• Louisiana Medicaid overhaul begins its first day in operation, By Bill Barrow, February 1, 2012, New Orleans Times-Picayune: “The first leg of Gov. Bobby Jindal’s Medicaid overhaul goes live today, with more than 180,000 southeast Louisiana residents, most of them children, being shifted from the state-run insurance program to private insurance networks. Jindal’s signature health care initiative, the Bayou Health rollout involves the south shore of Lake Pontchartrain from St. Bernard Parish to Jefferson Parish, and the north shore parishes of St. Tammany, Washington, Tangipahoa, St. Helena and Livingston…”
• Medicaid managed care system draws sharp complaints, By Deborah Yetter, February 2, 2012, Louisville Courier-Journal: “Complaints about the state’s new Medicaid managed care system boiled over Wednesday at a legislative meeting, where a top Medicaid official acknowledged major problems since the state hired three outside companies to provide services. ‘It is a drastic change to the system,’ Neville Wise, the state’s acting Medicaid commissioner, told the Senate Health and Welfare Committee. ‘We didn’t expect the level of issues that we had.’ Lawmakers voiced growing dissatisfaction with managed care, citing complaints about lack of payments for medical services, difficulty in getting patient medications approved and delays in authorizing services…”

• Private contractors play increasing role in Medicaid, audit finds, By Jason Stein, December 20, 2011, Milwaukee Journal Sentinel: “As the state’s health programs for the poor have ballooned in recent years, the state relied increasingly on private contractors to run its health programs for the poor and completed fewer investigations into potential fraud, a new audit has found. The report released Tuesday by the Legislative Audit Bureau found that as of June there were at least three times as many contract workers working on Medicaid health programs as there were state workers. Over the past four years, payments to private vendors for Medicaid have nearly doubled, the audit found…”
• Utah’s budget debate: transportation and Medicaid, By Kirsten Stewart, December 19, 2011, Salt Lake Tribune: “Unveiling his budget for next year, Utah Gov. Gary Herbert last week bemoaned the growing share flowing to Medicaid. The health insurance program for low-income people consumes 17.6 percent of Utah’s budget, hurting the state’s ability to fund other priorities such as public schools, said Herbert, sounding a theme popular among conservatives. But advocates for the poor say the national strategy of pitting Medicaid against public schools doesn’t reflect reality in Utah. They point to another familiar budget boogeyman: transportation…”

Feds: Florida can continue 5-county Medicaid pilot, By Kelli Kennedy (AP), December 15, 2011, Miami Herald: “Federal officials on Thursday approved the expansion of a five-county Medicaid privatization pilot program that allows for-profit providers to determine the health care of recipients, but there’s no indication whether a statewide expansion will be allowed. The Centers for Medicare and Medicaid Services was insisting on new protections, more accountability and quality reporting, spokesman Alper Ozinal said…”

Report: Reverse child welfare privatization, By Martha Stoddard and Paul Hammel, December 16, 2011, Omaha World-Herald: “Saying Nebraska is failing in its responsibilities to children, a panel of state lawmakers called Thursday for pulling back on the controversial privatization of child welfare services. In the final report from a months-long investigation, the Health and Human Services Committee proposed sweeping changes aimed at creating better outcomes for children and better financial oversight for the state. The report could mark the beginning of the end for Nebraska’s two-year-old experiment in turning over to private contractors the bulk of duties for ensuring the safety and well-being of abused and neglected children in the state. But it also sets up a potential conflict between lawmakers and Gov. Dave Heineman, who has resisted previous calls to slow or halt his administration’s privatization effort…”

Nebraska audit blasts child welfare services, By Grant Schulte (AP), September 7, 2011, Houston Chronicle: “Nebraska’s effort to privatize child welfare services increased costs by 27 percent in a two-year period and led to millions of dollars in overpayments to a provider that has since gone out of business, according to a state audit released Wednesday. Nebraska State Auditor Mike Foley told a legislative panel that the Department of Health and Human Services failed to publicly bid multi-million dollar contracts with private service providers, and spent thousands of dollars on duplicate claims and payments to the wrong contractors. The audit was part of a legislative review of the rising costs and instability within Nebraska’s child welfare system. The state began to privatize services in 2009, handing cases of neglected and abused children over to contractors. Three of the five providers have since dropped or lost their contracts as caseloads and costs grew unsustainable…”

Medicaid managed care is a growing but risky business, By Christopher Weaver, August 26, 2011, Washington Post: “Sanjuanita Espinoza, 55, doesn’t seem like a gold mine for private insurers. She’s disabled, has high blood pressure and has no family to help with her care. Yet, to some Texas insurers, she is an opportunity. In August, the state picked five health plans in South Texas to oversee care for people such as Espinoza who are enrolled in Medicaid, the state-federal program for the poor. This scenario is playing out across the country as states increasingly turn to private insurers to rein in the cost of Medicaid. But Medicaid managed care is a risky business. Many new enrollees are older and sicker than the people health plans typically cover. The political environment is fierce, and insurers face resistance from physicians, hospitals and perhaps patients…”

• Ruling: AHCCCS copays break law, By Mary K. Reinhart, August 25, 2011, Arizona Republic: “A federal appeals court ruled Wednesday that mandatory copayments charged to Arizona’s poorest residents violate federal law. The three-judge panel of the 9th U.S. Circuit Court of Appeals said federal health officials failed to show how the copays, imposed in November after a seven-year court battle, served any purpose besides cutting the state’s Medicaid budget. Federal law gives the U.S. Health and Human Services secretary discretion to approve state Medicaid ‘waivers’ as long as the programs have a ‘research or demonstration value.’ Raising copayments for more than 200,000 of Arizona’s poorest residents and making them mandatory, the judges said, helped balance the state budget but didn’t meet that federal standard…”
• Illinois Medicaid’s managed care effort stumbles, By Judith Graham, August 26, 2011, Chicago Tribune: “It can take years for people with cerebral palsy, autism, schizophrenia or Down syndrome to find trusted physicians to oversee their health. Now, families and advocates say, those medical relationships are being threatened as Illinois rolls out a new program of HMO-style care for people with serious disabilities. Many doctors and hospitals are refusing to join the new Medicaid program, which the state hopes will better coordinate care and lower costs for some of its neediest recipients. The providers’ rationale: They dislike the bureaucratic hassles and cost-cutting measures associated with managed care. The ranks of those who have said no, for the moment, include prominent medical centers and physician practices with a long track record of serving the disabled, among them Northwestern Memorial Hospital, Rush University Medical Center, the University of Chicago Medical Center, Children’s Memorial Hospital and Loyola University Health System. Because of the situation, hundreds if not thousands of vulnerable, chronically ill individuals are being forced to find new doctors, some of whom appear ill-equipped to handle their needs, according to consumer advocates and families…”

• State will switch to public workers for FoodShare program, By Jason Stein, August 12, 2011, Milwaukee Journal Sentinel: “In a deal that preserves millions of dollars in federal aid to Wisconsin, Gov. Scott Walker’s administration will drop hundreds of private contractor employees who work for the state’s food assistance program and hire scores of public workers as replacements. The agreement comes after federal officials had threatened in recent months to withhold some money for the state’s FoodShare program because of what they said were improper privatization efforts that were started by the administration of Democratic Gov. Jim Doyle and initially intensified by the administration of Walker, a Republican…”
• Local use of food stamps doubles, By Kathleen Foody, August 13, 2011, Wausau Daily Herald: “The number of residents receiving food stamps in Marathon and Lincoln counties nearly doubled during the last four years as the recession forced more people into poverty and stretched family paychecks. In the first six months of 2011, a monthly average of 14,784 Marathon County residents received food stamps, up from 7,936 in 2007. Almost 3,700 Lincoln County residents used the program in the same time frame, up from 1,587 in 2007. Tammy Beranek, a 44-year-old Wausau resident who has used the program for three years, said it allowed her to make ends meet when she was diagnosed with epilepsy and couldn’t continue working as a housekeeper…”

Child welfare overhaul still bumpy, By Martha Stoddard, July 24, 2011, Omaha World-Herald: “Before turning over major responsibility for Nebraska’s child welfare system to private contractors, state officials said the change would help abused and neglected children. Fewer children would be torn from their homes. Fewer would become wards of the state. Children would not be bounced from foster home to foster home. Families would be reunified or children adopted sooner. What’s more, those benefits could be gained with existing state dollars. Yet 20 months into the reform, the costs to the state have escalated, instability within the system has grown and benefits have been mixed, at best…”

• Utah leaders pushing feds for quick approval for state Medicaid waiver, By Wendy Leonard, July 24, 2011, Deseret News: “State government officials signed a letter last week addressed to federal officials, hoping to push their Medicaid waiver request along in a ‘timely fashion.’ The original waiver, which seeks flexibility in reforming the system locally, among other changes to Medicaid, was submitted to the U.S. Centers for Medicare and Medicaid Services on July 1. Utah Gov. Gary Herbert said the state’s plan ‘makes sense,’ is ‘innovative and homegrown,’ and is the result of much collaboration from stakeholders…”
• Jindal administration announces firms for Medicaid privatization, By Bill Barrow, July 25, 2011, New Orleans Times-Picayune: “The state health department today identified five companies to run a $2.2 billion privatization of the Louisiana Medicaid insurance program for low-income children and adults. The firms still must clear additional rounds of government evaluation, including by the federal agency responsible for the Medicaid program, before Medicaid recipients can join the new managed-care networks later this year. But the announcement is a key juncture for Gov. Bobby Jindal’s signature health-care initiative. The program would shift more than two-thirds of the state’s 1.2 million Medicaid recipients - most of them children - to a system of coordinated-care networks designed to save taxpayer money and provide better care through coordination among doctors, hospitals and other medical professionals. Medicaid currently operates on a traditional fee-for-service model, with a recipient choosing any physician or other provider who accept the program and the provider billing the state after delivering a service…”

Indiana’s bumpy road to privatization, By Matea Gold, Melanie Mason and Tom Hamburger, June 24, 2011, Los Angeles Times: “Louise Cohoon was at home when her 80-year-old mother called in a panic from Terre Haute: The $97 monthly Medicaid payment she relied on to supplement her $600-a-month income had been cut without warning by a private company that had taken over the state’s welfare system.  Later, the state explained why: She failed to call into an eligibility hot line on a day in 2008 when she was hospitalized for congestive heart failure. ‘I thought the news was going to kill my mother, she was so upset,’ said Cohoon, 63. Her mother had to get by on support from cash-strapped relatives for months until the state restored her benefits under pressure from Legal Services attorneys. Cohoon’s mother, now suffering from Alzheimer’s disease, was one of thousands of Indiana residents who abruptly and erroneously lost their welfare, Medicaid or food stamp benefits after Republican Gov. Mitch Daniels privatized the state’s public assistance program - the result of an efficiency plan that went awry from the very beginning, the state now admits. Though the $1.37-billion project proved disastrous for many of the state’s poor, elderly and disabled, it was a financial bonanza for a handful of firms with ties to Daniels and his political allies, which landed state contracts worth millions…”

• The other healthcare lawsuit: California Medicaid (aka Medi-Cal) case headed to Supreme Court, By Marilyn Chase, June 6, 2011, Los Angeles Times: “With valet parking for patients, video-conferencing for parents of premature babies and a healing garden abloom with azaleas, Santa Rosa Memorial Hospital tries to maintain the amenities of a thriving community hospital. But chief financial officer Mich Riccioni is focused on the fiscal strains Memorial is facing. Nearly a quarter of the hospital’s patients are on California’s Medicaid program, known as Medi-Cal, and the state has been trying for years to cut its reimbursement rates for hospitals and other healthcare providers. Memorial, a 278-bed hospital in this city 55 miles north of San Francisco, sued California to try to stop the payment reductions. Now it is part of a case before the U.S. Supreme Court that could redefine states’ responsibilities on Medicaid services and ultimately determine whether Democratic Gov. Jerry Brown can go forward with cuts he says are vital to closing the state’s budget gap. The court is likely to hear arguments in the fall and render a decision by next spring…”
• Texas House approves Medicaid changes, By Chris Tomlinson (AP), June 8, 2011, Houston Chronicle: “Texas lawmakers passed major changes to Medicaid on Wednesday that would privatize the health program in South Texas and allow the formation of health care cooperatives. The 142-page measure is part of a special legislative session. The Legislative Budget Board says it could save the state $467 million, almost two-thirds of that from Medic­aid savings. Medic­aid is a joint state and federal health insurance program for the poor and disabled…”

• GOP: Feds should let states tighten Medicaid eligibility, By Mary Agnes Carey and Phil Galewitz, May 24, 2011, Miami Herald: “With their proposal to turn Medicaid into block grants all but dead, Republicans are pushing legislation to let states tighten eligibility rules for the health program for poor people and those with disabilities. The move, which would affect Medicaid as well as the Children’s Health Insurance Program, would help cash-strapped states save money, but it also could cause hundreds of thousands of people to lose health coverage. While Democrats strenuously oppose the proposed Medicaid change, some advocates and physicians groups worry that the issue could wind up as a bargaining chip in the partisan wrangling over raising the federal debt limit and reducing the budget deficit…”
• Christie eyes curb on Medicaid rolls, By Matt Katz and Maya Rao, May 23, 2011, Philadelphia Inquirer: “Gov. Christie plans to seek approval for a proposal that would deny Medicaid coverage to adults in a family of four with an annual household income of little more than $6,000, down from the current $30,000. A single mother raising three children who earned as little as $118 a week would not qualify for the government-funded medical coverage. The eligibility-requirement change, which must be cleared by the Obama administration and would apply only to new adult Medicaid applicants, would follow Christie’s eliminating - for the second year - a long-standing line item that would provide nearly $7.5 million in funding to family-planning clinics…”
• State drops managed-care Medicaid plan for 5 counties, By Charles S. Johnson, May 23, 2011, Billings Gazette: “The Schweitzer administration has abandoned its controversial plan to set up a Medicaid managed-care demonstration project in Lewis and Clark, Cascade, Choteau, Teton and Judith Basin counties. The Gazette State Bureau reported last fall that the Schweitzer administration since August 2009 had discussed using managed-card Medicaid, the state-federal program that provides health care for the poor and disabled. One major proposal came from Centene Corp., a large managed-care firm based in St. Louis. It was based on the idea that the private company would be paid a certain amount of money for each patient and ‘manage’ that patient’s care by directing him or her to lower-cost health care. That, in turn, was supposed to save money for both the state and the company.
  By last week, the state pulled the plug on the idea…”
• U.S. objects to new law on clinics in Indiana, By Robert Pear, May 22, 2011, New York Times: “The Obama administration is raising serious objections to a new Indiana law that cuts off state and federal money for Planned Parenthood clinics providing health care to low-income women on Medicaid. The objections set the stage for a clash between the White House and Gov. Mitch Daniels, a Republican, over an issue that ignites passions in both parties. The changes in Indiana are subject to federal review and approval, and administration officials have made it clear they will not approve the changes in the form adopted by the state. Federal officials have 90 days to act but may feel pressure to act sooner because Indiana is already enforcing its law, which took effect on May 10, and because legislators in other states are working on similar measures…”

Feds threaten state with loss of FoodShare funds over privatization, By Jason Stein, May 20, 2011, Milwaukee Journal Sentinel: “Federal officials are threatening to withhold new money and take back previous funds for Wisconsin’s food assistance if state officials don’t scale back efforts to privatize the program. The letter from federal officials follows an April visit to Wisconsin by USDA staff and goes a step further than similar past warnings by saying the state FoodShare program is already in violation of federal rules because of the privatization efforts by two governors. Federal officials are also separately questioning a new privatization proposal put forward by Republican Gov. Scott Walker for FoodShare, the successor program to food stamps…”

• Fla. pilot program to cut Medicaid costs raises new questions, By N.C. Aizenman, May 11, 2011, Washington Post: “To visit the low-rise medical offices dotting the sun-bleached highways of Broward County is to meet doctors and patients who complain of being guinea pigs in a social experiment gone wrong. They are part of a five-year pilot program designed to test whether Florida can reduce spending on Medicaid, the public insurance program for the poor and disabled, by largely turning the program over to for-profit HMOs. Success would mean getting a handle on one of the fastest-growing and most vexing expenditures confronting states. But it’s unclear whether the pilot, which is also underway in four other counties, has achieved that. Health professionals here say any savings have come at a high cost: the quality of care. And they are outraged over the legislature’s decision last week to essentially expand the pilot statewide, which will be carefully watched by other financially strapped states across the nation…”
• Fla. Medicaid overhaul’s 1st enrollees: disabled, By Carol Gentry, May 12, 2011, Miami Herald: “The first Florida Medicaid patients required to join managed-care plans under the just-approved overhaul won’t be the strong and healthy. The first wave will be made up of frail elders and the disabled. Until now, Florida’s plans to transfer Medicaid patients into managed care have focused on children and families, not the sick and frail elderly who need constant care. The assumption was that health maintenance organizations’ complicated rules would trip up weak, confused elders. But that thinking has changed. In the Medicaid overhaul that the Legislature passed and Gov. Rick Scott is expected to sign, the elderly and disabled would be the first group required to enroll in managed care. If federal health officials approve the plan, in July 2012 the state will officially begin lining up HMOs and provider-service networks to take on the population beginning in October 2013…”

Walker wants private sector to run assistance programs, By Jessica VanEgeren, May 11, 2011, Capital Times: “Vivian Colon is often the first point of contact for Dane County’s most vulnerable residents when they find themselves in desperate situations. From parents seeking emergency medical care for a sick child to those who live paycheck to paycheck and have little money left for food, Colon treats everyone the same when they walk through the doors of the Dane County Job Center on Aberg Avenue. She greets them with a smile. ‘A lot of people need help when they first come in,’ says Colon, who has worked for the county for nearly four years. ‘For some people, it’s their first time applying for benefits. Other people aren’t computer-friendly. They don’t know how to use a mouse or they can’t type. It’s my job to help them if they get stuck during any part of the process - beginning, middle or end.’ Every county across the state has a center like the one where Colon works. The centers function as one-stop shops where people can apply for food and medical assistance at the same time. Applications can be filled out online, over the phone or on paper. Whichever way applicants choose to go, county and state workers are there to help them through any stumbling blocks. But a provision in Gov. Scott Walker’s proposed budget would change all that by creating an ‘income maintenance administrative unit’ to centralize and largely privatize the operation of the food assistance, or FoodShare program, and Medicaid programs in Wisconsin…”

• Fla. lawmakers pass historic Medicaid overhaul, By Kelli Kennedy and Brent Kallestad (AP), May 6, 2011, Miami Herald: “Two historic bills enacting sweeping changes to Florida’s Medicaid program won Senate and House approval Friday, placing the care of nearly 3 million beneficiaries in the hands of private companies and hospital networks. The bills inject sorely needed accountability into a statewide managed care program that has faltered in its current state in five pilot counties. The plan’s detractors say for-profit providers are making money scrimping on patient care. Patients have complained they couldn’t get appointments with specialists. Several providers pulled out of the program, causing lapses in care as patients were bounced among plans. Sen. Joe Negron, who spearheaded the overhaul, said leaders have learned from the pilot program’s shortcomings and includes increased oversight and more stringent penalties, including fining providers up to $500,000 if they drop out. The bills (HB 7107 and HB 7109) also require providers to generate a 5 percent savings the first year, which could save the state about $1 billion…”
• Florida legislature passes massive Medicaid overhaul, By Jim Saunders, May 8, 2011, Kaiser Health News: “Arguing that the proposal will save tax dollars and improve patient care, Republican lawmakers Friday approved a massive overhaul of Florida’s Medicaid system. The proposal, which has been debated for more than year, would eventually shift hundreds of thousands of poor and elderly beneficiaries into HMOs and other types of managed-care plans. Supporters say that would hold down spiraling costs in the $20 billion program, while also improving a fragmented system of care. ‘We get to save billions of dollars, and we get to deliver better health care,’ said House sponsor Rep. Rob Schenck, R-Spring Hill. But the proposal drew opposition from Democrats, who questioned whether it would adequately hold HMOs accountable and whether it would stick Medicaid beneficiaries with costs they can’t afford…”

Fla. can’t track child welfare contractors, By Kelli Kennedy (AP), May 3, 2011, Miami Herald: “A decade ago, Florida began turning its child welfare program over to private contractors instead of state workers. Almost everyone involved feels that the change has been for the best, but that’s all it is - a feeling. Despite spending a half billion dollars a year, the Department of Children and Families does not have a standardized system for evaluating in most areas its 20 child welfare contractors, making it impossible to prove that the 40,000 children in the system are being helped. Nor can the state show with confidence which contractors are performing well, adequately or poorly. ‘We’ve got to create better statewide data. We have very little,’ new DCF Secretary David Wilkins told The Associated Press. He plans to introduce a new system next year. Critics and advocates agree that the child welfare system has improved overall and cite numbers that prove their point…”

Walker plan brings warning from USDA, By Jason Stein, April 28, 2011, Milwaukee Journal Sentinel: “Gov. Scott Walker’s proposal to privatize work determining who is eligible for food assistance in the state would violate federal law and could expose the state to a loss of more than $20 million in federal money, federal officials say. In an April 14 letter to state Health Services Secretary Dennis Smith and Children and Families Secretary Eloise Anderson, Ollice Holden, a Midwest administrator for the USDA’s Food and Nutrition Service, warned that the work of interviewing applicants and deciding who is eligible for the Wisconsin FoodShare program needs to be done by public workers who are essentially civil servants. If not, he said, the state could lose some of the federal funds supporting FoodShare, the successor in Wisconsin to the food stamp program…”

In Florida, H.M.O.’s would treat Medicaid patients, By Lizette Alvarez, April 27, 2011, New York Times: “A crucial experiment in the future of Medicaid is playing out in Florida, where both houses of the Legislature are vying to find ways to drastically cut costs, manage care and reduce waste and fraud. The cuts and changes being sought by the Republican-led Legislature and encouraged by the new Republican governor, Rick Scott, a wealthy former hospital company executive, are deeper than those in many other states. In the past 11 years, the cost of Medicaid in Florida has grown to $21 billion from $9 billion and amounts to a third of the state budget. The federal government pays more than half the tab…”

House passes massive Medicaid overhaul bill, By Jim Saunders, April 1, 2011, Miami Herald: “Five years after a controversial pilot program began in Broward and Duval counties, the Florida House on Thursday approved a statewide proposal to shift Medicaid beneficiaries into managed-care plans. The Republican-dominated House voted 80-38 along almost straight party lines to approve a bill that details a five-year process for overhauling the Medicaid program. Another bill needed to carry out the changes passed 78-39. Supporters said the plan would improve care for Medicaid beneficiaries, reduce widespread fraud and control costs in the $20 billion program…”

Sides gird up for Medicaid fight, By Marc Caputo, March 7, 2011, Miami Herald: “In Florida, poverty is big business. Just look at the Medicaid healthcare program, which could account for $22 billion in spending in the coming budget year. It’s the most expensive program in the state budget right now and funds more than 80,000 providers, from large hospitals to podiatrists. It’s on pace to cover more than 3.2 million poor, elderly and disabled Floridians - 15 percent of the population, including more than a quarter of all children, half of all births and almost two-thirds of nursing-home care. But with all the increases - 50 percent over five years - lawmakers say they have to tamp down on costs and improve care. Their solution: require that HMO-like managed-care companies take more control of Medicaid. Lawmakers also want to trim reimbursement rates and cut some programs, including those for the catastrophically sick. Some hope to expand the use of vouchers for recipients to buy private health insurance, and they would like to use the program to help subsidize health insurance for employees of some private businesses…”

Lawmakers poised to privatize Medicaid statewide, By Kelli Kennedy (AP), February 28, 2011, Miami Herald: “Jason Rosenstock typically waits six weeks to see a specialist to treat his pituitary disease, a side effect from a childhood brain tumor. The private insurance company managing his care for Medicaid has repeatedly denied his medications, each denial eliciting a mountain of red tape. The 33-year-old and his mother kept a journal of every phone call and e-mail detailing their fight the past few years as Rosenstock has been bounced between three different health plans. Rosenstock lives in Broward County, the largest of five counties participating in a 2006 pilot program implemented under former Gov. Jeb Bush that puts Medicaid recipients into privately managed care. Gov. Rick Scott and Republican lawmakers want to expand the program statewide during the upcoming legislative session, which begins March 8. Lawmakers say Florida must overhaul Medicaid or its rising costs, which are expected to top $21 billion next year, will overwhelm the budget. The program has nearly 3 million low-income and disabled residents, with the federal government paying more than half the bill. The state is trying to eliminate a $3.6 billion budget deficit…”

• Crushed by Medicaid costs, states expand managed care, By Christine Vestal, February 4, 2011, Stateline.org: “Last week, Illinois Governor Pat Quinn signed a health care reform bill that will dramatically change the way many Medicaid patients receive care. The bill aims to push half of Illinois’ Medicaid caseload into the hands of managed care organizations by 2015. Illinois has a long way to go to reach that goal: Only 8 percent of Medicaid patients in the state receive care this way now. When he signed the bill, Quinn promised the reforms would reduce the state’s Medicaid costs by as much as $774 million over the next five years. The savings is supposed to come from shifting from a system in which the Illinois Medicaid program generally pays doctors for each service they provide, to one where the state pays insurers a set rate per year for each patient. Quinn also said Medicaid patients will see their health care services improve because insurers would be responsible for more carefully coordinating patient care to reduce avoidable hospitalizations and worsening of chronic conditions. Illinois is late to the managed care phenomenon - on average, states already have moved 46 percent of their Medicaid caseloads into managed care. But in a year of tight budgets and rising health care costs, Illinois is only one of many states turning to the managed care model to squeeze savings out of Medicaid, which now consumes 22 percent of state budgets. This year, at least a dozen states are expanding managed care for Medicaid, the state-run health insurance program for low income children, pregnant women, the disabled and frail elders…”
• Governors get advice for saving on Medicaid, By Robert Pear, February 3, 2011, New York Times: “Fearing wholesale cuts in Medicaid by states with severe budget problems, the Obama administration told governors on Thursday how they could save money by selectively and judiciously reducing benefits, curbing overuse of costly prescription drugs and attacking fraud. However, the administration refused to say whether it would allow states to adopt stricter eligibility standards that would, in effect, throw low-income people off the Medicaid rolls and eliminate their insurance coverage. Kathleen Sebelius, the secretary of health and human services, said she was still studying that question. Governors said the ideas, though constructive, were not nearly enough. They said they wanted waivers of some federal requirements and relief from Congress, and they noted that the new health care law would greatly increase Medicaid rolls in 2014…”

• Obama administration looking to help states cut Medicaid costs, By Noam N. Levey, February 3, 2011, Los Angeles Times: “Facing a brewing revolt among states wrestling with massive budget shortfalls and tattering healthcare safety nets, the Obama administration is intensifying a drive to help state leaders find ways to wring savings from their Medicaid programs. Thursday, Health and Human Services Secretary Kathleen Sebelius sent a letter to the nation’s 50 governors suggesting a range of cuts they can make to Medicaid, including dropping some people from the program…”
• Fla. lawmakers could expand Medicaid privatization, By Kelli Kennedy (AP), February 2, 2011, Miami Herald: “Florida legislators seem poised to pass a bill during its coming session aimed at reducing the state’s Medicaid expenditures by expanding privatization of the program, but that may not get federal approval. The Republican Legislature wants to put more of the state’s nearly 3 million Medicaid recipients into privately managed care, expanding a 2006 pilot program implemented under former Gov. Jeb Bush that affects five counties - Broward, Duval, Baker, Clay and Nassau. Gov. Rick Scott said Tuesday he’d like to expand the program statewide. Scott recently talked with federal health officials about the waiver and said he hopes it’s extended without changes. Florida’s Medicaid program cost about $18 billion during the last fiscal year, with the state paying $8 billion and the federal government footing $11 billion. The cost is expected to rise to more than $20 billion during the current fiscal year…”
• As many as 182,000 to join state Medicaid, By Ry Rivard, February 1, 2011, Charleston Daily Mail: “Three years before national health care reform’s most expensive provisions take effect, West Virginia officials are struggling to guess how many residents will suddenly be insured by the government-run Medicaid program and how much the state will owe because of it. As many as 182,000 new people could enroll in the state Medicaid program, costing the state as much as $175 million a year starting in 2017, officials from the West Virginia Department of Health and Human Resources said Monday. And as many as half of those people may already have insurance, including about 29,000 who currently pay for private insurance, according to separate estimates made by DHHR. Officials are still struggling to understand the effects of the Obama administration’s overhaul of the nation’s health care system. A tangle of administrative rules and shifting projections makes every number tentative and subject to change…”

• Fla. lawmakers mull how to transform Medicaid into managed health care for poor, By Kathleen Haughney, November 17, 2010, Palm Beach Post: “Florida’s newly installed lawmakers Wednesday began considering ways to cut what they fear could be a $20 billion Medicaid bill in the coming year, including shuttling more low income patients into private managed care programs and setting caps on the amount of money spent on each patient. Key senators held a six-hour meeting Wednesday on the heels of passing a non-binding message to Congress Tuesday that said the legislature intends to revamp the state’s Medicaid program by expanding the state’s five-county managed-care pilot program statewide. Since the summer, Senate President Mike Haridopolos and his top legislative lieutenants have been promising to overhaul the system during the 2011 legislative session…”
• Can Florida really alter Medicaid?, By Jim Saunders, November 18, 2010, Kaiser Health News: “Florida Republican leaders made a clear statement during a special legislative session Tuesday: They want to overhaul the Medicaid program and don’t want the federal government tying their hands. But that might ignore Washington realities. Congress this year required states to increase the number of people eligible for Medicaid in the future — the opposite of giving Florida more flexibility to run the program. What’s more, federal officials won’t agree to a relatively straightforward extension of Florida’s Medicaid ‘Reform’ pilot, which required thousands of beneficiaries to enroll in managed care plans. Instead, the federal government will require changes in the pilot…”

• Medicaid managed care programs grow; so do issues, By Phil Galewitz, November 12, 2010, USA Today: “After Tonya Bauserman slipped in a grocery store and hurt her right knee last July, an emergency room doctor prescribed painkillers and told her to see an orthopedic surgeon. But Bauserman, 27, who’s insured by a Medicaid managed health care plan called HealthCare USA, says she had trouble finding an orthopedist in her plan who would see her. Finally, she drove 2½ hours to Columbia from her home in a northwestern suburb here to see a physician, who fitted her for a brace and recommended physical therapy. HealthCare USA later said it wouldn’t pay for the brace. Furious, Bauserman says her experience was ‘crazy.’ But it’s not uncommon. Primary care physicians in the area say a shortage of specialists in Medicaid managed-care networks makes it difficult sometimes to refer patients…”
• Battle lines drawn over Medicaid in Texas, By Emily Ramshaw and Marilyn Serafini, November 11, 2010, New York Times: “A week after newly emboldened Republicans in the Texas Legislature floated a radical cost-saving proposal - opting out of the federal Medicaid program - health care experts, economists and think tanks are trying to determine just how serious they are, and if it would even be possible. The answer? It is complicated. But that is not stopping some conservative lawmakers in nearly a dozen other states, frantic over budget shortfalls and anticipating new costs from the federal health care overhaul, from exploring it. ‘States feel like their backs are against the wall, so this is the nuclear option for them,’ said Christie Herrera, director of the health and human services task force for the American Legislative Exchange Council, an association for conservative state lawmakers. ‘I’m hearing below-the-radar chatter from legislators around the country from states considering this option…’”

Nebraska groups criticize child welfare reform effort, By Margery A. Beck (AP), November 10, 2010, Lincoln Journal Star: “Several groups complained publicly Wednesday that agencies hired by the state to manage parts of Nebraska’s child welfare system have refused to work with attorneys in cases involving state wards, failed to return phone calls or even tell authorities where foster children have been placed for weeks. Voices for Children in Nebraska, Nebraska Appleseed and others gathered in Lincoln to release a letter signed by more than 800 organizations and individuals calling on the Nebraska Department of Health and Human Services for more information, transparency and accountability in the state’s child welfare reform process. The letter is being sent to Gov. Dave Heineman and officials with the state Health and Human Services Department…”

Privatizing child welfare near, By Martha Stoddard, October 26, 2010, Omaha World-Herald: “Department of Health and Human Services officials hope to take a first step this week in replacing child welfare workers with private contractors. Agency spokeswoman Kathie Osterman said Monday that the agency’s staff is working on documents justifying the change. The documents are expected to be submitted to the Department of Administrative Services for approval ‘within the week,” she said. The justification is required by a 1995 state law. But some legislators are questioning the agency’s plans and its timeline. State Sen. Gwen Howard of Omaha, a former state caseworker, said she is concerned that the change is being rushed through without legislative oversight. She said numerous questions need to be answered in light of the problems experienced already in the move toward privatizing care of state wards…”

• Legislators skeptical about plan to privatize Medicaid, By Matt Gouras (AP), October 15, 2010, Helena Independent Record: “Montana lawmakers and others said Thursday they are skeptical about Gov. Brian Schweitzer’s plan to privatize Medicaid services, especially those who remember a disaster in the mid-1990s to contract out some of those services. Only recently have health care providers and interested legislators learned about plans in the Schweitzer administration to consider a test letting a private, managed-care firm run Medicaid in part of the state, although many of the details have not been disclosed. ‘On first blush it sounds too good to be true. They don’t decrease care, they don’t decrease provider rates and plus they take their profit on top?’ said Rep. Mary Caferro, a Helena Democrat. ‘I just think if it sounds too good to be true, then it probably is.’ The Lee Newspapers State Bureau reported the state is considering asking companies to bid on a contract to manage Medicaid, the state’s $900 million health care program for the poor, in a five-county area that includes Helena and Great Falls…”
• Increasing Medicaid rolls and higher costs a challenge for next governor, By Bill Rufty, October 14, 2010, Lakeland Ledger: “Shannon Baxley and Brian Alvear and their two children receive health care through Medicaid. One daughter is disabled. Brian works two jobs, and Shannon is a full-time mom trying to get additional education. ‘It definitely helps,’ Baxley said. ‘But it does change, and you either are on full Medicaid like the children or you are on ’share of cost’ depending on your income from month-to-month, based on a formula. I could see someone older who may have Medicaid in addition to their Medicare not going to the doctor, just for the hassle of figuring it out.’ With Democrat Alex Sink and Republican Rick Scott hammering away on each other in the race to become Florida’s governor, one of them will soon be in a position to affect people like Baxley and her family. Whichever one gets the most votes in the Nov. 2 election will have to work with members of the state legislative leadership who have said the state’s share of Medicaid costs must be reduced…”
• Central Florida legislator looks to other states for Medicaid solutions, By Bill Rufty, October 15, 2010, Lakeland Ledger: “If anyone has seen all sides of the Medicaid issue, it has to be Ed Homan. He is a state legislator, an orthopedic surgeon whose medical group treats Medicaid patients, and he is a professor at the University of South Florida School of Medicine. The Temple Terrace Republican has tried to get a bill passed that would assure care for poor patients, would pay doctors compensation and would save money through a program that has been successful in North Carolina. But he said he keeps getting beaten back by corporate medical lobbyists. Homan’s latest attempt, and his last because he is leaving the Florida House after reaching term limits, was his introduction of a bill in the 2010 Florida Legislature that would have combined the best of the North Carolina plan and a similar one in Oklahoma…”

Welfare boss says backlog, errors fall, By Ken Kusmer (AP), Fort Wayne Journal Gazette: “Indiana human services chief Anne Murphy told a legislative panel Tuesday that the face-to-face contact for clients that she has added to the state’s error-plagued welfare automation system is showing success, but lawmakers said many problems remain. Murphy, secretary of the Indiana Family and Social Services Administration, said error rates are down and the percentage of new applications for food stamps, Medicaid and other benefits on backlog has fallen by 83 percent or more in southwest and west-central Indiana after her agency made the changes in those two regions. ‘Hybrid is what’s driving down this percentage,’ Murphy told the Medicaid Oversight Commission. FSSA rolled out the ‘hybrid’ system to 10 southwest counties in January and 11 west-central counties in June. The agency added 16 more southern counties this month…”

State makes progress on food stamp backlog, By Corrie MacLaggan, September 7, 2010, Austin American-Statesman: “With hundreds of new workers on board, Texas has dramatically improved its speed and accuracy processing food stamp applications, Health and Human Services Executive Commissioner Tom Suehs plans to tell state lawmakers today. But he’ll also tell the joint gathering of the Senate Health and Human Services Committee and the House-Senate panel overseeing the eligibility system that he needs more resources, including more workers. ‘Yes, we’ve turned it around,’ Suehs told the American-Statesman on Tuesday. But he added: ‘We still have a long way to go to maintain it there. This thing is still in a precarious situation.’ In August, Texas processed 93.5 percent of applications within the required 30 days, compared with 58.6 percent in September 2009, according to the commission. A year ago, the state routinely failed to process food stamp applications as quickly as required by the federal and state governments. Some families waited months for aid, and those who were eligible were at times denied benefits because of processing errors…”

Phone troubles hang up Texas welfare requests, By Robert T. Garrett, August 31, 2010, Dallas Morning News: “Even as Texas spends hundreds of millions to hire more workers to process welfare applications, it has skimped on replacing obsolete phone systems at more than 300 offices. At some, phones are more than two decades old and prone to ‘port failures’ in which callers hear a ring, but no line actually rings in the office, officials said. Also, many newly hired workers do not have voicemail. Experienced workers and supervisors do, but they complain of occasional malfunctions, which can make entire offices unreachable. The situation has added frustration and complications for Texans applying for benefits as the economy sags…”

Federal government throws up roadblock to Florida’s Medicaid reform, By Jermy Cox, August 23, 2010, Florida Times-Union: “Federal health officials want changes to be made to the Medicaid experiment that has put private managed-care companies in charge of covering thousands of patients in Northeast Florida. In a letter last week, the federal Centers for Medicare and Medicaid Services told state officials that it wouldn’t extend the program through an expedited process, as Florida had sought. Instead, the agency said it wanted to undertake a more rigorous review that would take into account ‘issues that have been raised in reviews’ of the program. The letter didn’t specify what issues federal officials want to address. While internal reviews have painted a positive picture of the program, it has come under fire from critics and some outside analysts. Expectations were high in 2005 when Florida won federal approval to place Medicaid patients in certain counties into privately run managed-care plans. Duval and Broward counties kicked off the reform program in 2006. Baker, Clay and Nassau followed in 2007…”

Food stamps agency requests staffing boost, By Robert T. Garrett, August 17, 2010, Dallas Morning News: “Texas’ system for handling requests for food stamps and other aid will require more than 1,900 additional state workers over the next few years to keep up with heavy demand, a top official has told state leaders. However, Health and Human Services Commissioner Tom Suehs asked for slightly more than 1,500 new eligibility workers in a recent preview of how much money his agency will request in the next two-year budget cycle. Commission spokeswoman Stephanie Goodman denied Monday that Suehs pared his budget request to help state GOP leaders cope with a massive budget shortfall. ‘We’ll request all the staff we believe we need,’ she said…”

• Medicaid cuts: Can Kentucky limit the pain?, By Deborah Yetter, August 8, 2010, Louisville Courier-Journal: “State lawmakers trying to cut Medicaid costs might consider Morgan Drugs in Bedford, Trimble County’s only pharmacy. Owner and pharmacist Bob Yowler depends on business from Medicaid patients to help make ends meet. Many of his customers - especially elderly and low-income people who lack transportation - have no other good option for prescriptions and advice. And the store provides about a dozen jobs - not bad for a farm community with an unemployment rate of 14 percent, Yowler said. ‘It’s a Main Street business,’ he added. While pharmacy benefits are one of Medicaid’s most expensive programs, the services provided by Morgan Drugs show that the impact of the cuts will go well beyond the poor and disabled who receive benefits. And it provides a good example of the difficult decisions lawmakers face as they look for savings in the sprawling, $5.2 billion-a-year health plan…”
• Medicaid growth burning budget, By Catherine Candisky, August 8, 2010, Columbus Dispatch: “The cost of Ohio’s largest safety-net program has nearly doubled in the past decade. Taxpayers spent $14.7 billion last year to provide health coverage to poor and disabled Ohioans as Medicaid - the largest and fastest growing segment of state government - now consumes about 26 percent of the state budget. ‘That is true of health care, period,’ Greg Moody, interim director of the Health Policy Institute of Ohio, said of skyrocketing costs. “If you look at a person’s paycheck or a business’ bottom line that offers coverage, health care has been this constantly growing component and the same is true for state government…”
• Medicaid changes will hurt kids, dentists say, By Alison Knezevich, August 7, 2010, Charleston Gazette: “Fewer poor children in West Virginia will get dental care when the state changes the way it administers Medicaid later this year, a group representing dentists says. The West Virginia Dental Association believes the new set-up will burden dentists, resulting in more tax dollars being spent on administrative costs, rather than on services for needy kids, said the group’s director, Richard Stevens. The state Department of Health and Human Resources plans to contract with managed-care companies to administer benefits of patients enrolled in Medicaid, the state/federal health insurance program for the poor. These companies also are called health maintenance organizations…”

State Medicaid reforms lead to fewer doctor visits, By Jeremy Cox, July 14,2010 Florida Times-Union: “Northeast Florida’s Medicaid recipients are making fewer trips to the doctor for chronic illnesses since state officials outsourced the government-subsidized health insurance program to private managed care companies. But it remains unclear from the analysis performed by the Florida Agency for Health Care Administration, which oversees the state’s Medicaid program, whether they’re healthier for it. Medicaid reform was launched in 2006 in Duval and Broward counties to test whether HMOs could rein in the state’s Medicaid spending. Baker, Clay and Nassau counties were added a year later. A University of Florida analysis last year suggested that medical costs were rising in reform counties at a slower rate compared with other parts of the state. But critics quickly lined up to attribute those savings to patients being denied care or being forced into bureaucratic tangles by the managed-care contractors…”

Hawaii’s Medicaid switch produces mixed results, By Mary Vorsino, May 24, 2010, Honolulu Advertiser: “Fifteen months after the state switched its Medicaid insurance program for more than 42,000 low-income seniors and disabled residents from a fee-for-service model to a managed care one, advocates say two firms hired to administer the program have improved services and beefed up provider networks. But some point to cases involving patients who have seen cuts in care or who have struggled to navigate the Mainland-based plans because of language barriers or other reasons as continued areas of concern. New statistics on the Quest Expanded Access program illustrate that mixed bag. The numbers show both insurance companies - ‘Ohana Health Plan and Evercare - have decreased the average processing time for claims, from a high of 22 days to about 10, and increased the number of participating specialists…”

Florida lawmakers OK Medicaid pilot program extension, By Jeremy Cox, May 15, 2010, Florida Times-Union: “Just when it looked like the Medicaid experiment in Northeast Florida and one South Florida county was going to be expanded to 19 more counties or even statewide, the legislation fell apart. Now, as leading state lawmakers vow to push anew next year for a Medicaid overhaul, the pilot program that was the basis for last month’s legislative drama may get a second chance to prove its advocates right. After failing to reach a compromise on expansive changes to the government insurance program for the poor, the House and Senate quietly voted on the last day of the session to extend Medicaid reform…”

Indiana, IBM trade suits over welfare contract, Associated Press, May 13, 2010, Wall Street Journal: “Indiana and its former partner in welfare privatization, International Business Machines Corp., sued each other Thursday over the technology giant’s canceled 10-year, $1.37 billion contract to automate the state’s intake for food stamps, Medicaid and other benefits. Both lawsuits were filed in Marion County courts in Indianapolis. In its lawsuit, the Indiana Family and Social Services Administration is seeking to recover the $437.6 million it paid IBM through Jan. 31, plus the costs of any third-party lawsuits, federal penalties, and state employee overtime that it incurs as a result of its association with the Armonk, N.Y., company. The state is seeking triple damages, or more than $1.3 billion, as it is entitled to do under state law. It accused IBM of intentionally denying benefits to clients to make its performance appear better and giving the state agency false and misleading information…”

• Indiana ‘hybrid’ welfare program set to expand, By Niki Kelly, May 11, 2010, Fort Wayne Journal Gazette: “The Family and Social Services Administration announced Tuesday the next region for its new ‘hybrid’ welfare eligibility system is an 11-county area that includes Vigo, Parke and Monroe counties. The expansion is dependent on federal approval. FSSA on Monday released statistics showing that adding more local welfare workers in 10 southwestern Indiana counties under a pilot hybrid system has cut the problems that clients have had with Indiana’s privatized, automated benefits system…”
• Officials: Changes in welfare cut complaints, By Mary Beth Schneider, May 11, 2010, Indianapolis Star: “Armed with evidence that the changes made to welfare delivery in a 10-county pilot project are working, the state will announce today whether it will expand the program to more areas of Indiana. Gov. Mitch Daniels pulled the plug on a $1.34 billion IBM contract for a centralized welfare intake system in October. The Family and Social Services Administration replaced it with a hybrid program, combining modernization and computerization of records with the face-to-face contact between caseworkers and clients that was the hallmark of past welfare systems…”

Florida Medicaid overhaul dies, By Jim Saunders, April 26, 2010, Miami Herald: “With differences remaining between the House and Senate — and a possible veto by Gov. Charlie Crist looming — an overhaul of Florida’s Medicaid system will not pass this year, legislative leaders said Sunday. ‘It looks like major reform isn’t going to happen this year,’ said Rep. Dean Cannon, a Winter Park Republican who has been a House leader on the issue. Cannon and House Health Care Appropriations Chairwoman Denise Grimsley, R-Lake Placid, said they expect to bring back the issue during the 2011 legislative session. The House proposed a sweeping plan that gradually would have led to almost all Medicaid recipients enrolling in managed-care plans, while the Senate proposed a smaller expansion of a pilot managed-care program. ‘I really think that what we did is good policy,’ Grimsley said. ‘But at the end of the day, if we don’t pass it this year, the sun will still rise on May 1 (the day after the legislative session ends).’ Cannon pointed to differences between the House and Senate as the main reason that a Medicaid overhaul will not pass. But Senate Ways and Means Chairman JD Alexander, R-Lake Wales, said aides to Crist made clear that the governor did not like parts of the House proposal and likely would veto it…”

• Medicaid measure clears Florida House, By Marc Caputo, April 20, 2010, Miami Herald: “Large HMOs will have more power than ever in Florida’s growing Medicaid program under a major health-reform package that cleared the House on Monday. The goals are lofty: Stop rampant fraud, reduce skyrocketing costs and improve healthcare for the almost 2.8 million poor, elderly and catastrophically sick Floridians served by Medicaid. The success of the bill hinges on the philosophy that private companies do a better job managing public health benefits than the government or individual Medicaid providers, who see patients on a pay-as-you go basis in what is known as a ‘fee for service’ system. By largely ending fee-for-service, the proposal so fundamentally changes Medicaid that almost every lobby — hospitals, doctors, insurance companies, homes for the developmentally disabled, pharmacists — has voiced concerns…”
• Fla. House ignores own analysts who warn of pushing elderly to managed care, By Stephen Nohlgren, April 20, 2010, St. Petersburg Times: “Elderly Floridians who want to stay out of nursing homes would be forced into managed care under two bills passed Monday by the House in an effort to pare Medicaid costs. But the Legislature’s own policy analysts suggest that managed care may be more expensive for frail older people, based on the track record of HMOs. A recent report examined a managed care program that provides home health care, housekeeping and many other at-home services, as well as assisted living when necessary. It did keep people out of nursing homes but was more expensive than two traditional programs, run by not-for-profit agencies, that cover the same services. The state could save by beefing up the traditional programs, the analysts said. The House bills would do just the opposite - wiping out the traditional programs and putting elderly clients into managed care…”

• Florida Medicaid overhaul heads to the House floor, By Bill Kaczor (AP), April 15, 2010, Miami Herald: “The Florida House set the stage Thursday for a vote next week on a massive overhaul of Florida’s Medicaid system, adopting a series of amendments with relatively little disagreement or partisan wrangling. The House began floor action on a pair of bills (HB 7223, HB 7225) that would put most Medicaid recipients in all 67 counties into privately operated managed care plans over the next five years, a move aimed at cutting rapidly rising costs and curtailing fraud…”
• House bill would turn Medicaid into managed care, By Gary Pinnell, April 16, 2010, Highlands Today: “Two bills approved Monday by the House Policy Council on Strategic and Economic Planning could privatize Medicare in every Florida county, saving Florida billions of dollars. HB 7223, co-written by Rep. Denise Grimsley, R-Lake Placid, would change from a fee-for-care system, in which more than 2.7 million patients are treated by a caregiver who bills the state. Moreover, Florida’s Medicaid could enroll more than a million new participants under the new federal health care bill. The new PSN will use a combination of federal and state taxpayer funds to provide free health care for the eligible population…”

• Food stamp frustration is valid, state audit report says, By Corrie MacLaggan, March 30, 2010, Austin American-Statesman: “Applying for food stamps in Texas can be quite a chore, according to a new state auditor’s report. Need to ask a basic question? Forget the phone. Workers often don’t have time to answer questions by phone and their voice mailboxes tend to be full, the report says. Instead, applicants ‘make unnecessary trips to a local office, in which they sometimes sit for hours just to ask a question or submit a document,’ says the report released Tuesday by State Auditor John Keel. ‘Crowded lobbies, long waits, and delays in eligibility determinations clearly resulted in frustrated clients,’ the report said. The report describes an inefficient system in which 80 percent of cases are kept on paper and a lack of experienced workers is contributing to problems processing applications accurately and within the 30 days required by the federal government. It recommends using technology such as automated kiosks and allowing applicants to check the status of cases online, an option the state now makes available only to certain applicants…”
• State auditor questions social services agency’s no-bid deal with ex-colleague to fix welfare problems, By Robert T. Garrett, March 31, 2010, Dallas Morning News: “State Auditor John Keel has questioned why state social services officials awarded work to a former colleague without seeking other bids, when his offer to curtail processing errors is good for only one-fifth of Texas’ 3.3 million food-stamp recipients. Keel also chided Health and Human Services Commission officials for seeking help last summer from former deputy commissioner Gregg Phillips’ company, though they ignored for nearly two years a similar offer by a Plano firm already on contract. Earlier this month, The Dallas Morning News reported that Phillips, who played a major role in the state’s botched privatization of eligibility screening for assistance programs, is making money trying to help Texas fix the problems that resulted…”
• Human Services to lay off 228 workers, By Mary Vorsino, March 30, 2010, Honolulu Advertiser: “The state Department of Human Services will lay off nearly half of its 517 workers who process applications for government benefits and will shut down 31 eligibility offices statewide under a cost-cutting plan set to go into effect June 30. The plan, which has been strongly opposed by advocates for the poor and several lawmakers, is expected to save about $8 million and DHS officials say it will actually speed up wait times by allowing people to apply on-line and over the phone, congregating workers in two main offices and streamlining workloads. The plan comes at a time when DHS is seeing increases in requests for Medicaid, cash assistance, food stamps and child care subsidies as families struggle to make ends meet. The increase in applications has meant significantly longer backlogs in processing requests for help…”
• Disputed welfare practices don’t hold up in court, By Jon Murray, March 31, 2010, Indianapolis Star: “When Gov. Mitch Daniels pulled the plug in October on a privatization contract that was the cornerstone of an aggressive welfare services modernization plan, he said it simply didn’t work. But the arrangement’s inefficiency, lost paperwork and wrongly denied benefits weren’t the only problems. A judge has ruled that parts of the modernization push also violated the law. Two recent rulings from a Marion County judge and a third from Clay County delivered a new slap to the state’s welfare services agency over several practices, including the handling of denials for some benefits and appeals for others. The Indiana Family and Social Services Administration is forging ahead by testing a new ‘hybrid’ plan in some places. In the meantime, dozens of counties still operate with vestiges of the aborted modernization attempt — and with one of the two disputed practices…”

• Florida Senate pushes Medicaid reform, By Marc Caputo and Steve Bousquet, April 1, 2010, Miami Herald: “The state Senate shifted rightward Wednesday by pushing plans to give private companies more tax money to manage prison operations and healthcare for the poor. As debate over the state budget began in earnest, the one-two privatization punch drew opposition from Democrats. They managed to soften the blow to the public prison system — job cuts had been on the table — but failed to halt a sweeping change for the Medicaid program that Republicans proposed in reaction to President Barack Obama’s signing of the new healthcare reform law. In the end, senators unanimously adopted a budget proposal, backing off a controversial plan to save money by opening a privately run prison and closing two state-run lockups. The Senate budget would allow the 2,200-bed, $113 million private Blackwater River prison in Milton to open Nov. 1. It would be run by the GEO Group and its cellblocks filled with inmates from other state-run prisons. The House has not yet approved a budget proposal…”
• Florida’s Republican leaders push for privatized Medicaid program, By Jim Ash, March 31, 2010, Fort Myers News-Press: “The same Republican leaders who vowed to maintain an open and transparent legislative process are pushing a last-minute plan on the Senate floor that would completely rewrite, and essentially privatize, the state’s $18 billion Medicaid program. An amendment by Sens. Mike Haridopolos, R-Merritt Island, Don Gaetz, R-Niceville, and Joe Negron, R-Port St. Lucie, would ask the federal government for permission to cap the program in exchange for increasing eligibility to another 2 million recipients. Medicaid recipients would get vouchers for private insurance, taking the state ‘out of the check-writing business,’ Negron said. Some would also see co-payments and deductibles. ‘It’s a way to treat people in the Medicaid program with the same dignity and respect as other people,’ Negron said…”

• Indiana agency begins hybrid welfare plan rollout, By Ken Kusmer (AP), January 26, 2010, Fort Wayne Journal Gazette: “Indiana’s human services agency said Tuesday the state’s third try at effectively enrolling and keeping people on food stamps and other welfare benefits has begun rolling out, but one affected caretaker said the frustrations keep mounting. The Family and Social Services Administration said it has begun implementing what it’s calling a hybrid welfare intake system, involving caseworkers and some automation, in 10 southwestern Indiana counties. It follows the agency’s aborted bid to turn over highly automated welfare intake to private vendors - a plan designed to replace an outdated, paper-based casework system - that remains in 33 counties…”
• Indiana agency begins hybrid welfare plan rollout, By Eric Bradner, January 26, 2010, Evansville Courier and Press: “The Indiana Family and Social Services Administration rolled out its pilot ‘hybrid’ system for processing welfare applications in a swath of 10 Southwestern Indiana counties on Tuesday. The rollout means the state’s human services agency now has three ways of handling applications for Medicaid, food stamps and Temporary Assistance for Needy Families operating simultaneously. The hybrid pilot is now in place in Daviess, Dubois, Gibson, Knox, Perry, Pike, Posey, Spencer, Warrick and Vanderburgh counties. The recently abandoned ‘modernization’ effort, which severely restricted face-to-face interaction with agency workers and instead had those seeking benefits apply online or by phone, remains in 49 counties.

Hybrid welfare system to roll out, By Ken Kusmer (AP), January 19, 2010, Fort Wayne Journal Gazette: “Indiana’s human services agency is expected to roll out its hybrid welfare intake program, aimed at correcting problems that arose when it tried to privatize the system, in 10 southwestern counties next week. The Family and Social Services Administration had said that it would roll out the hybrid system in the counties around Evansville in January, and last week spokesman Marcus Barlow said the change probably would occur during the last week of the month. Documents obtained by The Journal Gazette in December indicated Vanderburgh County - an early participant in privatization in 2007 and a squeaky wheel in bringing problems to light - was being considered as the first area to launch the new system. Under the hybrid system, which follows the state’s aborted effort to turn welfare intake over to private vendors, many state and private caseworkers will shift from call centers into local offices to give people more personal contact with those making decisions about their food stamps, Medicaid and other benefits…”

• U.S. food stamp official: State could be aiding more Texans, By Corrie MacLaggan, January 12, 2010, Austin American-Statesman: “Texas could be providing food stamps to 650,000 more people and could increase the amount of federal money it receives for the program each year from $4 billion to $5 billion if the state increased its participation rate to the national average, according to President Barack Obama’s top food stamp official. But Texas officials, who are struggling with a strained application system, say increasing participation is not their goal…”
• Official: Food-stamp application flubs hurt hungry Texas families, By Robert T. Garrett, January 13, 2010, Dallas Morning News: “Texas’ botched experiment with privatization of welfare application screening has caused “a five-year slide” in how fast and accurately the state handles food stamp applications, the federal government’s top food and nutrition official says. Now, the problems are punishing middle-class Texans who’ve recently lost jobs and are seeking government help - many, for the first time, says U.S. Agriculture Undersecretary Kevin Concannon…”
• Official: Texas has worst-ranked food stamp program, By Gary Scharrer, January 12, 2010, Houston Chronicle: “Texas has the worst performing food stamp program in the nation, the federal director for food assistance told state officials here Tuesday. It ranks last among the 50 states and U.S. territories in processing food stamp applications and also does a poor job getting eligible low-income people to apply, said Kevin Concannon, a U.S. Department of Agriculture undersecretary, in an earlier meeting with reporters. And because Texas does not even come close to the national average in enrolling those eligible, grocery retailers like H-E-B and Randalls are missing out on nearly $1 billion a year in food sales, he said…”

• Foster care news good and bad, By Paul Hammel, December 15, 2009, Omaha World-Herald: “While fewer Nebraska children were in foster care in 2008 and a record number of foster kids were adopted, the percentage of children who re-enter the system after being returned to family members was on the rise. And there are serious concerns about the lack of drug treatment for parents and the state’s move to privatize service delivery to kids in out-of-home care. Those are the good news-bad news highlights of the 2008 annual report by the Nebraska Foster Care Review Board, which was released today…”
• Report: Percent of children returning to foster care increasing, By JoAnne Young, December 15, 2009, Lincoln Journal Star: “There was good news in 2008 about children in foster care. The number of children dropped to 4,620, compared to 5,043 the year before. And 572 — 100 more than the year before — found permanent adoptive homes. But in the middle of the good news was a disturbing trend: The percentage of children who returned to foster care increased to 41 percent in 2008, according to the Foster Care Review Board’s 2008 annual report. The report highlighted the need for more funding for mental health services for kids traumatized because they are removed from their homes and parents and then moved around in foster care…”