SAMHSA222s Weekly Financing News Pulse: State and Local Edition August 4, 2010 8/4/2010 1 SAMHSA222s Weekly Financing News Pulse: State and Local Edition Arizona California Florida Illinois Iowa K ansas Louisiana Maryland Massachusetts Minnesota Mississippi Missouri Ohio Pennsylvania Texas Washington To Subscribe to SAMHSA222s Weekly Financing News Pulse, please go to the following link and choose 223Health Care Fi nancing224: https://service.govdelivery.com/service/multi_subscribe.html?code=USSAMHSA&origin=http://www.samhsa.go v/enetwork/success.aspx For quest ions or comments, please contac t Rasheda Parks ( Rasheda.Parks@samhsa.hhs.gov ). SAMHSA222s Weekly Financing News Pulse: State and Local Edition August 4, 2010 8/4/2010 2 Around the States: State and Local Behavioral Health Financing News Arizona La Paz County to Begin Substance Abuse Court : La Paz County officials plan to begin a substance abuse court by October 1. Initially, t he court will serve convicted individuals struggling with their probation because of substance abuse problems ; however, county officials hope to expand the program to other populations . The program will require mandatory treatment, monthly court appearances, and increased random drug and alcohol testing. Individuals convicted of selling, manufacturing, or transporting drugs are ineligible for the program ( Parker Pioneer, 7/31 ). California MHSOAC Awards $6.6 Million in Proposition 63 P revention and E arly I ntervention Programming Funds to Alameda, Mariposa, and San Mateo Counties : On July 29, the California Mental Health Services Oversight and Accounta bility Commission (MHSOAC) allocated $6,552,109 in Proposition 63 funds for prevention and early intervention (PEI) programming in Alameda, Mariposa, and San Mateo Counties. Proposition 63 generates funds for county mental health programming through a tax on state residents earning over $1 million annually. Under the July 29 allocation, Alameda County will receive $5,951,039, Mariposa County will receive $110,100, and San Mateo County will receive $490,970 ( The Pine Tree, 7/30 ) . Ventura County Mental Health Court Expands with Proposition 63 Funding : On July 27, Ventura County officials announced plans to double the capacity of the county mental health court . Unde r the expansion, the court could serve up to 40 offenders. County officials used Proposition 63 funds to hire an additional full- time clinical specialist to staff the expanded program . The voluntary court serves individuals with mental illnesses that ple ad guilty and agree to treatment and probation ( Behavioral Health Central, 7/28 ). Florida Circuit Co urt Judge Rejects Health Care Freedom Amendment : On July 29, Circuit Court Judge James Shelfer ordered the Health Care Freedom Amendment removed from the November ballot because it is 223manifestly misleading.224 Under state law, summaries of ballot measures must be both clear and accurate. If approved, the amendment would modify the state constitution to prohibit the state from participating in any health insurance exchange that requires individuals to purchase insurance. Lawmakers supportive of the amendment say they will likely appeal the decision ( Miami Herald, 7/30 ; Fort Myers News - Press, 7/30 ; Kaiser Health News, 7/30 ). Illinois Update: Governor Signs Legislation Reforming Nursing Home Care for Patients with Mental Ill ness : On July 29, Governor Pat Quinn (D) signed legislation ( SB 326 ) to ensure that nursing homes are adequately prepared to care for patients with mental illness and transition many residents into smaller, community residential programs. Targeting a subset of nursing home facilities that offer care to Medicaid patients with mental illness , t he bill will increase the intensity of criminal background checks and psychological SAMHSA222s Weekly Financing News Pulse: State and Local Edition August 4, 2010 8/4/2010 3 screenings for incoming residents and place potentially dangerous residents into secure wards. In addition , the bill will require all nursing homes t o increase staffing levels and enforce stricter safety and treatment standards at facilities caring for individuals with serious mental illness (SMI) . T he bill also requires the state to hire approximately 70 additional nursing home inspectors by July , wh ich state officials estimate will cost $5 million. Though the final funding for the plan has not yet been approved, l awmakers plan to generate the funds by increasing nursing home provider fees and draw ing down additional federal Medicaid funding ( Chicago Tribune, 7/29 ; Kaiser Health News, 7/30 ). Iowa IFP Finds More Children Enrolled in Public Health Insurance : On July 27, the Iowa Fiscal Partnership (IFP) released a report finding an increasing number of children enro lled in Medicaid and the state222s Children222s Health Insurance Program (CHIP), HAWK - I. The report found that , from April 2007 to April 2010, the percentage of Iowan children covered by Medicaid and CHIP rose from 29 percent to 37 percent. The authors suggest that the increase is the result of reduced eligibility requirements for the programs , the economic recession , and the rising cost of private health coverage ( Q uad - City Times, 7/27 ; Kaiser Health News, 7/29 ). Kansas Update: DOA Estimates Nursing Home Bed Fee Will Generate Less Than Anticipated: Kansas Department on Aging (DOA) officials revised their revenue projections for the state222s nursing home residential bed fee ( HB 2320 ), estimating that it will generate less funding than originally predicted . L egislators formulated the fee based on nursing homes222 expenditures , linking the nursing homes222 needs with the newly generated revenue. In their revised estimates, DOA officials found that lower than anticipated expenditures have decreased the expected revenue . State officials initially projected that the fee would raise $3 0 million from nursing homes and draw down an additional $56 million in federal Medicaid funds . However, officials now estimate that the fee will raise $23.1 million , draw ing down an additional $43.3 million in federal funds. The Kansas City office of th e Centers for Medicare & Medicaid Services (CMS) must approve the fee , which will be retroactive to July 1 ( Kansas Health Institute, 7/29 ; Kaiser Health News, 7/30 ). Louisiana Update: Medicaid Reimbursement Rate Cuts Take Effect : Medicaid reimbursement reductions approved in the FY2011 budget took effect on August 1 . Designed to save $168 million, t he cuts affect private hospitals, home and community - based care providers, physicians, and specialty service providers. Louisiana222s FY2011 budget cuts total Medicaid spending by $277 million ( AP via Business Week, 7/29 ; Kaiser Health News, 7/30 ). DHH Terminates 13 Medicaid Provider Agreements O ver Fraud: On July 30, Louisiana Department of Health and Hospitals (DHH) officials terminated 13 Medicaid agreements with health care providers and medical supply companies facing federal indictment s over Medicare fraud. DHH is launching an investigation of the organizations 222 Medicaid billing practices to determine if they have also defrauded Medicaid . Under state law, DHH can immediately terminate provider agreements without written SAMHSA222s Weekly Financing News Pulse: State and Local Edition August 4, 2010 8/4/2010 4 notice if the provider is the subject of sanctions or of a criminal, civil, or departmental proceeding. DHH will notify all affected Medicaid enrollees and outline new Medicaid provider options ( The Advocate, 7/31 ). Maryland HRC Awards $1.3 Million in Grants to Improve Access to Care, Behavioral Health Affected : On July 29, the Maryland Health Resources Commission (HRC) awarded 14 health care organizations a total of $1.3 million in FY2011 grants to improve access to health care and reduce infant mo rtality. The grants include a total of $500,000 for five behavioral health treatment centers. The HRC is a division of the Maryland Department of Health and Mental Hygiene (DHMH) ( Baltimore Business Journal, 7/29 ) . Massachusetts Legislature Approves Bill Strengthening DOI Insurer Oversight : On July 31, the Massachusetts Legislature approved legislation ( S 2585 ) strengthening the Massachusetts Division of Insurance222 s (DOI) insurer oversight . The measure gives the DOI authority to reject any proposed rate increase that fails to meet medical loss ratio (MLR) requirements or increases administrative expenses more than medical inflation . Additionally, the bill prohibit s certain contracts between insurers and hospitals that create provider monopolies and allows certain small businesses to purchase insurance jointly . Finally, the bill allows limited open enrollment periods to prevent individuals from obtaining coverage exclusively for periods of high cost illness . The bill now goes before Governor Deval Patrick (D) ( The Boston Globe, 8/3 ; AP via Business Week, 8/3 ). Legislature Approves Bill Mandating Autism Coverage for Children : On July 29, the Massachusetts Senate approved legislation ( HB 4935 ) that would require insurers to cover a broad range of services for children with autism. A state analysis conducted in March estimated that the mandated coverage would increase insurance premiums by $14.64 to $29.40 annually. However, based on similar legislation enacted in Minneso ta, a dvocates for the bill contend that the measure will increase premiums by only $10 annually. The bill now goes before Governor Deval Patrick (D) ( The Salem News, 7/30 ; The Boston Globe, 7/28 ; Kaiser Health News, 7/28 ). Update: DOI Reaches Agreement with Tufts on Rate Increases : On August 2, the Massachusetts Department of Insurance (DOI) and Tufts Health Plan reached an agreement on Tuft222s rate increases for the individual and small business markets. Tufts originally proposed rate increases ranging from 11.1 percent to 22.7 percent ; however, Massachusetts Insurance Commissioner Joseph Murphy rejected those proposals on April 1 . Under the new agreement, Tufts may increase rates up to 12.8 percent beginning in September. Blue Cross Blue Shield of Massachusetts (BCBS), Fallon Community Health Plan, and Health New England are still appealing the DOIs rate rejections ( The Boston Globe, 8/2 ; Boston Business Journal, 8/2 ; Kaiser Health N ews, 8/3 ). Minnesota Ramsey County Commissioners Approve Construction of Behavioral Health Facility: On July 27, the Ramsey County Commissioner approved the contraction of a $9.5 million facility to house mental health SAMHSA222s Weekly Financing News Pulse: State and Local Edition August 4, 2010 8/4/2010 5 and substance abuse services. Construction is set to begin this September and end in July 2011 ( Minneapolis Star Tribune, 7/28 ). Mississippi DMH Asks Four State Mental Health Facilities to Prepare Contingency Closure Plans : The Mississippi Department of Mental Health (DMH) has requested that officials at four state mental health facilities pr epare contingency closure plans . Without a $44 million increase in funding for next fiscal year, DMH officials plan to close all four facilities . DMH selected the four facilities because they receive most of their funding from the state. North Mississippi State Hospital, South Mississippi State Hospital, Mississippi Ad olescent Center, and Central Mississippi Residential Center are the four facilities under consideration for closure ( CNBC, 7/30 ). Missouri CMS Selects Missouri for 223 Gateway to Better Health 224 Demonstration Project : CMS has selected Missouri to operate a Gateway to Better Health Demonstration Project. Under the project, Missouri may redirect $25 million in annual Medicaid funds to improve care at community health centers in St. Louis and devel op a plan to transition patients currently enrolled in Missouri222s health care safety net programs to coverage available through national health care reform. The non - profit St. Louis Regional Health Commission (RHC ) will coordinate, monitor, and report on the project ( St. Louis Post - Dispatch, 7/29 ; Kaiser Health News, 7/30 ). Ohio Clermont County Commissioners Place Measure to Renew MH/SUD Levy on November Ballot : On July 28, the Clermont County Commissioners voted to place a measure to renew the county222s 0.5 mill MH/SUD levy on the November ballot. If approved, the measure would extend th e levy through 2016 but would not increase it ( The Cincinnati Enquirer, 7/29 ). Pennsylvania PBPC and PHAN Suggest BCBS Plans Extend Funding for A dultBasic : On July 28, the Pennsylvania Budget and Policy Center (PBPC) and the Pennsylvania Health Access Network (PHAN) released a report suggesting that the state222s Blue Cross and Blue Shield (BCBS) plans renew their agreement with the state to provide funding for adultBasic. AdultBasic is the state222s health care program for adults earning up to 200 percent of the federal poverty level ( FPL ) . In 2005, the BCBS plans agreed to fund the program to meet charitable obligations needed to maintain their tax - exempt status ; however, t hat agreement expires on December 31 . The report suggest s that , if the agreement is not renewed and the state fails to secure alternat e funding, adultBasic cannot continue to provide coverage to its 46,000 enrollees . The report suggests that the BCBS plans continue contributions to adultBasic through 2014, when national health care reform will expand Medica id eligibility and create insurance exchanges ( Pennsylvania Budget and Policy Center, 7/28 ; Pittsburgh Business Times, 7/29 ; Kaiser Health News, 7/30 ). SAMHSA222s Weekly Financing News Pulse: State and Local Edition August 4, 2010 8/4/2010 6 Texas Medicaid to Cover Substance Abuse Treatment Beginning September 1 : Beginning September 1, the Texas Medicaid program will cover substance abuse treatment. The change comes after the Texas Legislature opted to expand Medicaid services rather than provide the $33 million state officials requested for county agencies offering substance abuse treatment. In related news, state officials announced that they are reducing funding for substance abuse treatment centers by $7 million through contract reductions ( Fort Wor th Star - Telegram, 7/30 ; Kaiser Health News, 7/30 ). Washington State Begins Enrolling Residents in High - Risk Pool : On August 2, state officials began enroll ment for the state222s temporary high - risk health insurance pool. Until 2014, Washington will operate the pool with $102 million in federal funds. Individuals select ing the $500 deductible plan will pay monthly premiums ranging from $324 to $1,577, while t hose choos ing the $2,500 deductible plan will pay monthly premiums ranging from $161 to $769 ( Auburn Reporter, 8/2 ; AP via The Seattle Times, 8/2 ; Kaiser Health News, 8/3 ).