SAMHSA222s Weekly Financing News Pulse: State and Local Edition
September 29, 2010
9/29/2010
1
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
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SAMHSA222s Weekly Financing News Pulse: State and Local Edition
September 29, 2010
9/29/2010
2
Around the States: State and Local Behavioral Health
Financing News Arizona
AHCCS Cutting Health Services to Save $20 Million
: As part of budget
cuts authorized under Arizona222s
FY2011 budget, on October 1 the Arizona Health Care Cost Containment System
(AH
CCCS) will cut
coverage
for basic health services including
physicals, dental care, and podiatry. In addition, AHCCS will
reduce coverage for
some
surgical procedures and medical devices
.
State officials say the cuts will
save
$20 million through June.
The cuts are based on a review of medical and statistical data
and on
input
from
medical professionals ( The Arizona Republic, 9/26 ; Kaiser Health News, 9/27 ).
Alabama
Decatur Mayor Proposes Eliminating All Mental Health Center Funding
:
Decatur Mayor Don Stanford
222s
proposed
FY2011 budget recommend
s
eliminating
all funding for the Mental Health Center of North
Central Alabama. The
non
-
profit
center offers services to low-
income individuals with mental illnesses
in Decatur
,
and received $35,000 from the city
in
FY2010. The mayor222s proposed budget would
eliminate all funding for the center beginning October 1. City officials estimate that the cuts would
affect 430 individuals. The Decatur City Council is currently negotiating the FY2011 budget ( WHNT, 9/21 ).
California
Update:
San Francisco Mayor Vetoes Alcohol Fee Designed
to Cover Alcohol Abuse
Costs:
Shortly after
receiving approval from the San Francisco Board
of Supervisors on September 21
,
Mayor Gavin
Newsom
(D) vetoed a proposed alcohol fee designed
to cover the health care costs of alcohol abuse
currently
borne by San Francisco taxpayers. Levied on alcohol wholesalers and distributors, officials
estimated that the fee would raise $16 million annually and increase the cost of an average drink by no
more than five cents. Funds raised by the fee would go toward unreimbursed hospital care, ambulance
transportation, prevention programming, and a sobering center.
Supervisors supportive of the measure
say they may pursue a ballot initiative to enact the fee
( San Francisco Chronicle, 9/22 ).
Colorado
Update: DOI Issues Eme
rgency Regulations
to Maintain Children-
Only
Coverage
: On September 23, the
Colorado Department of Insurance
(DOI) issued emergency regulations establishing open enrollment
periods for children
-
only insurance. The regulations create semiannual
open
enrollment periods in
January and July
and
a special open enrollment period from September 23 to October 31
,
2010. The
DOI
is seeking to buttress the children
-
only insurance market after
six Colorado insurers announced
that
they
will
no longer offer child
ren
-
only plans
because
such plans
are
cost prohibitive under national
health
care
reform
. Neither the DOI222s regulations nor health care reform
require
insurers
to
offer
coverage in the children
-
only market ( Denver Business Journal, 9/23 ; The Denver Post, 9/24 ; Kaiser Health News, 9/24 ).
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
September 29, 2010
9/29/2010
3
Florida
Juvenile Behavioral Health Crisis Stabilization Unit Opens in St. Lucie County
: The Frances Langford
Center for Children, a 20
-
bed juvenile behavioral health crisis stabilization unit, opened at the New
Horizons of the Treasure Coast behavioral health treatment facility in St. Lucie County. The Frances
Langford Foundation gave the unit a $100,000 grant and
the foundation
plans to match donations to the
unit up to $900,000. New Horizons officials hope to raise
a total of
$3.2 million and add 10 beds after
additional
funding becomes available. The unit will serve children ages 5
to 17 for up to one week,
before transitioning them
to
outpatient care ( Treasure Coast Palm, 9/25 ).
HHS Audit Recommends AHCA Repay $5
.3 Million for Children Enrolled in Medicaid and CHIP
: The U.S.
Department of Health and Human Services
(HHS) conducted an audit of Florida222s Medicaid and
Children222s Health Insurance Program
s
(CHIP)
, concluding that the state owes the federal government
$5.3 million for
federal
funds spent
on
childre
n simultaneously enrolled in
Medicaid and CHIP. The audit
examined enrollment and claims
information
from April 1, 2007 to March 31, 2008. HHS officials say
that the
Florida Agency for Health Care Administration
(AHCA) did not have adequate internal cont
rols
to correct the
dual enrollment. The AHCA intends to challenge the finding. AHCA officials also contend
that the state owes less
than
$5.3 million because
program
spending on dually enrolled children was
lower than
the audit estimates ( HealthNews Florida, 9/22 ; Kaiser Health News, 9/23 ).
Insurance Advisory Board Approves Resolution to Seek Federal Waiver for Exemption from Health
Reform222s MLR Requirements
: On September 24, the Florida Insurance Advisory Board
unanimously
approved a resolution to seek a waiver exempting Florida from the national health care reform law222s
med
ical loss ratio (MLR) requirements.
Health reform requires an 85 percent MLR for large group health
plans and an 80 percent MLR for small group and individual plans. Board members argue that the
requirement will excessively
disrupt
the state222s insurance market. The approval of the resolution means
that
the state will formally seek the
waiver
; however,
the state will accept
public input on the matter
until October 8. Iowa and Maine have already requested similar
waivers ( The Hill, 9/27 ; Kaiser Health News, 9/28 ).
Illinois
NIH Awards UI $712,000 for Substance Abuse Research
: The U.S. National Institutes of Health
(NIH)
awarded
University of Illinois
(UI) researchers a five
-
year $712,000 grant to study treatment options for
young adults with substance abuse problems. The grant will fund research on the Peer
-
Enhanced
Community Reinforcement Approach, a method of treatment that involves close friends and family in
the recovery process and offers positive reinforcement for sob
er behavior. The study will target 18 to
25 year old young adults, with a particular focus on those who do not attend college ( The News
-
Gazette, 9/27 ).
Indiana
SAMHSA Awards
Mental Health Facility
$2 Million to Improve Primary Care
:
The
U.S. Substance Abuse
and Mental Health Services Administration
(SAMHSA) awarded the Indianapolis
-
based Adult and Child
Center a four-
year $2 million grant to improve access to primary care. T
he grant will fund a project in
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
September 29, 2010
9/29/2010
4
which the WindRose Health Network embeds a primary care physician and nurse care coordinators at
the
mental health center
,
offering
holistic care to young individuals with serious mental illnesses (SMI).
The project is part of a SAMHSA initiative to reduce early mortality of individuals with SMIs by 10 years
over 10 years. That initiative is based on a 2006 report by the National Association of State Mental
Health Program D
irectors
(NASMHPD) that found that adults with SMIs die an average of 25 years
before their peers ( Inside Indiana Business, 9/27 ).
Kansas
KHI
Finds
Mental Health Drugs Account for
Over 40 Percent of Kansas Medicaid Prescription Drug
Spending
: On September 28, the Kansas Health Institute
published an article
examining the Kansas
Medi
caid program222s prescription drug spending. KHI found that
,
in the fiscal year that ended June 30,
2010, the Kansas Medicaid program spent a total of $166.4 million on prescription drugs. Mental health
drugs accounted for $68.9 million, or over 40 percent
,
of
total prescription
spending. T
he program paid
for 924,000 mental health prescriptions for 94,700 beneficiaries
in the year ending June 2010
while, in
t
he previous fiscal year, the program paid for 57,000 fewer mental health prescriptions but
had 5,00
0
more beneficiaries. KHI also found that the program
has
spent a $300 million on mental health drugs
since FY2007 ( Kaiser Health News, 9/28 ).
Louisiana
Updat
e: CMS Approves LA222s
Request to Use Medicaid Funds for Primary Care Network
: On September
22, the Centers for Medicare & Medicaid Services
(CMS) approved Louisiana222s
application for a federal
waiver to use Medicaid funds to continue operating the primary c
are clinic network established after
Hurricane Katrina. The network began in 2007 with a federal Primary Care Access and Stabilization
grant that provided $30 million annually; however, the grant funding ends September 30. Under the
new
waiver, the state
will redirect approximately $20 million annually from
Medicaid Disproportionate
Share Hospital funds to the primary care clinic network. Operating until 2014, t
he state will require
clinics to meet best
-
practice standards for prima
ry care medical homes
a
nd continue to use the
Louisiana Public Health Initiative
(LPHI) as a third
-
party manager for the network. The network
currently includes over 90 clinics operated by 25 organizations offering primary care, obstetrics, mental
health s
ervices, dental care, and school
-
based services
. Half of the patients using the system are
uninsured and approximately 25 percent are Medicaid beneficiaries. Uninsured patients are
able to
obtain services based on an income
-
dependent sliding-
scale fee system
( Times
-
Picayune, 9/23 ).
Maine
DHHS Places Auburn Mental Health Agency on One
-
Year Conditional License
: The Maine Department
of Health and Human Services
(DHHS) ha
s placed the Auburn
-
based mental health agency on a one
-
year
conditional license, citing 223serious deficiencies224 found during an
August
inspection. The agency
,
Possibilities Counseling Services,
facilitates
care and processes insurance claims for approximately
10,000 individuals with mental illnesses statewide. The agency plans to appeal the decision ( WCSH, 9/26 ; Fox 23, 9/24 ).
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
September 29, 2010
9/29/2010
5
Massachusetts
Harvard Pilgrim Cancels MA Plan Because of Health Reform
:
In January, Harvard Pilgrim Health Care
will discontinue its Medicare Advantage (MA) plan, First Seniority Fre
edom,
citing
changes to MA plans
under the national health care reform law. Harvard Pilgrim will begin offering a Medicare Supplement
plan in October. Company officials are encouraging seniors enrolled in the company222s MA plan to enroll
in the supplement
al coverage. The change affects 22,000 individuals in Massachusetts, Maine, and New
Hampshire ( The Boston Globe, 9/28 ; Kaiser Health News, 9/28 ).
Michigan
Saginaw County Community Mental Health Authority Faces $450,000 Deficit
: The Saginaw County
Community Mental Health Authority is
facing a current
-
year
$450,000
deficit. Authority officials
say
they are
confident that they can close the gap using
funds from other mental health authorities in the
state and
from
the state222s general fund ( Grand Rapids Press, 9/23 ).
Minnesota
BCBS and HealthPartners Temporarily Suspend Individual Insurance Sales Amid Uncertainty O
ver
Reform
: C
iting uncertainty over the newly implemented measures of the national health care reform
law,
Blue Cross and Blue Shield of Minnesota
(BCBS) and
HealthPartners
temporarily suspended
individual insurance policy sales
. The suspension comes after
the law222s n
ew consumer protection
s
took
effect on September 23. Officials from the two insurers say they will resume sales when
guidance is
available on the law222s newest regulations ( Minneapolis Star Tribune, 9/23 ; Kaiser Health News, 9/24 ).
Mississippi
DOH Requests $33.3 Million for FY2012
: The Mississippi Department of Health
(DOH) requested $33.3
million
in state funds
for its FY2012 budget. The request is approximately 9 percent of the department222s
total
budget,
the bulk
of which
is funded by the federal government. DOH222s
request includes a $7.4
million increase over current
-
year funding to replace
American Recovery and Reinvestment Act
(ARRA)
Federal Medical Assist
ance Percentage (FMAP) funding ( The Clarion
-
Ledger, 9/24 ).
Montana
Montana Mental Health Settlement Trust Offering $10 Million in Grants
: The Montana Mental Health
Settlement trust is offering approximately
$10 million in grants to mental health projects, agencies, and
groups. E
ligible
activities include adult mental health services, children222s mental health services, and law
enforcement
mental health
crisis intervention. The funds come from a state settlement with Eli Lilly &
Co
.
over
the
promotion of off-
label use of
Zyprexa
,
a drug intended to treat schizophrenia and bipolar
disorder
( AP via Business Week, 9/28 ).
Nebraska
DHHS Files Budget Request for 2011
-
2013, Includes
Behavioral Health
Reimbursement Reduction: The
Nebraska Department of Health and Human Services
(DHHS) filed its main budget request for the 2011
-
2013 budget, including
a 5 percent reduction in
Medicaid and C
HIP
reimbursements to behavioral health
and
general
medical providers. The redu
ction would save a total of $68.5 million, $66.8 million from
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
September 29, 2010
9/29/2010
6
Medicaid and $1.8 million from CHIP. In addition, the proposed reduction would not apply to p
rimary
care
services
or
services for individuals with developmental disabilities ( The Lincoln Journal Star, 9/23 ; Kaiser Health N
ews, 9/24 ).
New Hampshire
Insurance Commissioner Warns Insurers
to Continue Offering Children-
Only Coverage
: On September
23,
New Hampshire Insurance Commissioner
Roger Sevigny
sent a letter
to New Hampshire insurers
warning them that they may not deny health coverage based on age within
the individual market. The
letter comes as several insurers
, including some in New Hampshire,
have announced that they intend to
stop offering children
-
only
health
coverage.
Insurance officials say that, if they continue offering new
policies in the children
-
only market, the rules will incentivize covering children only when they become
sick, drastically increasing insurers222 costs. The commissioner222s letter informs the insurers that,
under
health reform and state law
,
they may not deny coverage based on an applicant222s age
. The letter
further
state
s
that the
New Hampshire Insurance Department
wi
ll take action against any insurer
that
illegally denies such coverage
( Politico, 9/27 ; Kaiser Health News
, 9/27 ; Portsmouth Herald, 9/24 ).
Ohio
MHRS Announces MH/SUD Grants for Warren and Clinton County Programs
: Mental Health Recovery
Services (MHRS) of Warren and Clinton Counties is offering
$10,000
grants to innovative programs that
work to improve mental health or prevent substance abuse in Warren and Clinton Counties. MHRS is
the local
MH/SUD services board
. Grant a
pplications are due October 25 ( Wilmington News Journal, 9/22 ).
Sisters of Charity Foundation Awards $170,000 to MHRS Board of Stark County
: The Sisters of Charity
Foundation of Canton awarded the Mental Health and Recovery Servi
ces Board of Stark County a
$170,000 grant. The grant will fund the improvement of information technology infrastructure for
community behavioral health providers ( Akron Beacon Journal, 9/26 ).
South
Dakota
Xcel Energy Foundation Awards University of Sioux Falls $7,500 for Substance Abuse Research: The
Xcel Energy Foundation awarded the University of Sioux Falls a $7,500 economic sustainability grant to
support student research
on
the effects and proce
ss of
Face It Sioux Falls, a program that aims to shift
substance abuse treatment to a chronic care model. The grant will fund a mentorship program, lecture
series, and business plan competition for students researching the program ( Argus Leader, 9/24 ).
Utah
VMH Challenges OptumHealth222s
Behavioral Health Contract Award in Salt Lake County
: Salt Lake
County officials have awarded
OptumHealth
an 18
-
month $55 million behavioral health
administration
contract. Valley Mental Health (VMH
)
, which administered behavioral health services in Salt Lake,
Summit, and Tooele counties for
the previous
23 years
,
is
challenging
the new award. VMH officials
contend
that
OptumHealth is not properly equipped to guarantee adequate services. County officials
say the
y
will make a decision on the challenge
in the near future ( D
eseret News, 9/28 ).
SAMHSA222s Weekly Financing News Pulse: State and Local Edition
September 29, 2010
9/29/2010
7
Virginia
VCU Study Suggests VA Enact
Measures to Prevent Alcohol Abuse Privati
zing
Liquor Sales
: On
September 22, the Virginia Commonwealth University222s
(VCU)
Institute for Drug and Alcohol Studies
released a study examining the
potential
impact of privatizing liquor sales
in Virginia
.
Governor Bob
McDonnell
(R) has proposed privatizing the sale of liquor in Virginia, replacing
the current state
-
run
liquor stores. The report suggests that
,
if Virginia privatizes liquor sales, t
he state should also
take
actions to prevent and discourage excessive drinking.
The authors say preventive measures are
necessary because an increase
in liquor outlets correlates with increases in violent crime, child abuse,
injuries, and drunk driving.
The authors propose raising taxes on liquor, restricting marketing, limiting
the number and location of liquor stores, and limiting liquor store operating hours ( Richmond Times
- Dispatch, 9/23 ).
UVA Study Estimates Health Reform Will Yield
500,000
Newly
Medicaid Eligible Residents
: The
University of Virginia222s
(UVA)
Weldon Cooper Center for Public Service
released a study
examining the
demographic impact of the national health care reform law
in Virginia. The study examines the law222s
impact on Medicaid eligibility in Virginia, projecting
eligibility for each county
, and estimating that health
reform will make 500,000 individuals
newl
y eligible for Medicaid in 201
4. However, the study also
estimates
that only 240,000 to 340,000 of the newly eligible residents
are expected to enroll in
the
program
because m
any of the newly eligible residents will already have private health coverage
, not
know they are eligible, or elect not to obtain coverage
. T
he report suggests that
,
if the economic
recession continues
,
a higher proportion of newly eligible individuals will enroll in Medicaid ( UVa Today, 9/21 ; The Cavalier Daily ).
Wa
shington
SAMHSA Awards Washington $734,000 Grant Funding
for
Supportive Housing for Individuals with
SMIs
: The U.S. Substance Abuse and Mental Health Services Administration
(SAMHSA) awarded
Washington a five
-
year $734,000 Mental Health Transformation Gran
t for the Permanent Options for
Recovery
-
Centered Housing (PORCH) Project. The PORCH Project offers supportive housing to
individuals with serious mental illnesses (SMI) in Chelan, Douglas, and Pierce counties. The project aims
to
shorten
inpatient menta
l health stays, combat
homelessness, and
reduce
discharges to inadequate
facilities
. State officials say the program will house approximately 150 individuals and families annually.
The project is a partnership between the Washington Department of Social and Health Services222 (DSHS)
Division of Behavioral Health and Recovery
, OptumHealth Pierce Regional Support Network, the
Chelan
-
Douglas Regional Support Network, and local mental health and housing agencies ( DSHS, 9/23 ).
Wisconsin
Saint Joseph222s Hospital to Close Inpatient Psychiatric Unit November 1
: Citing a psychiatrist shortage,
Saint Joseph222s Hospital will close its 16
-
bed inpatient psychiatric unit
on November 1
. Hospital officials
say that the unit was unable
to operate at capacity this summer because of insufficient staffing
. The
unit serves approximately 450 individuals annually.
After the closure, Saint Joseph222s plans to
transfer
affected patients to Norwo
od Health Center
for inpatient treatment ( Wisconsin Rapids Tribune, 9/28 ).
