Kelley Arnold

Author Articles

According to CSG’s Book of the States, three states will hold gubernatorial elections in 2015, followed by twelve states in 2016, two states in 2017, and 36 states in 2018. Here's a look at the upcoming gubernatorial elections, with a breakdown of the party seats that are up for grabs.

Children often are a voiceless population, left to navigate the incredibly complex child welfare system—from family and juvenile courts to child protective services—depending on that system to provide the protection they need to survive and thrive. This workshop highlighted three state multibranch efforts to enhance services to children and families, provide protection for children and pave the way for future generations to escape cycles of violence, poverty and neglect.

For Arizona Gov. Jan Brewer, the decision to take the federal government up on expanding Medicaid just made sense.

“By expanding Medicaid just slightly beyond what Arizona voters have twice mandated at the polls, we can draw down nearly $8 billion of our own tax dollars from the federal government,” she said.

Since the federal government will cover individuals earning up to 138 percent of federal poverty level, Brewer said that influx of money will cover costs the state was incurring as people without health insurance sought care in emergency rooms—the least affordable option.

10 Questions with Oregon Gov. John Kitzhaber: Coordinating Care to Cut Medicaid Costs

Oregon Gov. John Kitzhaber, a physician, says his state’s new approach to Medicaid under a federal waiver has fundamentally changed the way health care is organized and delivered. It established coordinated care organizations, which are moving away from a fee-for-service model.

Technology Offers Savings, Fair and Timely Justice
Article by National Association of Medicaid Directors Executive Director Matt Salo

The question of how to produce savings in Medicaid is almost as old as the program itself. While Medicaid traditionally has sought cost savings via cutting eligibility, benefits or reimbursement rates, state Medicaid directors are recognizing that we cannot continue to cut our way out of this problem. In fact, there is growing awareness that the solutions lie along a different path, that of a broader delivery system and payment reforms.

U.S. health care costs are likely to be around $2.8 trillion in 2013. In 2010, U.S. spending on health was 17.6 percent of gross domestic product; for comparison, the Netherlands spent 12 percent of GDP, the next highest spender of developed nations. The Centers for Medicare and Medicaid Services expects health spending to hit $4.6 trillion by 2020—19.8 percent of GDP. While spending growth has slowed in recent years—it has been near 4 percent for about four years and has reached a 14-year low—many believe the spending levels are unsustainable.

Schools Strive to FInd Efficiences, Ways to Improve Academic Output

Unlike other school districts across the country, Clark County, Nev., was bursting at the seams.

Over a 25-year period, the district saw an increase of 200,000 students with a rapidly changing set of demographics. Before school officials knew it, they found themselves operating the fifth-largest district in the United States. Each year, the district added as many as 16 new schools and hired thousands of new teachers and staff to meet the demands of their growing system.

States Shrank Workforces, but Future Employment Issues Loom

States took a wide variety of actions with their workforces to try to rein in costs after the Great Recession started gripping the country in late 2007.

As Leslie Scott, director of the National Association of State Personnel Executives said, “As we’ve heard often, never waste a crisis.”

States certainly didn’t waste this one.

Texas Sen. Jane Nelson has one word to describe what she saw as abuse of her state’s Medicaid system—infuriating.

An investigation in 2012 revealed that between 2008 and 2010, Texas spent $424 million on medically unnecessary orthodontic braces for Medicaid recipients, more than was spent on braces by all the other states combined. In total, the Texas inspector general identified more than $6 billion in fraud and waste in the program from 2004 to 2011.

More than 3,000 adolescents go through Rikers Island prison in New York City each year. Half of them will reoffend and end up back in prison within a year after their release.

That’s an expensive problem. According to the Vera Institute of Justice, each inmate cost New Yorkers an average of $60,000 in 2012.


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