Governor Rips Nursing-home Lobby, Says Tax Cut Possible in '12

By Joe Vardon - THE COLUMBUS DISPATCH

In a suburban Cincinnati facility where tooling for engines used by the military is made, Gov. John Kasich unleashed a volley of verbal missiles at Ohio's nursing-home lobby yesterday.

Kasich, whose speech was scheduled as an event to stump for his two-year, $55.6 billion budget proposal, also said that if the state holds the line on spending this year, "we will have a tax cut next year."

The governor declined to disclose the type or amount of tax cut after his speech. He has in the past floated the idea of eliminating Ohio's income tax.

But Kasich was largely focused on the nursing-home lobby, which got his attention with an ad paid for by the Ohio Health Care Association that began airing on Friday.
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Bronx Grannies Hold Bake Sale to Save Grandparent Apartments, Threatened by NY State Budget Cuts

BY DANIEL BEEKMAN

Some Bronx grandmothers are raising money - one cake at a time - to offset more than $300,000 in state budget cuts to the funding for their unique residence.

The bake sales are a desperate attempt to sustain programs and services, from 24-hour security to after-school tutoring, at Grandparent Family Apartments.

When it opened in 2005, the Morrisania building was the first such facility in the nation for low-income grandparents raising grandchildren.

"These cuts are going to hurt," said Annie Barnes, 68, who cares for two grandchildren. "But our grandchildren need us. We'll continue to sacrifice for them."

A handful of grandmothers gathered yesterday to discuss bake sale strategy in a bright basement room of the building, where handmade Easter bunnies and colorful mobiles decorated the halls.

Most have cared for their grandchildren since birth. Their children are absent parents - sick, murdered, missing or in jail.

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What If We’re Not Broke? - The Washington Post

By E.J. Dionne Jr

We’re broke.”

You can practically break a search engine if you start looking around the Internet for those words. They’re used repeatedly with reference to our local, state and federal governments, almost always to make a case for slashing programs — and, lately, to go after public-employee unions. The phrase is designed to create a sense of crisis that justifies rapid and radical actions before citizens have a chance to debate the consequences.

Just one problem: We’re not broke. Yes, nearly all levels of government face fiscal problems because of the economic downturn. But there is no crisis. There are many different paths open to fixing public budgets. And we will come up with wiser and more sustainable solutions if we approach fiscal problems calmly, realizing that we’re still a very rich country and that the wealthiest among us are doing exceptionally well.

Consider two of the most prominent we’re-brokers, House Speaker John Boehner and Wisconsin Gov. Scott Walker.

“We’re broke, broke going on bankrupt,” Boehner said in a Feb. 28 Nashville speech. For Boehner, this “fact” justifies the $61 billion in domestic spending cuts House Republicans passed (cuts that would have a negligible impact on the long-term deficit). Boehner’s GOP colleagues want reductions in Head Start, student loans and scores of other programs voters like, and the only way to sell them is to cry catastrophe.

Walker, of course, used the “we’re broke” rationale to justify his attack on public-worker collective bargaining rights. Yet the state’s supposedly “broke” status did not stop him from approving tax cuts before he began his war on unions and proposed all manner of budget cuts, including deep reductions in aid to public schools.

In both cases, the fiscal issues are just an excuse for ideologically driven policies to lower taxes on well-off people and business while reducing government programs. Yet only occasionally do journalists step back to ask: Are these guys telling the truth?

The admirable Web site PolitiFact.com examined Walker’s claim in detail and concluded flatly it was “false.”
“Experts agree the state faces financial challenges in the form of deficits,” PolitiFact wrote. “But they also agree the state isn’t broke. Employees and bills are being paid. Services are continuing to be performed. Revenue continues to roll in. A variety of tools — taxes, layoffs, spending cuts, debt shifting — is available to make ends meet. Walker has promised not to increase taxes. That takes one tool off the table.”

And that’s the whole point.

Bloomberg News looked at Boehner’s statement and declared simply: “It’s wrong.” As Bloomberg’s David J. Lynch wrote: “The U.S. today is able to borrow at historically low interest rates, paying 0.68 percent on a two-year note that it had to offer at 5.1 percent before the financial crisis began in 2007. Financial products that pay off if Uncle Sam defaults aren’t attracting unusual investor demand. And tax revenue as a percentage of the economy is at a 60-year low, meaning if the government needs to raise cash and can summon the political will, it could do so.”

Precisely. A phony metaphor is being used to hijack the nation’s political conversation and skew public policies to benefit better-off Americans and hurt most others.
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Locals Protest Cuts to Medicaid | NevadaAppeal.com

Image by Getty Images via @daylife
By Geoff Dornan

Local officials on Wednesday protested human services cuts in the governor's proposed budget they say will cost counties nearly $50 million a year.

The biggest piece reviewed is a change in the Medicaid long-term care funding formula local officials say will cost them $20 million a year.

Medicaid provides long-term care beds for those unable to take care of themselves. The reductions are made by changing the complex formula for determining state funding for those Medicaid recipients in long-term care facilities. Under the current formula, the state, federal money and local governments share the cost of caring for those disabled people.

Charles Duarte, administrator of Health Care Financing and Policy, told a joint Senate/Assembly subcommittee the long-term care change saves the state $37 million over the biennium.

“A county cannot pay more than its budget,” said Mary Walker, lobbyist for Carson, Douglas, Lyon and Storey counties. “We'd be deciding whether to lay off police and firefighters or kick these people out of their beds. That would be a terrible choice.”
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Governors Differ on Extent of Flexibility for Medicaid

By Amy Goldstein and Dan Balz

Washington Post Staff Writers

Democratic and Republican governors, burdened by crushing budget pressures from Medicaid, said Sunday that federal officials should allow them more freedom to change eligibility rules and other aspects of the public health insurance program for the poor. But they displayed sharp ideological differences over how far such flexibility should go.

After a series of private conversations at the National Governors Association's semiannual meeting over the weekend, leaders of the group formed a bipartisan committee to explore in detail what kind of flexibility over Medicaid the governors can agree to seek from federal health officials.

It remains unclear whether they will be able to forge such common ground, given their partisan disagreements over both Medicaid and the new federal law to reshape the health-care system. "The closer governors get to Washington, the more they start acting like members of Congress," said Oregon Gov. John A. Kitzhaber (D), vice chairman of the NGA's Health and Human Services Committee, referring to the rancorous debate over health care that persists on Capitol Hill.
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Capitol Weekly: Opinion: California Should Take the Lead in Reducing Long-term Care Costs

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By David Kieffer

For those of us who work in long-term care, California’s budget crisis can be viewed in two ways – as yet another devastating blow to the seniors and people with disabilities we care for – or as an opportunity to get things right. Which of these views turns out to be accurate will depend on the choices we make.

Formulaic cuts to hours or types of services are not the right approach. The necessary search for savings has the potential to help California develop a more forward-looking approach to long-term care, but only if we go about it strategically. We need to use the federal funds available to us and expand the savings we have already achieved by taking more aggressive measures to care for more people at home instead of in more expensive institutions.
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Lobbyists Favored Over Elderly | The Indianapolis Star | indystar.com

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The 2011 version of the Indiana General Assembly has taken on such volatile issues as gun rights, abortion, same-sex marriage and immigration.

This week, lawmakers confront throngs of protesters drawn to the Statehouse by bills dealing with labor unions.

Education reform legislation also has sparked heated debate.

So how is it that a bill aimed at improving Indiana's nursing home care has been deemed too controversial?

It's more likely that the power of the nursing home lobby is the real reason why state Rep. Clyde Kersey's bill to require minimum staffing levels is unlikely to get a hearing before the House Public Health Committee.

The chairman, Rep. Tim Brown, R-Crawfordsville, told The Star's Heather Gillers that it would be pointless to "put people through the struggle of such divisiveness" when consensus on the Terre Haute Democrat's bill is a long shot.

"Dead on arrival" is how an industry spokesperson put it.
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New Data on CHIPRA, Medical Malpractice, Childhood Obesity Laws, HCBS, State Budgets, and More

Statehealthfacts.org has recently added new and updated data on Demographics & the Economy, Health Status, Medicaid & CHIP, Medicare, Providers & Service Use, Minority Health, HIV/AIDS, and Health Reform. You can also view a list of all recent updates.

Demographics & the Economy

• State Fiscal Distress
  Measures of aggregate state rankings in foreclosures, unemployment, and food stamp participation have been updated with the latest information from RealtyTrac, the United States Department of Agriculture (USDA), and the Bureau of Labor Statistics (BLS). Updated data on states with projected budget shortfalls for state fiscal year (SFY) 2012 have been added from the Center on Budget and Policy Priorities (CBPP).
• State Budgets
  The latest state-by-state information from the National Association of State Budget Officers (NASBO) on total state expenditures, per capita state spending, and the distribution of general fund spending is available for SFY2009.
  
• State or Federal Inmates
  Updated data from the Bureau of Justice Statistics on the number of adult prisoners under state jurisdiction, adult prisoners by gender, and the incarceration rate per 100,000 population have been added for all states and the nation for 2009.
• Union Employees
  Information on the number of workers represented by unions has been updated for 2010 based on data from the BLS.
• Cigarette Excise Tax
  The most recent data from the American Lung Association on state cigarette excise taxes are available for 2010.

Health Status

• Childhood Obesity and Firearm Safety
  The latest data on state laws addressing childhood obesity and states with firearm laws designed to protect children are now available for 2010 from the American Academy of Pediatrics’ State Legislation Report.
• Public Place Smoking Bans
  Updated information on states with public place smoking bans has been added for all states from the American Nonsmokers’ Rights Foundation for 2011.
  

Medicaid & CHIP

• Medicaid and CHIP Eligibility
  New data from the Kaiser Commission on Medicaid and the Uninsured (KCMU) and the Georgetown University Center for Children and Families on CHIP program type and children’s upper income eligibility limit for Medicaid/CHIP have been added as of January 2011.
• Co-Payments and Premiums for Children in Medicaid/CHIP
  Also new from KCMU and Georgetown University is information on premium and co-payment amounts and requirements as of January 2011.
  
• Children’s Health Insurance Program Reauthorization Act (CHIPRA)
  New data on state adoption of coverage and enrollment options in CHIPRA have been added for all states and the nation as of January 2011 from KCMU and Georgetown University. Also new are data on CHIPRA performance bonus awards for FY2009 and FY2010 from InsureKidsNow.gov.
• Home and Community-Based Services (HCBS)
  Updated data from KCMU and University of California at San Francisco analysis of CMS Form 372 are now available for all states and the nation for 2007. Updated topics include total HCBS waivers, expenditures by waiver type, aged/disabled participants, home health participants, and personal care expenditures.
• State Medicaid Spending
  The latest information from NASBO on the distribution of state Medicaid spending has been added for all states and the nation for SFY2009.

Medicare

• Medicare Drug Benefit
  The latest data on Medicare beneficiaries with prescription drug coverage and low-income subsidy eligible beneficiaries with Medicare prescription drug coverage have been added from the Centers for Medicare and Medicare Services (CMS) as of February 2010.
• Medicare Prescription Drug Plans (PDPs)
  Updated data from Mathematica Policy Research and Kaiser Family Foundation (KFF) analysis of the CMS Prescription Drug Landscape File on the number of Medicare PDPs, PDPs with no deductible, and PDPs with no coverage in the benefit gap are available for all states and the nation for 2011.
  
• Medicare Advantage
  Data on the number of Medicare Advantage contracts and Medicare special needs plan (SNP) offerings have been updated for 2011 from KFF analysis of CMS Landscape Source files.
• Medicare Service Use
  The most recent information on Medicare service use, including short-stay hospitals, skilled nursing facilities, and home health services, has been added from CMS for 2009.

Providers & Service Use

• Medical Malpractice
  Updated data from KFF analysis of the National Practitioner Data Bank Public Use Data File on the number of paid medical malpractice claims, total dollars in paid claims, and average claims payments are now available for all states and the nation for 2009. 
• Medical School Graduates
  The latest information on the number of medical school graduates and medical school graduates by gender has been added from the Association of American Medical Colleges for 2010. Data from 2002 through 2010 are available for trend analysis.
  

Minority Health

• Medical School Graduates
  Also updated from the Association of American Medical Colleges are state-by-state data on medical school graduates by race/ethnicity and Hispanic ethnicity.

HIV/AIDS

• Syringe Exchange Programs
  The most recent information from the North American Syringe Exchange Network on states with sterile syringe exchange programs has been added for 2011.

Health Reform

• Federal Lawsuit
  Updated information on states that have joined the federal lawsuit against the Affordable Care Act is now available from the National Council of State Legislatures for 2011.

Statehealthfacts.org is a Kaiser Family Foundation website.

Important Medicaid Information for States: CMS' Virtual Meeting on Cost-...

Designing an Exchange: A Toolkit for State Policymakers

This project builds on the NAIC model act with the purpose of providing technical assistance to state policymakers interested in a broader range of policy options for designing an insurance Exchange. Sponsored by the National Academy of Social Insurance (NASI) and funded by the Robert Wood Johnson Foundation, this project offers policymakers a toolkit that includes legislative language with alternatives and additions to the NAIC model act, as well as a narrative explaining key issues and concerns that motivated the NASI model act. The narrative also addresses longer-term policy issues that state lawmakers may reasonably defer to a later time or delegate to the Exchange. In addition, the project will include a series of issue briefs that explore critical policy issues in state implementation of the ACA; the first of these focuses on the issue of Exchange governance.

Download Toolkit/Read

Net Effects of the Affordable Care Act on State Budgets

The Affordable Care Act will affect state budgets in many ways. State Medicaid spending on low-income adults will increase between $21.1 billion and $43.2 billion during 2014-2019. But during this same period, the ACA will save states and localities between $83.8 billion and $153.0 billion by letting them (a) shift higher-income adults from Medicaid into coverage where subsidies are funded entirely by the federal government; and (b) substitute newly available federal Medicaid dollars for prior state and local spending on uncompensated care and mental health services. Altogether, net state and local gains will total between $40.6 billion and $131.9 billion.

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Health Care Facility Inspections to be Cut if Fees Not Raised - Las Vegas Sun

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If a panel of elected officials in Nevada rejects a proposal to increase health care facility licensing fees today as it did in October some state healthcare facilities inspectors will lose their jobs and the health care facility inspections will be greatly reduced, state officials said. The proposed fee increases are exponential in some cases, which has caused sticker shock for the facilities. Their lobbyist argues that the state, not the businesses, should bear the financial weight of protecting the public. "This amounts to what somebody calls a 'sick tax,'" said Charles Perry, president/CEO of the Nevada Health Care Association, the lobbying group for long-term care facilities.
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Report Calls for Action to Stem Alzheimer’s Deluge | StarTribune.com

By WARREN WOLFE, Star Tribune

The number of Minnesotans with Alzheimer's disease and other forms of dementia will swell from 88,000 now to 198,000 in the next 30 years, with the prospect that state coffers, families and employers could be overwhelmed by the stress and costs of care, according to a report that will be delivered to the Legislature on Thursday. Without action, the report concludes, "the burden will be heaviest on public funding as the number of individuals with Alzheimer's increase and their family caregivers are stretched beyond their capacity and exhaust their resources."

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H. Res. 23: Expressing the Sense of the House of Representatives that the Federal Government Should not Bai Out State or Local Government Pension Plans

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Expressing the sense of the House of Representatives that the Federal Government should not bail out State and local government employee pension plans or other plans that provide post-employment benefits to State and local government retirees.

Sponsor: Rep. Jason Chaffetz [R-UT3) Cosponsors: Jeff Flake [R-AZ6, Doug Lamborn [R-CO5],Cathy McMorris Rodgers [R-WA5]Devin Nunes [R-CA21]

This resolution is in the first step in the legislative process. Introduced bills and resolutions first go to committees that deliberate, investigate, and revise them before they go to general debate. The majority of bills and resolutions never make it out of committee.

[Last Updated: Jan 7, 2011 12:00PM] Last Action:Jan 6, 2011: Referred to the House Committee on Education and the Workforce.

H. Res. 23: Expressing the sense of the House of Representatives that the Federal Government should not bail... (GovTrack.us)

HCBS Reductions? What Advocates Can Do

Steve Gold's Information Bulletin # 324  (9/2010)

Has your State threatened to cut back or reduce Medicaid-funded home and community-based services ?  Has your State actually reduced HCBS Medicaid services?  What impact will these reductions have on people remaining in the community?

What can advocates do about these reductions?  What should CMS do? In addition to how the ADA and integration will be impacted if the reductions are implemented, another handle is the Medicaid statute itself?

To receive federal Medicaid funds, a State must have a written state plan that has been submitted to and approved by the Secretary of the U.S. Dept of Health and Human Services.  CMS posts state MA plans and amendments at www.cms.gov/medicaid/stateplans/

State MA plans must be amended to reflect changes in federal policy, Court decisions, and "material changes" in policy, state law, or operation of the program. 42 Code of Federal Regulations ' 430.12.  Proposed State plan amendments must be submitted to the CMS regional office which must "consult with central office staff on questions regarding application of Federal policy." 42 C.F.R ' 430.14.  CMS must make a "determination as to whether State plans (including plan amendments and administrative practice under the plans) originally meet or continue to meet the requirements for approval are based on relevant Federal statutes [including the ADA] and regulations."  42 C.F.R ' 430.15.

Hmmm.  The United States Supreme Court in 1999 in the Olmstead decision found that unnecessary segregation in institutions violated the ADA - sure sounds like a Court decision.  CMS has issued several "Dear State Medicaid Director" letters telling states that their State plans must comply with both the Medicaid and the ADA statutes, and these letters sure look like federal policy. Therefore, when your State proposes reductions in HCBS, advocates must analyze what impact the reductions will have on causing or preventing unnecessary segregation. 

Advocates must ensure that CMS will disapprove the amendments based on Olmstead and its own policy requiring compliance with the ADA.

Advocates for older and younger Americans with disabilities should:

1.  Find out if your Governor has reviewed the proposed amendments, a Medicaid requirement for State plan amendments?

2. Contact your regional CMS officials and obtain copies of documents between your State and CMS regarding the amendment.

3. Unbelievably, there is no requirement for public hearing or even an opportunity for public comment.  Nevertheless, each State has a Medical   Care Advisory Committee that reviews and comments on proposed changes.    Get to them and make your voices heard.

4.  Send your comments to the CMS regional office AND to the Secretary of   HHS.  Tell them how the amendments will impact on people unnecessarily   being institutionalized.

Thanks very much to the National Health Law Program for their invaluable suggestions and observations, many of which are the basis for and incorporated in this Information Bulletin.

Steve Gold, The Disability Odyssey continues

To contact Steve Gold directly, write to stevegoldada@cs.com or call 215-627-7100.

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New Fiscal Year Brings More Grief for State Budgets, Putting Economic Recovery at Risk — Center on Budget and Policy Priorities

Image by dj @ oxherder arts via Flickr

By Erica Williams, Phil Oliff, Ashali Singham and Nicholas Johnson

Dismal state revenue collections caused by the severe recession are setting the stage for a new round of state budget cuts as fiscal year 2011 begins in most states on July 1. The states’ cumulative budget shortfall will likely reach $140 billion in the coming year, the largest shortfall yet in a string of huge annual gaps that date back to the beginning of the recession. Closing it will have severe effects on services and jobs.

In many states, the new fiscal year will bring immediate cuts to programs and services that are facing unprecedented demand. As of July 1, 10,000 families in Arizona will lose eligibility for temporary cash assistance; Georgia will lay off as many as 284 workers who help low-income families enroll for food stamp, Medicaid and TANF benefits; and Kansas will cut off nearly 2,800 individuals with a disability from independent living services. Education, health care, and other priority areas will also face new cuts in the coming fiscal year — on top of extensive cuts that at least 45 states have enacted over the last two years.

States are raising taxes as well for 2011. Effective July 1, Kansas and New Mexico increase their sales taxes; Hawaii, New Mexico, New York, South Carolina, and Utah increase their tax on tobacco products; Washington begins taxing soda, and Oklahoma is temporarily suspending various business and energy tax credits. Other changes have already taken effect or will take effect later in fiscal year 2011. Since 2008, more than 30 states have raised taxes or tax-like fees.

Separate and apart from dismal revenue collections, the budget situation for states just got worse. Last week, the U.S. Senate failed to pass jobs legislation that would have extended an enhanced federal match for the Medicaid program that 30 states were counting on to balance their budgets. Without these funds, states will make even deeper spending cuts and more tax increases than previously planned.
These state actions, while necessary to meet state balanced-budget requirements, will nevertheless slow the economic recovery and raise the risk that the nation will fall back into recession as the loss of Americans’ spending power ripples through the economy. States’ actions to close their $140 billion gap without more federal aid could cost the economy up to 900,000 public- and private-sector jobs.

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Medicaid Expansion in Health Reform Not Likely to “Crowd Out” Private Insurance — Center on Budget and Policy Priorities

By Matt Broaddus and January Angeles

Contrary to claims by some critics, the Medicaid expansion in the new health reform law will overwhelmingly provide coverage to people who otherwise would be uninsured, rather than shift people who already have private coverage to Medicaid.

Under the new law, beginning in 2014 Medicaid will cover non-elderly individuals with incomes up to 133 percent of the federal poverty line — about $29,000 for a family of four.[1] The Congressional Budget Office (CBO) estimates that by 2019, 16 million more adults and children will enroll in Medicaid and gain access to affordable coverage as a result.

Some critics claim that a large share of the insured individuals who become eligible for Medicaid will drop their existing employer or individual market coverage and instead enroll in Medicaid. This claim does not withstand scrutiny: there has been only modest substitution of public for private coverage, or “crowd-out,” in similar state-level expansions of public programs in the past.[2]

• In states that have raised Medicaid income eligibility limits to levels similar to those under health reform, the shares of low-income residents who have private coverage are virtually identical to the shares in states that have not expanded Medicaid coverage.
• An extensive body of research finds that among low-income children enrolled in Medicaid, the proportion that previously was privately insured is between 10 percent and 20 percent, nowhere near the 48 percent rate assumed, for example, in a dubious analysis commissioned by the state of Indiana that some health reform critics have cited (see below).
• The vast majority of low-income individuals who will become eligible for Medicaid under health reform do not have access to affordable private health insurance coverage.

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U.S. GAO - Nonprofit Sector: Treatment and Reimbursement of Indirect Costs Vary among Grants, and Depend Significantly on Federal, State, and Local Government Practices

GAO-10-477 May 18, 2010

Nonprofits are key partners in delivering federal services yet reportedly often struggle to cover their indirect costs (costs not readily identifiable with particular programs or projects). This raises concerns about fiscal strain on the sector. To provide information on nonprofits' indirect cost reimbursement, especially when funding flows through entities such as state and local governments, GAO was asked to review, for selected grants and nonprofits, (1) how indirect cost terminology and classification vary, (2) how indirect costs are reimbursed, and (3) if gaps occur between indirect costs incurred and reimbursed, steps taken to bridge gaps. GAO selected six Departments of Health and Human Services and Housing and Urban Development grants and 17 nonprofits in Louisiana, Maryland, and Wisconsin. GAO selected these agencies for their historical relationship with nonprofits. GAO reviewed policies and documents governing indirect costs and interviewed relevant officials. GAO also reviewed research on nonprofits' indirect costs.
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50 New York City Senior Centers Expected to Close - NYTimes.com

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By DAVID W. CHEN

Convinced that the deteriorating budget situation in Albany leaves it no other choice, the Bloomberg administration plans to close as many as a quarter of the city’s more than 300 senior centers by July 1, with Manhattan being hardest hit.

Lilliam Barrios-Paoli, the commissioner of the Department for the Aging, said in an interview on Thursday that 50 senior centers would definitely be closed — selected largely on the basis of three criteria: the fewest meals served, the fewest hours open and the most maintenance or management problems. She also said another 25 centers would be notified soon that they could be closed on July 1 if the city received less money from Albany than it currently anticipates.


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SAMHSA’s Weekly Financing News Pulse: State and Local Edition April 21, 2010

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Alabama Legislature Approves Budget, Medicaid and CHIP Funding Maintained

On April 13, the Alabama House of Representatives and Alabama Senate approved a $1.6-billion general fund budget for state agency operations that maintains Medicaid and Children's Health Insurance Program (CHIP) funding at their current levels. The budget relies on a $197-million Federal extension of American Recovery and Reinvestment Act funding that Congress has not yet approved.

Michigan's Shiawassee County Considers Bond Issue To Refinance CMHA

The Shiawassee County Board of Commissioners is considering putting together a bond issue to refinance the Community Mental Health Authority (CMHA) facility. The proposal under consideration requires the board to issue bonds and use the proceeds to acquire CMHA's facility, which it would then lease to CMHA. CMHA would make payments equal to the amount of debt service on the county's bonds for 23 years, at which point the bonds would be paid off and CMHA would take back control of the title from the county. CMHA would be responsible for all costs and maintenance of the building for the duration of the lease. The CEO of CMHA says that the plan would save them $15,000 annually.

Nevada Governor Agrees To Allocate Funds To Prepare for Medicaid Expansion

On April 14, Governor Jim Gibbons (R) agreed at a Nevada Board of Examiners meeting to spend $279,119 in state funds to establish a planning unit to prepare for the expansion of Medicaid in 2014. Nevada currently only allows families with incomes up to 100 percent of the Federal Poverty Level (FPL) to enroll in Medicaid, but under the Patient Protection and Affordable Care Act, adults without children will become eligible for Medicaid and the income eligibility expands to up to 133 percent of the FPL. The funds will allow Nevada Department of Health and Human Services Director Mike Willden to hire staff and a consultant to determine how much additional staff and funding will be necessary for the state to comply with the new requirements. Willden projects that under the new law, Nevada will add 150,000 to the 260,000 currently on its Medicaid rolls.

Virginia Governor Proposes Budget Amendments on Mental and Substance Use Treatment

Governor Bob McDonnell (R) proposed two budget amendments that would affect behavioral health treatment in Virginia. The first would authorize the expansion of the state's Medicaid managed care program to cover community mental health and substance abuse services and residential treatments. The second would add behavioral health drugs to the Medicaid Preferred Drug List, a proposal that legislators rejected under previous administrations. Lawmakers will vote on the measures on April 21. To continue reading these articles and see all articles included in this week's State and Local Financing News Pulse
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