Kentucky is taking the lead, by using an innovative approach to provide its 9,000 state employees and their dependents with readily accessible primary care options. Data from Kentucky’s 2014 employee health plan’s actuary, AON reported that, Kentucky saved $723,900 for 15,000 clinic visits.

Long-term care for the elderly and disabled is driving up Medicaid costs, and states should take notice. That was the message of speakers at the 2015 CSG Medicaid Policy Academy held June 17-19 in Washington, D.C. “In nine states, at least 30 percent of Medicaid enrollees are elderly or disabled,” explained Matt McKillop, an officer for the State Health Care Spending division of The Pew Charitable Trusts. The main source of funding to provide long-term care and support for these individuals streams from Medicaid through state budgets. McKillop highlighted national data from the Centers for Medicare and Medicaid Services that showed the elderly and disabled individuals comprised 24 percent of Medicaid enrollees in 2010, but accounted for 64 percent of total Medicaid expenditures in the states.

This week Gov. Jerry Brown signed into law SB 277 which removes the personal belief exemption parents could use to exempt their children from vaccination requirements tied to public school attendance.  When the law becomes effective in 2016, California will become the third state, after Mississippi and West Virginia, to allow vaccination exemption for medical reasons only.  

State legislators attending the fourth annual CSG Medicaid Policy Academy June 17-19, in Washington, D.C., learned how critical Medicaid funding can be to services for vulnerable persons. Dr. Jeffery Brenner, a 2013 winner of a MacArthur Foundation genius award, challenged the group to rationalize the health care system. He described how his project in Camden, N.J. has reduced costs and improved care for patients suffering from a complex set of chronic diseases. Health care workers visit patients in their residences and seek to evaluate not just medical needs but social and emotional needs as well. 

Dr. Jeffrey Brenner—executive director of the Camden Coalition of Healthcare Providers, a 2013 MacArthur Fellow and family physician—thinks we don’t need to ration health care. “We need to rationalize care,” Brenner said at a recent CSG eCademy session, “Delivering Better Health Care for Less.” The webcast was broadcast live as part of CSG’s 2015 Medicaid Policy Academy in Washington, D.C.

For much of the past week, the Supreme Court has been issuing opinions at a dizzying pace. Four cases in particular impact states directly. Rulings on same-sex marriage and Affordable Care Act cases affect everyday life and have incited much discussion in Congress and among the public. Other rulings on what license plates may say and access to hotel registry information have not garnered as much attention, but have important impacts on states as well.

CSG Midwest
Last summer, lawmakers in the Illinois House declared a “heroin emergency” in the state. This year, the legislature overwhelmingly approved a comprehensive plan (HB 1) to deal with it. According to The State Journal-Register (Springfield), the state's new fight against drug abuse will cost between $25 million and $58 million.

Sixteen states have passed laws explicitly authorizing needle exchange programs, and there are a number of states with statutes that either decrease barriers to the distribution of clean needles or altogether remove syringes from the list of drug paraphernalia. Additionally, a recent HIV outbreak in the small town of Austin, Ind., has led more states to consider authorizing such programs.

Sixteen states have passed laws explicitly authorizing needle exchange programs, and there are a number of states with statutes that either decrease barriers to the distribution of clean needles or altogether remove syringes from the list of drug paraphernalia. Additionally, a recent HIV outbreak in the small town of Austin, Ind., has led more states to consider authorizing such programs.

Long-term care and supports were the focus of the 2015 CSG Medicaid Policy Academy, held in Washington, D.C., June 17-19, 2015. The 30 registered CSG members came from 19 states. Home states are marked in purple in the map below. Over the four years CSG has convened the Medicaid Policy Academy, legislators from 42 states have participated. 

The program concluded with a plenary session featuring Dr. Jeffrey Brenner, medical director of the Urban Health Institute at the Cooper University Healthcare as well as the founder and executive director of Camden (N.J.)  Coalition of Healthcare Providers. In 2013, Dr. Brenner was named a MacArthur Fellow for his work on addressing the health care needs of the chronically ill in impoverished neighborhoods. 

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