All Entries in the "Social Services" Category

Health care providers say Medicaid managed care riddled with problems

By Beth Musgrave
bmusgrave@herald-leader.com

FRANKFORT — The baby was coming, no matter what a managed care company had to say.

A pregnant woman came to one of Appalachian Regional Healthcare’s eight Kentucky hospitals already in labor before Christmas. But the hospital was told by one of three managed care companies that now run Medicaid in much of Kentucky that it must get pre-authorization to deliver the baby in order to get paid.

Fourteen days after the woman and baby went home, the hospital was still waiting for approval to deliver the baby, said Joe Grossman, vice president and chief financial officer of Appalachian Regional Healthcare.

Grossman was just one of several people to testify Wednesday before a Senate panel about problems with private companies that are now managing Medicaid care in Kentucky.

Medicaid asks for additional funding for substance abuse treatment

By Beth Musgrave

bmusgrave@herald-leader.com

FRANKFORT — If approved by the legislature, almost 6,000 additional people could be treated for substance abuse under the state-federal program for the poor and disabled.

Kentucky is one of seven states that does not offer substance abuse treatment in its Medicaid program.

With the number of Kentuckians with substance abuse on the rise, treating more people with addiction will not only improve health outcomes but will improve the state’s bottom line, said Stephen Hall, the commissioner of the Department for Behavioral Health, Developmental and Intellectual Disabilities.

The average cost of intensive outpatient drug addiction services is about $2,500. Adults who are not treated costs the taxpayers more than $23,000, some of those costs would include the cost of incarceration as well as other public benefits such as food stamps.

Moreover, studies of Kentucky drug treatment programs show dramatic increases in the level of employment of people who successfully complete drug treatment, Hall said.

Hall testified Monday before a House budget subcommittee on health and human services. The expansion of the state’s drug addiction services in the Medicaid program is one of several new spending items Gov. Steve Beshear has proposed in his two-year budget. Beshear has said that expanding drug treatment is key to tackling the state’s drug epidemic.

Legal fight over child abuse death records continues

By Beth Musgrave
bmusgrave@herald-leader.com

FRANKFORT — A Franklin Circuit judge expects to rule by Tuesday whether a battle over child abuse death records should stay in his court.

Franklin Circuit Court Judge Phillip Shepherd said he hoped to have a decision by Tuesday, when the state Court of Appeals is expected to hear motions in the case involving the state’s two largest newspapers and the Cabinet for Health and Family Services, which oversees child protection.

Shepherd has ruled previously that child protection records are open to the public when a child dies or nearly dies from abuse or neglect. Shepherd said only limited information in those files could be kept secret — such as social security numbers and the names of children who are injured but don’t die.

The state appealed Shepherd’s order to the state Court of Appeals, arguing that more information in those documents should be kept secret under exemptions in the state’s Open Records Act. At the same time, the cabinet has released case files of eight children who were killed or nearly killed as a result of abuse and neglect, but with more redactions than allowed under Shepherd’s previous ruling.

Providers say Medicaid managed care payments late

By Beth Musgrave
bmusgrave@hearld-leader.com

FRANKFORT — Home health agency officials told a legislative panel Thursday that Kentucky’s new managed care system for Medicaid is three months behind in its payments to them.

Jeannie Lemaster, chief compliance officer of Nurses Registry and Home Health, based in Lexington, told the House Health and Welfare Committee that the agency has outstanding claims of between $300,000 and $400,000 that have not yet been paid.

Kip Bowmar, executive director of the Kentucky Home Health Association, said that only 8 percent of the claims from the approximately 150 home health agencies have been paid since the switch to managed care on Nov. 1.

“If these problems don’t get corrected, there is a likelihood that some agencies could go out of business,” Bowmar said. “We are hopeful and optimistic that it will get better.”

House panel unanimously approves adult abuse registry

By Beth Musgrave
bmusgrave@herald-leader.com

FRANKFORT — The House Health and Welfare Committee on Thursday unanimously passed House Bill 259, which would establish a registry of adult protection workers who have had substantiated cases of abuse and neglect.

Gov. Steve Beshear has included $2 million in his proposed two-year state budget to establish the registry that supporters say will protect seniors and adults with disabilities.

Currently, if someone who works with vulnerable adults has a substantiated case of abuse and neglect against them, a potential employer has no way of knowing the worker’s past history. The $2 million would help provide technical support to create the registry and for administrative overhead for an appeals process, said Rep. Ruth Ann Palumbo, D-Lexington, the sponsor of HB 259.

It is now headed to the full House, where it is expected to be approved. A similar bill passed the Democratic-led House last year but stalled in the Senate because health care providers were asked to foot the bill for the registry. With Beshear agreeing to include $2 million for the registry in his proposed two-year budget, hopefully those concerns will be alleviated, Palumbo said.

Social workers say caseloads too high, workers are burned out

By Beth Musgrave
bmusgrave@herald-leader.com

FRANKFORT — State child-protection workers applauded Gov. Steve Beshear for requesting an additional $21 million to hire more front-line social workers in his budget, but told lawmakers Wednesday that more needs to be done to improve morale and working conditions.

“They are the most honorable, hard-working people I know and they are breaking down,” said Patricia Pregliasco, who works in child protection in Jefferson County. “Workers are leaving or trying to leave every day.”

Jefferson County child protection workers told the Senate Health and Welfare Committee Wednesday that additional staff will help with high case loads — which they said are inching past 50 per worker. The workers also said they are toiling under hostile work conditions and are being reprimanded and demoted for failing to close out old investigations of child abuse and neglect, yet are being asked to investigate new cases of abuse.

On top of that, they are frequently told that because of budget constraints there is no overtime available. If they take their work home and try to complete it, they are reprimanded again, social workers told the committee on Wednesday.

Beshear proposes more money for child protection and substance abuse treatment

By Beth Musgrave
bmusgrave@herald-leader.com

FULL TEXT OF GOV. BESHEAR’S BUDGET SPEECH

FRANKFORT — Gov. Steve Beshear proposed Tuesday spending an additional $21 million to decrease case loads for frontline social workers and asked for additional money for substance abuse treatment for adults and adolescents.

Beshear’s two-year, $19.4 billion budget proposal also spares several social services programs from cuts, including Medicaid, the state’s community mental health centers, behavioral health, child protection and other keys areas of the Cabinet for Health and Family Services.

However, most other programs in the cabinet — public health departments, nursing home inspectors and a commission that oversees treatment for children with chronic health care needs — will receive an 8.4 percent cut, Beshear said Tuesday. The Department of Aging and Independent Services, which runs programs for seniors, would be cut 6.4 percent.

It’s not clear how the cabinet will implement those cuts and what services will be effected. Those details are likely to be released when Beshear’s budget bill is filed in the next few days.

Judges say juvenile courts should be open, system in shambles

By Beth Musgrave
bmusgrave@herald-leader.com

FRANKFORT — Family court judges told a legislative panel Thursday that opening juvenile courts to more public scrutiny will improve Kentucky’s child-protection system.

The judges — who oversee abuse, neglect and other juvenile court proceedings — told the House Health and Welfare Committee that they also support a measure to create an external review panel to examine fatalities and near-fatalities of abused and neglected children.

The judges also told lawmakers that Kentucky’s child-protection system is stretched too thin, with not enough social workers or services to protect vulnerable children. Good child-protection workers are leaving and those that remain are exhausted, said Bullitt County Family Court Judge Elise Givhan Spainhour.

“I had a social worker yesterday break down in tears in the court room because she was operating on four hours of sleep,” Spainhour said.

Child therapists: We will close if state doesn’t pay soon

By Beth Musgrave
bmusgrave@herald-leader.com

FRANKFORT — Therapists who work with abused, neglected and at-risk children told a legislative panel Wednesday that they may have to close their doors if they don’t receive back payments from the state soon.

“Our business is struggling to keep the doors open,” said Peggy Smith-Puckett, a licensed family and marriage therapist from Glasgow. “We have received only a small fraction of the money we have billed.”

Smith-Puckett and other providers in the state’s Impact Plus program, which provides therapy to children who are at risk of being removed from their home, told the Senate Health and Welfare Committee Wednesday that payments for services provided to 5,700 children in the program have been minimal since the state moved to managed-care Medicaid on Nov. 1.

Impact Plus providers now must bill the four companies that offer Medicaid plans in Kentucky. The managed care companies pay the state, which then pays the providers.

Because of communication mix-ups between the state and the managed care companies, the billing codes for therapy services were not provided to managed care companies in a timely manner, said Sen. Julie Denton, R-Louisville, and chairwoman of the Senate Health and Welfare Committee.

Judge: State withholding too much information about child-deaths

By Bill Estep
bestep@herald-leader.com

A circuit judge plans to release new guidance on what information the state can withhold when it releases files on children who die or nearly die as a result of abuse or neglect.

Franklin Circuit Judge Phillip Shepherd said Wednesday it seemed almost certain that rules the state had proposed to use would result in information being withheld that should be public under the law.

Shepherd’s ruling comes after the Lexington Herald-Leader and The (Louisville) Courier-Journal filed complaints against the Cabinet for Health and Family Services.

Under state law, the cabinet must do a review of its performance when a child with whom it had prior contact — such as a child placed in foster care — dies from abuse or neglect.