WeeklyFinancingNewsPulseStateandLocalEditionfinal20091223.pdf (PDF | 265.74 kb)
SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 23, 2009 12/23/09 1 SAMHSA222s Weekly Financing News Pulse: State and Local Edition Arizona California Georgia Maine Nebraska New Hampshire New Jersey New York Ohio Pennsylvania Rhode Island Texas Vermont Virginia Washington West Virginia Wisconsin SAMHSA222s Weekly Financing News Pulse will be on hiatus over holidays. The next issue of the State and Local Edition will be published on January 13, 2010. To Subscribe to SAMHSA222s Weekly Financing News Pulse, please go to the following link and choose 223Health Care Financing224: https://service.govdelivery.com/service/multi_subscr ibe.html?code=USSAMHSA&origin=http://www.samhsa.go v/enetwork/success.aspx For questions or comments, please contact Kevin Hennessy ( kevin.hennessy@samhsa.hhs.gov ). SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 23, 2009 12/23/09 2 Around the States: State and Local Behavioral Health Financing News Arizona Governor Brewer Orders Agency Cuts, Institutes CHIP Waiting List, May Require Premiums for Mental Health Treatment : On December 21, Governor Jan Brewer (R) ordered state agency directors to make a number of cost saving policy changes. Governor Brewer ordered the Arizona Health Care Cost Containment System (AHCCCS) to institute a waiting list for the state222s Children222s Health Insurance Program (CHIP), KidsCare. The governor also instructed AHCCCS authorities to consider a $25 to $50 monthly premium for the seriously mentally ill, who currently pay no AHCCCS premiums. The orders come in addition to a $194 million package of cuts approved by the Arizona Legislature that Governor Brewer is expected to sign this weekend ( Arizona Republic, 12/22 ; Arizona Republic, 12/20 ). California Update: CMS Delays CHIP Funding Decision Until 2011 : In a letter to California officials, Center for Medicare & Medicaid Services222 (CMS) Center for Medicaid and State Operations (CMSO) Director Cindy Mann said that the agency will delay a final decision regarding the state222s CHIP funding mechanisms until mid 2011. Earlier this year, the California Legislature and Governor Arnold Schwarzenegger (R) passed a measure to continue funding for the state222s CHIP, Healthy Families, in part through a 2.35 percent tax on health insurers designed to raise $100 million. CMS preliminarily found that the tax violates federal regulations; however, the delay will allow Healthy Families to continue operation through 2011 ( Los Angeles Times, 12/18 ; Kaiser Health News, 12/18 ). Supporters Say Initiative to Legalize Marijuana Will Appear on 2010 Ballot : Advocates for marijuana legalization say they have gathered well over the required 433,971 signatures to sponsor an upcoming ballot initiative to legalize marijuana possession in California. The initiative, the 223 Tax, Regulate and Control Cannabis Act of 2010224 would allow adults over 21 years of age to possess up to one ounce of marijuana and cultivate 25 square feet of marijuana for personal use. The California Secretary of State must certify the measure prior to inclusion on the 2010 ballot ( Bloomberg, 12/15 ; Join Together, 12/18 ). Medicaid Cuts Force Marin County to Cutback Mental Health Treatment : After the state cut Marin County222s Medicaid mental health funding by $650,000 (50 percent), the Marin County Division of Mental Health announced it will no longer provide individual therapy to Medicaid enrollees in Marin. In addition, Marin will limit adult Medicaid enrollees to 16 group therapy sessions annually and cap children222s family group sessions at 25 annually ( AP via San Jose Mercury News, 12/20 ). Fresno County Seeks Funding to Maintain Housing Aid for Mentally Ill : The Fresno County Department of Behavioral Health (DBH) is searching for funding to maintain housing aid for 50 mentally ill residents. The county currently provides subsidized housing and living assistance for the residents through a private contract set to expire December 31 after county officials refused to agree to a contract increase from $319,680 to $500,000 annually. A spokesperson for the county DBH says that the residents will not be evicted on the 31st and notes that the BDH plans to pursue a solution at a meeting with the Fresno County Board of Supervisors on January 26 ( Fresno Bee, 12/21 ). SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 23, 2009 12/23/09 3 Georgia DBHDD to Cut Budget by $15 Million, Numerous Services Affected : The newly formed Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) announced it will cut roughly $15 million from its $1 billion annual budget for the fiscal year ending in June. DBHDD officials have not detailed all of the program cuts but plan to continue a 5 percent cut to community service boards, eliminate an outdoor juvenile therapy program, eliminate a hospital based crisis stabilization program, and impose furloughs on numerous department employees. A spokesperson for the DBHDD said the cuts will not interfere with the department222s compliance with a January 15 deadline for psychiatric hospital improvements imposed as part of a settlement with the U.S. Department of Justice (DOJ) ( Atlanta Journal Constitution, 12/18 ). Maine Governor Proposes Budget Cuts to Close Deficit, Medicaid Affected : On December 18, Governor John Baldacci (D) proposed a plan to close the state222s projected $438 million budget deficit through FY2011. Among other changes, the governor222s plan would reduce funding for the Maine Department of Health and Human Services (DHHS) by $68 million, including reductions in provider reimbursement rates for certain Medicaid services. The Maine Legislature will consider the proposal when it reconvenes in January ( AP, 12/19 ; Gov Monitor, 12/18 ). Nebraska Sen. Nelson Negotiates Additional Medicaid in Health Care Reform Legislation : In exchange for his vote on the Senate Democrats222 health care reform bill ( HR 3590 ), Senator Ben Nelson (D NE) negotiated tighter restrictions on federal funding for abortion coverage and additional federal funding for Illinois222 Medicaid program. Under the deal, federal funding will permanently cover the costs of Nebraska222s health care reform associated Medicaid expansion though the bill will not provide similar permanent funding for other states. Sen. Nelson said that he did not explicitly request the additional funding and Governor Dave Heineman (R) issued a statement saying that that he was uninvolved in the senator222s negotiations ( CQ Today, 12/20 ; Omaha World Herald, 12/20 ). New Hampshire Report Documents Need to Revise New Hampshire222s Behavioral Health System : A report by the University of New Hampshire Institute on Disability and New Hampshire Department of Health and Human Services (DHHS) Bureau of Behavioral Health enumerated numerous challenges facing the state222s behavioral health system and recommended a set of policy solutions.Among other challenges, the report highlights a lack of behavioral health expertise among primary care physicians, a lack of statewide parity in spite of state and federal parity laws, poor coordination between health care professionals, and poor outreach to the uninsured. The report recommends establishing better outreach programs for the mentally ill, enhancing care coordination through electronic health records (EHRs), requiring additional training in integrated care models, and creating more sustainable payment plans ( Foster222s Daily Democrat, 12/21 ; Sea Coast Online, 12/16 ). SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 23, 2009 12/23/09 4 New Jersey Report Documents Hospital Pricing Data for Uninsured, Finds NJ Prices Above Average: A report by the New Jersey Health Care Quality Institute provides average pricing data for uninsured patients, documenting prices for 20 common conditions at all of New Jersey222s acute care hospitals. Because the state controls costs based on income level, the report lists the average charges for those earning above 500 percent of the federal poverty level (FPL), between 500 and 300 percent of the FPL, and less than 300 percent of the FPL. In addition, the report finds that New Jersey hospitals222 charges for the highest income group are 4.1 times the cost of care, well over the national average of 2.8 times the cost of care ( New Jersey Real Time News, 12/13 ; Kaiser Health News, 12/14 ). New York Audits Find Medicaid Lost $92 Million Due to Improper Payments : State audits revealed that New York222s Medicaid program paid roughly $92 million in improper payments, including $53 million for Medicaid enrollees with multiple Medicaid identification numbers. The remaining $39 million includes state payments for discharged patients and payments for unauthorized services ( Bloomberg, 12/22 ). Attorney General Settles $23 Million Medicaid Home Health Care Suit : New York Attorney General Andrew Cuomo announced that the state222s Medicaid Fraud Control Unit has reached a deal with three home health care agencies to settle charges that they defrauded the state222s Medicaid program by billing for unqualified home health aides. Under the deal, B&H Health Care Services Inc., Excellent Home Health Care Services LLC, and Extended Nursing Personnel CHHA LLC, will pay a combined $23.9 million, including $14.3 million to repay New York for the state222s share of the Medicaid costs ( Consumer Affairs, 12/20 ). Ohio Update: Governor and Legislature Reach Budget Deal, Fix Mental Health Funding Error : On December 22, Governor Ted Strickland (D) signed a bill ( HB 318) to close the state222s $851 million current year budget deficit. Though the major provisions of the bill affect state taxes and education, the bill also corrects a legislative drafting error in the original budget bill ( HB 1 ), allocating $14.7 million to the Department of Mental Health222s community services that the legislature intended to include in its original budget ( Business First Cincinnati, 12/22 ; Business First Columbus, 12/18 ; Cleveland Leader, 12/17 ). Ohio House Approves Bill Mandating Autism Coverage : On December 8, the Ohio House approved a bill ( HB 8 ) that would require state health insurers to cover certain treatments for autism spectrum disorders (ASDs). The bill now heads to the Ohio Senate ( Suburbanite, 12/21 ; AP, 12/8 ). Pennsylvania Commission Recommends Changing Mandatory Minimum Sentencing Laws for Cocaine Possession : The Pennsylvania Commission on Sentencing released a report , commissioned by the Pennsylvania Legislature in 2007, recommending three alterations to the state222s mandatory cocaine sentencing laws. The commission recommended increasing the amount of cocaine needed to trigger mandatory penalties SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 23, 2009 12/23/09 5 from 2 grams to 5 grams, allowing courts to use alternative sentencing options to satisfy mandatory minimums for lowerlevel traffickers, and repealing legislation that imposes mandatory two year prison terms for selling drugs within 1,000 feet of a school zone. The commission noted that the broadly defined school zones effectively encompass entire urban communities ( Join Together, 12/15 ; Delaware County Daily Times, 12/7 ). Rhode Island Governor Proposes Cuts to Charity Care Hospitals : As part of a package designed to close a $220 million budget shortfall, Governor Don Carcieri (R) proposed eliminating $3.7 million in funding for four hospitals that have seen increasing numbers of charity care patients. Democrats, who hold a veto proof majority in the Rhode Island General Assembly , say they want the cuts overturned. If implemented, the cuts would affect South County, Miriam, Westerly, and Kent Hospitals ( AP via Nashua Telegraph, 12/20 ). Texas Hogg Foundation Awards Four Mental Health Grants : The Hogg Foundation for Mental Health has awarded $256,348 through four mental health grants. The grants went to Mental Health America of Texas , the Texas Network of Youth Services, Advocates of Abilene Inc., and the University of Texas Health Science Center at Houston to develop boarding home regulations, support public services for Texas youth, produce educational materials on employment opportunities for the disabled, and study the relationship between public need for mental health services and Medicaid funding ( University of Texas, 12/21 ). Denton County Opens Veterans Behavioral Health Court : This month, the Denton County Commissioners approved a veteran222s behavioral health court to provide alternative sentencing for veterans with mental health and substance abuse conditions. The Denton County court is part of a statewide veterans222 behavioral health court program approved earlierthis year by the Texas Legislature ( Dallas Morning News, 12/22 ). Vermont Review Recommends Community Mental Health System Reduce Salaries, Rely on Cash Reserves : A 223Tiger Team224 assembled by Governor Jim Douglas222 (R) Administration reviewed the state222s $250 million community mental health system to identify cost saving strategies. The team released a report recommending that community health organizations reduce salaries and rely on their collective $35 million in cash reserves in the event that state officials reduce mental health funding. Mental health advocates said the review did not fairly present their reasons for higher salaries or cash reserves ( Rutland Herald, 12/19 ). Virginia Governor Kaine222s Proposed Budget Cuts Medicaid, Mental Health Funding: On December 18, Governor Tim Kaine (D) proposed a budget designed to close a projected $4.2 billion shortfall using $2.3 billion in cuts and a major overhaul of the state222s tax system featuring a higher income tax. The governor222s proposed budget would cut $419 million from Medicaid, reduce mental health funding for local SAMHSA222s Weekly Financing News Pulse: State and Local Edition December 23, 2009 12/23/09 6 community services boards by $12.2 million, and close units at the Southwestern Virginia Mental Health Institute in Marion. Governor Elect Bob McDonnell (R) assumes office January 16 and, though he has not provided specifics, he is expected to cut additional spending rather than moving forward with Governor Kaine222s proposed tax changes ( Roanoke Times, 12/19 ; AP, 12/19 ; Daily Press, 12/19 ; Daily Press, 12/18 ). Washington State Legislator Introduces Bill to Legalize Marijuana : Backed by Seattle Mayor Elect Mike McGinn (D), State Rep. Mary Lou Dickerson (D) has pre filed a bill ( HB 2401 ) to legalize marijuana in Washington for residents 21 and older. The bill, which is opposed by Washington Attorney General Rob McKenna , would allow liquor stores to sell the drug and impose a special drug sales tax to fund substance abuse and alcohol prevention ( KOMO, 12/18 ; Seattle Post Intelligencer, 12/18 ). West Virginia PEIA Finance Board Increases State Employee Health Costs : On December 16, the Public Employees Insurance Agency (PEIA) Finance Board approved plan changes to increase out of pocket costs for state employees and retirees. Effective July 1, premiums for both active and retired workers will increase 4 percent. In addition, the changes will increase some deductibles and out of pocket maximums for select populations. The increased payments are not expected to cover the plans222 claims costs and PEIA Director Ted Cheatham says the agency will rely on roughly $30 million from its trust fund next fiscal year, likely requiring another vote on out of pocket increases ( Metro News, 12/16 ). Wisconsin Facing Rising Costs, State to Cut $600 Million by 2011, Still Facing Shortfall: A report by the Wisconsin Taxpayers Alliance found that Medicaid costs have increased 140 percent since 1998 while Medicaid enrollment tripled over the same period ( Milwaukee JournalSentinel, 12/18 ). The report comes as the Wisconsin Department of Health Services (DHS) prepares to cut $600 million from the state Medicaid program by June 2011 as ordered by Governor Jim Doyle (D) and the Wisconsin Legislature earlier this year. In addition, DHS reports that the state222s Medicaid program may face a $150 million shortfall in spite of the cuts, largely due to the recession ( AP, 12/18 ; Kaiser Health News, 12/18 ; Milwaukee Journal Sentinel, 12/17 ).
