Clip files / Local news from the states
Clip files / Local news from the states
This column features selected short items about state health care policy.
HCFA discontinues support for New Mexico’s mental health managed care program
WASHINGTON, DC—The Bazelon Center for Mental Health Law today applauded an unprecedented decision by the federal Health Care Financing Administration (HCFA) to end support for mental health services in New Mexico’s managed care Medicaid program. The decision came recently when, in response to a letter from Tim Westmoreland, director of HCFA’s division for state programs, the state agreed to withdraw its Medicaid mental health services from managed care.
The Bazelon Center asked HCFA last March to deny the state’s renewal request, based on serious problems with mental health managed care services, documented by the national legal center in a series of reports. Policy research analyst Rafael Semansky, the reports’ author, calls the decision "extraordinary, but absolutely appropriate, given the evident collapse of New Mexico’s mental health system after several years of managed care."
To his knowledge, Mr. Semansky said, this is the first time the federal agency overseeing the Medicaid program has terminated a managed care waiver. "We hope HCFA’s decision will send a signal," he added. "Managed care should be a way to serve people better and more cost-effectively. But a state that wants to use it only to save money on meeting mental health needs should consider what happened in New Mexico."
—Bazelon Center for Mental Health Law
Percentage of uninsured children dropping in some communities
WASHINGTON, DC—Some U.S. communities experienced a significant decline in the percentage of children lacking health insurance between 1996-97 and 1998-99, according to a study by the Center for Studying Health System Change (HSC).
The communities of Boston; Little Rock, AR; and Syracuse, NY, all saw drops in children’s uninsurance rates even though the national percentage of children lacking health insurance did not change during the same time period.
The change reported by the HSC study included a drop from 7% to 3% in Boston, from 17% to 12% in Little Rock, and from 7% to 4% in Syracuse. Other declines were also found in the communities of Miami; Greenville, SC; and Cleveland, although those decreases were not statistically significant.
"The strong economic growth that our country has seen in recent years is clearly a contributing factor to lower rates of uninsured kids," said Peter Cunningham, HSC senior researcher and co-author of the study. "In some communities, the decrease in uninsurance rates was due almost entirely to an increase in private insurance coverage among children. With the current economy, more parents are probably getting family coverage through their employers."
Other communities examined in the study, including Indianapolis; Lansing, MI; Phoenix; and Orange County, CA, reflected the national trend showing no statistically significant change in uninsurance rates, as reported by HSC in an April study.
That study found a sharp increase in coverage through Medicaid and other state insurance programs like the State Children’s Health Insurance Program, but an equally sizeable decrease in private insurance coverage. The result was no net gain in coverage among low-income children nationally between 1996-97 and 1998-99.
—Center for Studying Health System Change
Congress passes public health funding measure
WASHINGTON, DC—Congress recently passed the Public Health Threats and Emergencies Act of 2000, which includes the first-ever authorization of new federal funding designated specifically to help state and local public health agencies prepare to deal effectively with public health threats, from West Nile virus to acts of terrorism with biological weapons.
The bill was incorporated into a larger measure called "The Public Health Improvement Act of 2000," which addresses the basic capacities that public health agencies need to detect and respond effectively to public health threats, such as the use of current technology for rapid communication and data analysis.
That legislation requires the Department of Health and Human Services, in cooperation with state and local public health agencies, to define what is needed. It then provides grants to states and localities to assess their public health needs and establishes a competitive grant program to fill unmet needs.
Grant funds can be used for work force training; emergency planning; coordination, network development, and participation in electronic data sharing and communication; and improving public health laboratories.
—National Association of County and City Health Officials
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