States grapple with mental illness issues; Oregon moves closer to limiting Medicaid patients' access to new hepatitis C drugs

Jul 16 2014

A selection of health policy stories from Illinois, Maryland, Oregon, Colorado and others.

The Associated Press: Jails Struggle To Deal With Flood Of Mentally Ill
The numbers, posted daily on the Cook County sheriff's website, would be alarming at an urgent care clinic, let alone a jail: On a Wednesday, 36 percent of all new arrivals report having a mental illness. On a Friday, it's 54 percent. But inside the razor wire framing the 96-acre compound, the faces and voices of the newly arrested confirm its accidental role as Chicago's treatment center of last resort for people with serious mental illnesses (Geller, 7/14).

Stateline: Helping the Mentally Ill Join The Workforce
Because of poor funding from state and other sources, the "supportive employment" that benefited (Cyrus) Napolitano is unavailable to most of those with serious mental illness. According to one study, only 1.7 percent of those served by state mental health systems received supported employment services in 2012, even though it has proven to be the most effective way to keep the mentally ill in steady jobs. Soon that situation may change. Under the Affordable Care Act (ACA), states can apply to use Medicaid funds to train and employ the seriously mentally ill, under the theory that steady employment is a form of treatment (Ollove, 7/14).

The Oregonian: Oregon Moves Closer To Limiting Access On Hepatitis C Drugs As Senate Investigation Begins
The state of Oregon appears to be nearing what could be a first-in-the-nation stance limiting availability to Medicaid patients of new hepatitis C treatments that offer great promise at a very high price of $84,000 per 3-month treatment. On July 31, a state committee will consider guidelines intended to limit treatment only to patients who face serious liver damage without the drug. If adopted later this year, the approach would reduce the state's costs from an estimated $168 million in the coming year to about $40 million (Budnick, 7/14).

Propublica/NPR: Why Are Obstetricians Top Billers For Group Therapy In Illinois?
A few years ago, Illinois' Medicaid program for the poor noticed some odd trends in its billings for group psychotherapy sessions. Nursing home residents were being taken several times a week to off-site locations, and Medicaid was picking up the tab for both the services and the transportation (Ornstein, 7/14).

Baltimore Sun: Maryland Lawmakers, Child Advocates Seek Probe Into Oversight Of Troubled Group Home
Maryland lawmakers and child advocates called Monday for an investigation into regulators' oversight of a troubled group home operator, asking why the state continued to give the company millions in taxpayer dollars despite long-standing financial and regulatory problems. State Sen. Joan Carter Conway, chairman of a committee that oversees group homes, said she would call a hearing this month to determine why state officials continued to award contracts to LifeLine even after it had filed for bankruptcy reorganization and a state audit found it insolvent. The company has faced years of problems, including many that state regulators were unaware of, a two-month investigation by The Baltimore Sun showed. This month, a 10-year-old boy died at an apartment that was part of the company's Laurel-area group[ home, even as the state was moving to take children from its care (Donovan, 7/14).

The Associated Press: New Cook County Health CEO Searching For Savings
Dr. John Jay Shannon, the new chief of Cook County's health system, has a big job ahead: finding $67 million in savings to help erase a projected year-end budget deficit, according to a published report. Most of the anticipated budget shortage stems from CountyCare, the county's new Medicaid managed care program, which had been expected to bring more than $270 million in revenue this fiscal year. CountyCare started in 2013 as an early expansion of Medicaid to the low-income adults who would be eligible under President Barack Obama's health care overhaul in 2014. Shannon told Crain's Chicago Business there were "unrealistic expectations" that the CountyCare program would be "some kind of profit center" for the county's entire public health care system (7/14).

Denver Post: Birth Control Programs For Teens Gain Traction In Colorado, Nationally
Aggressive state and national programs supplying teens with long-term contraceptives have put a big dent in the teen birth rate, seemingly quieting what was once a loud policy debate. The success of these public health policies -; boosted by donations from billionaire Warren Buffett -; was highlighted recently by a 40 percent drop in teen births in Colorado over the last five years. The state handed out 30,000 free or low-cost contraceptives during that time. Advocates of abstinence-only say equipping teens for safe sex, without their parents' involvement, signals a surrender to reality rather than a victory. But health officials say that curbing the teen birth rate relies on a simple formula -; and it has little to do with curbing teen sexual appetites (Draper, 7/15).