Medicaid On! :: FITSNews

Medicaid On! :: FITSNews


There may be no use crying over “spilt’ milk,” but when it comes to the root cause of a $225 million Medicaid deficit, S.C. lawmakers are at each other’s throats … and the stakes are higher than ever.
At the center of the storm is the explosive revelation – first reported on FITS – that former Gov. Mark Sanford’s office instructed its Department of Health and Human Services (DHHS) director to lie to state lawmakers about the true size of the state’s Medicaid budget.
Specifically, former DHHS director Emma Forkner testified under oath Wednesday morning that she was ordered by Scott English, chief of staff to former Gov. Mark Sanford, to deliberately conceal the true rate of growth of the state’s Medicaid program.
English has denied Forkner’s claims. In fact, he told the Charleston Post and Courier on Wednesday that he gave the “green light” the only time she requested permission to ask lawmakers for additional funds.
Forkner was appointed by Sanford in July 2007. A native of Dillon, S.C., she is a former Air Force nurse who rose through the military’s medical ranks before becoming a health care researcher and policy analyst.
Not surprisingly, Forkner’s testimony is being used by Republicans and Democrats alike in the S.C. Senate to oppose government restructuring reforms that would give S.C. Gov. Nikki Haley expanded authority over her own branch of government. This executive authority is currently splintered via a maze of unaccountable bureaucracies (many of which are directly controlled by the legislature).
“This is all about government restructuring and the legislature driving up health care spending by accepting stimulus dollars and meddling with the executive branch,” said S.C. Sen. Tom Davis (R-Beaufort), a long-time Sanford ally.
He’s right …
In fact, as we’ve noted on several occasions state lawmakers have repeatedly blocked efforts initiated by the executive branch to cut Medicaid costs. Lawmakers have also refused to let DHHS set provider rates – making South Carolina the only state in the nation operating under this restriction. On top of that, lawmakers have also raided the DHHS budget over the last three years to the tune of $500 million – spreading that money around to other state agencies.
Clearly, there is no shortage of legislative blame when it comes to our state’s soaring health care budget – just as there was no shortage of legislative blame for the failed management of the old Employment Security Commission, which was run (into the ground) by three former lawmakers appointed by their legislative peers.
Having said all that, though, lawmakers do have a valid point – particularly if they can prove that they were deliberately misled by the Sanford administration. Sources tell FITS that lawmakers “smell blood in the water” and plan on holding hearings into the matter. S.C. Sen. Jakie Knotts (RINO-Lexington) and others have also demanded that subpoenas be issued for English and other former Sanford staffers.
Obviously a key player in the drama will be S.C. Gov. Nikki Haley – who earlier this month voted to let DHHS run a $100 million deficit.
Will Haley side with lawmakers in an effort to distance herself from the responsibility for the Medicaid deficit?
Or will she defend Sanford in an effort to keep lawmakers from blocking her restructuring goals?
We’ll have to see …
In the meantime, this year’s $225 million deficit is projected to explode in the coming fiscal year to more than $600 million. That’s due in large part to the fact that South Carolina has added more than 100,000 people to its Medicaid rolls since the recession began.
Currently, 975,000 South Carolinians – or one out of every five people in the state – receives services through Medicaid. Meanwhile, 52 percent of live births in South Carolina are now covered by Medicaid – a number which is also on its way up.
***
Tags: Emma Forkner, Mark Sanford, medicaid, Nikki Haley, sc medicaid, SC Senate, South Carolina Governor, south carolina medicaid, South Carolina Politics, tom davis

Your Help Needed! N.H. CACR 9- RELATING TO: parental rights

http://www.gencourt.state.nh.us/legislation/2011/CACR0009.html

This Bill is before the N.N. House of Representatives right now Please write to the N.H Legislature and let them know this Bill MUST be Passed!!!!!

CACR 9 – AS INTRODUCED

2011 SESSION

11-0081

06/09

CONSTITUTIONAL AMENDMENT

CONCURRENT RESOLUTION 9

RELATING TO: parental rights.

PROVIDING THAT: the state shall not abridge the responsibility of parents for the health, education, and welfare of their children.

SPONSORS: Rep. Itse, Rock 9; Rep. Ingbretson, Graf 5; Rep. Comerford, Rock 9; Rep. Mirski, Graf 10; Rep. Manuse, Rock 5; Rep. Seidel, Hills 20

COMMITTEE: Children and Family Law

ANALYSIS

This constitutional amendment concurrent resolution provides that the state shall not abridge the responsibility of parents for the health, education, and welfare of their children.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

11-0081

06/09

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Eleven

CONCURRENT RESOLUTION PROPOSING CONSTITUTIONAL AMENDMENT

RELATING TO: parental rights.

PROVIDING THAT: the state shall not abridge the responsibility of parents for the health, education, and welfare of their children.

Be it Resolved by the House of Representatives, the Senate concurring, that the

Constitution of New Hampshire be amended as follows:

I. That the first part of the constitution be amended by inserting after article 2-a the following new article:

[Art.] 2-b. Parents have the natural right to control the health, education, and welfare of their children; therefore the State shall not abridge the role or responsibility of parents in controlling the health, education, or welfare of their children.

II. That the above amendment proposed to the constitution be submitted to the qualified voters of the state at the state general election to be held in November, 2012.

III. That the selectmen of all towns, cities, wards and places in the state are directed to insert in their warrants for the said 2012 election an article to the following effect: To decide whether the amendments of the constitution proposed by the 2011 session of the general court shall be approved.

IV. That the wording of the question put to the qualified voters shall be:

“Are you in favor of amending the first part of the constitution by inserting after article 2-a a new article to read as follows:

[Art.] 2-b. Parents have the natural right to control the health, education, and welfare of their children; therefore the State shall not abridge the role or responsibility of parents in controlling the health, education, or welfare of their children.”

V. That the secretary of state shall print the question to be submitted on a separate ballot or on the same ballot with other constitutional questions. The ballot containing the question shall include 2 squares next to the question allowing the voter to vote “Yes” or “No.” If no cross is made in either of the squares, the ballot shall not be counted on the question. The outside of the ballot shall be the same as the regular official ballot except that the words “Questions Relating to Constitutional Amendments proposed by the 2011 General Court” shall be printed in bold type at the top of the ballot.

VI. That if the proposed amendment is approved by 2/3 of those voting on the amendment, it becomes effective when the governor proclaims its adoption.

Study finds children abused in DHS custody, DHS denies - KFOR

Study finds children abused in DHS custody, DHS denies - KFOR

OKLAHOMA CITY -- A study commissioned by the watchdog group, Children's Rights, details some disturbing trends at the Department of Human Services.

"This report confirms absolutely that the DHS system is severely broken," said Paul DeMuro, Children's Rights attorney.

Children's Rights hired an independent group, the Center for the Support of Families, to put together the study.

It tracked 374 children of the more than 7,400 in state custody.

According to the findings, 12 percent of the children suffered confirmed abuse or neglect while in state custody.

The study also points out that some kids are shuffled back and forth to different foster homes.

According to DHS, the study is flawed and officials questions how the research was conducted.

"It does not come to the same conclusion that our own federal review of the information shows," Sheree Powell with DHS, said.

According to DHS, each year a review is conducted by the federal government.

In that report, DHS claims its safety rating is 99.8 percent, that's higher than the national average.

Powell says the agency is currently locked in a class action lawsuit with Children's Rights.

State senators calling for audit of Department of Health and Human Services | SCNOW

State senators calling for audit of Department of Health and Human Services | SCNOW

Some state senators say they're going to investigate the state Department of Health and Human Services and are calling for an audit of the agency after they say the Sanford administration instructed the head of the agency to mislead lawmakers about the agency's budget.

DHHS is running a $125 million deficit in the current budget year. It had been $225 million short, but the state Budget and Control Board agreed that the state will cover $100 million of the shortfall.

Former DHHS director Emma Forkner testified before senators Wednesday about the agency's budget and its deficit. Sen. Vincent Sheheen, D-Camden, says what he understood from her testimony is that Gov. Mark Sanford's chief of staff, Scott English, instructed Forkner to give lawmakers false information about the agency's budget needs.

"She was told to use a 4 percent number in the agency growth when, in fact, she believed that it would be higher," Sen. Sheheen says. "I think that was not appropriate. I think that if the number was being changed then we, the General Assembly, and the public should have been told that it was being changed."

He says the fact that lawmakers budgeted 4 percent growth for the agency, when it had been experiencing growth in Medicaid of 9 or 10 percent a year, is why the agency has a deficit now. That deficit has forced the agency to eliminate some services and cut back on others.

Sheheen, Senate President Pro Tem Glenn McConnell, R-Charleston and others are asking the Legislative Audit Council to audit the agency.

But Forkner says her testimony is being taken out of context. In an email response to our questions for this story, she replied, "Absolutely no one in Gov. Sanford's administration told me to mislead lawmakers about the Medicaid budget. It was quite the opposite. They asked me to be transparent, communicate with legislators and stakeholders, which I did.

"During the executive budgeting process an expenditure growth rate was targeted at 4 percent. This was done in the context the agency would implement cost-saving measures and the legislature would restore flexibility. Since the legislature did not restore rate-setting flexibility, cost-saving measures which the agency implemented were not enough to achieve the targeted 4 percent growth rate. Therefore, the actual growth rate was higher than expected."

Senators discussed the issue Thursday on the Senate floor and Sen. Tom Davis, R-Beaufort, also defended the Sanford administration. Davis served as Sanford's chief of staff at one point.

He backs up Forkner, saying there was no deception. "What the governor had realized, Gov. Sanford, and what the chief of staff had realized that we can't afford a 9, 10, 11 percent growth in health care each year, and so he had instructed his HHS director to ask for 4 percent and to ask for various reforms in terms of flexibility to allow the HHS director to control costs," he says.

He and Forkner are referring to attempts to get lawmakers to remove a restriction that prevents the state from renegotiating the rate it pays doctors and hospitals for Medicaid services. If it removed the restriction and the state paid lower rates, the growth in the Medicaid budget would have been closer to the 4 percent goal, they say.

Since lawmakers did not remove that restriction, there was no way to control Medicaid costs and they grew closer to 10 percent, which is why the agency is running a deficit.

Scott English didn't want to comment until after he gives his testimony to senators, but he did say of the Sanford administration, "We would never ask an agency director to deceive a legislator or a committee."

Psychotropic Meds for Foster Kids Controversial | Psych Central News

Psychotropic Meds for Foster Kids Controversial | Psych Central News

By RICK NAUERT PHD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on September 24, 2010
Over the past decade, use of psychotropic medications for youth has more than doubled.

Moreover, for foster children, the rates are much higher, with an astonishing 13 to 52 percent of foster kids receiving the medications, as compared to 4 percent of the general youth population.

In response, a newly released multi-state report from The Tufts Clinical and Translational Science Institute (CTSI), examines state policies and practices regarding the use of medication for treating behavioral and mental health problems in foster care children and adolescents ages 2 to 21 years.

In 2008, President Bush signed into law the Fostering Connections to Success and Increasing Adoptions Act, which requires state child welfare agencies and Medicaid to provide ongoing oversight and coordination of medical and mental health services, including psychotropic medications, for youth in foster care.

Since then, state child welfare agencies have been working to develop sound policies and practices for this population of kids.

The Tufts CTSI multi-state study, begun in 2009, concluded that while oversight of psychotropic medication is a high priority of the state child welfare agencies, there is also great variability among the state policies and practices governing such oversight.

The study calls for a national approach and resources for medication oversight for youth in foster care. A more detailed national look at which state policies and practices are the most effective for improving the mental health of these youth is also needed.

Without a national approach, crossing a state border could mean the difference between a youth in foster care being appropriately treated with medications or not.

The report also stresses the need for youth-serving organizations and state agencies to work together, and for more informed decision-making and appropriate medication monitoring for youth in foster care.

The majority of states in the multi-state study reported an increasing trend in the use of psychotropic medications among youth in foster care, specifically regarding: increased use of antipsychotics, antidepressants, and attention-deficit hyperactivity disorder (ADHD) medications; increased polypharmacy (the use of more than one psychotropic medication at the same time); increased medication use among young children; and increased reliance on giving medications “as needed” and “blanket authorizations” for such drug use in residential facilities.

Officials in some states felt that this increase partially reflected demand by foster parents, schools, and other stakeholders.

Others felt that reimbursement and time pressures in the health care system encouraged medication use. A few states, however, indicated a decrease in medication use in their states and thought that these changes reflected policy and practices implemented over the last several years.

Many child welfare officials understood that medication plays an important role in addressing mental health problems. However, officials were concerned that medications were being used to manage problems that might respond as well, or better, to psychosocial treatments.

The study involved interviews with state child welfare agency key staff as well as a review of existing policies and guidelines available on state public websites or provided by staff.

The new report was funded by the Charles H. Hood Foundation and the National Institute of Mental Health-funded Child and Adolescent Services Research Center in San Diego.

Source: Tufts University, Health Sciences

Camreta v. Greene Because "Children's Rights" should include the Fourth Amendment NCCPR

Camreta v. Greene

Tuesday, February 1, 2011
Supreme Court to hear arguments on whether "children's rights" include freedom from unreasonable search and seizure
For a printable .pdf version of this press release, please go to the link above.
“Children’s Rights” must include the right to be free from unreasonable search and seizure, according to a broad coalition of child advocacy groups supporting a family seeking to have those rights upheld by the United States Supreme Court.

The advocates are supporting a child known as “S.G.,” her sister, and their mother Sarah Greene. The Supreme Court will hear arguments on March 1 in their case, known as Camreta v. Greene. It is the first major case concerning child protective services systems to reach the high court in more than 21 years.

The child was only nine years old when she was called out of her classroom and forced to endure a two-hour interrogation by a male caseworker for the Oregon Department of Human Services because DHS had received a false allegation of sexual abuse. Sitting silently in the room during the entire interrogation was another man - an armed deputy sheriff.

The child repeatedly denied any abuse, only to be browbeaten by the caseworker, who kept insisting she was giving the wrong answers while questioning the little girl about the most intimate details of her life.

In recent decades, there have been many cases, such as the notorious McMartin preschool case, in which hundreds of families were torn apart as a result of false allegations coerced from young children by zealous case workers and law enforcement officers.

In S.G.’s case, the experience so traumatized the child that she became physically ill.

S.G. sued and the Ninth U.S. Circuit Court of Appeals agreed that her Fourth Amendment right to be free from unreasonable search and seizure had been violated.

“Our legal system is wise enough that it can protect children without violating the Bill of Rights,” said Carolyn Kubitschek, of Lansner Kubitschek Schaffer who is representing the family before the Supreme Court.

(The 9th Circuit also said that the caseworker and sheriff’s deputy were immune from damages because, before the ruling, the law was unclear. Yet officially – and oddly – it is they who are officially appealing the decision, though they have nothing to gain personally from the appeal.)

Eighteen “Friend of the Court” briefs have been filed by 70 child and family advocacy organizations and national experts in support of S.G. and her family. They run the gamut from the Southern Poverty Law Center to the Family Research Council.

Several of the groups, including the Legal Aid Society Juvenile Rights Practice, Lawyers for Children, and the Children’s Law Clinic at Penn State University specialize in representing children in cases involving alleged child maltreatment.

“This case raises a fundamental question of liberty for children and families,” said Diane Redleaf, executive director of the Chicago-based Family Defense Center, which coordinated the national amicus briefing effort and wrote a brief pointing to flaws in investigations that cause more damage than good for children and families.

“While the State argues it should be allowed to question children at any length it deems necessary in order to ‘protect’ them from possible abuse, this sort of intervention harms children more than it helps them. Children need to be questioned with care and only removed from their families if the state has evidence showing abuse or neglect did occur.”

In the case of S.G., the interrogation set off a cascade of other errors, including the needless removal of S.G. and her sister from her home for three weeks, during which time she was consigned to Oregon’s chaotic system of foster care, and a stripsearch and traumatic medical examination as doctors she had never seen before examined her for signs of sexual abuse.

In an extra measure of cruelty, the same male caseworker who interrogated S.G. refused even to allow her mother to be present to comfort her during the exam.

“Those who favor unlimited state power in these cases say the issue is children’s rights” – and on that we agree,” said Richard Wexler, executive director of the National Coalition for Child Protection Reform. (Kubitscheck is NCCPR’s volunteer Vice President.) “Children have a right to be safe from needless two-hour interrogations about the most intimate details of their lives overseen by armed police officers. Children have a right to be safe from needlessly being torn from their mothers and consigned for several weeks to the chaos of foster care. And children have a right to be safe from stripsearches and medical exams which, in any other context, would in themselves be a form of sexual abuse.

“One way to increase the chances of these children’s rights being protected is to ensure that children receive the full measure of protection under the Fourth Amendment,” Wexler said.

Had S.G. herself been suspected of committing a crime, the caseworker and the deputy sheriff could not have conducted this interrogation without a warrant,” Wexler said. “Surely it is not too much to ask that, under the Constitution of the United States an innocent child receive the same measure of protection as a suspected criminal.”

Although those opposing Fourth Amendment protection for children have concocted a variety of scare scenarios, none of them holds up to scrutiny.

The 9th Circuit decision does not ban caseworkers or sheriff’s deputies from schools. Nor does it bar them from questioning children without parental consent. It requires only that they obtain a court order before doing so, something that can be done in a matter of hours. And in cases where that really would pose a risk to the child, they don’t even have to do that.

“What those supporting untrammeled state power really are asking for is the right to traumatize children and trample on their rights not for child protection but for agency convenience,” Wexler said. “They actually admit in their own brief that they want to continue to traumatize children this way based on no more than – in their own words – 'speculation and hearsay.'

“But the Constitution is meant to protect citizens from harm, not to spare bureaucracies a little inconvenience.”
Posted by National Coalition for Child Protection Reform at 7:37 AM Email ThisBlogThis!Share to TwitterShare to FacebookShare to Google Buzz
Labels: Camreta v. Greene, Carolyn Kubitschek, Diane Redleaf, Family Defense Center, Fourth Amendment, National Coalition for Child Protection Reform, Richard Wexler, Supreme Court

Study finds foster care system puts children at risk in Oklahoma

Study finds foster care system puts children at risk in Oklahoma

Thousands of kids are in foster care in the state, and they're all at risk of harm, at least, that's the argument behind a federal lawsuit.

The group behind it, Children's Rights, says a recent study backs that up.

It called upon the Center for the Support of Families, a company that collects state and government data, to conduct a study.

It investigated close to 400 randomly selected children in the system, and CSF found one in eight were abused or neglected.