WeeklyFinancingNewsPulseStateandLocalEditionfinal200911004.pdf (PDF | 280.68 kb)
SAMHSA222s Weekly Financing News Pulse: State and Local Edition November 4, 2009 11/4/09 1 SAMHSA222s Weekly Financing News Pulse: State and Local Edition Arizona California Colorado Florida Georgia Hawaii Illinois Iowa Kansas Kentucky Louisiana Maine Massachusett s Michigan Missouri Nebraska Nevada New Mexico New York Ohio Oregon Rhode Island Utah Virginia Washington Washington D.C. West Virginia To Subscribe to SAMHSA222s Weekly Financing News Pulse, please go to the following link and choose 223Health Care Financing224: https://service.govdelivery.com/service/mu lti_subscribe.html?code=USSAMHSA&origin=http://www.samhsa.go v/enetwork/success.aspx For quest ions or comments, please contact Kevin Hennessy ( kevin.hennessy@samhsa.hhs.gov ). SAMHSA222s Weekly Financing News Pulse: State and Local Edition November 4, 2009 11/4/09 2 Around the States: State and Local Behavioral Health Financing News Arizona Report Summarizes Expert Panel Findings on State Behavioral Health System : A report released November 2 by the Arizona State University (ASU) Center for Applied Behavioral Health Policy and the Morrison Institute for Public Policy summarizes the views of a panel of behavioral health experts convened in July to discuss the state222s behavioral health system. The report finds that 35 percent of the state222s adults with serious mental illness do not qualify for the Arizona Health Care Cost Containment System (AHCCCS), the state222s Medicaid program. The report also finds that the state does not provide funding for crucial housing or food assistance to behavioral health patients even under AHCCCS because such services are not deemed 223medically necessary224 ( ASU, 11/2 ; ASU News, 11/2 ). California Court Preliminarily Rules Against State and Insurers in Autism Treatment Case : A Los Angeles County Superior Court judge preliminarily ruled that Kaiser Permanente violated the spirit of California222s Mental Health Parity Act when the company refused to pay for autism treatment because the service provider did not hold a state license. The ruling clears the way for a trial to determine whether the California Department of Managed Health Care (DMHC) , th e state222s insurance regulatory agency, is properly regulating state health plans. A consumer watchdog group sued the DMHC for blocking access to costly autism treatments ( Los Angeles Times, 10/27 ). Sonoma County Cuts Health Care Funding, Taps Reserves to Fund Drug Treatment : The Sonoma County Board of Supervisors approved roughly $4 million in cuts to health services, eliminating $1.8 million from the public health dep artment, $706,000 from the mental health department, $666,000 from prevention and planning and $114,000 from administrative services. In addition, the Alcohol and Drug Services Department has lost $1.3 million this year, about 12 percent of the department222s 2009 budget, largely do to the elimination of state Substance Abuse and Crime Prevention Act funds. However, the supervisors allocated $251,076 in supplementary funding for substance abuse treatment for the under - severed ( North Bay Business Journal, 11/2 ). Colorado Governor Announces Cuts, Medicaid Affected : On October 28, Governor Bill Ritter (D) outlined $286 million in cuts to the state222s current- year budget ending in June. Among larger funding changes, Governor Ritter will reduce Medicaid provider reimbursement rates by 1 percent, saving $3.1 million. Including this new cut, Medicaid reimbursements rates have been cut 4.5 percent this year ( AP, 10/29 ; Durango Herald, 10/30 ). The governor will announce his proposed budget for the coming biennium later this week ( AP via KJCT, 11/2 ). Florida Survey Finds 5 Percent of UCF Students Abuse Prescription Stimulants : A self - report survey conducted by the Alcohol and Other Drug Prevention Programming Center at the University of Central Florida (UCF) found that 5 percent of students used prescription stimulants as study aids despite not having a prescription for them ( Central Florida Future, 11/1 ). SAMHSA222s Weekly Financing News Pulse: State and Local Edition November 4, 2009 11/4/09 3 Georgia Update: State Defends Psychiatric Hospital Improvement Plan: On September 30, U.S. District Court Judge Charles A. Pannell rejected the state222s January agreement with the U.S Department of Justice (DOJ) to improve conditions at the state222s psychiatric hospitals over five years. The judge said that he could not approve the agreement because DOJ officials no longer supported t he motion after finding that 223harmful and unsafe224 conditions continued at the state222s hospitals and that there has been 223little substantive, sustained improvement224 over the past nine months. On October 28, state representatives filed arguments asserting that the state has until January 15, 2010 to show significant progress towards the goals outlined in the original DOJ settlement and that a status conference before that date would be premature ( Atlanta Journal Constitution, 10/28 ). Hospital to Reduce Hours, Close Behavioral Health Clinic : The non - profit Medical Center of Central Georgia is reducing hours and pharmacy offerings and eliminating three clinics at the W.T. Anderson Healt h Center, which provides care for low - income patients. These changes are, in part, due to a $3 million reduction in funding from Bibb County for FY2010. The center has already closed two of the three clinics and plans to close its behavioral health clinic on November 25, referring patients to River Edge Behavioral Health Center. In addition, the center, which previously offered prescription medications for as little as $5 for a 60 - day supply, will phase out its prescription program for all drugs, except those which pharmaceutical companies agree to supply for free ( Macon Telegraph, 10/28 ; Kaiser Health News , 10/28 ). Hawaii State222s ERISA Waiver Would be Unaffected by National Health Care Reform : Provisions in both the Senate Finance Committee and the House Leadership222s health care reform legislation ( HR 3962) would allow Hawaii to maintain its employer health insurance mandate in the event that a new national employer mandates is weaker than the state222s requirements. Hawaii has an Employee Retirement Income Security Act (ERISA) waiver, currently allowing the state to require all employers to provide health insurance for employees working more than 20 hours a week and limiting employees222 premium contributions to 1.5 percent of their annual wages ( Hon olulu Star Bulletin, 10/31 ). Illinois Tribune Investigation Finds Nursing Homes Misusing Psychotropic Drugs : A Chicago Tribune investigation of Illinois nursing homes found over 1,200 instances of homes administering psychotropic medications without cau se, affecting at least 2,900 patients. The investigation culls its data from reports from state and federal inspections of over 40,000 Illinois nursing homes. Tribune investigators note that the reports are infrequent and sample only a small number of pat ients, therefore these practices are likely more widespread ( Chicago Tribune, 10/27 ; Kaiser Health News, 10/28 ). Iowa State Releases 2010 Drug Strategy : On November 2, the Iowa Office of Drug Control Policy (IODCP) released 223 Iowa222s Drug Control Strategy 2010 ,224 outlining the state222s plan for coordinated treatment, prevention, and enforcement actions to combat substance abuse and its consequences. The strat egy SAMHSA222s Weekly Financing News Pulse: State and Local Edition November 4, 2009 11/4/09 4 notes that the state222s primary drugs of abuse are alcohol, marijuana, and methamphetamine; however, prescription drug abuse is also on the rise. The report222s recommendations include regulating Salvia divinorum , requiring all prescribers to utilize the state222s prescription drug monitoring program (PDMP), instituting full substance abuse and mental health parity, requiring substance abuse prevention education in schools, continuing to prohibit medical marijuana, and enhancing community - based programs com bating underage drinking. The IODCP, the Drug Policy Advisory Council , and the state Departments of Corrections; Education; Human Rights , Criminal and Juvenile Justice Planning ; Human Services ; Public Health; and Public Safety collaborated to create the s trategy ( Iowa Independent, 11/2 ; Iowa Politics, 11/2 ; IODCP, 11/2 ). Kansas GOP Legislators Pro pose Bill to Alter Constitution, Block Potential Health Care Mandates : Three GOP legislators have proposed a bill in the Kansas Legislature to amend the state222s constitution to say that no law can require individuals or employers to purchase health insurance. Because the measure would amend the state222s constitution, it requires a two - thirds majority in both legislative houses and approval by popular vote in next year222s election ( Kansas City Star, 10/27 ; Kaiser Health News, 11/2 ). Kentucky C ounty Approves Funding for Substance Abuse Prevention Program : The Carroll County Fiscal Court approved a $10,000 grant to Champions for a Drug - Free Carroll County for two new prevention programs, including one focused on preventing prescription drug abuse ( Madison Courier, 10/31 ). Louisiana DHH Secretary Rejects Medicaid Provider Cuts to Close Shortfall, Relies on One - Time Funds and Non- Medicaid Cuts Affecting Mental Health: Louisiana Department of Health and Hospitals (DHH) Secretary Alan Levine said that DHH will tap several one - time revenue sources and cut non - Medicaid funding to close Medicaid222s $308 million shortfall, rather than cutting Medicaid provider reimbursements by $232 million. DHH will use $4.9 million in American Recovery and Reinvestment Act (ARRA) funding that will draw down an additional $39.6 million in federal matching funds. In addition, DHH will shift funding from the state222s mental health and public health programs into the Medicaid program and derive savings from changes to the state222s pharmacy program, including increased reliance on generic drugs. Levine notes that increased Medicaid enrollment and increased service utilization have both contributed to the state222s Medicaid budget shortfall ( Times - Picayune, 10/29 ; Times - Picayune, 11/2 ; AP via The Advocate, 10/26 ; Times - Picayune, 10/26 ; Kaiser Health News, 10/27 ). DHH Secretary Announces Increased Medicaid Fraud Investigations : DHH Secretary Alan Levine announced that DHH plans to contract with up to six private firms to increase the number of audits performed on the companies providing in - home services for elderly and disabled Medicaid patients. The state will fund the investigations with $3 million recovered from previous Medicaid fraud investigations. This increased investigative effort was sparked by a sample audit conducted earlier this year that found a 23 percent error rate for in - home service provider billings ( Times - Picayune, 10/29 ). SAMHSA222s Weekly Financing News Pulse: State and Local Edition November 4, 2009 11/4/09 5 Maine AG Says People Must be 21 to Purchase Low - Alcohol British Lemonade : The Office of the Maine Attorney General determined that individuals must be 21 to purchase low - alcohol British lemonade with an alcohol content of 0.05 percent. The determination comes after a high - school student brought the beverage to school, prompting school officials to inquire about its legal status with the police ( AP, 10/29 ). Massachusetts Report Analyzes Effects of National Health Care Reform on Massachusetts : A report , conducted by the Center for Health Law and Economics at the University of Massachusetts Medical School, funded by the Blue Cross Blue Shield of Massachusetts Foundation, and released October 28, examined the effects of proposed national health care reform on Mas sachusetts222 health care system. Among other findings, the report notes that, under some versions of health care reform, the state could be pressured to reduce the health insurance subsidies that it provides under its 2006 health care reform initiative. T he negative effects are most pronounced under the version of health care reform passed by the Senate Finance Committee. The Finance Committee222s legislation would also end the Massachusetts Health Insurance Connector Authority222s ability to aggressively bargain with insurers ( Boston Globe, 11/1 ). Michigan Update: Governor Finalizes State Budget with Vetoes, Medicaid and Mental Health Affected: On October 30, Governor Jennifer Granholm (D) signed the last of several budget bills, including over 70 line - item - vetoes, which finalizes the state222s $44.5 billion FY2010 budget. The budget includes an 8 percent cut to Medicaid reimbursements for h ospitals, doctors, and nursing homes as well as a $40 million reduction in mental health services. ( AP, 10/30 ; Detroit Free Press, 10/30 ). Earlier in the week, the Michigan Senate rejected a 3 percent physician tax ( HB 5386 ), supported by Governor Granholm, that would have drawn down additional federal matching funds for Medicaid ( Crain222s Detroit Business, 10/28 ). Ottawa County Board Approves Budget, Cuts Health Department : The Ottawa County Board approved a $64.3 million general fund budget for 2010 on October 27, cutting $3 million from original departmental proposals. Among the cuts, the board cut $556,000 from the county222s health department, eliminating funding for an alcohol awareness program ( Grand Rapids Press via MLive, 10/27 ). Missouri Governor222s Budget Cut Affect s Medicaid and Mental Health Care : On October 28, Governor Jay Nixon (D) cut $204 million from the s tate budget and eliminated 700 jobs to offset continued declines in state revenue. The cuts will reduce Medicaid funding by $32.5 million, mental health funding by $3 million, and funding for hospitals and clinics by $3 million. Missouri Budget Director Linda Luebbering says it is not yet clear what portion of the cuts will come from provider reimbursements and what portion will come from other savings; however, the state will only cut rates for those services where state Medicaid reimbursements are greater than Medicare rates. The mental health cuts will halt new admissions for certain mental health services ( AP, 10/29 ; Columbia Missourian, 10/29 ). SAMHSA222s Weekly Financing News Pulse: State and Local Edition November 4, 2009 11/4/09 6 Nebraska Governor Proposes Cuts, Medicaid Affected : To close the state222s projected $334 million shortfall for the current biennium, Governor Dave Hein eman (R) proposed imposing a 2.5 percent across - the - board cut to most state agencies this year, followed by a 5 percent cut next year. In addition, the governor proposed eliminating planned Medicaid reimbursement increases for 2011 and cancelling a $20 million contribution to the state employee retirement fund. The Nebraska Legislature will convene a special session November 4 to consider the cuts ( AP, 11 /3 ; Journal Star, 11/2 ). Nevada Supreme Court to Hear Pharmacy Liability Case : In March, the Nevada Supreme Court will hear a case (Sanchez v. Wal - Mart Stores et al.) to determine whether pharmacies can be held liable for the actions of individuals to whom they have provided controlled substances despite warnings from prescription drug monitoring programs (PDMPs). In the case under consideration, numerous Las Vegas - area pharmacies prescribed thousands of doses of controlled substances to a woman despite receiving letters from the Nevada controlled substances task force informing them that she may be abusing pharmaceuticals. The woman subsequently killed one man and injured another while driving under the influence of the controlled substance. The family of the deceased sued the driver, her doctors, and the pharmacies; however, the lower court dismissed the pharmacies from the suit and the case now heads to the state supreme court. The suit has drawn nationwide attention because it is the first to consider the culpability of pharmacies receiving PDMP information. Thirty - three (33) states currently have PDMPs and numerous others have passed legislation to creat e them ( Wall Street Journal, 10/29 ; Kaiser Health News, 10/2 8 ). New Mexico Update: Debate Surrounds Medicaid Funding in State Budget Bill : State legislators say that the state budget bill ( HB 17 ) passed by the New Mexico Legislature last week was not intended to cut funding from Medicaid, instead allocating tobacco settlement and ARRA funds to the program. However, Governor Bill Richardson (D) and the New Mexico Human Services Department contend that recent changes in the Medicaid budgeting process passed earlier this year will force the state to cut some Medic aid services. Specifically, the governor contends that although the legislature222s budget protects the 223medical assistance224 portion of Medicaid, it does not protect 223Medicaid Physical Health managed care or Behavioral Health services224, cutting $38 million in state funds and subsequently reducing the state222s federal matching funds. Governor Richardson has until November 12 to sign or veto the legislation ( New Mexico Independent, 10/29 ; AP, 10/29 ). New York U.S. DOJ to Intervene in Adult Homes Case Against State : On October 23, the U.S. Depart ment of Justice (DOJ) filed a motion to intervene in a federal district court case (Disability Advocates Inc. v. David A. Paterson et al.) in which advocates allege that New York violated the Americans with Disabilities Act by housing mentally ill individuals in adult homes that do not allow them to interact with the community. The DOJ has intervened to ensure that New York develops an appropriate court - ordered remedy ( PRNewswire, 10/23 ). SAMHSA222s Weekly Financing News Pulse: State and Local Edition November 4, 2009 11/4/09 7 Ohio OSU Receives Cardinal Foundation Grant to Combat Prescription Drug Abuse : Ohio State University222s (OSU) College of Pharmacy received a $100,000 grant from Cardinal Health Inc. to fund the development of educational programming detailing the dangers of prescription drug abuse, safe disposal methods, and warning signs of abuse. The university222s materials will be used at pharmacies, colleges, and universities throughout the state and authorities hope to take the campai gn national in 2011 ( Business First Columbus, 10/28 ). Oregon Update: State Health Care Expansion Raises Some Residents222 Health Insurance Premiums : A law that took eff ect October 1 ( HB 2116) to provide state health care coverage to an additional 80,000 uninsured children and 35,000 low - income adults is partially funded by a tax on state health insurers. The funding, combined with federal matching funds, increased the i ncome eligibility cap for the Oregon Health Plan from 185 percent of the federal poverty level (FPL) to 200 percent of the FPL and will increase it to 300 percent of the FPL in January 2010. However, many state insurers have passed the tax on to enrollees through premium increases, causing numerous complains to the Oregon Insurance Division. The average family premium is expected to increase by $125.88 a year because of the new tax ( Statesman Journal, 11/1 ). Rhode Island State Releases Analysis of Health Insurers222 Financial Performance : The Rhode Island Department of Health and the Office of the Health Insurance Commissioner (OHIC) r eleased 223 The Health of RI222s Health Insurers, 2008 224 analyzing the financial health of the state222s health insurers. The study found that, though the financi al health of state insurers declined in 2008 with profitability declining from 4.2 percent to 2.6 percent, Rhode Island insurers outperformed other New England insurers. The report also found that commercial premiums were 3 percent lower than those in the surrounding region, Medicaid premiums were 18 percent lower, and Medicare premiums were 5 percent lower ( Providence Journal, 10/30 ; OHIC, 10/28 ). Utah Behavioral Health Facility to Layoff Staff , Alter Service Delivery System : On December 1, behavioral hea lth facility Valley Mental Health will determine the details of a 100 to 125 - person layoff that agency officials say comes as the result of an $8 to $10 million budget shortfall. Valley officials said that the staffing changes will center on a change in the agency222s service delivery system wherein the agency will rely more on care - coordination and allow non - professionals to provide popular non - medical services like music and ceramics rather than paying for more costly staff. Valley has seven locations in Salt Lake, Summit, and Tooele counties ( Salt Lake Tribune, 10/28 ; Desert News, 10/30 ). Virginia State Eliminates Community Resource Pharmacy for Mental Health Patients, Will Direct Funds to Local Boards : The Virginia Department of Behavioral Health and Developmental Services (DBHDS) will close the state222s community resource pharmacy on January 1, 2010. T he pharmacy provides $13 million SAMHSA222s Weekly Financing News Pulse: State and Local Edition November 4, 2009 11/4/09 9 because of his mental illness, instead housing him in a psychiatric hospital. The judge ruled that a diagnosis of mental illness cannot preclude participation in MRDD, potentially setting a precedent for a change in state MRDD program admission policy ( Charleston Gazette, 11/2 ).
