WeeklyFinancingNewsPulseStateandLocalEditionfinal20100203.pdf (PDF | 317.78 kb)
SAMHSA222s Weekly Financing News Pulse: State and Local Edition February 3, 2010 2/3/10 1 SAMHSA222s Weekly Financing News Pulse: State and Local Edition Alaska Arizona California Colorado Florida Georgia Idaho Iowa Kansas Kentucky Louisiana Massachusetts Missouri Nevada New Hampshire North Carolina Ohio Oklahoma Rhode Island Tennessee Utah Virginia West Virginia Wisconsin 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 February 3, 2010 2/3/10 2 Around the States: State and Local Behavioral Health Financing New Alaska Senate Majority Leader Proposes Bill Directing All Alcohol Tax Revenue to Substance Abuse Services : Alaska Senate Majority Leader Johnny Ellis (D) proposed a bill to direct 100 percent of the state222s alcohol tax revenue to substance abuse treatment and prevention. The state currently allocates half of its alcohol tax revenue to treatment and prevention services. Alaska222s annual alcohol tax revenue is roughly $40 million ( AP via CNBC, 1/27 ). Arizona Coconino County Suspends DARE Over Funding Issues: Citing a lack of funding, the Coconino County Sherriff222s Office has suspended the Drug Abuse Resistance Education (DARE) program. DARE has operated in Coconino county for more than 20 years ( AP via KGUN, 1/29 ). California Update: Senate Approves Single Payer Health Care Bill : On a 22 14 vote January 24, the California Senate approved a bill ( SB 810) to create a single payer health care system in the state. The system is estimated to cost $210 billion in its first year, roughly twice the state222s entire budget but equal to federal, state, and personal spending on health care in California. If approved, the bill would cost only $1 million in the coming fiscal year, creating a commission to determine how to implement the single payer system. In addition, the commission222s recommendations would require direct voter approval prior to implementation. The bill now heads to the California Assembly but Governor Arnold Schwarzenegger (R) has promised to veto the bill if it passes both houses ( AP, 1/28 ; San Francisco Chronicle, 1/29 ; Kaiser Health News, 1/29 ). UC Davis Receives Mental Health Training Funding: As part of a $267,000 training grant from the Office of Statewide Planning and Development222s Song Brown Program, the University of California Davis will receive $99,000 to train mental health professionals. The grant seeks to increase the number of trained health care professionals in the state ( Sacramento Business Journal, 2/1 ). DCR Expands Substance Abuse Treatment for Traumatized Women at Three Prisons: The California Department of Corrections and Rehabilitation (DCR) opened substance abuse treatment programs for traumatized women at the Central California Women222s Facility, the Valley State Prison for Women, and California Institute of Women. Each program will serve 175 female offenders over 90 days. DCR previously implemented similar programs as long term treatment in other prisons but has modified the programs222 previous six to 36month model for the current three prison deployment due to budget reductions ( California DCR via Corrections.com, 1/27 ). L.A. Council Votes to Close Most Medical Marijuana Dispensaries : The Los Angeles Council voted 9 3 in favor of an ordinance setting 70 as the maximum number of medical marijuana dispensaries, closing most of the city222s roughly 1,000 dispensaries.The ordinance still requires approval from Mayor Antonio Villaraigosa (D). It also bans marijuana use at medical dispensaries, limits the dispensaries222 hours, and SAMHSA222s Weekly Financing News Pulse: State and Local Edition February 3, 2010 2/3/10 3 necessitates the approval of a separate measure increasing dispensary fees ( New York Times, 1/26 ; Join Together, 1/27 ). Colorado Boulder County Suspends Some Substance Abuse Treatment : The Boulder County Department of Public Health is suspending substance abuse treatment services under its Transitional Residential Treatment program until at least May 15. During the suspension, staff will evaluate program costs and investigate new funding sources to address rising costs and increased enrollment. County Addiction Recovery Centers will continue admitting patients for assessments and 3 to 5 day stabilizations throughout the suspension ( Boulder Daily Camera, 1/30 ). Florida Governor Proposes FY2011 Budget Increasing Medicaid Funding, Relying on Federal Funds : On January 29, Governor Charlie Crist (R) proposed a $69.2 billion FY2011 budget, a 4.1 percent increase over current year funding levels. The governor222s budget assumes that the federal government will continue American Recovery and Reinvestment Act (ARRA) Federal Medical Assistance Percentage (FMAP) increases, netting the state over $1 billion. In addition, Governor Crist222s budget assumes that state revenue will increase despite warnings from lawmakers that the state may face a $3 billion deficit for the coming year. Including federal and state funds, the governor222s budget increases Medicaid funding by $2.7 billion ( Lakeland Ledger, 1/29 ; Orlando Sentinel, 1/29 ; Florida Times Union, 1/30 ). AHCA Medicaid Medical Home Taskforce Issues Recommendations: A Florida Agency for Health Care Administration (AHCA) taskforce created by the Florida Legislature issued recommendations to the legislature and Governor Charlie Crist (R) on implementing the medical home model in the state222s Medicaid program. Among other recommendations, the AHCA taskforce recommends using the National Committee for Quality Assurance222s (NCQA) standards for medical homes, ensuring that medical home providers are equipped to handle behavioral health care, and utilizing reimbursements for participation on medical home pilots ( AHCA via WCTV, 2/2 ). Georgia Update: DOJ Says State Psychiatric Hospitals Still Subpar, Seeks New Monitor and Binding Targets : The U.S. Department of Justice222s (DOJ) Civil Rights Division filed a motion January 28 requesting the appointment of an independent monitor to set binding targets and timetables for Georgia222s Department of Behavioral Health and Developmental Disabilities (DBHDD) to reduce the number of residents in its psychiatric hospitals. The state222s psychiatric hospitals have been the target of DOJ investigations for three years and the request comes despite a mutual agreement reached last year but not yet approved by the court. The DOJ contends that the conditions in the state222s hospitals remain unsafe and is seeking an expansion of the state222s community based outpatient mental health care capabilities ( AP via Chattanooga Times Free Press, 1/29 ; Behavioral Health Central, 1/30 ). SAMHSA222s Weekly Financing News Pulse: State and Local Edition February 3, 2010 2/3/10 4 Idaho New Law Creates External Review Board for Health Insurance Claims : Effective January 1, the Idaho Health Carrier External Review Act allows Idaho residents to appeal health insurance claim denials to an outside board run by the Idaho Department of Insurance . Many state insurers already have review processes that culminate in independent review ( Idaho Statesman, 1/28 ; Kaiser Health News, 1/28 ). Iowa Governor Proposes Budget Maintaining Most Current Year Cuts, Increasing Medicaid Funding: Governor Chet Culver (D) proposed a $5.3 billion state budget for the coming fiscal year, maintaining most of the 10 percent cuts he imposed on all agencies October 8. However, the governor222s budget would increase Medicaid funding by $180 million and increase funding for children222s health care, including the state222s Children222s Health Insurance Program (CHIP), by $17 million ( Des Moines Register, 1/28 ; KHQA, 1/29 ). Update: Democratic Legislators Propose Health Care Expansion, Rely on Federal Funding: On January 26, Democratic legislators officially unveiled a plan to expand IowaCare, the state222s program for residents earning up to 200 percent of the federal poverty level (FPL) that do not qualify for Medicaid. The legislators proposeallowing IowaCare enrollees to receive care at facilities around the state. In addition, the legislators222 expansion would provide limited tiered health insurance subsidies for those earning up to 400 percent of the FPL. Providing the expanded subsidies is estimated to cost $200 to $300 million annually. Both the IowaCare expansion and the subsidies are contingent on the receipt of federal funding through national health care reform ( AP via Chicago Tribune, 1/26 ; Kaiser Health News, 1/27 ). Update: Polk County Receives State Funds to Reduce Mental Health Services Wait List : Roughly $3.5 million in ARRA from the state222s 223risk pool224 for mental health patients enabled Polk County to remove 160 patients from a record long wait list for long term mental health care. Four hundred and ninety patients remain on the county222s waitlist. Polk County was slated to receive $7.3 million in ARRA funding from the state but budget cuts reduced the county222s share ( Des Moines Register, 1/27 ). Kansas Update: Senate Affirms Governor222s Medicaid Cuts : On January 27, the Kansas Senate affirmed Governor Mark Parkinson222s (D) $22 million Medicaid funding reduction. The governor222s package, introduced November 23, reduces provider reimbursements by 10 percent, and now heads to the Kansas House for approval. However, the governor222s cuts took effect January 1 ( Topeka CapitalJournal, 1/27 ; Kaiser Health News, 1/28 ; Kansas City Star, 1/27 ). Committee Introduced Bill to Require Parity for Private Pay Hospital Patients : The Kansas Senate Public Health and Welfare Committee introduced legislation that would require hospitals to charge 223private pay224 patients227uninsured patients paying for their health care out of pocket227earning up to 300 percent of the FPL the same prices they charge insurance companies for insured patients. Insurance SAMHSA222s Weekly Financing News Pulse: State and Local Edition February 3, 2010 2/3/10 5 companies negotiate rates with hospitals that are frequently much lower than 223private pay224 rates ( Kansas Health Institute, 1/28 ; Kaiser Health News, 1/29 ). Kentucky Company Donates $500,000 for Substance Abuse Treatment : Kentucky River Properties LLC donated $500,000 to Operation UNITE. A spokesperson for Operation UNITE says the agency will use the donation to fund substance abuse treatment vouchers in Perry, Knott, Leslie, and Lecher Counties and support drug courts throughout the state ( AP via WAVE, 1/27 ). Louisiana State Receives $475 Million in Federal Funds to Repair Charity Hospital : A federal arbitration panel ruled that the federal government must pay $474.8 million to repair damage done to New Orleans222 Charity Hospital by Hurricane Katrina in 2005. Louisiana officials had requested $491.1 million and the Federal Emergency Management Agency (FEMA) had offered $150 million, leading the two parties to arbitration. The state plans to use the federal funds to finance a $1.2 billion replacement facility ( New York Times, 1/27 ; Kaiser Health News, 1/28 ). DHH Announces Tentative Deal to Repay Federal Medicaid Funds : The Louisiana Department of Health and Hospitals (DHH) announced a tentative deal with the federal government to repay misspent Medicaid funding stemming from two separate violations. Under the deal, the state would repay $266 million at a reduced interest rate to settle its use of Medicaid funds to pay for hazardous road claims against the state and improper payments made to state nursing homes ( AP via WXVT, 1/25 ; Daily World, 1/29 ). Massachusetts Governor Releases FY2011 Budget Proposal, Medicaid Affected : On January 27, Governor Deval Patrick (D) released his $28.2 billion FY2011 budget proposal. The governor222s budget increases spending by 3 percent over the current year budget based on a projected 3.2 percent revenue increase. The governor222s budget also assumes that the federal government will extend the ARRA FMAP increase, yielding $600 million for the state222s Medicaid program. However, Governor Patrick222s budget still cuts the state222s Medicaid program, MassHealth, by $265 million, forcing modest service delivery changes and slight copayment increases. In addition, the governor222s budget proposes allocating $75 million to provide health insurance for lowincome legal immigrants. The state previously eliminated coverage for the immigrants under Commonwealth Care but restored one third of the funding to offer limited policies to some eligible immigrants. Governor Patrick222s funding would expand coverage to more of the previously covered legal immigrants. The governor222s budget relies on significant tax increases on alcohol, sugared beverages, and tobacco to fund numerous health care programs ( Boston Globe, 1/27 ; BusinessWeek, 1/27 ; Boston Globe, 1/28 ; MassLive, 1/31 ). Attorney General Finds Health Insurance Reimbursement Disparity: Massachusetts Attorney General Martha Coakley (D) released a preliminary report, finding that the state222s insurance companies pay some doctors and hospitals twice as much as others for largely equivalent care. The investigation found SAMHSA222s Weekly Financing News Pulse: State and Local Edition February 3, 2010 2/3/10 6 that, rather than receiving higher reimbursements for quality or difficulty of care, providers reimbursements are closely tied to market leverage. Coakley did not provide the names of the insurers or providers identified through the investigation, saying she wanted to focus on the system wide problems leading to inflated health care costs ( Boston Globe, 1/29 ; Kaiser Health News, 1/29 ). Missouri Update: GOP Senators Propose Bills Mandating Drug Tests for Welfare Beneficiaries : After similar legislation passed the Missouri House but failed in the state Senate last year, five Republican state senators have introduced separate but similar bills requiring drug tests for Temporary Assistance for Needy Families (TANF) recipients.Details of the bills vary but all of the proposed legislation would prevent TANF recipients from receiving funds if they test positive for drugs. TANF is a federal program but the Missouri Department of Social Services administers the program within the state ( Springfield NewsLeader, 1/27 ). Nevada Update: DHHS Releases Analysis on Eliminating Medicaid, Governor Says Nevada will Continue the Program : The Nevada Department of Health and Human Services (DHHS) released a report , requested by Governor Jim Gibbons (R), estimating the effects of eliminating the state222s Medicaid program. DHHS found that dropping out of Medicaid would eliminate coverage for 250,000 residents as well as supplemental coverage for over 40,000 Medicare beneficiaries. The DHHS report also found that a state funded health safety net would cover only 15,700 people. On January 27, Governor Gibbons said that the state would remain in the Medicaid program. The governor noted that Democratic national health care reform ( HR 3590 , HR 3962 ) was the impetus for his desire to drop out but it is now unlikely to become law ( Las Vegas Sun, 1/28 ; Las Vegas ReviewJournal, 1/28 ). New Hampshire Update: Supreme Court Rules State Cannot Use JUA Funds : Upholding a lower court222s decision, the New Hampshire Supreme Court ruled that the state cannot appropriate $110 million in medical malpractice funds from the Joint Underwriting Association (JUA) as Governor John Lynch (D) proposed. The governor planned to use $65 million in JUA funds this year and $45 million in the 2010 2011 budget but says that the loss of the JUA funds will not significantly alter state spending ( Manchester Union Leader, 1/28 ). North Carolina DHHS EstimatesNational Health Reform Would Increase State Spending 3 to 8 Percent : A report by the North Carolina Department of Health and Human Services (DHHS) estimates that Medicaid expansions in the national health care reform bills passed by the House ( HR 3962 ) and Senate ( HR 3590 ) would increase state spending 3 to 8 percent. DHHS estimates that the House222s Medicaid expansion would cost the state $1.8 billion between 2013 and 2019 while the Senate222s would cost $740 million over the same period ( Lincoln Tribune, 1/30 ). SAMHSA222s Weekly Financing News Pulse: State and Local Edition February 3, 2010 2/3/10 7 Ohio Prescription Drug Coverage Changes Under Medicaid Managed Care : Beginning February 1, residents enrolled in one of Ohio222s seven Medicaid Managed Care plans will see changes to their prescription drug coverage designed to save the state $243 million. Some clients will see increased copayments, some will be forced to switch from band name to generic pharmaceuticals, and all clients with pre authorized prescriptions must get them re authorized by May 1 ( Cleveland Plain Dealer, 2/1 ). Wayne and Holmes County Residents to Vote on Mental Health Levy : The Mental Health & Recovery Board of Wayne and Holmes Counties unanimously approved a May ballot measure seeking approval for a 10year 1.5 mil levy on property owners. The levy would generate $4.2 million for mental health treatment and cost the owner of a self inhabited $100,000 home $46 annually. County voters rejected the levy on the November 2009 ballot ( Daily Record, 1/27 ). Oklahoma Governor, Legislators Reach Current Year Budget Deal, Medicaid Affected : Oklahoma legislative leaders and Governor Brad Henry (D) have reached a deal to continue previously enacted 10 percent funding reductions for most state agencies through the end of FY2010. However, under the deal, the Oklahoma Health Care Authority (OHCA) and several other state agencies will receive supplemental appropriations. In spite of the supplemental appropriations, the OHCA will still face some funding reductions ( Oklahoman, 1/27 ). Rhode Island Medicaid Enrollment and Costs on the Rise : According to Governor Don Carcieri222s (R) Administration , enrollment in the state222s Medicaid program grew by more than 1000 residents per month in the second half of 2009. The Rhode Island Department of Human Services (DHS) reports that enrollment in RIte Care, the program for parents, pregnant women, and children, increased 6.7 percent in 2009. In addition, enrollment in RIte Share, the program for residents with employer sponsored insurance but incomes within the state222s Medicaid limits, increased 8.3 percent. Carcieri Administration officials say that the increased enrollment will cost an additional $17 million, which they intend to address through midyear budget adjustments ( Providence Journal, 2/1 ; Kaiser Health News, 2/1 ). Tennessee Governor Proposes Budget with Medicaid Cuts : Governor Phil Bredesen (D) proposed a $28.4 billion state budget on February 1, reducing current spending levels by 5.1 percent. Among other cuts, the governor222s budget would reduce funding for TennCare, the state222s Medicaid program, by $200 million. However, Governor Bredesen222s budget does not include the estimated $279 million in federal Medicaid funds that the state would receive under President Obama222s proposed FY2011 budget ( Knoxville News Sentinel, 2/1 ). Utah Update: House Approves Bills to Combat Prescription Drug Abuse : On January 26, the Utah House approved two bills ( HB 28 and HB 35) to improve the state222s ability to track 223doctor shopping224 by SAMHSA222s Weekly Financing News Pulse: State and Local Edition February 3, 2010 2/3/10 8 improving the Utah Division of Occupational and Professional Licensing222s prescription drug monitoring database. The bills would make the database more real time and more user friendly. HB 28 is expected to cost $3,100 over three years and both bills now head to the Senate for consideration ( Desert News, 1/26 ). House Committee Approves Bill to Keep Prisoners on Private Health Insurance : On January 27, the Utah House Law Enforcement and Criminal Justice Committee approved a bill ( HB 22) preventing state health insurers from terminating health coverage for incarcerated beneficiaries. Proponents of the bill say it will shift inmate medical costs from the Utah Department of Corrections (DOC) to the private sector ( Desert News, 1/27 ; Kaiser Health News, 1/28 ). Virginia Virginia Senate Approves Bills to Block Individual Health Care Mandate: Five Democrats joined all 18 Senate Republicans to pass three bills on February 1 that would make it illegal to require an individual to purchase health insurance.The measures are designed to combat the individual mandate included in the Democrats222 national health care reform bills ( HR 3590 , HR 3962 ). Experts expect the GOP controlled House of Delegates to approve the bills. Governor Bob McDonnell (R) said that, though he will review each bill, he supports their intent ( Washington Post, 2/2 ; Kaiser Health News, 2/2 ). Governor Announces New Mental Health Initiative for Uninsured : On February 1, Governor Bob McDonnell (R) announced a $2 million 223A New Lease on Life224 initiative, which will provide mental health treatment for uninsured patients through the Virginia Health Care Foundation. The program is funded by a $1 million grant from the Office of the Virginia Attorney General and $1 million in matching funds ( AP via Daily Press, 2/1 ). West Virginia Senate Taskforce Proposes Bills to Combat Prescription Drug Abuse : Members of a Senate taskforce on substance abuse in West Virginia have proposed 11 bills aimed a curbing the abuse of prescription drugs. Among other bills, SB 362 would expand existing law prohibiting prescription fraud; SB 361 would categorize 50 new drugs as Schedule IV; SB 364 would expand the list of officials permitted to view the state222s prescription drug monitoring database to include the chief medical examiner; and SB 365 would require pharmacies to grant all personnel access to the prescription drug database. The taskforce has not proposed any treatment related bills but more bills may be forthcoming ( Behavioral Health Central, 1/31 ; AP via Business Week, 1/27 ; Charleston Daily Mail, 1/28 ). Wisconsin Update: Senate Passes Behavioral Health Parity Bill : To augment the federal Wellstone Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), the Wisconsin Senate passed SB 362 . MHPAEA does not mandate M/SU coverage but requires that all employer sponsored group health plans with 51 or more employees that offer M/SU coverage do so on an equal basis with general health care. Wisconsin222s law would require the same parity between M/SU and general health care coverage from small employer and individual plans ( Wisconsin Radio Network, 1/29 ; Cap Times, 1/28 ).
