Lawrence Health Leaders Offer Priorities
Karrey Britt, LJWorld reporter, talks with Gene Meyer and other health care leaders about the upcoming legislative session. For Karrey's story with photos: http://wellcommons.com/groups/wellness/2011/jan/7/health-leaders-offer-thei/
The Lawrence-Douglas County Health Department’s top legislative priority is to preserve the smoking ban.
Dan Partridge, director, said the ban saves the state money in health care costs and, more importantly, it saves lives.
“It’s nonsensical in my mind to even go there,” Partridge said.
The department also supports preservation of the Affordable Care Act. Partridge said he hopes legislators discuss how to implement the bill rather than how to repeal it because it contains much-needed changes. He said the state needs to continue to be proactive in applying for federal grant money and in setting up its own health insurance exchange.
“I hope we, as a state, don’t take a short-sided view of this and try to prove a point politically at the expense of people’s health care,” Partridge said.
David Johnson, CEO of Bert Nash Community Mental Health Center, agrees. One of the hallmarks of the Affordable Care Act is going to be more equal treatment for mental illnesses.
“I hope they don’t spend too much time trying to derail health care reform because I don’t think it will happen,” he said.
Johnson was encouraged to hear Gov.-elect Sam Brownback talk about reforming Medicaid.
Johnson said changing Medicaid to more of a managed care program would save money and provide better services.
About 50 percent of the people who get mental health services, first get them at an expensive state hospital because that’s what Medicaid pays for. If Medicaid paid for early intervention, education and prevention, then those high hospitalization costs could be reduced, he said.
When it comes to the budget, he hopes legislators take a look at the specific ramifications of any cuts they make. He said reduced mental health services can cause growing jail populations. It also can affect the economy as workers are unable to get help for their illnesses.
Johnson said mental health services have been cut year after year, and he’s getting an indication that 2011 will be no different.
Mitzi McFatrich, executive director of Kansas Advocates for Better Care, hopes the Legislature doesn’t cut funding for any long-term care services. She said elders and individuals with disabilities thrive when they have the supports and services that allow them to maintain their highest level of independence and ability. Unless a person requires 24-hour care, in-home services are more economical than care in a nursing home.
McFatrich said a lot of times the Legislature cuts the home health services because they don’t fall under an entitlement program, like nursing homes. “It just allows people to have more independence, more freedom, and the ability to stay within their social network. That’s where most of us want to get our care, instead of going to a nursing home,” McFatrich said.
Last year, the state passed a nursing home provider fee assessment. The federal government matches $3 for every dollar that is collected on the assessment. She expects it to generate $60 million. She hopes the money is used to increase nursing staff who provide direct care to residents. Nursing homes provide access to care 24/7, but are only required to provide care two hours a day.
“You don’t have to talk to very many people to understand that sometimes they wait 15 minutes and sometimes they wait 45 minutes for somebody to answer their call bell if they need help to the bathroom, getting dressed, or anything else,” she said.
McFatrich also would like to see that two-hour minimum requirement, which has been in place for about 20 years, raised. The U.S. Government Accountability Office did a study and suggested 4.15 or 4.85 hours of care per day per resident.
She also would like to see the state implement an ombudsmen program for community- and home-based services. There is a federal and state mandate that nursing home residents have access to an ombudsman, but that’s not available to people who receive services elsewhere.
McFatrich also would like the Legislature to implement regulations regarding nursing home residents who have a felony background. Currently, nursing homes don’t have to separate the populations or notify other residents. So, a resident may have shot, raped or beaten someone, and others don’t know. McFatrich said other states have taken up the issue legislatively.
Janet Williams, founder of communityworks inc., also hopes funding isn’t cut for home- and community-based services. These services help people get the training to become more independent and, as a result, reduce health care costs.
For example, she said the state is required to pay for traumatic brain injury rehabilitation, which is $25,000 a month more in a hospital than in the community or at home. There are 22 people with brain injuries receiving care at a hospital outside of Kansas. The state is paying about $350,000 a year for each of them.
“So, every time someone comes home or comes out of one of those expensive hospitals, we provide the services in the community and that’s when they get the assistance they need at a much lower cost,” she said. I believe people can come home sooner and even avoid going at all if there is a concerted effort to make it happen. That is one cost saving idea I plan to share with the new administration.”
Williams believes Gov.-elect Sam Brownback understands the importance of home health agencies.
“I think the greatest challenge is going to be educating all of the new legislators about the good that these programs do,” she said. Hospital Lawrence Memorial Hospital President and CEO Gene Meyer hopes the state adequately funds Medicaid, especially with the health reform initiatives and expansion of eligibility for Medicaid.
He said health care providers and the hospital already are not adequately reimbursed for the costs of providing care to Medicaid patients.
“This is huge because if they don’t, the availability of providers who will accept Medicaid becomes limited, thus creating significant backlog in the system,” Meyer said.
Tort reform is another concern. Currently, there is a case before the Kansas Supreme Court that challenges malpractice limits. If the current limits are found to be unconstitutional, he said the Legislature may be forced to make some changes that would expand the limits of awards. And that, he fears, would create significant increases in malpractice premiums for providers. “Kansas has been able to recruit physicians because of what’s termed a favorable malpractice climate. If this becomes not so favorable by legislative activity, it’s going to be another big problem with development of providers to meet future needs.”