SAMHSA222s Weekly Financing News Pulse: State and Local Edition
October 6, 2010
10/6/2010
1
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
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owa Kentucky M
aine Massachusetts O
hio P
ennsylvania Utah Washington Wisconsin
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SAMHSA222s Weekly Financing News Pulse: State and Local Edition
October 6, 2010
10/6/2010
2
Around the States: State and Local Behavioral Health
Financing News California
Update:
Governor Signs Bills Establishing Health Insurance Exchanges and
Consumer Protections,
Vetoes Bills Requiring Mental Health Coverage and Limiting Health Premium Increases
: On September
30,
Governor Arnold Schwarzenegger
(R) signed seven health care bills that establish the state222s health
insurance exchange and codify the national health care reform law222s consumer protections under
state
law. SB 900
create
s
a health insurance exchange whil
e
AB 1602
establishes
the exchange222s duties and
fees
.
Under the bills, a
five
-
member board will govern the state222s exchange
,
with the authority to
contract with insurers. California Chamber of Commerce
officials
project
that
the exchange will cost the
st
ate
over
$1 billion annually
; however, the
California Legislative Analyst222s Office
(LAO) estimates that
the
federal government will cover the cost of the exchange until 2016, at which point health insurers
and beneficiaries
will cover the costs
.
Also on S
eptember 30, Governor Schwarzenegger signed bills
barring insurers from
denying coverage to children with preexisting conditions and extending
health
coverage to beneficiaries222 adult dependents up to age 26
.
The day before, Governor Schwarzenegger
vetoed
AB 1600
, which
would have required all insurers to cover mental health and substance abuse
treatment on an equal basis with general health care
,
and
AB 2042
,
which would have barred health
insurers from raising premiums more than once annually ( AP, 10/1 ; Kaiser Health News, 10/1 ; San Jose Mercury News, 9/29 ).
SAMHSA Awards CommuniCare Health Center $1.2 Million for Care Integration in Yolo County
: The
U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) awarded CommuniCare
Health Center a three
-
year $1.2 million
grant under the
Grant to Expand Substance Abuse Treatment
Capacity in Targeted Areas of Need-
Local Recovery Oriented Systems of Care
program
. The funding will
enhance the integration o
f behavioral health services and primary care in Yolo County
, funding
services
at three homeless shelters in the county
. Covered services will include outreach, behavioral health
assessments, case management, integrated outpatient care, and referrals to c
ommunity support
services ( Daily Democrat, 10/1 ).
Colorado
DBH Awards $500,000 to Chaffee County DHHS for Family and Children222s Programming
: The Colorado
Department of Human Services222
(DHS)
Divi
sion of Behavioral Health
(DBH) awarded a five
-
year
$500,000
Family and Youth Initiatives (FYI) grant to
the Chaffee County Department of Health and
Huma
n Services222 prevention division.
The
Colorado Division of Justice
(DIJ) also awarded FYI a $37,000
grant. Together, the grant
s
will fund resident mentoring, parenting, and teen programs. FYI serves
approximately 350 youth and families in the Upper Arkansas River Valley region ( The Mountain Mail, 10/1 ).
NEJM Study Highlights Low
-
Cost Care in Grand Junction: The New England Journal of Medicine
(NEJM)
published
a stu
dy
examining health care in Grand Junction, seeking to understand the city222s below
average health
care
costs
. The authors highlight seven
payment and service delivery
features that they
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
October 6, 2010
10/6/2010
3
believe contribute to
Grand Junction222s performance, suggesting that o
ther cities and towns incorporate
them
to improve health care efficiency
( Kaiser Health News, 10/1 ).
Aetna Ending Small Group Health Coverage in Colorado
:
Over
the next year,
Aetna Inc.
will stop
offering small group health coverage in Colorado
,
ending
its existing small group plans
. Company
officials say Aetna can no longer offer the policies competitively. Employers whose policies expire
through the end of March
2011 may renew their plans for one year, while companies whose plans
expire between April
2011 and
October
2011 may renew
them
through March 2012. Under state law,
Aetna may not reenter the small gr
oup health insurance
market until 2015. State officials say the
change will affect approximately 1,200 employers and
5,200 employees. Aetna
also
plans to discontinue
similar coverage in Michigan ( The Denver Post, 9/29 ; Kaiser Health News, 9/29 ).
Connecticut
Governor Requests Exception for High-
Risk Pool222s Six
-
Month Waiting Period: Citing low
enrollment in
Connecticut222s high-
risk insurance pool, on September 30,
Governor Jodi Rell
(R) sent a letter
to
U.S.
Department of Health and Human Services
(HHS)
Secretary Kathleen Sebelius
requesting
waiting
period
exception
s
for Connecticut222s high
-
risk pool. The national health care reform law requires that
individuals be uninsured for six months before becoming
eligible for the pool.
Governor Rell is
re
questing exceptions to
that
rule for economic hardship, expiration of COBRA coverage, and
disenrollment in Medicaid or the Children222s Health Insurance Program (CHIP) for age or income changes.
Only five individuals
enrolled in the state222 spool when it began on October 1 ( The Connecticut Mirror, 10/4 ; Kaiser Health News, 10/5 ).
Florida
Update: Law Regulating Pain-
Management Clinics Takes Effect
: On October 1, a law (
S 2272
)
took
effect
giving
Florida
greater oversight of pain-
management clinics. The law enhances
that state222s ability
to regulate the
clinics
and
increases the penalties
the state may impose upon them
. In addition, the law
prevents the
clinics from advertising or promoting the use
or
sale of controlled substances and bars
the
clinics from dispensing more than a
three-
day
supply of controlled substances to patients paying
with
cash, check, or credit card. Patients paying through insurance or workers
-
compensation
may
receive
more than a
three
-
day
supply. State officials intended to implement the
law
before
the December
implementation of Florida222s prescription drug monitoring program (PDMP)
; however,
a bid
ding
dispute
has delayed the
PDMP222s
implementation ( The Florida Times
-
Union, 10/1 ).
Palm Beach County D
rug Farm Closes as Part of Sheriff Department222s Budget Cuts
: On September 29,
the Palm Beach County Sheriff222s Department closed the Palm Beach County Drug Farm, a residential
substance abuse treatment program for county jail
inmates
. The closure comes
because the
department
is
ending its Substance Abuse Awareness and Prevention programming to save $2.6 million.
Operating for nearly 20 years, the nationally accredited program offered repeat offenders substance
abuse treatment
through
a boot camp progra
m. The county222s Criminal Justice Commission (CJC) found
that those who participated
in the department222s programs
had a 31 percent recidivism rate
,
down
from
51
percent
among
the jail222s general population
.
The CJC voted to
request that the Palm Beach Coun
ty
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
October 6, 2010
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4
Commissioners provide nearly $1 million to the sheriff222s department, preserving
centralized substance
abuse assessments and beds in local substance abuse treatment facilities. The CJC will go before the
commissioners
to
argue
for that funding
on Novemb
er 30 ( The Palm Beach Post News, 9/29 ).
Medicaid
HMOs Implement Premium
Increases After Actuarial Dispute
: One month after
their
schedul
ed effective date, Medicaid HMOs in Florida implemented retroactive
premium rate increases on
October 1
. Medicaid HMOs in the
five counties participating in the state222s Medicaid managed care pilot
implemented average increases of 4 percent, while HMOs ope
rating in other counties imposed
average
increases of 1.55 percent. Originally scheduled to
take effect September 1
,
implementation was delayed
over
an actuarial dispute between HMO officials and the Florida Agency for Health Care Administration
(AHCA). The increases are retroactive to September 1 ( Health News Florida, 9/29 ; Kaiser Health News, 9/30 ).
Georgia
DOJ Awards Macon County $250,000 for Mental Health Court
: The U.S. Department of Justice
(DOJ)
awarded Macon County a two
-
yea
r $250,000 grant to implement and
operate a mental health court.
The court will offer mental health treatment
for up to 25 offenders at once
,
and county officials hope to
serve 75 individuals over the duration of the grant.
On September 30, the Macon County Board222s Justice
Committee approved a measure to amend the state
attorney222s budget to reflect the grant. The full
board will vote on the change on October 14 ( Herald
-
Review, 10/2 ).
Illinois
Update: Federal Judge Approves Agreement to Transition Residents
with Mental Illnesses
Out of
IMDs
:
On
September 30,
U.S. District Judge William Hart
approved an agreement between the
American Civil Liberties Uni
on
(ACLU) and Illinois officials
to settle a 2005 lawsuit over the
institutionalization of individuals with mental illnesses. T
he
ACLU contended that the state violated the
Americans with Disabilities Act (ADA)
by housing patients
with mental illnesses
in 223institutions for
mental disease224 (IMDs). Under the terms of the deal, Illinois will offer the
approximately
4,500 IMD
residents the option
to undergo assessments for placement into community
-
based
treatment
settings
over the next five years
.
Disability advocates project
that the transition could save the state $50 million
over several years, largely by allowing Illinois to receive federal Medicaid funds for the
community
-
based care provided outside of IMDs
( ACLU via PR Newswire, 9/30 ).
Lemont Village Begins Youth
Alternative Sentencing Substance Abuse Education Program
: On
September 27, the Lemont Village Board of Trustees unanimously approved an amendment to Lemont
222s
municipal code requir
ing
individuals
to undergo substance abuse education for first
-
time
citations
for
underage possession of alcohol and
tobacco, or
possession of
small amounts
of marijuana
for youth up
to age 21
. The Lemont Police Department will
conduct
the Drug, Alcohol and Tobacco Education
Program, a two
-
session six
-
hour course that promotes behavioral change with basic substance abuse
education.
A
$100 offender fee will
fund the program and t
hose who miss
a
session will face a $750 fine
( Lemont Reporter, 10/1 ).
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
October 6, 2010
10/6/2010
5
Iowa
DHS Awards
Ingenix
$14 Million
Contract to Reduce Medicaid Fraud and Waste
: The
Iowa Department
of Human Services
(DHS) awarded
Ingenix
Inc.
a three
-
year $14 million contract to reduce fraud and
waste in Iowa222s Medicaid program. Jointly funded by the federal government and the state, I
ngenix will
employ
data min
ing techniques to identify questionable Medicaid expenditures.
Under the contract
,
Ingenix
must
identify
$20 million in waste
during
the first
and second years and
$25 million in the third
year ( Des Moines Register, 9/29 ; Kaiser Health News, 9/29 ).
Kentuck
y
Medicaid Begins Covering Smoking Cessation
: As part of a program established in the 2010
-
2012 state
budget, on October 1, Kentucky222s Medicaid program began covering smoking cessation treatment. The
program will operate on $3 million in state funds and $8.4 million in federal matching funds
. Under the
program, beneficiaries receive
assessment
s
to determine tobacco usage, willingness to quit, coping
skills, and barriers to quitting. After
the
assessment
s, beneficiaries begin counseling and a cessation
program, which can include nicotine replacement therapy ( The Courier
-
Journal, 10/4 ).
Maine
Governor
Cuts
$10 Million
From
Budget, Includes $5.6 Million Cut to DHHS
: Citing economic
uncertainty and lower
-
than
-
anticipated federal aid, on October 1,
Governor John Baldacci
(D)
announced $10 million in cuts to Maine222s
current
-
year
budget. The cuts include a
$5.6 million
reduction
from
the
Maine Department of Health and Human Services
(DHHS); however, DHHS official
s say the
cuts will not result in significant service reductions.
Governor Baldacci
made the cuts using his power of
curtailment, which allows the governor to restrain spending temporarily
without legislative approval
( The Portland Press Herald, 10/1 ).
DOE Awards Sanford School District $1 Million
GRAA: The U.S. Department of Education
(DOE)
awarded the Sanford School District a three
-
year $1 million Grant to Reduce Alcohol Abuse (GRAA)
.
The
grant will
provide resources for the development and implementation of
alcohol abuse
prevention
programming. School officials say the program will
involve alcohol education, early intervention for at
-
risk youth, and targeted intervention for those already abusing alcohol and other drugs. In addition to
the Sanford School District, seven other school districts received GRAAs: Alaska222s Anchorage Sch
ool
District; California222s San Francisco Unified School District and Soledad Unified School District;
Massachusetts222
Watertown; Maine222s Maine School Administrative District 49; Texas222 Cormal
Independent School District; and Wisconsin222s Beaver Dam U
nified School District ( Sanford News, 9/16 ; DOE ).
Massachusetts
HealthAlliance
Hospital Closing
Adult Mental Health Unit
:
Facing
low
patient
volume
, UMass Memorial
Health Care222s HealthAlliance
Hospital
will close
its 15
-
bed adult inpatient mental health unit
by
December 31
. Hospital officials say the majority of mental health patien
ts have
sought care
at the
HealthAlliance Leominster campus emergency department
. Officials note t
hat patients previously
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
October 6, 2010
10/6/2010
6
served by the unit
may
receive care at other UMass system hospitals
or
at
other
local
facilities ( Telegram & Gazette, 9/30 ).
November Ballot Measure
Would
Exempt Alcohol from Sales Tax, Reduce Funding for Substance
Abuse Treatment
: On November 2, Massachusetts residents
will
vote
on
a ballot measure (
Ballot
Question 1
) that would exempt alcohol from the state222s sales tax. Alcohol was exempt until 2009, when
the state legislature applied the 6.25 percent tax to retail alcohol purchases
. F
unds raised by the tax
finance
substance abus
e treatment
in Massachusetts,
and state officials estimate that
the tax will
generate
$108 million for that purpose in FY2011 ( Boston Herald, 9/28 ).
Ohio
Ohio Prescription Drug Abuse Task Force Releases Final Report, Recommends Increase and
Diversification of Treatment Funding
: On October 1,
the
Ohio Prescription Drug Abuse Task Force
(OPDATF) delivered its final report to
Governor Ted Strickland
(D). Governor Strickland created the
group by executive order on April 2 to research prescription drug abuse in Ohio and recommend
non
-
binding
immediate action
s
to reduce it. The OPDATF suggests
treating prescrip
tion drug abuse as a
public health issue. Additionally, the authors propose increased law enforcement
,
regulation
,
and
treatment
to combat the abuse of prescription drugs
.
Available through the
Ohio Department of
Health222s
(DOH) website , t
he report recommends increasing and diversifying funding sources for facilities
offering treatment for
prescription drug abuse
( Lancaster Eagle Gazette, 10/2 ).
Pennsylvania
AHRQ Awards PRHI $3.5 Million to Integrate Behavioral Health into Primary Care
: The U.S. Agency for
Healthcare
Research and Quality
(AHRQ) awarded the Pittsburgh Regional Health Initiative (PRHI) a $3.5
million
American Recovery and Reinvestment Act
(ARRA)
grant to identify ways to integrate behavioral
health services into primary care. Under the grant, PRHI will partner with Clinical Systems Improvement
in Minnesota and the Wisconsin Collaborative for Healthcare Quality to help up to 90 primary care
medical practices implement behavioral health screening and early intervention in three states
( Pittsburgh Business Times, 9/30 ).
Lawmakers Introduce Bill to Establish Office of Health Insurance Consumer Advocate
: State lawmakers
have introduced a measure (
HB 2735
) that would establish a
State Office of Health Insurance Consumer
Advocacy
.
Located within the Pennsylvania Department of Commerce and Economic Development
,
t
he office would represent consumers222 interests on health insurance matters before courts
and state
agencies. Additionally, the office would identify and track trends in the health insurance industry,
recommend consumer protections, respond to complaints, and educate state residents about health
insurance issues.
Under the bill, the governor would appoint the advocate
to
serve a six
-
year term with
a two
-
term limit. Lawmakers supportive of the measure hope to approve it before the
end of the
2009-
2010 legislative session ( Pittsburgh Post
-
Gazette, 9/29 ; Kaiser Health News, 9/29 ).
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
October 6, 2010
10/6/2010
7
Utah
Insurance Department Issues Regulations
Limiting Open Enrollment for Children
-
Only Insurance: On
September 30, the Utah Insurance Depa
rtment
issued new rules establishing
semi
-
annual open
enrollment periods for children
-
only health insurance
plans
. Citing the
increased costs
of intermittent
coverage
under health reform, several Utah insurers stopped offering children-
only health coverag
e.
S
tate officials intend to reduce intermittent coverage
through the new rules, thereby reducing insurer
s222
cost
s. Insurers not obeying
the new rules will be subject to fines and may lose the authority to do
business in Utah. Colorado, Ohio, and Indiana
have implemented similar rules to address the same
problem ( The Salt Lake Tribune, 9/30 ; Kaiser Health News, 10/1 ).
W
ashington
Update:
DSHS Announces 6.3 Percent Cuts, Include
s
$25.6 Million
Cut
From Mental Health
Programming
:
In
r
esponse to Governor Chris Gregoire222s
(D) request that state agencies implement
6.3
pe
rcent across
-
the
-
board
budget reductions
to close a deficit
,
Washington Department of Social and
Health Services
(DSHS) officials announced $168 million in current biennium
cuts
on
September 29
.
The
cuts
will reduce mental health program funding by
$25.6
million
, including
the elimination of 30
inpatient beds at Western State Hospital.
DSHS will also eliminate
380 full-
time
-
equivalent positions by
June 30 and implement unpaid furloughs. As part of the governor222s cuts, the Washington Department
of Correct
ions
(DOC) is also reducing drug abuse treatment and education for prisons. Finally, in
addition to the $168 million cut, DSHS is
eliminating $112.8 million in Medicaid spending
, through
numerous service reductions
. In January, the Medicaid program will
end
vision, dental, hearing, and
hospice services. In March, Medicaid will
end
outpatient pharmacy benefits and subsidized health
coverage for children in the Apple Health for Kids Program
( The Seattle Times, 9/30 ; DSHS, 9/29 ; The News Tribune, 9/30 ; AP via Business Week, 10/1 )
.
Regence Stops Selling Children
-
Only Health Coverage
: Citing increased costs under the national health
care reform law,
Re
gence BlueShield
of Washington
has stopped offering children
-
only health coverage
in Washington. Regence also discontinued children-
only
plans in Oregon and Utah. In an attempt to
stop insurers from
fleeing the children
-
only market,
Washington Insurance
Commissioner Mike Kreidler
has
established an emergency special enrollment pe
riod for children
-
only policies, running
from
November 1 to December 15 ( AP, 9/29 ; Kaiser Health News, 9/29 ).
Wisconsin
Milwaukee County Executive Offers Budget Proposals, Includes Increased Mental Health Funding
: On
September 30, Milwaukee County Executive Scott Walker (R) presented his 2011 budget proposal
to the
Milwaukee County Board of Supervisors, including a
$5.5 million
increase
for mental health services.
The increased funding would finance
ad
ditional nurses, staff training, and increase
d
community
-
based
services. The board will hold a public hearing on County Executive Walker222s proposed budget on
November 1, and will likely approve a budget by mid
-
November ( WISN, 9/30 ; Behavioral Health Central, 9/23 ; The Business Journal of Milwaukee, 9/30 ).
