California governor signs bill to stop circumcision ban
Sacramento, CA, United States (AHN) – California Gov. Jerry Brown signed a bill Monday prohibiting cities and counties from banning male circumcision.
The bill was the result of a San Francisco measure, the first of its kind, designed to prohibit child circumcision there. The initiative drew national attention. A judge in July ordered the circumcision ban off the November ballot, but Los Angeles assemblyman Mike Gatto’s bill proceeded through the Legislature and was passed with a unanimous vote. Gatto argued that such bans were an affront to the exercise of “personal, medical and religious freedom.”
Circumcision is the removal of the male foreskin, a practice that has roots at least as far back as Biblical times. Many proponents believe it was commanded by God in a covenant with Abraham. Opponents of circumcision say it is akin to “genital mutilation,” the forced removal of a healthy body part from an unconsenting child.
Circumcision rates in the United States have been declining. According to the Centers for Disease Control and Prevention, currently half of all males born in U.S. hospitals are circumcised.
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Oakland clinic provides medical care to ex-offenders
Oakland, CA, United States (KaiserHealth) – Most former inmates leave California prisons with no consistent place to get medical care. Instead, they rely on a scattershot of county-funded clinics or end up at county emergency rooms. But in California, that’s beginning to change.
The state negotiated with the Obama administration to gain early access to funds available under the federal health law. Starting last month, counties began enrolling all low-income residents — including ex-offenders — into a version of Medi-Cal.
Ex-convict Darren Thurmond wears a prison-issued grey sweat suit, stretched tightly over his large belly and carries a crumbled brown paper bag, as he climbs out of the prison van stopping just outside the metal gates of San Quentin.
Waiting for him is Don Williams – a counselor from a local health clinic who’s here to give Thurmond a ride to Oakland.
“I’m not sure how many times I can do this, man,” Thurmond says to Williams.
Thurmond has been in and out of prison in the last twenty years for cocaine and methamphetamine possession. Now at age 45, all the drug use and hard living has damaged his heart.
Like many ex-convicts, he says hasn’t had health insurance since he was a kid, and his heart problems were first diagnosed and brought under control in prison. But each time Thurmond gets out, he’s left with a 4-week supply of medication and no insurance. Now that’s changing.
With the early expansion of health coverage this summer, former inmates will be covered for preventive care, prescription drugs, specialty visits and mental health and substance abuse. One place where Thurmond will now get care is at the non-profit Healthy Oakland, his first stop after his release from prison.
This is one of the few clinics in the state that offers medical care to ex-convicts who have typically been excluded from public insurance programs like Medi-Cal.
Thurmond sits down for a full medical checkup with George Pearson, the clinic’s physician assistant. They discuss his heart problems, his weight and the painful arthritis that’s overtaking Thurmond’s hips.
Pearson says a 45-year old ex-convict will often have the ailments of someone 10 years older. They have higher rates of almost all chronic conditions, like high blood pressure, diabetes and asthma. To be sure, these ailments stem from living a hard life, but it’s also because they have common medical problems that go untreated.
“So the hypertension becomes heart failure. The diabetes becomes diabetic neuropathy, which can lead to amputation, even blindness,” Pearson says.
Researchers say that when these pervasive problems are left untreated, they can lead right back to prison or jail, and that giving ex-offenders health insurance and assigning them a regular doctor brings some order to their chaotic lives.
“Their whole life is transitional. And it lacks stability. You need a facility that’s going to be the home of their records, [that's] going to know them as a person,” Pearson says. Having a regular health care provider can prevent ex-offenders from over utilizing the ER.
Expansion of Care in Some Counties
Some county health departments are using the new federal money to re-structure their safety nets to provide a fuller array of services. For example, Alex Briscoe of the Alameda County public health department says he’s adding mental health specialists to primary care clinics.
“Historically, services for this population are fragmented and tend to be episodic. And what we’re trying to do is prepare for health reform by assigning all consumers in our system, all clients in our system, to a medical home.”
Those preparations are especially important as California begins to comply with a court order to reduce its state prison population. To relieve overcrowding, tens of thousands of lawbreakers are expected to be put on probation in their home towns instead of going to state facilities. That means even more ex-offenders signing up for the expanded health coverage.
However, health researchers say the new enrollees will likely only add to a maxed out Medi-Cal system. Wait times for specialists have long plagued Medi-Cal across California, largely due to the state’s low reimbursement rate.
Still, providing coverage is important for public health, experts say. Emily Wang of the Yale School of Medicine says many former inmates return home with communicable diseases.
“Treating substance abuse, HIV, hepatitis C will reduce the disease rates in our communities,” she says.
But Wang and others say health insurance though is no magical cure for a group of people with more pressing, every day needs.
After Darren Thurmond finished his doctor’s visit at Healthy Oakland, this reporter drove him to a pharmacy to pick up his many prescriptions. By bus, this trip would’ve taken an hour, plus a painful walk with his arthritic hips.
Afterward, we headed to a Mexican restaurant in downtown Oakland for lunch. Thurmond says he had fantasized in prison about authentic enchiladas.
He’s thankful that he now has a regular doctor, he says. But he’s homeless. Living in his van, he’s unsure how he’ll get to his appointments to get his blood work checked or his prescriptions refilled.
“Being homeless, often I have the time to do it, but I don’t have the gas to get there,” Thurmond says.
For now, Thurmond is thinking pragmatically. On his first day out of San Quentin the basics are his main concerns: finding a job, getting money for food and gas, and a place to shower. “I’m pretty resourceful,” he says with no hint of pity. “I know a few places where I can shower.”
Alex Liu contributed to this story.
– Provided by Kaiser Health News.
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Brown to unveil revised California budget, tax proposal
Sacramento, CA, United States (AHN) – California Gov. Jerry Brown on Monday was set to unveil an updated budget plan to close a record $26.6 billion deficit while taking into account better-than-expected April tax receipts and Republican opposition to a June ballot on tax extensions.
The announcement will come as the end of the fiscal year looms, and teachers and students in the state, which has the nation’s largest university system and the world’s eighth-largest economy, protest further cuts.
Brown early this year proposed a plan reducing spending by $12.5 billion, including $1.4 billion in cuts to higher education, and generating $12 billion from an extension of taxes that are due to expire this summer.
The tax extensions require a June ballot that in turn, must first be approved by two Republicans from the Assembly and two from the state Senate. The deadline for including the extensions in the ballot has passed, and unions have asked lawmakers to instead pass a bill allowing the ballot.
The governor’s revised budget plan is expected to seek at least some of his revenue-generating tax hikes even as Republicans point out the state’s more than $2 billion in unanticipated April tax revenue.
Last week, Brown announced drastic measures such as eliminating the Unemployment Insurance Appeals Board and shuttering 70 of 278 state parks, including the governor’s mansion.
Eliminating the appeals board, which is composed of appointees who preside over appeals on disputes about jobless and disability claims, would save the state $1.2 million.
The closure of parks would reduced spending by $11 million in the fiscal year starting in July, and another $22 million the following year. Parks with the least attendance and cultural and environmental significance were chosen for the closure, which will not affect 92 percent of public attendance in parks.
Brown, who served as governor for two terms nearly three decades ago, also plans to merge the state’s two personnel agencies into a single human resources department to save at least $5.8 million.
Previously, he ordered a hiring freeze and slashed the number of state cars and cell phones by 50 percent.
Republicans, who released an alternative budget plan last week, have railed against the latest proposals as “posturing” and ” misguided threats.”
State GOP spokesman Mark Standriff called the planned closure of parks “a ‘Washington Monument Strategy’ that is both cynical and manipulative, and shows little respect for the taxpayers.”
The Republican plan relies on the higher April revenue to prevent cuts to education and law enforcement. It does not raise taxes and calls on state workers to “do their part” with a 10 percent reduction in pay, benefits and other employee costs, which the GOP says would provide the government with $1.1 billion in savings.
The California Teachers Association, which held statewide protests last week, said the GOP’s alternative proposal would leave a $14.7 billion budget gap and fails to provide “real solutions.”
The San Francisco Chronicle said in its editorial on Monday that the GOP plan “should be dismissed as a nonstarter,” because it “included a heavy dose of borrowing and reliance on ‘savings.’ ” The newspaper also blasted Republicans for pushing “a ridiculously long wish list that strayed far from the subject of the budget.”
In March, Brown ended negotiations with Republicans after what he said was “an ever changing list of collateral demands” in return for support for a special election, such as giving a $1 billion tax break to out-of-state corporations so the companies would bring jobs to California.
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California mom admits to giving 8-year-old botox
San Francisco, CA, United States (AHN) – A British beautician has sparked the ire of parents on both sides of the Atlantic after revealing she injects Botox into her 8-year-old daughter’s face every three months. The reason– so the child can be a “star.”
In a report in the Sun of London she said, “I wish that I’d had the same advantages when I was younger.”
“I know one day she will be a model, actress, or singer, and having these treatments will ensure she stays looking baby-faced for longer,” added Campbell, who now resides in San Francisco.
Campbell admitted she purchases Botox and Restalyne over the Internet and first tests them on herself before injecting them into her daughter.
Kerry also gives her daughter regular full-body waxes. “She also has her virgin wax monthly, which gets rid of her fluffy leg hair and makes sure she won’t develop pubic hair in the future,” said Kerry. “It will save her a fortune in waxing when she’s older.”
Despite experts warning that Botox is only considered safe for adults there currently aren’t any laws stating that it is illegal to inject it into children.
Britney Campbell who frequently competes in beauty pageants said that she no longer “cries that much” during the injections. She also hopes to get a “boob and nose job soon, so that I can be a star.”
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Health Overhaul Could Double Community Health Centers’ Caseload
United States (KaiserHealth) – Community health centers serve 20 million people every year, and that number is expected to double by 2015, thanks to an $11 billion infusion from the health-care overhaul and $2 billion in federal stimulus funds.
If you’re a middle-income worker with health insurance through your job, chances are these centers have been under your radar, since their target clients are low-income and uninsured people. But as the number of uninsured has risen to 50 million, more people than ever are struggling to get and pay for health care, and community health centers are an affordable option. As they expand, they’re adding new services and new locations nationwide.
Although their mission is to provide a primary-care safety net for people in underserved areas, no one is ever turned away from a community health center. People with incomes up to 200 percent of the federal poverty level ($44,700 for a family of four in 2011) pay on a sliding scale; uninsured people with higher incomes pay the full cost of care, which is generally comparable to costs in the private sector. The centers accept Medicaid and Medicare in addition to many private insurance plans.
The new health care law is full of incentives to encourage doctors to provide “medical homes” for their patients, with coordinated care and close patient monitoring to stay on top of necessary preventive services. But community health centers have always taken this approach, say experts.
“It’s necessity on their part,” says Laurie Felland, a senior health researcher at the Center for Studying Health System Change. “Because of the difficulty low-income people face in getting services, … community health centers over time have tried to add them.”
In addition to primary care, many community health centers have behavioral health providers, pharmacies, and preventive and restorative dental services on site. Some have pediatric centers, reflecting the fact that more than a third of their patients are children.
At the William F. Ryan Community Health Center on Manhattan’s Upper West Side, the new women and children’s center is decorated in slate gray with bright primary color accents. The building has banks of windows looking down on the street and is so expansive that staff members carry around tablet computers to keep tabs on patients, says Jessica Sessions, director of pediatrics. “Patients are happier here,” she says.
A Commonwealth Fund survey of 800 community health centers last year found that 29 percent of them had all five medical-home indicators it measured, including usually providing same- or next-day appointments, off-hours clinical advice, tracking of test results, tracking of patient referrals to specialists, and being able to generate lists of patients by diagnosis. Another 55 percent of centers had three or four indicators.
Still, arranging for specialty care can be tough, the survey found. Ninety-one percent of centers said they had trouble getting their uninsured patients in to see a specialist, while 71 percent said that was the case for Medicaid patients, and 49 percent reported difficulty scheduling their Medicare patients with specialists.
Wait times are another problem at many centers. In part, because they don’t turn anyone away, getting an initial appointment can take months. Once someone becomes a patient at a center, wait times for appointments aren’t generally as long, but they still exist.
Mark Cushman says he generally waits two to three weeks for a non-urgent appointment at the community health center near his home in Medford, Ore. Laid off from his job selling ads for a local newspaper, he has a part-time position at a local car dealership that doesn’t provide health insurance.
Cushman, 54, recently visited the health center for blood work and to refill his prescription for a statin drug to keep his cholesterol in check. His bill for the office visit was $28, the prescription $4, and the blood work a few dollars more. “It’s great,” he says of the center. “What a relief to have this.”
You’d never know it wasn’t a private clinic, he says, except for the less-than-luxe waiting room. And that will change soon, says Peg Crowley, the center’s executive director. Under the health-care overhaul, the center received nearly $2 million to renovate its facility. The money will allow officials to spruce up the aged facility, but more important, redesign it for better workflow and efficiency. Continued federal funding for community health centers faces some obstacles. House Republicans have suggested they may trim the government’s contributions as part of the party’s effort to cut spending.
In keeping with their focus on preventive care, an increasing number of community health clinics are emphasizing wellness services. At the Petaluma Health Center, in California’s Sonoma County, patents are receiving evidence-based care that melds Eastern and Western medicine. An eight-week chronic-pain group, for example, introduces participants to a variety of integrative approaches to managing pain, including acupuncture, meditation and Qigong, and helps show them how nutrition and sleep habits contribute to pain, says Fasih Hameed, a physician there.
Rebecca Langenfeld participated in one of the center’s pain groups. Langenfeld, 59, has Sjogren’s syndrome, an autoimmune condition that causes dryness of the body’s mucous membranes as well as joint and muscle pain and fatigue. Langenfeld says the pain group and the acupuncture sessions she’s had at the clinic have helped.
“I wish that every clinic would do this stuff,” she says.
– Provided by Kaiser Health News.
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On Health Law’s Anniversary: Predictions For Next Year
Washington, DC, United States (KaiserHealth) – The health care law has been on a roller coaster ride since its passage one year ago, moving forward with implementation plans even as opponents throw up legal and legislative challenges to stop it in its tracks.
At Kaiser Health News, we wondered where these moving parts might be in March 2012, at the measure’s two-year mark. So we asked players and experts from across the nation what they thought the landscape would be like – and, in their view, should be like.
They discussed issues ranging from the new insurance marketplaces called exchanges to the future of accountable care organizations: combinations of hospitals, doctors and sometimes insurers. Here are their edited responses:
Bill Hazel
– Secretary of Health and Human Resources in Virginia, one of the states challenging the constitutionality of the law.
We will be extraordinarily busy. We will probably have designed the new marketplaces – the exchanges – as best we can, but we will still have to go back to the General Assembly for implementation. We’ll have a whole lot to do in a very short period of time. Unless something changes with the law, we will have the whole issue of getting the benefit exchange up and running. Getting it implemented will be a technical challenge.
Currently, everything is in a state of flux. We suspect that aspects of the bill will change with this Congress and we also have the lawsuits, which likely will not be resolved by this time next year.
In Virginia, we’ve authorized the Bureau of Insurance to enforce the law as it stands today. We’ve been told by the General Assembly to plan an exchange and bring it back for approval next year. And we have money budgeted to build an infrastructure that will allow us to determine eligibility for both the formerly eligible and the people newly eligible for Medicaid. We’re trying to streamline and automate the process and are well into that.
Lloyd H. Dean
– President and CEO of Catholic Healthcare West
Over the next year you’ll see more ACOs and more sharing of data and integrating ourselves with other providers.
We’ll begin to see the cost curve bending in the organization. Last year we were one of the first organizations in the country to launch a major accountable care organization – I like to call it a triumvirate, with CHW, Blue Shield of California and Hill Physicians. That’s been a success: We’ve reduced hospital admissions by 22 percent; we’ve reduced the length of stay and hospital days by almost 13 percent. A year from now we’ll be relatively far along in the path of implementing our new electronic health record.
What’s important here is that we’re not sitting on the sidelines waiting for something to happen in Washington, D.C., before we all get in the game. When you look at us a year from now, we’ll be more efficient, with better medical outcomes and better alignment with our physicians and others in the communities we serve.
Tom Goldstein
– Attorney, co-founder of SCOTUSblog
One year from today we should be waiting for a ruling from the Supreme Court. The courts of appeals should have decided the constitutionality and upheld the statute of the reform bill by this fall and the cases should have proceeded quickly to the Supreme Court for expedited consideration.
During the appeals process, I will be watching whether a court invalidates the individual mandate and therefore the entire law. I think that there will have been vigorous dissents on the Commerce Clause so the issue of the fate of the law will still be unsettled by the time it gets to the Supreme Court. But once the cases have been argued, I think the conventional wisdom is that the statute will be upheld because the justices have taken a very broad view of Congress’s power.
Wendy Schiller
– Associate Professor of Political Science and Public Policy, Brown University
The health care message is going to get more complicated for the American voter in 2012. The Republicans clearly ran against the health care bill in 2010, but they’re going to have to come to the table in making cuts to Medicaid and Medicare in the next year. You can’t even get close to cutting the deficit if you don’t cut entitlement spending. It’s going to be much harder for the Republicans to make this a key issue in the 2012 elections.
In Obama’s favor, a lot of the provisions of the health care bill will kick in. And the more people who actually benefit, the more entrenched these programs will be. As we see with Medicare and Medicaid, once a program is entrenched and voters see clear benefits, the [program is] almost impossible to get rid of.
Independents are the only [voting] group you’re really looking at in terms of health care. And the issue will be the battles for the key states — Ohio, Pennsylvania, Illinois, Michigan, Florida and California. It’s really, ironically, going to be a much more localized issue than it is a national issue. From this point forward, it’s the implementation of the health care act that will matter much more for Obama in 2012 than the passage of the act itself.
Ceci Connolly
– Senior Adviser, McKinsey Center for U.S. Health System Reform
What I will be watching are the Republican presidential primaries and the CMS innovation center. I want to be keeping an eye on that, because I feel strongly that the real transformation in health care will come from the private sector. So I am very eager to see if and how quickly seed money from the innovation center can foster truly significant change. Will the innovation center grants help us find a way to deliver the right care at the right time for the right price?
I think what has been striking about health care to date here in the U.S. is this: We have amazing one-off success stories. We can point to them dotting the landscape but the real question is, can and will those be replicated or expanded? That’s why I’m eager about the private sector, but also hopeful that at least this grant money could help nudge it along.
Steven E. Wojcik – Vice President, Public Policy, National Business Group on Health
By March 2012, we hope to convince Congress to adopt medical liability reform that limits how much providers pay in non-economic damages and restricts attorneys’ fees. The administration has signaled that it is open to changes, and there’s a significant gap in the health care law to reduce the unnecessary, added costs we all pay for defensive medicine.
We also will have made sure health care payment reforms pilot projects called for in the health law get implemented quickly and widely throughout the Medicare program because we want to be paying for outcomes and quality not just care. We expect to work through the regulatory process to make sure “consumer directed” or high-deductible health plans are allowed to be offered as rules get drawn up for new insurance exchanges. These plans are the key to getting health costs under control.
Sarah James – Analyst, Wedbush Securities
One of the insurance industry’s main focuses in the next year of health care reform is medical loss ratio [provision, which requires insurers to spend 80 percent of premium revenues on medical care] and how it may change. There’s a push to change the definition of MLR to exclude brokers’ commissions. If it goes through, it would be very positive for the managed care plans. Also, removing broker commissions from premium revenue would make it easier for plans to stay in states like Maine.
Also, there’s the impact of exchanges. Each state’s exchange could be different, creating some favorable markets and some less favorable markets. Another negative aspect is the potential repeal of the individual mandate, which fines people for not having insurance. If you remove that, you’re more likely to have healthy people stay out of plans.
Meanwhile, a lot of insurers are diversifying to areas outside the U.S. with a particular interest in Asia, and also in the technology area. There’s a lot of federal money coming into health information technology.
Katie Mahoney – Director of regulations, U.S. Chamber of Commerce
By March 2012, we hope to persuade Treasury to clarify how the health law bans employers from giving richer health benefits to high paid executives than their employees. We want the regulations to be made clear so employers are not unfairly accused of discriminating against their employees.
The Chamber also hopes to convince regulators to define “essential benefits package” in a less extensive way so it doesn’t make the cost of coverage unaffordable. We don’t want every desirable benefit to be required, because that will drive up costs. The Chamber expects to work through the regulatory process to make sure that employers continue to have important flexibility to design workplace wellness programs. The health law expands the incentive amount that employers’ can offer to workers for participating in wellness programs beginning in 2014. The Chamber also hopes to convince Congress to change the health law’s provision that bars employees from using their flexible spending accounts from buying over-the-counter medications unless they have a doctor’s note.
Howard Bedlin – Vice President for Public Policy and Advocacy, National Council on Aging
Seniors will become more aware of what’s in it for them, because there’s still a lot of confusion and misunderstanding about the implications of health care reform in general. If you’ve been looking at the Kaiser tracking polls, many people don’t even know it’s law.
People will gain a greater understanding of what this means, the fact that some of the Medicare reductions did not cut benefits or impede access to care. They did not cut payments to doctors. They will have access to physicians and may have better access to primary care physicians. Hopefully more will avail themselves of preventive services, annual wellness visits.
I do think an important issue next year, particularly in the fall before the elections, will be what the trends are with regards to Medicare Advantage plans. It will vary a lot by geographic region. What happens next year will have particular implications for folks. We’re talking about a quarter of beneficiaries.
I anticipate that sometime next year, the CLASS program [voluntary long-term care insurance] will be made available for people to sign up. That will affect baby boomers more than seniors, because there will be a work requirement. But seniors who are working will be eligible to sign up. It will provide some meaningful benefits for folks that will be interested in it.
Thomas Johnson – President and CEO, Medicaid Health Plans of America
By March 2012, we want to have regulations on accountable care organizations that ensure managed care plans can play a major role in these new payment and delivery systems. We hope to convince more states to carve drug benefits back into Medicaid managed care. Many states now exclude drug benefit from being managed by their Medicaid managed care plans. We hope to have more guidance on how Medicaid will interact with the insurance exchanges. There should be a recognition that Medicaid health plans have experience in dealing with this population with complex medical histories, and we think our health plans are well suited to be in the exchange. Medicaid health plans should have the option of offering coverage to small business and individuals in the exchanges. We don’t think there should be any barriers that limit their participation.
David Godfrey – Medicaid director, Minnesota
I think we will have made a lot of progress in terms of trying to put the pieces together necessary at the state level to prepare for the creation of the exchanges, although a lot of work will still need to be done on that. But we’ll have a framework, I believe. Also (we’ll be) pursuing different grant opportunities through the ACA, and also begin thinking about policy and program redesign and response to the ACA as well. There’s a lot of interest in administrative simplification. We think this is an opportunity for that. There’s still a lot of work to be done in that area, and we’re still waiting for a lot of the guidance from CMS in terms of just what our programs need to look like by 2014.
The backdrop to all this is we have a significant budget deficit, and there’s going to be incredible pressure in trying to find cost savings in the Medicaid program in response to that and just trying to manage those pressures but still moving forward and putting into place the building blocks we need for 2014.
Rose Ann DeMoro – Executive Director, National Nurses United
(What will you be doing this time next year?) Same thing we’ve been doing: Fighting for a single payer health system, Medicare for all. We’re working with [Sen.] Bernie Sanders in Vermont on his campaign for single payer.
It’s incumbent on us to figure out a way to pay for it and how to get the ideological opposition groups out of the way. We see the Obama thing as essentially a setback in fighting for genuine reform. Obama says he is trying to figure out a way to provide health care for all, and the industry turns around and raises rates to make it unaffordable. We’ve done massive protests in an effort to get insurers to get rate increases rolled back. The problem is that Obama and the Democrats are bipartisan, but the right wing is not.
– Provided by Kaiser Health News.
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Initial jobless claims drop to 385,000
Washington, DC, United States (AHN) – Both the number of Americans filing first time jobless claims and the number filing ongoing claims have dropped, the Department of Labor announced Thursday.
Initial unemployment claims filed during the week ending March 12 were 385,000, representing a decrease of 16,000 from the previous week’s revised figure of 401,000.
The four-week moving average dropped to its lowest rate since July 2008. It was 386,250, a decrease of 7,000
Ongoing jobless benefits claims dropped by 80,000 to 3,706,000 during the week ending March 5, the most recent week for which data is available. That was below the 3,750,000 continuing claims economists had expected and it was the lowest number of continuing claims since September 2008.
Although the amount of time that individuals can claim jobless benefits varies by state, the maximum benefit period in 99 weeks. In addition, not every jobless American qualifies for unemployment benefits. The percentage of Americans covered by the unemployment insurance compensation program remained unchanged at 3.0 percent for the week ending March 5.
For the week ending Feb. 26, the number of people claiming benefits in all jobless programs was 8,953,610.
Extended benefits were available for the jobless in 35 states and the District of Columbia. Those states were Alabama, Alaska, Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Virginia, Washington, West Virginia and Wisconsin.
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States’ Mental Health Budgets Fall In Recession
Washington, DC, United States (KaiserHealth) – In the days following the shooting of Rep. Gabrielle Giffords in Tucson, there was close scrutiny of the inadequacies of the nation’s mental health system. Worrying that the spotlight has already faded, the National Alliance on Mental Illness, a grassroots advocacy group examined recent state budget cuts and found that from 2009-2011, states cut $1.8 billion or about 8 percent, from their total state mental health budgets.
That’s compromising an already frayed system, according to NAMI’s new report out today, based on state budget documents.
That’s at the same time that demand for community-based services is actually going up in most states, according to the National Association of State Mental Health Program Directors (NASMHPD).
States Making Biggest Cuts To Mental Health
Here are the 10 states making the biggest percentage cuts to their mental health budgets:
- Kentucky 47.5%
- Alaska 35%
- South Carolina 22.7%
- Arizona 22.7%
- Wisconsin 22.4%
- Nevada 17.3%
- Kansas 16.4%
- California 16.3%
- Illinois 15.1%
- Mississippi 14.7%
- Washington D.C. also was high on the list, with a 19.1 percent cut.
Source: National Alliance on Mental Illness
States have already or have planned to cut 3,930 state psychiatric beds since 2010, which represents over 8 percent of total bed capacity, according to NASMHPD Research Institute data. And NAMI executive director Michael Fitzpatrick says the latest cuts — affecting emergency and long-term hospital treatment, mental health case workers and crisis teams — only make things much worse: “People end up involved in the criminal justice system, living in homeless shelters and going to the emergency room.”
Thirty-two states and the District of Columbia have cut their mental health budgets since 2009. The budget ax in Kentucky was the most severe, cutting 47.5 percent of their budget. Alaska was second at 35 percent.
States are undoubtedly in a no-win situation, as they face daunting multi-billion dollar budget shortfalls and are still struggling with the effects of the recession. The choice often comes down to health care, education and other essential government funded programs.
“States are making budget cuts across the board, and few areas are exempt,” says Stacey Mazer, senior staff associate at The National Association of State Budget Officers. “If anything, due to the financial aid from the Recovery Act funds, education and Medicaid tend to be areas that are cut last after” other government functions, such as administrative services, accounting and parks.
Kevin Martone, president of NASMHPD, however, explains that “because mental health services have traditionally been paid for out of state general revenues, the impact of the downturn in the economy has been more devastating on these services than to other safety net services for general healthcare.” State general funds, which are administered by state mental health authorities, represent 40 percent of total state support for mental health services. Medicaid, the joint federal-state health insurance program for low income people, makes up another 46 percent.
Martone adds that while “other safety net health providers such as community health centers received infusions of federal stimulus dollars that mental health did not receive while the demand for services increased.”
Now, Medicaid services are due to be on the chopping block as well in many states. Medicaid received a temporary increase in federal funding from the stimulus package, which has helped to fill a growing hole in many state budgets. But that extra funding is set to expire on June 30. Mental health budgets are particularly vulnerable in the next budget cycle, because many of the services are technically “optional” benefits under federal Medicaid rules and can therefore be cut.
NAMI’s Fitzpatrick points to the Giffords tragedy and the aftermath of the 2007 shooting at Virginia Tech, which killed 32 people, and says that, after all the attention, the nation “walks away.”
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GOP governors cold to Obama offer to let states opt out from healthcare
Washington, DC, United States (AHN) – Republican governors have coldly received the administration’s offer to let them opt out of the federal healthcare law earlier to help states address growing deficits and increasingly costly Medicaid programs.
“Pretty much all he did was reset the clock on what many of us consider to be a ticking time bomb,” Texas Gov. Rick Perry, chair of the Republican Governors Association, told Townhall.
President Barack Obama over the weekend announced his support for a bipartisan bill that allows states to implement their own healthcare system by 2014 instead of 2017.
The federal Affordable Care Act, which passed Congress with only three GOP votes, provides coverage for 94 percent of Americans by requiring everyone except for those under 100 percent of the poverty level to purchase health insurance.
It makes Medicaid benefits available to more people by making virtually all adults younger than 65 and with incomes of up to about $15,000 a year eligible.
These two provisions, which have received the most opposition from states, are set to begin in 2014.
Several Republican governors have filed lawsuits to keep from enforcing a “one-size-fits-all” law in their state. They say the individual responsibility requirement is unconstitutional.
In addition, they believe the mandate on Medicaid, the biggest driver of the federal debt, would simply force them to “herd hundreds of thousands more people into today’s broken Medicaid system.”
Under the federal law, governors can apply for waivers in 2017 that would let them follow healthcare plans uniquely suited to the needs of their state.
The bipartisan bill from Sens. Ron Wyden (D-OR) and Scott Brown (R-MA) would let states seek waivers three years earlier as long as the same kind of coverage and affordability are provided.
Republican governors led by Indiana Gov. Mitch Daniels have asked for more control in limiting beneficiaries of Medicaid, which is jointly funded by states and the federal government.
They also want “complete flexibility” in deciding which insurers are permitted in exchanges, which are state-run marketplaces to help individuals and businesses choose health plans that comply with requirements of the federal law, such as providing coverage for those with pre-existing conditions.
The president offered an olive branch during his meeting with governors on Sunday, praising a former election rival and assuring them that he would support proposals to make the law better.
“Many of you have asked for flexibility for your states under this law,” Obama said.”In fact, I agree with Mitt Romney, who recently said he’s proud of what he accomplished on health care in Massachusetts and supports giving states the power to determine their own health care solutions. He’s right. Alabama is not going to have exactly the same needs as Massachusetts or California or North Dakota.”
Health and Human Services Department Sec. Kathleen Sebelius has said the federal government would cover 96 percent of the costs of expanding Medicaid under the law.
Nonetheless, the president asked governors to form a bipartisan group to work with Sebelius to find more ways to lower Medicaid costs while providing the same coverage.
“I will go to bat for whatever works, no matter who or where it comes from,” Obama said. “I am not open to re-fighting the battles of the last two years, or undoing the progress that we’ve made. But I am willing to work with anyone… to make care even better; to make it more affordable and fix what needs fixing.”
But critics have dismissed the president’s new approach.
The conservative publication Human Events cited Bill Felkner, director of policy for the Ocean State Policy Research Institute, as saying, “This will allow the states to follow their own path toward health care so long as that path leads to the same goal that is reached by the ‘Affordable Care Act’—ObamaCare.”
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Jobless economic recovery continues as unemployment claims rise to 410,000
Washington, DC, United States (AHN) – The ongoing recovery in the nation’s financial service sector still has not reached the rest of the economy, causing the number of Americans filing first time jobless claims to rise to 410,000 for the week ending Feb. 12.
That was an increase of 25,000 from the previous week’s revised 385,000 jobless workers who filed initial claims for unemployment compensation insurance, the United States Department of Labor said Thursday.
Some analysts had expected jobless claims to remain below the 400,000 mark. Economists say that if initial jobless claims fall below 400,000 weekly and stay there for a prolonged period that would signal the general economy had begun a recovery.
However, for now, it is the financial services sector of the economy, including the banks that started the economic crisis, that are recovering. The rest of the nation’s economy lags behind, meaning it is still a jobless recovery.
Federal Reserve Bank of Chicago President Charles Evans said Thursday that continued high unemployment coupled with low inflation meant that the Fed had missed both of its policy objectives and that the nation’s economy still needed help and time to dig its way out of the hole created by the recession.
In the meantime, the percentage of jobless workers covered by the unemployment compensation insurance program remained unchanged at 3.1 percent for the week ending Feb. 5 compared to the previous week, the latest dates for which that data is available.
A total of 9,250,156 people claimed benefits in all jobless programs for the week ending Jan. 29, the latest week for which such data is available.
Extended jobless benefits were still available in 35 states and the District of Columbia during the week ending Jan. 29. Those states were Alabama, Alaska, Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Virginia, Washington, West Virginia, and Wisconsin.
The largest increases in initial claims for the week ending Feb. 5 were in Michigan (+2,693), North Carolina (+1,222), New Jersey (+877), Maryland (+527) and Pennsylvania (+475).
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