CHILDREN’S HEALTH
Terminally Ill Kids Get More Options
In February, Colorado became the second state in the nation to receive a waiver to implement a children’s palliative care program as part of Medicaid. The waiver allows the Centennial State to implement CHI PACC, the Children’s Hospice International Program for All-Inclusive Care for Children and their Families. Specifically, the CHI PACC waiver allows children who are receiving Medicaid reimbursement for palliative care to also pursue curative treatments. Under current Medicaid rules, a child may receive palliative care only if he or she has less than six months to live and forgoes all other healing efforts. Florida is the only other state with a CHI PACC waiver, which it received in 2005. The two states used two different waivers to set up the programs; Colorado used a Section 1915(c) waiver, and Florida, a 1915(b) waiver. CMS encourages states to use the 1915(c) waiver, since it provides more flexibility to states and has an element of institutional care. Florida used a (b) waiver since it already had one in place, making the process easier. States can also use state plan amendments or 1115 waivers to apply for this waiver, but CMS states that these options are not ideal for CHI PACC. To learn more about what states are doing in children’s hospice care, see the Oct. 30, 2006 State Health Notes article at www.ncsl.org/programs/health/shn/2006/shn478b.htm.
Workforce Solutions
Legislators looking for solutions to health workforce shortages in rural areas can turn to a new Web site created by the University of North Dakota Center for Rural Health. The Web site highlights the latest findings by the federal Rural Health Research Centers. Sample topics include whether home visitation programs by lay health workers can improve pregnancy and birth outcomes; the lack of preventive care for diabetes in rural areas; implementation of Medicaid disease management programs in rural areas; and current trends in the clinical skills, prescriptive authority and geographic distribution of advanced practice psychiatric nurses. "Rural health care can face significant challenges and it is hard to find solutions when you are operating in a data-free zone," Mary Wakefield, director of the Center for Rural Health, told AHA News. To view the website, visit www.ruralhealthresearch.org/about/
Tax Breaks for Organ Donors
Legislators in Connecticut are considering a bill that would provide significant tax deductions to residents who donate an organ while living. The bill (SB 190) would allow a living donor to deduct up to $10,000 for expenses associated with donating an organ to another human being. Eligible expenses include the cost of travel, lodging and lost wages. Some have expressed concern that the deduction would not be beneficial to donors of lower income, and they would prefer other benefits, such as paid leave. If passed, Connecticut would become the 12th state to provide this deduction to donors, according to NCSL. Seven other states are considering this legislation in this session. Wisconsin and Maryland provide 30 days of paid leave to state employees who donate organs. The federal government provides the same leave for its employees.
A premium assistance program in Arizona may be falling short of expectations, according to The Arizona Republic. Under the program, the state provides low-income individuals (up to 250 percent of the federal poverty level) and small businesses (2 to 25 employees) with certificates ranging from $500 to $3,000. The parties then give the certificates to an insurance company and receive a discount for that amount on annual premiums. In turn, the insurance companies then receive credits on their state taxes based on the amount of the certificates. The program was launched after the Legislature passed HB 2177 in the 2006 session. So far, the state has issued 60 certificates to individuals and 335 to small businesses. However, since several thousand individuals and businesses are eligible, some critics have suggested that the program may be too complex for applicants. Others question whether insurance companies are in fact discounting their rates. “We do not know if, in fact, the insurance company made any reduction at all,” said Rep. Phil Lopes during a recent hearing on expansion of the program. Supporters argue that the program will serve more people over time as more become aware of it; they note that many business owners have expressed interest and enthusiasm.
© Copyright 2007, State Health Notes
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