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This column features selected short items about state health care policy.
LANSING, MI—The Michigan Health & Hospital Association (MHA) says plans to cut state Medicaid funding would result in a loss of $14 million to nonprofit community hospitals. Michigan’s House and Senate appropriations committees has approved an executive order by Gov. John Engler that calls for the Medicaid cuts.
"The latest round of Medicaid cuts is clearly inappropriate. At a time when Michigan residents expect and deserve a strong and responsive health care system, the state is sending the wrong message, that health care doesn’t count," said MHA President Spencer Johnson. He noted that Michigan faces the continued loss of programs and services because of government cuts to health care, and hospitals now face costs estimated at $100 million to prepare for public and employee safety and potential disaster protocols.
—American Hospital Association, Nov. 8, 2001
WASHINGTON, DC—Health and Human Services Secretary Tommy Thompson indicated that President Bush would likely agree to a Democratic provision in an economic stimulus plan that would assist unemployed workers pay for health insurance coverage.
Thompson said if the measure meets the overall parameters the president set for the stimulus package, the president would sign it. Such a provision is absent in Bush’s original $60 billion to $75 billion stimulus plan, as well as the House $100 billion plan.
Treasury Secretary Paul O’Neill echoed the sentiments, saying the administration may accept elements of a compromise $75 billion plan offered by Senate moderates, which includes assistance to the unemployed for health coverage, business and individual tax cuts, and an extension of unemployment benefits by 13 weeks. Thompson additionally remarked that the public health system would need at least $300 million a year for five years to combat bioterrorism.
—American Hospital Association, Nov. 21, 2001
DES MOINES, IA—According to the Iowa Department of Inspections and Appeals, Georgian Court of Oskaloosa failed to supervise seven residents, resulting in three residents falling and one resident eloping twice without being noticed by the staff.
The home also was cited for numerous deficiencies related to residents’ rights, quality of care, dietary services, pharmacy services, and cleanliness. During a state inspection, the staff allegedly failed to clean feces from a couch near the nurses’ station for more than six hours.
The administrator and director of nursing allegedly told the inspector that they did not know what sort of in-service training they needed to provide for the staff.
Earlier this year, when the home was operating as Siesta Manor, it was fined $250 for allegedly failing to provide kind and considerate care. The state alleged that a worker had become angry after observing a resident feed ice cream to a fellow resident with cerebral palsy.
—Des Moines Register, Dec. 1, 2001
NASHVILLE, TN—Gov. Don Sundquist’s proposal to rewrite the TennCare program is so far-reaching that TennCare advocates and medical provider groups want lawmakers to delay the plan, perhaps until a new governor is elected. Sundquist has proposed replacing TennCare with a managed-care Medicaid program for Medicaid-eligible Tennesseans and creating a separate HMO-style program for the state’s chronically ill "uninsurables" — adults under the poverty level and poor children without access to health care — if there’s money to fund it. Under Sundquist’s plan, an estimated 180,000 TennCare enrollees would not be eligible for either of the replacement programs. The restructured program would go into effect Jan. 1, 2003, only days before Sundquist leaves office.
Given Tennessee’s financial straits, lawmakers, TennCare advocates, and medical industry officials fear the state won’t have the money to fund the HMO-style "TennCare Standard" program for those who aren’t Medicaid-eligible.
As a result, they fear, Sundquist’s plan could push as many as 500,000 Tennesseans off TennCare with no access to health coverage. The loss of those patients also would cost the state’s health care system $1 billion in federal Medicaid matching funds, they say.
—Memphis Commercial Appeal, Dec. 3, 2001
NASHVILLE, TN—TennCare recipients remain satisfied with the care they receive under the 7-year-old program for poor and otherwise uninsured Tennesseans, according to a new survey. They’re also seeing doctors without excessive travel or waiting time, and visiting emergency rooms less frequently, according to the survey by the University of Tennessee-Knoxville.
The survey of about 3,000 TennCare recipients found that 79% of respondents are satisfied with TennCare, a figure that has remained stable since 1996.
"TennCare continues to achieve its mission — effective health care within a predictable budget for Tennesseans who are Medicaid eligible or who lack access to health insurance," said TennCare Director Mark Reynolds in a statement detailing the survey’s findings. "It’s also important that members are satisfied with the quality of care they’re getting."
Three-quarters of the TennCare recipients rated the quality of medical care for their children as either "excellent" or "good," according to the TennCare bureau. That was a slight improvement over last year.
—The Tennessean, Dec. 2, 2001
SACRAMENTO, CA—A statewide coalition of community groups and three state lawmakers, have joined to ask for federal approval to let parents enroll in a government insurance program for poor children.
California officials requested a waiver in December 2000 from the U.S. Department of Health and Human Services to allow low-income parents to enroll in the Healthy Families program. But since then, Gov. Gray Davis has proposed delaying the expansion as part of cuts to this year’s budget, which would save $53 million. Members of the Pacific Institute for Community Organization, which advocates for the working poor, said Monday they want the state funds protected and for Health and Human Services Secretary Tommy Thompson to approve the long-sought waiver.
Rob Sweezy, director of public affairs for the federal Centers for Medicare & Medicaid Services, said California’s application was still under review.
Thompson approved applications by Minnesota, Wisconsin, Rhode Island and New Jersey earlier this year.
—Associated Press, Dec. 3, 2001
ATLANTA—Georgia health officials are dispatching 150 state employees to check on the welfare of 3,600 people with mental retardation in group homes and other private residences, says Human Resources Commissioner Jim Martin. The move came as an immediate response to news stories about 163 residents of the homes who died under the state’s watch during the last four years. The deaths included people who were scalded, malnourished, severely bruised, and dehydrated; at least 13 died as a result of choking.
"If there is a person in crisis, we will identify that," Mr. Martin said. "Based on that information, we will move to our next step — how we go about improving the system for all of our people."
—Atlanta Journal-Constitution, Dec. 4, 2001
ST. PAUL, MN—Gov. Jesse Ventura and top legislators say they will delay consideration of proposals to lower health care costs for at least a year while a task force examines the issue.
Ventura, joined by top officials and legislators, announced plans to form a task force made up of senators and representatives that will receive advice from a community group. The group will include former U.S. Sen. David Durenberger, health providers, consumers, and labor and business leaders. Mr. Ventura said the group should try to tackle rising premiums, suggest ways to engage consumers in decisions about their care, and propose ways to stabilize the market through new insurance risk pools.
Still, as the governor acknowledged, the move all but guarantees that no significant changes will be undertaken during the governor’s first term in office. He has not said whether he will seek reelection. "It’s a problem that is monumental, so it’s going to take awhile," Mr. Ventura said. "It’s going to go long through the legislative session and past the election of next year."
—Associated Press, Dec. 4, 2001