Clip files / Local news from the states
Clip files / Local news from the states
This column features selected short items about state health care policy.
Simplified enrollment and expanded coverage for parents push Rhode Island Medicaid enrollment to all-time high
CRANSTON, RI—Enrollment in Rhode Island’s Medicaid managed care program reached an all-time high of 86,000 people this summer, a milestone state officials attribute to a simplified enrollment process and expanding the program among parents. RIte Care increased the eligibility income threshold among parents with covered children under 18 to 185% of the poverty level, about $25,600 annually for a family of three. The previous level for parents was less than $9,000 per year. For enrollment, state officials also replaced an in-person interview with a short, mail-in application.
Legislators in July also expanded eligibility in RIte Care, extending the upper age limit for children from 18 to 19 and providing coverage regardless of immigration status. The expansions mean virtually universal coverage for Rhode Island children with incomes less than 250% of the poverty level, state officials said.
—RIte Care release, July 22
Hospitals need at least 15% excess capacity to prevent crunch in emergency admissions, say UK researchers
YORK, ENGLAND—Spare beds in a hospital, about 15% of the total, to be exact, are necessary to handle normal variation in emergency admissions without running the risk of affecting quality of care, write researchers in the July 17 issue of the British Medical Journal. Such extra capacity is "essential for the effective management of emergency admissions, and its cost should be borne by purchasers as an essential element of an acute hospital service," conclude the authors, noting that hospitals can expect "periodic bed crises" when average bed occupancy rises to 90% or more.
Policies designed to reduce the rate of growth in demand for emergency admissions and to provide alternatives to admission provide the greatest long-term benefit to address the problem, say the University of York researchers.
—Bagust A, Place M, Posnett JW. Dynamics of bed use in accommodating emergency admissions: Stochastic simulation model. BMJ 319:155-158.
Feds develop model program to help states certify assisted reproduction laboratories
WASHINGTON, DC—States wishing to certify embryo laboratories can use a model certification program recently released by the Department of Health and Human Services. While state adoption of the guidelines is voluntary, development of the model was mandated by the federal Fertility Clinic Success Rate and Certification Act of 1992. The guidelines address a broad range of administrative requirements as well as laboratory standards involved in a certification program. Under the federal legislation, pregnancy rates and other clinical indicators of laboratories adopting the model guidelines are collected and disseminated to the public. The standards, published in the July 21 Federal Register, are available at www.phppo.cdc.gov/dls/art/art.asp.
—Health Care Financing Administration release, July 21
Productivity gains can outweigh costs associated with highly active antiretroviral therapy for HIV
BASEL, SWITZERLAND—Highly active antiretroviral therapy (HAART) for HIV infection increases health care costs, but the corresponding gains in survival and productivity can match or exceed such costs, write researchers in the journal AIDS. The results support continuation of Switzerland’s policy of unrestricted access to HAART and suggest a re-evaluation in countries that limit access, say researchers in the journal’s June 18 issue.
—Sendi P, Bucher H, Harr T, et al. Cost effectiveness of highly active antiretroviral therapy in HIV-infected patients. AIDS 1999; 13:1,115-1,122.
Race-related variation found among middle-class kids for asthma, low birth weight, and behavior problems
Black middle-class children have substantially higher rates of asthma, low birth weight, and school problems than their white middle-class peers, according to a recent analysis in Pediatrics. White and black middle-class children do have similar rates of other health and behavioral problems and do not differ in their receipt of mental health or special education services, say researchers in the July supplement. Even when private insurance is available, though, black and white middle-class children vary in their sources and patterns of use of medical services, the researchers found.
—Weitzman M, Byrd R, Auinger P. Black and white middle class children who have private health insurance in the United States. Pediatrics July 1999; 104:151-157.
National Medicaid association selects new leader
WASHINGTON, DC—Texas Medicaid director Linda Wertz has been elected chair of the National Association of State Medicaid Directors (NASMD). She replaces Bruce Bullen, who left his position as Massachusetts Medicaid director and NASMD chair in June to enter the private sector.
—NASMD release, July 18
Three states approve mental health parity laws, bring total to nine during 1999 legislation session
ARLINGTON, VA—Louisiana, Hawaii, and Nevada are the latest to enter the ranks of states with mental health parity laws, according to the National Alliance for the Mentally Ill (NAMI). Their actions bring to 27 the tally of states with such laws, according to NAMI.
Louisiana’s measure, signed by the Gov. Mike Foster July 13, provides parity for 13 specific illnesses. Hawaii’s bill, signed June 26, addresses only three diseases — schizophrenia, schizoaffective disorder, and bipolar disorder — and commits to a study of the impact of expanding the scope of the legislation to other disorders. Nevada’s bill, signed June 8, focuses on severe mental illness, defined as schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorders, panic disorder, and obsessive-compulsive disorders.
Nine states in total have approved mental health parity legislation during 1999. The other six — Montana, Virginia, Indiana, New Jersey, Nebraska, and Oklahoma — are profiled in State Health Watch, July 1999, p. 1.
—NAMI release, July 16
Virginia agencies fall short in providing community services to mentally disabled
RICHMOND—Mentally disabled citizens aren’t getting the community services to which they are entitled from local agencies, state Medicaid officials acknowledged in recent legislative hearings. The shortcoming puts the state out-of-compliance with requirements of the Medicaid waiver requirements under which the services are offered, but state officials promise action before the waiver is yanked. The program paid $87.9 million for services to almost 3,200 people last year. The funds are channeled through 40 community service boards throughout the state.
—Richmond Times-Dispatch, July 9
New Jersey increases income limits in most recent amendment to Children’s Health Insurance Program plan
WASHINGTON, DC—New Jersey will increase income thresholds under an amendment in its Children’s Health Insurance Program (CHIP) plan recently approved by the Health Care Financing Administration. The state’s NJ KidCare program currently operates both a Medicaid CHIP expansion plan (NJ KidCare plan A) and a separate state CHIP plan (NJ KidCare plan B and plan C), which already have enrolled nearly 35,000 children. State officials expect the most recent amendment to provide health insurance to an additional 9,000 children by September 1999.
New Jersey is eligible to receive as much as $88 million in new CHIP funds for fiscal year 1999 and an additional $88 million in fiscal year 2000. The new amendment, NJ KidCare Plan D, will offer managed health care coverage to uninsured children through age 18 whose families have incomes, slightly higher than those in Plans A-C, from 200% to 350% of the federal poverty level.
—Health Care Financing Administration release, Aug. 3
Short takes
Health Care Compliance Association: Third Annual Compliance Institute, Oct. 24-27, Chicago Marriott. For more information, call (888) 580-8373 or visit the Web at www.hcca-info.org.
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.