Clip files / Local news from the states

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

Maine officials take steps to retain nursing force

AUGUSTA, ME—Maine’s shortage of nurses, technicians, and other health care workers is approaching crisis proportions, according to a new study that recommends spending $4 million a year on education to ease the problem.

The report calls for expanding health care training at Maine colleges and universities and free tuition for graduates who agree to stay and work in Maine.

"This issue represents a great risk to Maine people and the economy" unless the state takes bold steps to beef up health care education, said Senate President Michael Michaud (D-East Millinocket), who co-chaired the Committee to Address the Health Care Skilled Worker Shortage.

The panel found that working conditions, including long hours, have made it hard to attract and retain workers.

Portland (ME) Press Herald, Oct. 18

In a multistate buying program, a drug-purchasing group thrives

CHARLESTON, WV—Six states have signed on with West Virginia to create a multistate drug purchasing pool, says Tom Susman, director of Public Employees Insurance Agency (PEIA).

With 1.4 million insurees and $852 million in pharmaceutical claims in the 2001 budget year, the multistate drug purchasing program will have eight times the buying power of PEIA, he said.

"We will move our market share," he said.

By pooling the buying power of 10 public employee health insurance plans in the six states, the program should be able to get lower prices by buying from drug manufacturers in bulk, Susman said.

He also hopes that the multistate program will attract a pharmacy benefits manager that will be reimbursed at a fixed rate, not on a percentage of the drug costs.

"Currently, as we get sicker, they get wealthier," he said of percentage reimbursements for pharmaceutical claims processors.

PEIA will issue a request for proposals today for a pharmacy benefits manager for the new program, with a Dec. 10 deadline for firms to submit bids.

The goal is to award the contract in March and to initiate the purchasing pool July 1.

Charleston (WV) Gazette, Oct. 18

New leader: Changes made in Kentucky’s Medicaid program

FRANKFORT, KY—State Medicaid officials are moving ahead with changes expected to significantly reduce spending on prescription drugs in Medicaid, and they plan to bring on a new leader for the $3 billion program that serves the poor.

Health Services Cabinet Secretary Marcia Morgan told a legislative committee that Mike Robinson, director of administrative services in the Governor’s Office for Technology, will become Kentucky’s new Medicaid commissioner. Morgan said Gov. Paul Patton is expected to make an official announcement before Nov. 1, when Robinson takes over.

Robinson, 54, who has 18 years of state government experience in areas including finance, replaces Dennis Boyd, who was booted from the job after holding it for three years. Boyd was asked to resign in March in a move spurred by multimillion-dollar deficits in Medicaid and an intensified effort to overhaul the program.

Robinson, who did not want to comment until the announcement becomes official, steps in as the state prepares to have new restrictions — by Dec. 1 — on prescription drugs in Medicaid, the federal-state health program that serves 600,000 poor and disabled Kentuckians.

Lexington Herald-Leader, Oct. 18

Thirty-two states are now signed up for cancer Medicaid extensions

WASHINGTON, DC—HHS Secretary Tommy Thompson has approved 13 new state requests to extend Medicaid benefits to uninsured women who are diagnosed with breast or cervical cancer through a federal screening program.

Alaska, Arizona, Arkansas, California, Connecticut, Florida, Kansas, Hawaii, Nebraska, Maine, Michigan, Vermont, and Wyoming are the latest of 32 states to take advantage of the 2000 Breast and Cervical Cancer Prevention and Treatment Act. The federal law allowed states to expand Medicaid benefits to women who are diagnosed with breast or cervical cancer through the National Breast and Cervical Cancer Early Detection Program run by the federal Centers for Disease Control and Prevention.

—American Hospital Association, Oct. 22

Mississippi cautious about confusing flu symptoms with anthrax attacks

JACKSON, MS—Mississippi health officials expect heightened public interest in receiving flu shots this season because of the similarity in early symptoms between flu and anthrax.

"It’s not expected to be any more virulent or severe than in previous years," William Bell, MD, a physician at the Barnes Crossing Medical Clinic Urgent Care Center, said of this year’s expected flu strains.

"But people are going to be a lot more concerned with the early symptoms," Mr. Bell said. "Recently, with the West Nile virus, we had several calls about that."

The early symptoms of anthrax infection are similar to those of the flu, including fever, fatigue, and respiratory problems.

"All viral infections start out with symptoms similar to the flu," said Mary Currier, MD, state epidemiologist with the Mississippi State Department of Health in Jackson.

"This really is going to be difficult," Currier said, if the public starts associating those early symptoms with possible anthrax exposure. "We always have an increase in flulike symptoms this time of the year."

The state has ordered 110,000 doses of flu vaccine and began offering the shots last week at all of its county health offices. The cost of the vaccine is $10.

The Associated Press, Oct. 22

Doctors on the lookout in Nevada for clusters of new, strange diseases

LAS VEGAS—Nevada doctors are on alert to spot and immediately report unexplainable symptoms of disease, such as the sudden onset of severe pneumonia, coughing up blood, turning blue, and fluid-filled lungs.

Alerted to the potential for a biological attack in the United States, doctors nationwide are quickly learning how to detect symptoms of six diseases in particular. These are botulism, plague, smallpox, tularemia, anthrax, and viral hemorrhagic fevers, primarily Ebola.

These six diseases are the most feared by both doctors and government officials because of their high fatality rates.

The Centers for Disease Control and Prevention warned doctors nationwide to be on the lookout for unusual illnesses that may be caused by the release of a biological weapon designed to spread any of the six diseases.

Nevada doctors are looking for clusters of disease, strange disease patterns, or the sudden onset of disease in otherwise healthy people, said Dr. Dale Carrison, director of University Medical Center’s emergency department.

Las Vegas Review Journal, Oct. 19

Shortfalls in Maryland may mean cutbacks in Medicaid services

ANNAPOLIS, MD—As tax revenue continues to decline, fiscal analysts say Maryland is facing more than a $500 million shortfall in paying for Medicaid and other health care costs.

When lawmakers return to Annapolis in January, they will face the daunting task of trying to cover increasing health care costs not only in the next budget they prepare but also in the current year’s budget — work they supposedly completed during the last General Assembly session. The shortfalls could mean cuts in services for recipients of Medicaid, the health care program for the poor.

The shortfalls come only a week after Gov. Parris N. Glendening (D) announced $205 million in cuts to the $21 billion state budget because of weakening tax revenue. He instituted a state hiring freeze, canceled capital budget programs, and ordered state agencies to cut spending by 1.5%.

Washington Post, Oct. 24