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November 2007

November 30, 2007

State health facts for children

The Kaiser Family Foundation publishes a wonderful website call State Health Facts, which enables one to explore an individual state's health statistics and compare health indicators across different states. In a new update to the site, the Kaiser Foundation has added detailed children's health statistics. For example, the site's information on the health of children in Ohio includes the number and percent of children in the state who receive health coverage through employer-offered coverage and Medicaid; their demographic breakdown by race, ethnicity, poverty; their breakdown by heath status indicators, and much more. Anyone needing quick and accurate state-level statistics should bookmark this site.

Timetable for new Medicaid health care programs

The Strickland administration has announced the implementation timetable for health care programs called for under the most recent biennial budget. (Source: Gongwer Ohio Report, November 29, 2007.) According to Ohio Department of Job and Family Services (ODJFS) spokeswoman Scarlet Bouder, the increase of Medicaid eligibility for "pregnant women earning up to 200% of the federal poverty level and to cover individuals aging out of foster care up to 21 years of age will go into effect on or before Jan. 31." A buy-in program for disabled adults will by implemented by April 1st. ODJFS is still awaiting federal approval for expanding the eligibility of the State Children's Health Insurance Program (SCHIP) from families earning 150% of the federal poverty level to 300% FPL. Bouder also said ODJFS was still working on the Medicaid buy-in program for children with special needs from families earning more than 300% FPL.

The timetable announcement comes a week after the Strickland administration delayed the implementation of Medicaid rate changes and the reinstatement dental coverage due to budget and caseload concerns. When Governor Strickland was asked whether predicted economic conditions would permit the state to adhere to the planned implementation schedule, he said “"What we have rolled out today I believe is consistent with what we will be able to accomplish. I will continuously monitor our situation and will make decisions based upon conditions as they develop."

November 29, 2007

Ohio ranked as one of the "most depressed" states in U.S.

In a new report released today, Mental Health America says Ohio is one of the "most depressed" states in the country. (Source: press release, Nov. 29, 2007.) The report examined state and national data on mental health status and suicide rates and found that South Dakota leads the nation with the best depression status while Utah ranked last. Ohio came in at number 43. (Source: Ranking America's Mental Health: An Analysis of Depression Across the States.)

To determine the measures of depression and mental health status across the different states, the report's authors examined the percentage of adult and adolescent populations experiencing at least one major depressive episode in the past year, the percentage of the adult population experiencing serious psychological distress, and the average number of days per month in which the population reported that their mental health was not good. The report also examines suicide rates across the country, with Ohio ranking in the middle at number 22.

Estimate of heath care savings from HIT expansion

In a report that may apply to current efforts to expand health information technology (HIT) in Ohio, Oregon has estimated that overall health expenditure savings in their state from the widespread adoption of HIT are $1.7 billion per year. "Of the total statewide savings, $0.6 billion is due to avoidable services, and $1.1 billion is due to increased clinical and operational efficiencies. Employers would benefit from $6.1 million in time-loss reductions." (Source: "Potential Impact of Widespread Adoption of Advanced HIT on Oregon Health Expenditures," PDF download.)

The report, by the Oregon Health Care Quality Corporation and the Office of Oregon Health Policy Research, estimated that the cost impact for the required health care information technology systems statewide "at between $0.44 billion and $0.75 billion per year. These estimates include both one-time and operating/maintenance costs. The cost estimates include (a) the widespread implementation of advanced HIT systems by providers, and (b) development of health information exchange services between providers."

Ohio Senate looks at requiring certification of pharmacy technicians

The Ohio General Assembly's Senate Health, Human Services and Aging Committee is considering legislation to require certification of pharmacy technicians in the state. (Source: Gongwer Ohio Report, November 28, 2007.) Senator Timothy Grendell (R-Chesterland), who is sponsoring the legislation through Senate Bill 203, said "Ohio is one of only a handful of states that does not license, certify or otherwise regulate pharmacy technicians. There is no minimum educational or training requirement, no oversight by a state licensing board and no way to track a technician who may get fired for errors only to move on to another pharmacy--perhaps your local pharmacy."

Under the bill, the Board of Pharmacy would certify pharmacy technicians if they met minimum requirements, such as being at least 18 years of age, having a high school diploma or equivalent, and passing a background check. Applicants would also have to pass a national exam and maintain clean records.

November 28, 2007

Ohio policymakers, officials explore ways to cut, delay Medicaid expenditures

"With stubborn unemployment figures and high foreclosure rates, Ohio appears to be on the forefront of a looming national economic slowdown forecast by the Federal Reserve, which downgraded its previous projections last week in response to problems in the housing market and rising oil prices." This is prompting Ohio policymakers and officials to "explore ways to cut expenditures in a range of areas" including Medicaid. (Source: Gongwer Ohio Report, November 27, 2007.)

The Strickland administration recently announced plans to delay both the restoration of dental benefits for adults and a rate increase for hospitals and providers due to an unexpected increase in Medicaid caseload. Now, "Medicaid stakeholders are watching to see if the administration moves to delay other planned health care expansions that could save the state additional millions. For example, the biennial spending bill appropriates: about $16.3 million in state share over the biennium for the creation of a Medicaid buy-in program for disabled adults; about $24.9 million to increase Medicaid eligibility for pregnant women; and about $6 million for covering individuals that age out of foster care."

Strickland spokesman Keith Dailey said, "The governor is prepared to take the steps necessary to protect the fiscal integrity of the Medicaid program and the integrity of the budget." However, Dailey added that the governor remains committed to implementing the recent Medicaid expansions for children that were passed in the budget, which expands eligibility for the State Children's Health Insurance Programs to children in families with incomes of 300% of the federal poverty level and to create a separate health insurance buy-in program for children from higher income households.

Medicaid autism aid granted reprieve

"Children with autism will continue receiving specialized services through Ohio's health insurance program for the poor, blind and disabled" at least through April 1, 2008. (Source: "Reprieve for autism aid," Columbus Dispatch, Nov. 27, 2007.) The Strickland administration had planned to alter Medicaid billing rules on autism starting at the first of the year, with a Joint Committee on Agency Rule Review (JCARR) hearing on the matter scheduled for next week. "The rules proposed by (Department of Job and Family Services) and the Department of Mental Health would prevent providers from billing the state's Medicaid program for autism services that don't match the federal guidelines. The proposal sparked considerable outrage from families of children with autism who said they would be cut off from critical treatment." (Source: Gongwer Ohio Report, November 27, 2007.)

ODJFS spokesman Dennis Evans said, "We agreed at this point to hold rules to provide more time to reach out to families, addressing their needs and helping them find solutions to their concerns." However, the agencies plan to re-file the rules without any major changes for JCARR consideration in January 2008, with an effect start date in April of that year.

November 27, 2007

Ohioans using credit cards to pay for health care

According to an article in the Marietta Times, many Ohioans are using credit cards to pay medical and prescription bills. (Source: "Americans use plastic to help pay for health care costs," Nov. 26, 2007.) Pam Dowler, executive director of the Consumer Credit Counseling Service of the Mid-Ohio Valley, said this is due to a number of factors, including the economy and higher fuel, utility, and grocery bills. Another reason, though, is that "many health care facilities, especially hospitals, are offering a 25% discount if the person pays the balance of their health care bill up front, before insurance pays. The easiest thing for many in that situation is to put the balance on a credit card."

Cincinnati physician creates bone density guide amid worries about children having weak bones

A study led by a Cincinnati physician has created the first ever "bone-growth guide" for children. (Source: "Little milk, exercise hurts kids' bones," Associated Press, Nov. 26, 2007.) "Dr. Heidi Kalkwarf of the Cincinnati Children's Hospital led a national study that gave bone scans to 1,500 healthy children ages 6 to 17 to see how bone mass is accumulated." The resulting bone-growth guide can be used by pediatricians like height-and-weight charts, only in this case for children at high risk for bone problems.

This guide arrives as doctors worry that "too little milk, sunshine and exercise" are leaving American children with weak bones, including in some cases rickets ... Already there's evidence that U.S. children break their arms more often today than four decades ago--girls 56% more, and boys 32% more, according to a Mayo Clinic study. Kalkwarf's hospital recently found that kids who break an arm have lower bone density than their playmates who don't. That suggests the fracture rise isn't due solely to newer forms of risky play, like inline skates."

According to experts, less than a quarter of adolescents get enough calcium. "But strong bones require more than calcium alone." Exercise is at least as important, but with childhood obesity rising, exercise among kids is falling. In addition, bodies can't absorb calcium and harden bones without vitamin D. However, kids are not getting enough exposure to sunlight, which creates vitamin D in a body, due to "computer use, urban youngsters without safe places to play outdoors and less school P.E. ... Because skin pigment alters sun absorption, black children are particularly at risk."

Attorney General signs off on Akron Children's Hospital purchase

Yesterday Attorney General Marc Dann "signed off on Akron Children's Hospital's $26 million purchase of a pediatric medical facility in the Mahoning Valley ... after reviewing the proposal's compliance with antitrust laws." (Source: Gongwer News Service Ohio Report, Nov. 26, 2007.) As previously reported, ACH will purchase the Forum Health Beeghly Medical Park facility and open a new pediatric hospital there in 2008. "Forum Health will transfer its birthing, obstetrics, and gynecology center to Northside Medical Center in Youngstown."