Before the issue can be brought before Missouri voters in the November 2008 election, signatures must be obtained from registered voters equal to five (5) percent of the total votes cast in the 2004 governor's election from six of the state's nine congressional districts. Depending on the combination of districts, the number of signatures required ranges between approximately 86,000 and 95,000 valid signatures.
The ballot title for this statutory change reads:
Shall Missouri statutes be amended to:
reinstate and provide health care for eligible low income Missouri families, children, elderly, and disabled based, at a minimum, on the level of services and eligibility criteria that were in effect on January 10, 2005;
provide health care for Missourians who are paid no more than minimum wage, households whose income does not exceed two hundred percent of the federal poverty level, and persons with disabilities who are employed in sheltered workshops; and
pay health care providers at a level no less than that set for Medicare reimbursement for such services?
The exact cost of this proposal to state governmental entities is unknown, but not less than an estimated $255 million annually. It is estimated the proposal would have little or no costs or savings to local governmental entities.
Science Friday: Mizzou Viriologist Views the Enemy
A key to defeating an insidious bug like the rapidly-adaptive HIV virus is understanding how it is built, and how it uses cells to replicate itself. Marc Johnson has developed a new imaging technology that will help scientists view the virus in greater detail than ever before.
Johnson blend two existing imaging techniques fluorescence microscopy (which uses dye and specific light to create and image) and electron microscopy (which uses the precision bombardment of electrons).
The technique provides the real-time, but imprecise fluorescence image and correlates it with the detailed electron microscope image.
SB 577 aka MOHealth Net is one of the biggest bills left for the legislature to pass by Friday 6pm.
The Senate and the House passes different versions. Most people I talk to explain how different the versions are by stretching their arms and shaking their hands. The conference committee met again last night to stitch these two Health Nets together. It was a slow process. Let's skip over that one for now and come back later. And frankly, it didn't feel like the way our society should be determining the nuts and bolts of health care access and delivery.
The legislators in that conference last night they were trying to play the part of experts at health care; hours before they were working as experts on economic development, and experts at education, and experts at crime... And they can't be experts at all of these fields, even with Super Staff, and long hours. We're lucky if they're experts in even one.
As they sat around a table and plodding through the versions, category by category, line by line - Anyone have a feeling about... - I felt like I was watching one of those British sit-coms where they are no jokes, but the absurdity of the whole thing has a comic effect.
I wanted to turn to the lobbyist on my right and say, "This is how we decide who gets a home visit from a nurse? No. You're kidding. Really?" What's the fiscal note on that nurse?
The Board of Aldermen passed a resolution today endorsing the legislation before the U.S. Senate and House that seeks to prevent the "75% Rule" from being imposed on patient rehab facilities.
The rule requires that 75 percent of a facilities admissions meet a list of criteria in order to receive Medicare funding. Currently rehab facilities must meet 60 percent.
If the rule is extended it would reduce the number of facilities that qualify as inpatient rehabilitation hospital under Medicare's rules, thus reducing Medicare members' access.
"What the 75% rule does, is it pushes [patients] out the door real fast," said Alderman Steven Gregali, the sponsor of the resolution (Res. #23). "Ask Congress to have doctors make the decisions."
Alderman Freeman Bosley Sr., 3rd Ward, endorsed the proposal. He pointed to the homeless in St. Louis as an example of a failed health care system. Bosley pointed out that many of them are on the street due to mental health issues, a situation exacerbated in St. Louis when a number of mental health patients, who were formerly treated in places like the St. Louis Psychiatric Rehabilitation Center (former the City Sanitarium and State Hospital), lost services or were pushed into out-patient care.
"Everyone is entitled to health care, period," said Bosley.
Before the meeting Gregali gave Tim Ogle, an aide to Congressman Russ Carnahan who was attending the meeting, a heads-up.
The press release. Julie Eckstein will head the local chapter. The Center for Health Transformation, founded by former U.S. House Speaker Newt Gingrich, is a high-impact collaboration of private and public sector leaders committed to creating a 21st Century Intelligent Health System that saves lives and saves money for all Americans.
Rep. Chapelle-Nadal wants to expand eligibility for in-home care
Governor Matt Blunt's State of the State call to increase in-home care funding by $53 million opened the door, now Rep. Maria Chappelle-Nadal wants to bring 'em in.
Chappelle-Nadal wants to see the availability of in-home care to seniors and the disabled expanded. She cites the better health outcomes and quality-of-life issues that in-home care can provide, if it's available. Her plan focuses on those who fall in the grey middle; just outside the eligibility requirements, but without the assets to provide it themselves.
To do so, Chappelle-Nadal proposes to increase the amount of non-exempt cash assets an individual or couple is allowed to have and still qualify for in-home care. Currently the limit is $1,000 for an individual and $2,000 for a couple. Chappelle-Nadal doesn't specify an increased figure.
A second step would increase the individual income eligibility level to 300% of the poverty level. The current cut-off is just over the individual poverty level, or $12,636.
"As an advocate for seniors and the disabled, I plan to introduce legislation that will address the eligibility guidelines for in-home care. This bill is progressive and will aid in planning for our population’s future." said Chappelle-Nadal in a letter to constituents.
The discomfort was palpable in the silence following Mayor Slay's motion that the Board of Estimate and Apportionment sign off on legislation approving the BJC-Forest Park deal.
Neither Aldermanic Board President James Shrewsbury or Comptroller Darlene Green, Slay's two colleagues on the city's top board, moved or uttered a sound. Slay's request hung there until Slay, clearing his throat, continued on with a short statement acknowledging the sincerity and hard work of all the groups involved, for and against.
Slay thanked Green for her and her office's efforts in negotiating a deal with BJC, even if she didn't support it in the end.
"Thanks to you and your office, this bill is much better than it was," said Slay.
Though gracious in defeat, the Mayor couldn't hide his wish the deal had passed.
"I was unaware of the Comptroller's position when she walked into the room," said Slay when asked after the meeting if he was surprised at the Comptroller's decision.
That said, Slay seemed a bit ruffled at the outcome of the meeting.
On the flip side, opponents of the deal were ecstatic.
"We did it!" said Carla Scissors-Cohen of Citizens to Protect Forest Park, who called her husband to tell him the news. "This is a victory for the citizens of St. Louis."
"You can fight city hall," said Scissors-Cohen. "You can fight city hall if you feel the city is doing something not in the interest of the city."
Green said during the meeting that her decision not to support the deal was influenced by Protect Forest Park's successful petition initiative. In April voters will decide whether the sale of park land should be put to a city-wide vote, or be left in the hands of elected officials.
"I believe in the democratic process," said Green. "I don't believe it is the time to vote in lieu of the petition."
Afterward, Green said she would continue working with both parties to find a compromise position saying there must be "give and take on both sides."
Scissors-Cohen, however, said there would be no sale of any park land. City leaders, she said, would have to find another way to fund park maintenance.
Proponents of the BJC-Forest Park deal say it is an effort to help BJC expand its patient facilities and offices and that the millions given annually to the park by BJc were part of the price, funding park maintenance did not drive the deal. The section of park south of the main building–which BJC currently has a lease on and is home to an underground parking garage–was the most convenient place to add more hospital rooms and offices.
Given the orthodox position of the Protect Forest Park supporters, its is unlikely that Green's "middle ground" exists for them and they will put the pressure on anyone who supports any expansion onto the parcel.
Alderman Joe Roddy, 17th ward, was disappointed the deal failed. BJC is in his ward and he has talked at length about the enormous positive impact they have had in his ward which, not long ago, teetered on the brink.
"I hope we can salvage some of the construction projects," said Roddy, on his way into the Board Chambers. "I hope we can salvage some of the jobs."
While Democrats are certainly wary of having "Hillarycare" hung around their necks again, it seems that the debate over the form of a universal-style healthcare system has moved from inter-party to intra-party.
Republican Governors Mitt Romney and Arnold Schwarzenegger have unveiled new programs that propose to provide health care for every citizen of their state through a mix of mandates and subsidies. They are not the single-payer systems that conservatives are loath to see created, but they may represent its early stirrings.
Not surprisingly the two Governors–both from states with a distinctly moderate-to-left leanings–have come under fire from conservatives who see it as an attack on the "free market" system that insures us all; minus the roughly 47 million who go without.
Nolan Holingsworth (back to camera), president of the Family Heath Care board of directors, and Congressman Lacy Clay, D-1, cut the ceremonial ribbon opening the new clinic in the Forest Park Southeast neighborhood.
They were joined by Rep. Jeanette Mott Oxford (D-59), Sen. Joan Bray (D-24), Senator-elect Jeff Smith (D-4), Rep. Rachel Storch (D-64), Senate President Pro Tem Michael Gibbons (R-15), Sen. Maida Coleman (D-5), Family Health Care CEO Bob Massie, D.D.S. (holding ribbon) and Alderman Joe Roddy (Ward 17).
On Friday May 20th 2005 the Department of Social Services filed an emergency rule making request to the Secretary of State Robin Carnahan to allow Medicaid cuts to over 68,000 parents to be implemented July 1, 2005. Citizens for Missouri's Children believe this request should be denied and standard rule making procedure should be followed. This standard rule making would potentially allow these Medicaid recipients another 6-9 months of health insurance coverage.
They are asking people to call Secretary of State Robin Carnahan at 573/751-2379 and ask that she reject the emergency rule and direct the Department of Social Services to follow the standard rule making procedure for any Medicaid cuts that the state intends to make.
While some dedicated legislators continue to work in Jeff City to try and salvage what they can of Missouri's medicaid there are a few points that voters should keep in mind for the next two years. The Center on Budget and Policy Priorities published an excellent analysis of the Governor's sales pitch for medicaid cuts.
•...the Governor uses a misleading measure of where the state stands relative to other states. When more appropriate measures of Medicaid costs are used, Missouri is found to spend less on Medicaid than the majority of states. In terms of state general fund Medicaid expenditures per state resident, Missouri ranked 34th in the nation in 2003. In terms of state general fund Medicaid expenditures as a share of state personal income, Missouri ranked 38th in the nation in 2003.
•...national studies demonstrate that Medicaid is less expensive than private health insurance and that Medicaid costs have been growing less rapidly in recent years than private health insurance. A study by Urban Institute ... found that the average amount Medicaid spends on medical costs for adults is 30 percent less than ... if the same people were instead covered by private health insurance.
•Missouri ranks 34th in the nation in Medicaid expenditures per enrollee.
•...for each dollar by which the state would lower Medicaid expenditures financed by state funds, it would lose $1.53 in federal matching funds that finance the provision of health care to low-income Missourians and go into the Missouri economy. A recent study, based on analyses by economists at St. Louis University, indicates that this loss of federal funds would have repercussions across the state and lead to the loss of about 10,000 jobs and more than $700 million in economic activity in Missouri. A Medicaid reduction of this magnitude thus would adversely affect Missouri’s economy.
The economic effects of the Medicaid cuts will likely end in a net negative for the state. The political fallout will likely end in a net negative for the Republican Party as well.
For the many Missourians following the continuing pruning of health care services you may be interested to know that yesterday, May 1st, kicked off "Cover the Uninsured Week."
While Missourians certainly don't need to be reminded that there are countless people living without health insurance, the effort is designed to help bring attention to the tenuous position in which many working people find themselves.
Many Missourians are facing difficult times ahead thanks to budget cuts, but the health insurance system at-large is riddled with problems and requires a serious national dialogue to diagnose its ailments. The only way these issues will be treated effectively is if the political leadership take serious steps toward addressing the state of health insurance, rather than passing politically favorable but generally ineffective lawsuit restrictions.
Businesses, individuals, advocacy groups and legislators need to sit down and examine reform efforts to help ensure access to efficient and affordable heath insurance. Access isn't simply an ethical issue but also an economic one. The specter of government intervention needs to be dismissed. The health care industry doesn't provide consumer goods but is a necessary partner in sustaining a healthy, productive economy.
A key to defeating an insidious bug like the rapidly-adaptive HIV virus is understanding how it is built, and how it uses cells to replicate itself. Marc Johnson has developed a new imaging technology that will help scientists view the virus in greater detail than ever before.
While Democrats are certainly wary of having "Hillarycare" hung around their necks again, it seems that the debate over the form of a universal-style healthcare system has moved from inter-party to intra-party.
Nolan Holingsworth (back to camera), president of the Family Heath Care board of directors, and Congressman Lacy Clay, D-1, cut the ceremonial ribbon opening the new clinic in the Forest Park Southeast neighborhood.
