This week’s legislative update delivers a summary of public health issues in the Governor's State of the State Address, information about Idaho’s Catastrophic Health Care program, and other topics of interest during the week.
State of the State
On January 11, 2016 Governor Otter began the legislative session with his State of the State and Budget Address, during which he touched on a few public health initiatives.
The Governor recommended that Idaho follow through on its plan to provide more physician training by adding five more seats to our medical school partnership with the University of Washington. He acknowledged that there are quicker ways to address the shortage of primary care physicians in the state and encouraged legislators to continue providing medical loan reimbursement incentives for primary care doctors who agree to serve in Idaho communities. The Governor also asked that the Board of Education work with the medical community and higher education institutions to develop a new plan for addressing future healthcare provider demands.
The Governor recognized and commended Health and Welfare Director Dick Armstrong and his team, as well as legislative leaders Representative Fred Wood and Senator Lee Heider, who have worked to develop an “Idaho-based alternative” to Medicaid expansion under the Affordable Care Act. The Governor noted that he looks forward to discussing the plan (PCAP) that he unveiled last week.
Last year, Governor Otter recommended a second behavioral health crisis center for the state. Idaho now has two centers, one in Idaho Falls and one in Coeur d’Alene. This session, the Governor’s budget request includes funding for a third crisis center in southern Idaho. The Governor reported that, “during the first nine months that the Idaho Falls center was open, it had more than 1,100 admissions and diverted 47 people from more expensive in-patient psychiatric care – all while saving an estimated 860 hours of law enforcement officers’ time.” He expressed his appreciation for the Legislature’s continued support of efforts to improve local access to care while reducing costs to the community.
The Governor’s State of the State and Budget Address can be read here.
The physician shortage may hinder Governor Otter’s proposed PCAP
The CEO of Kootenai Health, John Ness, told the Economic Outlook and Revenue Assessment Committee last Friday that Idaho does not currently have enough doctors to provide care to the 78,000 people in the “gap” through the proposed program. Full article.
Close the Gap Press Conference
Close the Gap held a press conference following the State of the State on Monday in response to Governor Otter’s proposed Primary Care Access Program (PCAP). Dr. Ted Epperly, CEO of the Family Medicine Residency of Idaho, expressed that PCAP is not a “total solution”. He explained that the Medicaid expansion plan, dubbed the Healthy Idaho Plan, recommended by the governor’s Medicaid redesign task force should be implemented to close the health coverage gap. The Healthy Idaho Plan would use federal funds to purchase private health insurance for folks who fall in the gap. Neva Santos, executive director of the Idaho Academy of Family Physicians, explained that PCAP is not health insurance coverage. It is a good idea to provide additional access to primary care for those in the gap, but the solution to the dilemma is to implement full coverage through the Healthy Idaho Plan.
Tobacco Tax
There have been many questions regarding the tobacco tax following the proposal of PCAP. A couple news articles from the Idaho Statesman sought to clear up the confusion.
The Joint Finance-Appropriations Committee
JFAC held special hearings on Wednesday, January 13. Byron Welch, Principal Evaluator from the Office of Performance Evaluations, presented “The General Fund Distribution Formula for Public Health Districts.
On Friday Jared Tatro, Principal Analyst from the Department of Health and Human Services, presented the Catastrophic Health Care Program – Reduce Excess OT Funding, Psychiatric Hospitalization – Personnel Funding Shortfall SHS, Indirect Support Services - Federal Earned Revenue Rate, and Independent Councils - Victims of Crime Act- Additional Oversight.
Idaho’s Catastrophic Health Care (CAT) program has been spending less than projected. The CAT fund is the state share of Idaho’s arrangement for paying the catastrophic medical bills of residents who can’t afford them. Counties cover a portion of each bill from local property taxes and amounts beyond that are paid for by the CAT fund. As more Idaho residents have obtained health insurance, the CAT program has been spending less. During the JFAC meeting on Friday morning, Senator Dan Schmidt (D- Moscow) proposed a transfer of $28,892,700 from the CAT fund back to the state general fund. Betsy Russel’s account of the committee meeting can be found here.
House Health & Welfare Presentations
This week, the Board of Pharmacy and the Bureau of Occupational Licenses presented to the House Health & Welfare Committee. Committee minutes can be found here.
Senate Health & Welfare Presentations
The Board of Pharmacy also presented to the Senate Health & Welfare Committee. Committee minutes are not online yet.
National News
President Obama made headlines this week when he proposed to boost federal funding for states that choose to expand Medicaid. Full article.
What to look forward to next week
Next week is Health & Human Services Week at JFAC. A full schedule of the presentations can be found here.
