State news: Governor might soften proposed Medicaid cuts

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State news: Governor might soften proposed Medicaid cuts
State news: Governor might soften proposed Medicaid cuts
MINNESOTA--Just days after approving expansion of the state's Medicaid rolls by 95,000 people in mid-February, Gov. Mark Dayton unveiled a fiscal budget that would cut Medicaid payments for long-term care by $87 million.

Days later, the Democratic governor said he would give priority to easing up on the cuts if state revenue forecasts improve.

The cuts—part of a long-term plan to trim a projected $6.2 billion budget deficit over the next two years—include a 6.4% reduction ($50 million) for the state's 400 nursing homes and an 11% reduction ($37 million) from a program that helps keep people out of nursing homes. Observers say the deep cuts are intended to encourage low-care nursing home residents to seek alternative care options.

Dayton also has proposed increasing the per-bed nursing home surcharge to capture more federal Medicaid matching money.

Actors' home saved
CALIFORNIA–A West Coast nonprofit health services provider will operate a nursing facility and hospital in Woodland Hills once dedicated exclusively to the entertainment industry, ending a 2009 plan to close the facilities because of a $10 million budget shortfall.

According to the Motion Picture and Television Fund, Renton, WA-based Providence Health & Services will lease the fund's skilled nursing facility and hospital, allowing the facilities to remain open. The UCLA Health System, meanwhile, will operate a new neurological rehabilitation unit at the facility under the proposed long-term lease agreement.

Providence will assume financial responsibility for the facilities while state licenses for the hospital will be transferred to nearby Providence Tarzana Medical Center.

For the first time in the facilities' long history, people outside the entertainment industry will be allowed entry.

Home care hits SNFs
DELAWARE–Managing the care of disabled people in their homes saves needless spending on costlier nursing home care and may offer tangible long-term health benefits, say advocates of a planned program.

Nearly 17,000 of the 195,000 Delaware residents on Medicaid stand to benefit from the program, which is projected to save close to $10 million a year by 2013, officials said. Set to begin in mid-2012, the measure is modeled after similar successful programs in 14 other states and is primarily intended to serve the needs of low-income disabled residents at home.

Like others across the country, the Delaware program would be administered by managed care organizations. These groups would be given a fixed monthly fee to care for each Medicaid-eligible patient.

State nursing home advocates are leery of the plan, saying patient care quality may suffer.

Medicaid cuts remain
NEW YORK–Far in advance of a March 1 deadline, a special committee representing the state's healthcare providers agreed on more than $1 billion in voluntary savings measures.

It was an effort to avoid across-the-board Medicaid cuts this year, but fell short of the needed $2.3 billion identified in Gov. Andrew M. Cuomo's budget proposal, The New York Times reported.

The proposed measures include moving more people to managed care, imposing spending controls on home health care and personal care and limiting non-economic damages in medical malpractice cases.

All healthcare providers in the state face an across-the-board 2% cut in Medicaid payments this year.

Tort reform bill to House
OKLAHOMA–Proposed tort reform legislation would limit defendants' financial liability to damages for which they are at fault, and could protect healthcare providers from exorbitant jury awards in personal injury lawsuits, observers say.

The Oklahoma Senate overwhelmingly passed SB 862, which would eliminate joint and several liability and protect defendants from judgments that exceed their liability. In sum, defendants would be held responsible only for the portion of damages for which they are found to be at fault.

The bill was awaiting further action in the House of Representatives at press time.

“No one should have to pay for the wrongs of others,” Sen. Anthony Sykes, R-Moore, the bill's sponsor, told The State Column, a news service covering national and state politics. Observers point out that existing state laws hold defendants liable for paying a higher percentage of awards to plaintiffs, beyond the percentage of their fault, based on their ability to pay.

Report: Home aides overused
NEW MEXICO–A Medicaid-funded program that provides home health aides and arguably keeps recipients from seeking costlier nursing home care, is now under the gun.

A recent state legislative report concludes that New Mexico residents are over-using the program. It proposes measures that would cap the number of eligible low-income people and cut back on the number of reimbursable aide hours.

The report contends that the overuse of personal health aides is the chief culprit for a skyrocketing $850 million Coordination of Long-Term Services (CoLTS) program budget, which has nearly doubled since 2009. More than half of the $750 million spent on the program in 2010 went toward paying for personal health aides, many of whom bill for work in excess of 30 hours a week, according to the report.

Critics of the report's findings said cutting the CoLTS program would force many once-independent elderly into nursing homes earlier than needed. State Human Services officials blame the phenomenon on a tough economy and exponential increases in the population eligible for long-term care services.

Meter re-use led to deaths
NORTH CAROLINA–Improperly trained diabetes care staff and alleged re-use of blood glucose monitoring equipment in a North Carolina nursing home were blamed for a series of hepatitis B infections that led to six residents' deaths, according to a report released by the state's Division of Health Service Regulation.

Meanwhile, the CDC said the residents' deaths point to a need for better safety compliance.

Health officials said the faulty procedures likely spread hepatitis B in late October 2010 to eight elderly residents, including six who later died. They added that the hepatitis virus was likely transmitted after tainted blood inadvertently ended up in one or more blood monitoring meters.

Similar safety missteps have caused 16 outbreaks of hepatitis B at assisted living facilities around the country since 2004, according to the CDC.

Bailout spares Medicaid cuts
SOUTH CAROLINA–The state's Medicaid program was given a 30-day reprieve from cutting off payments to providers after receiving a $100 million bailout that will keep it solvent until mid-April. Meanwhile, as it faces a $228 million operating deficit for the current fiscal year, the program already is slashing services.

Many of the state's 832,000 Medicaid recipients already are being denied such services as adult dental, vision and podiatry care. Threats also are looming to cut off payments for hospice care for dying adults, respite care for caretakers and nutritional supplements for nursing home residents.

The situation has become so dire that lawmakers are considering overturning a law that forbids South Carolina to lower Medicaid provider payments. No other state Medicaid program contains such a provision, officials there said.

Deep cuts, big loans
ILLINOIS–In a state facing one of the country's largest budget shortfalls, Illinois nursing homes are bracing for 6% Medicaid cuts, totaling close to half a billion dollars next year.

In unveiling his $53 billion fiscal 2012 budget, Gov. Pat Quinn promised deep, painful cuts in a host of services, from Medicaid to schools. He vowed to restructure the state's mounting debt by borrowing nearly $9 billion just to cover last year's overdue obligations.

“This massive cut will put the health and well-being of thousands of nursing home residents in peril, along with causing [7,000] healthcare workers to lose their jobs,” Pat Comstock, executive director, Health Care Council of Illinois, wrote in a local newspaper editorial.

Comstock added that cutting services also would jeopardize additional federal funding for senior support services.

Snow put lives at risk
INDIANA–Nursing homes in Gary lashed out at city officials for failing to quickly clear streets during February's record blizzard, saying such missteps put thousands of frail residents at serious health and safety risks.

While no nursing home deaths were directly linked to the event, a number of residents went without such vital services as dialysis because there was no way to transport them through snow-clogged streets. Nearly two feet of snow fell on the city during a 24-hour period. The body of one nursing home resident, who died during the record storm, remained in an unheated room for hours, awaiting transport to a funeral home, according to published reports. The facility reportedly had to hire a private contractor to plow nearby streets at a cost of $1,400.

Medicaid bailout bill nixed
SOUTH DAKOTA–The sponsor of a bill that would have soothed the sting of looming 10% Medicaid cuts on nursing homes that provide care for the developmentally disabled, withdrew the proposal after a storm of protests.

He said he hoped to see its provisions incorporated instead in the state's overall budget package.

State Rep. Scott Munsterman's bill also had proposed to privatize the state-run program.

Under Munsterman's bill, the cuts would have been based, in part, on the proportion of total Medicaid revenue a facility receives: A facility whose total revenues were more than 80% Medicaid-based would have received no cuts, while a facility whose total revenues were less than 44% Medicaid-based would have faced cuts of 13%.

Opponents argued the proposal would have unfairly harmed some facilities more than others by forcing physicians and hospitals to make up the shortfall.

Nursing homes in the state likely will have to cut hundreds of positions and trim services because of budget shortfalls, South Dakota Health Care Association officials said.


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