Health Changes : On September 1, U.S. District Judge J. Michael Seabright halted the implementation of Hawaii222s new prog ram for pacific island migrants, Basic Health Hawaii. Judge Seabright halted the program because it may violate due process rights and the Compact of Free Association, a deal under which the U.S. government agreed to provide financial assistance to m igran ts from the Federated States of Micronesia , the Republic of the Marshall Islands , and the Republic of Palau in exchange for defense rights. The program, which was slated to take effect September 1, would have saved Hawaii $15 million by eliminating covera ge for chemotherapy and prescription drugs ( AP via Boston Globe, 9/1 ; Kaiser Health News, 9/2 ). Illinois Governor Closes Home for the Disabled : On August 28, Governor Pat Quinn (D) announced that he will close Howe Developmental Center, a facility for the disabled. CMS and the Illinois Department of Public Health decertified Howe in 2007 for abuse and neglect, leaving the facility unable to bill for its Medicaid patients and without $26 million in annual federal funding. Since its decertification, Illinois has spent nearly $150 million funding Howe. Under the governor222s plan, the 251 residents at Howe will be relocated by the spring of 2010 ( Chicago Sun Times, 8/29 ). Hospital Closes Mental Health Unit : The Illinois Health Facilities Planning Board, a division of the Illinois Department of Public Health, has given Kishwaukee Community Hospital permission to close its 6 -bed acute mental health center. The closure will take pla ce within 30 days. Kishwaukee requested permission to close the unit because it is underutilized and difficult to staff ( Daily Chronicle, 9/1 ). SAMHSA222s Weekly Financing News Pulse Sept ember 8, 2009 9/08/09 9 Indiana Medicaid Managed Care Company Offers Rewards for Preventative Health Care : Managed Health Services, a subsidiary of Centene Corp. and one of three Medicaid managed care providers in Indiana, instituted a program on August 31 to allow its Medicaid and SCHIP enrollees to earn health care rewards for preventative care. Plan participants earn money on a debit card that they can use to purchase health-related items. Participants earn $10 -$20 for every scheduled checkup or screening they attend ( AP, 8/31 ). Iowa State Considers Closing 4 Mental Health Facilities: A state task force will visit four mental health facilities in Iowa, all constructed between 1861 and 1902, to determine whether they ought to be closed. The task force222s decision will be subject to the approval of the Iowa Legislature . The facilities are located in Cherokee, Clarinda, Independence, and Mount Pleasant ( Sioux City Journal, 9/2 ). Kansas State Receives Prison Substance Abuse Grant : As part of $3 million in public safety grants that Governor Mark Parkinson (D) announced September 3, Kansas will receive funding from the DOJ222s Federal Residential Substance Abuse Treatment for State Prisoners Grant Program (RSAT). The RSAT grant will provide $85,402 to the Topeka Correctional Facility for substance abuse treatment ( WIBW, 9/3 ). Kentucky State Cuts 4 Percent from Agency Budgets, Spares Medicaid and Mental Health : To compensate for a shortfall in Kentucky222s budget, most state agencies will be forced to cut their budge ts 4 percent to save a total of $80 million. The state will not cut the budget for education, Medicaid, mental health, the state police, and Kentucky Educational Television ( Lexington Herald-Leader, 8/28 ). Louisiana Survey Finds Doctors Will Reduce Medicaid Care Under Cuts: A survey conducted by a Louisiana medical society found that 67 percent of respondents plan to stop accepting Medicaid patients altogether or stop accepting new M edicaid patients as a result of provider reimbursement reductions that began July 1 ( AP via WXVT, 9/1 ; Financing News Pulse 8/10, 7/6 editions). Maryland Howard County Officials Discuss Effects of State Cuts : On August 26, the Maryland Board of Public Works approved Governor Martin O222Malley222s (D) plan to cut $454 million in state spending, including $20.1 million for local government222s health department funding (Financing New s Pulse 8/31 edition) . Howard County Executive Ken Ulman and County Health Officer Peter Beilenson announced that the county will lose $8.3 million in state funding which will force layoffs and service reductions in county health services, likely affecting smoking cessation, STD prevention, and health screenings ( Baltimore Sun, 8/30 ). SAMHSA222s Weekly Financing News Pulse Sept ember 8, 2009 9/08/09 10 Massachusetts Update: Governor Restores Legal Immigrant Health Funding but Exclude s Some Care: On June 29 Governor Deval Patrick (D) signed a budget eliminating state-sponsored health care for 31,000 legal immigrants; however, on July 29, the Massachusetts Legislature voted to add $40 million in funding to restore some of those cuts (Financing News Pulse 8/3, 7/20 editions). The new coverage, which takes effect October 1 in the Boston area and by December 1 elsewhere, will not cover dental, vision, hospice, or skilled nursing services and may increase copayments for some tre atments and medications ( AP via Boston Herald, 8/31 ; Boston Globe, 9/1 ; Kaiser Health News, 9/1 ). Insurers Settle Charges With State, Will be Ba nned for 5 Year Minimum : On August 31, Massachusetts Attorney General Martha Coakley announced a settlement with HealthMarkets Inc. and its subsidiaries to resolve allegations that the companies used deceptive marketing to sell limited plans to small group s, failed to provide state -mandated benefits, and denied coverage based on preexisting conditions. Under the terms of the deal, the insurers will pay $17 million and may not sell their products in Massachusetts for at least five years. The companies are permitted to renew existing plans through 2012 ( AP via Houston Chronicle, 8/31 ). Boston Globe Analysis Finds State Receiving Second Most ARRA NIH Grants: An analysis by the Boston Globe found that biomedical researchers in Massachusetts are receiving the second largest total of ARRA National Institutes of Health (NIH) grants behind California. Massachusetts researchers have received 660 grants totaling $178 million and Californ ia researchers have received 927 grants totaling $244 million ( Boston Globe, 9/4 ; Kaiser Health News, 9/4 ). Michigan Update: House Speaker Releases Draft Legislation for Public Employee Health Reform : After proposing legislation to cover all of Michigan222s public employees, including both sta te and local employees as well as retirees and union members, under a single 400,000 -person health plan (Financing News Pulse 7/20 edition), Michigan House Speaker Andy Dillon (D) released draft legislation , providing additional details about his proposed plan. The draft legislation would establish a 13 -member Michigan Health Benefits Board within the Michigan Department of Management and Budget . The board, which would be comprised of representatives of the broad range of stakeholders, would develop the single public employee plan and create a report analyzing relative costs. Under the new plan, all public employees would be required to enroll unless their current coverage had lower costs ( Michigan Messenger, 8/31 ). Nebraska State222s SCHIP Expansion Takes Effect: Legislation ( LB 603) signed by Governor Dave Heinem an (R) on May 22 (Financing News Pulse 6/1 edition) to expand health care for children took effect on September 1. The income eligibility cap for Nebraska222s SCHIP program, Kids Connection, increased from 185 percent of the federal poverty level (FPL) to 2 00 percent of the FPL. In addition, the new law adds Medicaid reimbursement for community-based behavioral health services, expands services for families by allocating funds to Nebraska222s six behavioral health regions, creates a 24 -hour helpline, and esta blishes the Behavioral Health Education Center at the University of Nebraska Medical Center to SAMHSA222s Weekly Financing News Pulse Sept ember 8, 2009 9/08/09 11 increase the state222s supply of mental health professionals. Finally, the law also creates a legislative committee to oversee the implementation of the new initiatives ( Lincoln Journal Star, 8/29 ; Kaiser Health News, 8/31 ). North Carolina Update: Appeal Halts the Creation of Psychiatric Emergency Center : In July, the North Carolina Division of Health Services Regulation approved the construction of a $13.8 million psychiatric emergency center at Old Vineyard Behavioral Health Services in Winston-Salem on the condition that the center agree to receive certain clients that would otherwise go to state psychiatric hospitals (Financing News Pulse 7/13). Construction was set to begin this spring and the facility was slated t o open in 2011; however, Holy Hill Hospital has halted the process by filing an appeal. Holy Hill Hospital, which is owned by Psychiatric Solutions Inc. , competes with Old Vineyard, which is owned by Universal H ealth Services Inc. , and is likely seeking a modification to the Old Vineyard deal to obtain a share of the state business or force Old Vineyard to accept Medicaid patients at the new facility ( Winston -Sa lem Journal, 8/31 ). Substance Abuse Center Closes For Lack of Funding : The Bridge at Brookstown, an adult substance abuse treatment facility in Winston-Salem, was forced to close because of funding shortfalls. When it opened in December 2008, organizer s planned to spend $7 million on the facility but were unable to raise sufficient capital ( Winston -Salem Journal, 9/1 ). Hospital Makes Budget Cuts, Lays Off Staff: Faced with a projected loss of $35 million in government reimbursements, WakeMed Health & Hospitals will eliminate 85 positions as part of a larger cost -cutting move ( Triangle Business Journal, 8/28 ). Ohio Update: Promised Department of Mental Health Funding Elusive : Ohio222s budget, signed by Governor Ted Strickland (D) on July 17, was slated to reduce the governor222s proposed $179 million cut the Ohio Depart ment of Mental Health (DMH) by $65 million; however, in late July, DMH and counties reported that the funding was unavailable (Financing News Pulse 8/3 edition). The Ohio Legislature has allocated $14.7 million for DMH community services but advocates say the rest of the funding is missing or unusable because it is allocated only for Medicaid patients. Overall, DMH222s budget was cut 17 percent under the most recent state budget and DMH has cut funding for communities by 34 percent ( Ironton Tribune, 8/28 ). In a related story, state funding reductions have forced the Tri - County Board of Recovery and Mental Health Services to cut $1.64 million from its $11.9 million budget. The cuts will affect service agencies in Miami, Drake, and Shelby counties ( Dayton Daily News, 8/28 ). U nitedHealth Group Expands Medicaid Presence: As part of a plan to move more Medicaid enrollees into managed care plans, the Ohio Department of Job and Family Services has contracted with Unison Health Plan of Ohio, owned by UnitedHealth Group, to enroll Me dicaid beneficiaries in 18 new counties. The move will bring the plan to 46 of Ohio222s 88 counties ( Business First of Columbus, 9/3 ). SAMHSA222s Weekly Financing News Pulse Sept ember 8, 2009 9/08/09 12 State Budget Provision Allows School Districts in Cuyahoga County to Create Regional Districts for Special Education: A provision included in the Ohio budget signed July 17 (Financing News Pulse 7/27 edition) allows school districts in Cuyahoga County to create joint regional student education districts. The districts would fund behavioral health care and special education for students with property tax levies capped at three mills. However, many groups have opposed the provision, including numerous children222s rights groups, because of the potential interaction it may have on current levies in Cuyahoga County ( Cleveland Plain-Dealer, 8/31 ). Texas Hogg Foundation Grants $7.7 Million t o Children222s Groups : The Hogg Foundation for Mental Health has awarded $7.8 million to eight Houston -area children services organizations to fund children222s mental health services for three years. Eligible services under the grant include mental health pr omotion, prevention, early identification and intervention, and treatment services in schools and community settings ( Houston Business Journal, 9/2 ). Williamson County La unches Mental Health Website: Funded by a grant from the Texas Health Institute , the Williamson County Mental Health Task Force and the Williamson County Department of Information Technology launched a webs ite on August 27 to assist county residents seeking mental health treatment resources ( Williamson County Conservative Exa miner, 8/30 ). El Paso Mental Health Provider to Close Over Funding Crisis: Unable to obtain sufficient funding from the University Medical Center, the El Paso Mental Health and Mental Retardation Center (MHMR) (Financing News Pulse 6/29, 4/13 editions) closed its doors September 1 and placed 1,500 mental health clients on a waiting list. While closed, MHRM patients will be unable to access MHMR services, including prescription drugs. MHMR officials obtained $250,000 of the $2 million they needed from U niversity Medical Center to keep the center open; however, hospital officials plan to work closely with MHMR to resolve the crisis, including extending the hospital222s prescription plan to MHMR to save $500,000 to $1.6 million annually ( ABC, 8/31 ). Washington State to Issue Medicaid ID Cards : On August 27, the Washington Department of Social and Health Services (DSHS) announced that, beginning in November, the department will mail p lastic ID cards to Medicaid enrollees to replace the paper coupons the department currently issues monthly. The plastic cards, which will be replaced only if lost or stolen, are expected to cut costs for DSHS, which spends $2.5 million annually on monthly coupons. In addition, the cards will work with a new computer payer system, ProviderOne, which is scheduled for deployment on December 6 ( DSHS, 8/27 ). Wyoming Governor Warns of Rising Medicaid Costs: On September 2, Governor Dave Freudenthal (D) warned that increased demand for Wyoming222s Medicaid program could increase program costs by as much as $100 million over the current fiscal year. State officials said that 3,500 residents have enrolled in the Medicaid program in the past two years, raising enrollment to over 74,000 in June ( AP via Forbes, 9/3 ). SAMHSA222s Weekly Financing News Pulse Sept ember 8, 2009 9/08/09 13 Benton Franklin Health District to Cut Staff : To cope with a $500,000 funding shortfall for 2009, the Benton Franklin Health District will eliminate 12 positions on October 1. Officials say they cannot fully anticipate the effects of the cuts; however, they will eliminate the district222s childcare program ( Seattle Post Intelligencer, 8/29 ).
