Clip files / Local news from the states

This column features selected short items about state health care policy.

Hearing loss, America’s leading birth defect, under siege under new Florida law

ORLANDO, FL—A new state law will require that all babies receive hearing screenings before leaving the hospital.

Every baby across the state, along with its first coo, first taste of milk, and first grip of his mother’s finger will — beginning this fall — also undergo his first hearing test. Effective Oct. 1, a new state law will require that babies receive a hearing screening before they leave the hospital. More than 25 states have similar requirements in place.

Leaders in pediatrics and audiology rank hearing impairment as the leading birth defect in the United States, affecting one in 200 newborns. Often, parents don’t realize their child has trouble hearing until months, or even years, after the child should have been learning how to speak. Testing all babies will prevent them from playing catch-up in their learning skills.

The new law — the issue received unanimous support in both the state House and Senate — requires that babies born at home be referred within 30 days by their health care providers to an audiologist who can perform a hearing test. "There’s just this huge harm done to children when you deny them the opportunity to learn a language during the early stage of their life," said John Zeigler, an audiologist and director of Lake County Hearing Clinic in Tavares. "We want to start to identify these children and hopefully get them amplified with hearing aids or cochlear implants by the time they are 18 months old."

The effort will mean a big boost in business for audiologists in Lake County and across the state. "There are not enough audiologists in the state to test all the babies," said Dr. Holle Whitaker, an audiologist and manager of the infant-hearing program at Arnold Palmer Hospital for Children & Women in Orlando. There are 689 practicing audiologists in Florida. There are more than 195,000 babies born each year in the state.

The Orlando Sentinel

New PA state study says many hospitals lost money and meltdown’ is occurring

HARRISBURG, PA—About 40% of Pennsylvania’s hospitals lost money in 1999 and a growing number are relying on stock investments and charitable contributions to stay afloat, according to a recent state report. The report highlights a continual downturn. In 1998, 30% of the hospitals lost money.

Hospitals’ overall net income last year dropped 31% statewide, while profits earned solely from treating patients, or operational income, fell to nearly zero due in part to the rising expense of treatment, according to the study by the Pennsylvania Health Care Cost Council. "Clearly what we saw is a troubling sign for hospitals," said council spokesman Joe Martin. "The loss to hospital earnings has continued and gotten worse. In addition, more and more the average hospital is unable to make money on patient care alone and is utilizing investments and endowments."

Carolyn F. Scanlan, president and chief executive officer of The Hospital and Healthsystem Association of Pennsylvania, called the report "frightening evidence" that the hospital system is in "meltdown." She said hospitals have been hurting after Medicare reimbursements declined under the federal Balanced Budget Act of 1997 and as Pennsylvania reduces the number of Medicaid-eligible recipients. Hospitals dependent on stock investments, meanwhile, are at risk should the market soften. "This report is very frightening," she said. "If Pennsylvania hospitals don’t get relief soon, the result may be catastrophic — fewer hospitals, longer trips to the hospital, and more anxiety for you and your neighbors."

The council said it was difficult to determine what was specifically to blame for hospitals’ continuing losses, but pointed to the growing rate of uncompensated care and declining Medicare reimbursements as likely factors. The rate of uncompensated care, which makes up about 4.9% of a hospital’s net revenue, rose 9.9% to $834 million last year, according to the report. Uncompensated care includes both charity care to patients who can’t afford services and bad debt from patients who are supposed to pay but don’t. The report also found a "predominant shift" in terms of fewer hospitals with a healthy net income in the 4% to 6% range in 1999, and a greater number in the 0% to 2% income range. That demonstrates that hospitals must find new ways to stem costs, Mr. Martin said.

"They need to keep their expenses below their revenue, whether that means other ways to maximize revenue streams or ways to cut expenses without hurting patients," he said.

—The Associated Press

Gore calls for increased mental health coverage for children

CHEVY CHASE, MD—Vice President Al Gore on May 31 proposed requiring health insurers to offer children the same level of coverage for mental illness as they provide for other medical needs. The proposal was part of a broader plan by the presumed Democratic nominee for president to combat the stigma of mental illness and expand access to treatment. "Mental illness is nothing to be ashamed of," Gore told several dozen advocates for the mentally ill. "But stigma, discrimination, and ignorance shame us all."

The release of Gore’s mental health agenda was the latest in a series of events this week to outline his positions and flesh out his personal background after weeks of attacking his presumed Republican rival, Texas Gov. George W. Bush. Gore unveiled the plan at a mental health forum co-hosted by his wife, Tipper, who disclosed last year that she took medication for depression after their only son was struck by a car and nearly killed in 1989.

Gore called for training teachers to spot symptoms of mental illness, expanding programs for the homeless and strengthening protections of patient privacy.

The government’s total cost, which would be covered by the federal budget surplus, would be $2.5 billion over 10 years, a Gore aide said. The cost of health insurance to employers and consumers would rise by roughly 1%. Gore’s key proposal was to expand insurance coverage for children so that mental illness is treated the same as heart disease, diabetes, or other physical ailments. The requirement would apply to employer-sponsored health plans and to the Children’s Health Insurance Program, which covers youngsters in families with incomes too high to qualify for Medicaid.

Mental health experts say children with mental disorders who get treatment are less apt to commit suicide, drop out of school, abuse drugs, or turn to violence. Gore cited the two boys who shot and killed 12 schoolmates, a teacher, and themselves last year at Columbine High School in Colorado. "As Columbine taught us, we cannot wait until tragedy strikes to reach out effectively to troubled young people and give them help and hope," Gore said.

Los Angeles Times