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This column features selected short items about state health care policy
LINCOLN, NE—Three top University of Nebraska administrators have drawn criticism from pro-life activists for signing a letter urging federal funding for human embryonic stem cell research.
L. Dennis Smith, University president, Harvey Perlman, University of Nebraska-Lincoln chancellor, and Harold Maurer, University of Nebraska Medical Center chancellor, were among more than 110 who signed.
Signers included three leading organizations in higher education, as well as presidents and chancellors from many of the nation’s top universities.
Maurer said he endorsed the letter because of the great promise offered by embryonic stem cell research.
"In the future, there’s going to be a combination of new knowledge and technology that’s going to be important to health care prevention and treatment," he said. "Embryonic stem cell research falls into that."
But Nebraska pro-life activists said the letter will create more controversy for the university, which already is under fire for research that uses tissue from aborted fetuses.
"For these three university administrators to sign on to this is kind of like in your face," said Julie Schmit-Albin, executive director of Nebraska Right to Life. "People are going to be just as opposed to using embryos as they are to using aborted baby brains [for research]."
—Lincoln Journal Star, March 29
HELENA, MT—The state House has killed a bill to give older Montana residents an income-tax credit to offset their prescription drug purchases.
On a 43-57 vote, the House voted down House Bill 534 by Rep. Holly Raser (D-Missoula). The measure would have provided an income-tax credit of up to $200 per year for senior citizens who have prescription drug bills that aren’t covered by Medicaid.
Raser told the House that during the campaign last year, the rising cost of prescription medications was a key issue. While the Legislature has addressed most other concerns of their constituents, lawmakers have yet to tackle the prescription drug problem, she said.
The measure would have cost $10.4 million per year, if all those eligible for the credit applied, and just over $1 million if 10% of eligible seniors applied. Eligible taxpayers could have taken a tax credit of 50% of their prescription drug costs, up to the $200 a person annual cap.
Raser proposed paying for the bill with interest earned from the state’s tobacco trust fund. And she put off the bill’s effective date until 2003, when the trust will garner interest not yet directed to other programs. But those concessions did not save the bill.
"Using tax policy to run human services is a very bad idea," said Rep. Karl Waitschies (R-Peerless).
—Billings Gazette, March 27
TALLAHASSEE, FL—Floridians worried about an elderly mother or a favorite uncle at a nursing home may soon have a new way of keeping tabs on their relatives.
Florida may become the first state to allow the electronic surveillance of nursing home patients. A provision — permitting the so-called "granny cams’’ — is contained in House and Senate bills moving through the Legislature this spring. Advocates say the proposal, which would allow families or guardians to pay for and set up the surveillance systems in their relatives’ rooms, is another step in improving the quality of care in the homes.
"In a perfect world, we wouldn’t need this,’’ said Republican state Sen. Ginny Brown-Waite, sponsor of the Senate nursing home bill.
Raising questions of privacy and further litigation, nursing home operators say the surveillance could make it even harder to find qualified workers for their homes. Others suggest constant monitoring will damage the personal bonds between residents and caregivers.
"We’re inadvertently bringing in Big Brother to watch us to the point where it will be detrimental to the welfare of nursing homes," said Eddie Bursztyn, representing Claridge House, a North Miami nursing home.
—Miami Herald, March 27
WASHINGTON, DC—Ohio’s effort to revamp a group-home program for the mentally retarded and developmentally disabled is "bogging down,’’ said a federal official who oversees the initiative.
Nonetheless, the federal government has given the Ohio Department of Mental Retardation and Developmental Disabilities until June 24 to correct problems, after which the state could see federal dollars for the program suspended.
Ohio currently receives a federal Medicaid waiver to run the residential care facility program, which lets about 2,800 mentally retarded and disabled people live in small group homes instead of in institutions. The state puts nearly $35 million annually into the program and receives about $49.9 million in federal money.
The Ohio program first drew federal fire last year, when an audit by the Health Care Financing Administration concluded that "Ohio has not met its obligations to assure the health and welfare of its waiver participants.’’
An April 21, 2000, letter to the state from Cheryl A. Harris, the financing administration’s associate regional administrator in Chicago, said incidents involving group home residents "are not effectively reported, investigated, or corrected. There does not exist an effective system for preventing, identifying, and remedying incidents of abuse and neglect, or for assuring adequate care and coordination of services.’’
This latest extension to correct problems is the fourth granted Ohio since that audit was released.
"I am concerned that your last progress report shows that many of the time lines you have established for the process of redesigning your waiver have not been met,’’ said Sina Ann Mercado, the health care administration’s regional operations branch manager for Medicaid, a health care program for the poor. Ms. Mercado made her comments in a recent letter granting Ohio another three-month extension of the waiver.
—Columbus Dispatch, March 30
BOISE, ID—Senate Republicans overwhelmingly voted to slap a cap on subsidized health care for children of the working poor and ordered the Health and Welfare Department to drastically curtail efforts to let those families know they are eligible for the help.
The provision, part of the $800 million Medicaid budget, now goes to the House.
Sen. Robert Lee (R-Rexburg), who has been on a yearlong crusade to find some way of checking the growth of the Medicaid budget, argued that the department’s aggressive campaign to identify children eligible for the Children’s Health Insurance Program has turned up four times as many who qualify for Medicaid.
After starting off extremely slowly with just a few hundred children in 1997, participation in the past two years has skyrocketed to more than 10,000 children, whose families are too poor to afford health insurance but not poor enough to qualify for Medicaid. At the same time, the promotional effort has been credited with uncovering tens of thousands of new Medicaid participants.
By capping the participants in the children’s health care program and then doing as little as possible to let people know the program exists, Mr. Lee said the state can rein in the explosive expansion of Medicaid rolls. Medicaid is costing taxpayers $204 million in state general tax revenue and another $516 million in federal money this year.
"We must face fiscal reality," Mr. Lee said, mirroring comments he made earlier in convincing legislative budget writers to endorse the approach. "It has the potential of really bankrupting the state."
—Idaho Statesman, March 30
BATON ROUGE, LA—A proposed moratorium on new hospitals is dead for the legislative session in the face of heavy opposition from doctors and residents of rural communities. Authors of Senate and House legislation, pushed by the Louisiana Hospital Association, said Wednesday it is evident that more study is needed on the volatile issue.
Proponents argued a two-year moratorium on new hospitals would protect people’s access to quality hospital care. Others said it was an effort to protect existing hospitals from healthy competition. "My main purpose was to get this dialogue going," said Sen. Tom Schedler, chairman of the Senate Health and Welfare Committee (R-Slidell). "I think the debate should rage."
Mr. Schedler’s committee heard testimony for more than two hours on the controversial issue, then deferred action, which locks up the bill up in the committee. Rep. Rodney Alexander, House Health and Welfare Committee chairman (D-Quitman), said there was no sense in proceeding with his House bill.
—The Baton Rouge Advocate, March 29
LOUISVILLE, KY—The Kentucky Cabinet for Health Services has agreed to an 8% funding increase for Passport Health Plan, the managed care Medicaid organization that covers about 115,000 people in the Jefferson County area.
In announcing the agreement, for the fiscal year that starts July 1, the cabinet said Passport has saved the state $30.4 million this fiscal year.
Passport is the only organization of its kind in Kentucky, administering care and providing special programs such as a 24-hour nurse line — for its members. Outside the Jefferson County area, the state manages the Medicaid program and has been running a deficit.
"We think we’ve been doing a good job," Robert Slaton, executive vice president for University Health Care, which does business as Passport, said on behalf of his board.
—The Courier-Journal, March 30