November 16, 2005
News from the States
To follow up on any of the items featured in this publication, please contact Steven Buck, director of state policy at email@example.com
Colorado Voters Approve TABOR Suspension
Colorado voters narrowly approved a five-year suspension of the Taxpayers Bill of Rights (TABOR) in early November. TABOR was designed to control the growth of government by linking growth in state appropriations to the inflation rate. Prior to the suspension, any revenue above the mandated growth caps was returned to taxpayers. With the suspension, experts concluded that Coloradoans will forfeit $3.7 billion in tax refunds over five years. However, proponents of the suspension cite TABOR for drastic reductions in state programs and services, including funding for Medicaid.
TABOR-like initiatives are expected to be key political issues in several states in 2006, with Arizona, Kansas, Maine, Ohio, Oklahoma, Oregon, Nevada, and Wisconsin being the main battlegrounds. (Stateline.org, November 3, 2005)
Louisiana Faces Budget Cuts of 6 to 7 percent Across the Board
Louisiana’s Department of Health and Hospitals (DHH) anticipates budget cuts of 6 percent to 7 percent, as the state continues to recover from the devastation of Hurricane Katrina. The projected cuts for the DHH system represent $223 million in state-appropriated dollars. For private healthcare providers, income would decrease by $118 million (including both state dollars and federal matching funds), according to DHH Secretary Fred Cerise. Congress is currently considering legislation that could potentially minimize the proposed cuts. (theadvocate.com, November 10, 2005)
Medicaid Cuts “Gruesome”; Future Reforms Focus on Healthy Behavior
Six hours of testimony before five members of the Missouri Medicaid Reform Commission produced an ugly picture of the impact of cuts in the state’s Medicaid program. Testimony included reports of a suicide by a former Medicaid recipient who could no longer afford his medications and a five-month wait for a child awaiting authorization for psychological counseling through Head Start. The cuts initiated by the state in 2006 removed 90,000 Missouri residents from the Medicaid rolls. (News-Leader, November 3, 2005)
The commission that heard this testimony is charged with redesigning the state’s Medicaid program. Early proposals have included mandatory tobacco cessation for tobacco users and dietary counseling for the obese. The recommendations are consistent with national trends to encourage healthy behaviors through Medicaid benefit design. In Missouri, the state is contemplating lower co-payments for those who participate in healthy-living initiatives. (Missourian, November 10, 2005)
Advocates Encourage Georgia Governor to Slow Down Push for Medicaid Reform
Advocates in Georgia are asking Governor Sonny Perdue to slow the pace of his Medicaid reform proposals. Citing the state’s current efforts to implement disease management programs and the introduction of Medicaid managed care, advocacy groups are asking Perdue to let the current programs take hold before introducing additional changes. The advocates also cite the need to evaluate the effectiveness of a recently approved waiver program in neighboring Florida before committing Georgia to a similar path. (Atlanta Journal Constitution, November 2, 2005)
Wisconsin Legislature Looking to Borrow Ideas
Republican legislative leaders in Wisconsin have asked the state’s health department to evaluate Medicaid overhauls across the country to develop strategies for curbing the state’s growing expenditures on healthcare. The leaders have requested a response by December 1. According to health department spokesperson Jason Helgerson, the department is committed to working with legislative leaders, but that the state is already well ahead of other states in program overhaul, including the use of managed care as a strategy for managing program growth. Helgerson also remarked that the state is “doing a lot that other states could learn from.” (Journal Sentinel, October 28, 2005)
Massachusetts’ House and Senate at Odds on Healthcare Plans
The governor’s office and the state legislature are wrestling with competing plans to meet a requirement from the Center for Medicare and Medicaid Services (CMS) to address the state’s uninsured population. The House plan, which would cover an estimated 95 percent of the uninsured, would expand the state’s Medicaid program and require individuals who can afford health insurance to purchase coverage. Revenue for the expansion would come from a proposed payroll tax. According to the primary Senate author, the bill under consideration in the Senate chamber would cover an estimated 50 percent of the uninsured. Governor Mitt Romney also has a proposal on the table that would cover up to 95 percent of the uninsured, but he does not support the payroll tax strategy used in the House bill. (Boston Globe, November 4, 2005)
NAMI Advocacy Tools & Resources
On November 10, NAMI Oklahoma held a successful Emergency Summit on Mental Illness, Substance Abuse, and Criminal Justice. The event was attended by more than 450 participants, including mental health professionals, law enforcement officials, state legislators, and concerned citizens. A copy of the summit’s agenda is available by clicking here.
One of the highlights of the conference was the release of a proclamation by the Oklahoma Department of Corrections, calling for greater recognition of the mental health needs of individuals incarcerated in the state’s correctional facilities. The full proclamation, unanimously accepted by the Department of Corrections board, is available here.
Washington Quick Glance
$5 Million Appropriation Pending for Mentally Ill Offender Treatment and Crime Reduction Act
The Fiscal Year 2006 Science, State, Justice Appropriations Bill, awaiting presidential approval, contains $5 million in funding for the Mentally Ill Offender Treatment and Crime Reduction Act. Although this is far less than the $50 million authorized in the Act, it is nevertheless a very positive development at a time when it is very difficult to get funding for new programs. The appropriation for this important new program reflects bipartisan consensus about the value and importance of jail diversion, correctional mental health treatment, and community reentry services.
Particular thanks go to Senator Mike DeWine (R-OH) who has continued to champion this program and worked tirelessly on the Hill to get it funded. Additional recognition goes to Senator Richard Shelby (R-AL), Chair of the Senate Science, State, Justice Appropriations Subcommittee; Congressman Frank Wolf (R-VA), Chair of the House Science, State, Justice Appropriations Subcommittee; and Congressman Ted Strickland (D-OH), who, like Senator DeWine, has led efforts on Capitol Hill to focus attention on the plight of people with serious mental illnesses in the criminal justice system.
The new program will be administered by the Bureau of Justice Assistance, U.S. Department of Justice. The criteria and schedule for applying for grants has not yet been determined. NAMI will continue to provide updates on this important initiative as details emerge.
NAMI Statehouse Spotlight is an electronic newsletter provided free of charge as a public service. With more than 1,100 state and local affiliates, NAMI is the nation's largest grassroots organization dedicated to improving the lives of people with severe mental illnesses. Contributions to support our work can be made online at www.nami.org/donate.
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