Thursday, October 22, 2009
Editor, Hull House NC Policy Blog
Monday, October 19, 2009
Wednesday, October 14, 2009
Published Wed, Oct 14, 2009 07:42 AM
Modified Wed, Oct 14, 2009 05:47 AM
Strained Medicaid in for cuts
North Carolina is trying to squeeze savings out of Medicaid, even as
people than anticipated sign up for coverage under the government
health-care program for the poor.
So far, the cuts primarily mean that doctors, hospitals and providers
being paid less for their services, but state officials and others are
warning that cuts to medical services and significant job losses in
care could be looming.
Cuts ordered by the legislature this year mean that Medicaid, which is
funded jointly by federal and state government, will lose $1.5 billion
Those cuts have touched nearly all areas of health care. Doctors and
hospitals are being paid less to treat Medicaid patients, and the state
spending less on community mental health and personal care services for
Meanwhile, more people are asking for help. About 8,000 more people than
legislators budgeted for were signed up for the government insurance
in August, and September enrollment was 3,000 people higher than
Unless there's a dramatic economic turnaround in the next year, the
pressure could increase, said Lanier Cansler, head of the state
of Health and Human Services, which oversees Medicaid.
The state is expected to get $440 million less next year from the
government to fill Medicaid budget holes, he said, which may mean
legislators will have to consider cutting medical services.
"We're at the point to where we're not going to be able to keep access
place if we reduce the budget substantially more," Cansler said Tuesday.
Department administrators also worry that some doctors may decide to
treating Medicaid patients.
"We've got a tremendous challenge this year," Cansler said. "The
will just be multiple next year."
This year, most of the state's 1.4 million Medicaid recipients -- those
use the insurance for routine health care -- won't feel the pinch,
But doctors, hospitals and health agencies that care for them will get
money to do so, and paid caregivers will be watched more closely as the
state tries to contain costs by making sure patients don't get
they don't need.
Hospitals, mental health providers and home health agencies anticipate
thousands of job losses as a result of rate reductions and program
Mental health to be hit
Mental health providers who call the budget and program cuts "an
of destruction" will hold a news conference today to demand the
call a special session to restore mental health money.
Late Tuesday, Gov. Beverly Perdue announced that DHHS has been told to
an additional $15 million to cushion the drop in community mental health
spending. This year's Medicaid cuts in mental health came to $400
Hospitals expect to cut about 400 jobs because of the cut in Medicaid
payments, said Don Dalton, spokesman for the N.C. Hospital Association.
of those losses will be from rural hospitals.
The recession has already forced hospitals to cut staff, Dalton said,
lower Medicaid payments only add more pressure.
"These will force administrators and trustees to make hard decisions on
services to eliminate in their communities," he said.
The home health care industry expects substantial job losses, with fewer
patients receiving home care and agencies earning less money for them.
Up to one-fifth of the state's 100,000 home health employees could lose
their jobs as a result of state and federal cuts, with the state budget
reductions responsible for about 80 percent of the loss, said Tim
chief executive officer for the Association for Home & Hospice Care of
For elderly people who have trouble getting in and out of a bathtub or
the bathroom, the state wants to replace home care workers with bathroom
bars and raised toilet seats, Rogers said.
"They're trying to replace caregivers with pieces of equipment," he
"That's not the right thing to do."
Everyone wants Medicaid services to stay the same, Cansler said, but
"The system can't stay the same when we're taking the amount of dollars
of it the legislature has required us to take out of the system because
the budget crisis," he said.
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Monday, October 12, 2009
NATION: "Mom's depression tied to child abuse in some families"
By: Staff Writer
According to a study of 5,500 U.S. families investigated by child welfare agencies published Archives of Pediatrics & Adolescent Medicine, a mother's depression may increase the risk that she will act aggressively toward her child, including engaging in name-calling and threats. While the research does not prove that a mother's depression, per se, leads to child abuse, it does suggest that adults with children should be screened by a physician for depression and partner abuse, which also increases the risk of child abuse. The research shows that mothers that developed depression during the course of the study had increased incidents of psychological aggression against their children.
Mothers who reported an increase in abuse from their partner were more likely to state that there was also an increase in neglect and physical abuse toward their children. However, there was a reported decrease in psychological aggression towards children by mothers who moved in with a non-violent partner during the study.
Reuters News Service, October 5, 2009
For Full Article Click Here
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Wednesday, October 7, 2009
DHHS to ask that Dix restraining order be lifted
Raleigh, N.C. ��� The North Carolina Department of Health and Human Services will ask a judge Wednesday afternoon to lift a temporary restraining order that prohibits the state from moving patients to the state's newest mental hospital.
Secretary Lanier Cansler said last month that he would like to begin moving 100 patients from Dorothea Dix Hospital in Raleigh to Central Regional Hospital in Butner.
If Superior Court Judge Allen Baddour lifts the order, Cansler said, it would take about 30 to 45 days to begin moving patients. The move would take several months to complete. About 120 patients would remain at Dix.
The $130 million Central Regional Hospital opened last July, yet nearly half the beds remain empty.
Advocacy group Disability Rights North Carolina filed a complaint last September, citing more than a dozen safety concerns and conditions the state failed to meet for the move, as outlined under state law.
Since then, DHHS and Disability Rights have been working together about the concerns.
In August, Vicki Smith, the group's executive director, said she believes the hospital is significantly safer now than when it opened last year.
Once the move is complete, it will save the state an estimated $800,000 a month, Cansler has said.
Eventually, Central Regional will replace both Dorothea Dix and John Umstead Hospital, which is also in Butner.
Dorothea Dix, now a subsidiary campus of Central Regional, will stay open for at least three more years as an overflow unit and to house children and adolescents in need of long-term care.
[Jack Register] this article is from a community psychiatry listserv