Posts Tagged ‘Health and Human Services’

Gov. Sandoval Says Many Questions Must Be Answered Before Medicaid Expansion Decision Can Be Made

By Sean Whaley | 2:28 pm July 13th, 2012

CARSON CITY – Gov. Brian Sandoval said today he needs a lot of questions answered before he can decide whether to expand Medicaid eligibility in Nevada, and that it could take several months to resolve all the uncertainties.

“There’s no specific time schedule,” he said. “I mean I understand right now we’ve had the Supreme Court decision. Everyone has been waiting for that. I think there are still people that are trying to interpret it.

Gov. Brian Sandoval. / Nevada News Bureau file photo.

“There’s still a question within the law regarding the penalty provision,” Sandoval said. “That if a state, whether it ops in or opts out, whether it is still subject to some type of a penalty. Although the federal government can’t withhold all of your Medicaid money there is still an outstanding question about whether it can withhold some of it.”

The U.S. Department of Health and Human Services has to interpret the U.S. Supreme Court ruling upholding most of the Affordable Care Act and answer the many questions before a decision can be made in Nevada, he said.

“The answers to those questions will have a lot to do with how we’re going to estimate the expenses in this state,” Sandoval said. “So it’s premature right now. We’re doing the best that we can with the information that we have. And once I have that information then I can make an informed decision.”

State officials are busy preparing information on what expanding Medicaid to 138 percent of the federal poverty level, as proposed in the health care law, would cost Nevada. The information should be in Sandoval’s hands within two weeks. But having that information does not mean that Sandoval will be ready at that time to make a decision.

The federal government will pick up most of the cost of an expansion for the first several years, but there will be costs to the state as well.

Sandoval also said Nevada decided in the 2011 legislative session to establish its own health care exchange under the law, and that the process of doing so is moving forward. This despite the fact that a $72 million contract sought by the Silver State Health Insurance Exchange to create the information technology needed to operate the exchange beginning Oct. 1, 2013, was delayed today.

The contract with Xerox State Healthcare was scheduled for a vote by the Board of Examiners, including Sandoval, but was pulled because the board overseeing the Exchange was unable to approve it on Thursday.

Six dozen Republican members of Congress have called on the nation’s governors not to implement the exchanges, arguing they add to the cost of doing business. Several governors, including Rick Perry of Texas, who is in Nevada today campaigning for Mitt Romney, have said they won’t move forward with establishing an exchange.

“My biggest concern as I’ve said all along is that I don’t want the federal government coming to the state of Nevada running our exchange,” Sandoval said. “This is a state issue that we should be handling. We have a great board. We have a great director. And we’re going to move in accordance with the law.”


Audio clips:

Gov. Brian Sandoval says there is no timetable to make a decision on expanding Medicaid:

071312Sandoval1 :12 to interpret it.”

Sandoval says questions remain, including the penalty provision for opting out of a Medicaid expansion:

071312Sandoval2 :17 some of it.”

Sandoval says that when he has all the information he can make an informed decision:

071312Sandoval3 :24 an informed decision.”

Sandoval says Nevada needs to run its own health exchange:

071312Sandoval4 :13 with the law.”




Acting Administrator Appointed For Nevada State Mental Health Programs

By Nevada News Bureau Staff | 5:01 pm October 3rd, 2011

CARSON CITY – Richard Whitley, administrator of the Nevada State Health Division, has been appointed to serve as acting administrator for the Nevada Division of Mental Health and Developmental Services.

The appointment by Mike Willden, director of the state Department of Health and Human Services, took effect Saturday. Whitley is replacing Dr. Harold Cook, who is retiring after 33 years of state service.

Health Division Administrator Richard Whitley has also been named acting administrator of the Nevada Division of Mental Health and Developmental Services.

The Division of Mental Health and Developmental Services oversees a public and private network of programs involving mental health, substance abuse and developmental disabilities. The agency also operates the Rawson-Neal Psychiatric Hospital in Las Vegas and the Dini-Townsend Psychiatric Hospital and the Lake’s Crossing Center forensic facility in the Reno-Sparks area.

Whitley was previously appointed as administrator of the Nevada State Health Division in January 2008. He led the Health Division through the agency’s regulatory changes that resulted from the hepatitis C outbreak associated with a surgical center in Las Vegas that was identified in 2008.

Whitley began state service as the senior psychologist for the Nevada Women’s Correctional Facility in 1986. A graduate of Willamette University, he holds a master’s degree in counseling psychology from Western Oregon University. He will continue his role as administrator of the Health Division.

Additionally, Dr. Tracey Green is being appointed as acting medical director for the Division of Mental Health and Developmental Services. Dr. Green currently serves as the state health officer, providing medical leadership for Nevada’s public health programs, a position she has held since July 2009. She is a board certified family physician and graduate of the University of Nevada, School of Medicine. Dr. Green will also continue in her role with the State Health Division.

“Combining forces with mental health and public health allows us to continue to provide evidence-based and cost-effective treatment spanning a continuum of care for Nevadans whose needs are both mental and physical,” Willden said. “I look forward to continuing the theme of collaboration that we are developing among Nevada’s Health and Human Services agencies.”

A search has been conducted to find a permanent replacement for Cook. Willden said he is evaluating his options.

Budget Office Says Democratic Spending Plan Nearly $1 Billion Over Sandoval Budget

By Andrew Doughman | 3:56 pm May 23rd, 2011

CARSON CITY — Legislative Democrats intend to spend almost $1 billion more than Gov. Brian Sandoval requested in his $6.3 billion budget, according to a spreadsheet obtained from Gov. Brian Sandoval’s budget office today.

The majority of the $968 million in spending replaces budget cuts in K-12 education, higher education and social services, which Democrats have long argued will eviscerate the state’s social safety net and destroy the state’s education system.

Throughout the past few weeks, the Legislature’s money committees have closed various state budgets, sometimes at levels higher than the governor recommended in his general fund budget. They finished that process this past Thursday and staff reviewed the numbers this weekend.

The majority of the expenditures come from $626 million in the K-12 budget, $205 million in higher education and $121 million for health and human services.

Democrats plan to pay for their budget with a $1.2 billion combination of extending 2009 tax increases, a business “margin” tax and transaction tax on services.

Extending the 2009 taxes would secure $626 million in funding for the Democratic budget plan, $342 million less than legislators would like to spend.

Since extending the taxes appears to be the most likely to pass, legislators may have to whittle away at their additions to the governor’s budget. They have scheduled a meeting tomorrow during which they intend to “reconsider” some of their earlier budget add backs.

Republicans and Sandoval have so far opposed the plan, and Democrats need at least several Republicans to join them to create a two-thirds majority to override a Sandoval veto of any tax plan.

Republican legislators on the Senate and Assembly’s money committees have also largely voted against the additions to the budget.

“Between Thursday and Monday, they [Democrats] realized they closed a budget that is totally unrealistic,” said Sen. Ben Kieckhefer, R-Reno.

Kieckhefer had also requested the full expenditure list from the governor’s budget office. The $968 million number has not yet been finalized.

Representatives from the office of Assembly Speaker John Oceguera, D-Las Vegas, declined to comment since they have not had time to review the governor’s numbers.



Nevada Could Pay $625,000 To Implement Obama Health Care Reform Law

By Andrew Doughman | 2:05 pm February 8th, 2011

CARSON CITY – Nevadans could pay up to $625,684 to consultants who are helping the state implement the controversial federal health care reform law under a state contract.

The contract with Massachusetts-based Public Consulting Group allows up to that level of spending through June 30, 2012.

Officials at the state’s Department of Health and Human Services hired the consultants for their expertise in health care reform. The state has already paid $132,121 to the consultants, according to Lynn Carrigan, the chief fiscal officer with the department’s Division of Health Care Financing and Policy.

The contract and subsequent expansions of it were approved during meetings last year, when Jim Gibbons, who had also called the law unconstitutional, was still governor.

Nobody can yet say whether that’s money well spent or wasted. Several challenges to the Patient Protection and Affordable Care Act are winding their way through the court system, and many predict the case will end up before the U.S. Supreme Court.

Gov. Brian Sandoval has called the law “unconstitutional,” but he’s also acknowledged that the state will continue to implement the law that’s on the books.

The law mandates that the states have health insurance exchanges up and running by 2014. The exchanges are marketplaces like Travelocity and Expedia through which people could purchase the best insurance plan for them.

To be on target for implementation, the state Legislature should pass a bill this session that sets up the skeleton structure of the exchange. Should they not, the federal government might intervene and create that structure for Nevada.

States legislatures across America are also taking up the issue.

Republican governors unhappy with law’s mandates

Sandoval has also signed a letter submitted yesterday by several Republican governors to  Kathleen Sebelius, director of the U.S. Department of Health and Human Services. The letter asks Sebelius to make changes to the law’s mandate to establish state health insurance exchanges. Otherwise, the governors write, they may opt out of running their own exchanges and let the federal government intercede.

“While we hope for your endorsement, if you do not agree, we will move forward with our own efforts regardless and HHS should begin making plans to run exchanges under its own auspices,” they wrote.

The statement seems to run counter to what Sandoval said in his State of the State address several weeks ago.

“We must also plan for a Health Insurance Exchange so that we – and not the federal government – control the program,” he said during the speech in which he also called the federal law “unconstitutional.”

Sandoval said today, however, that he signed on to the letter primarily to put pressure on the federal government to make a decision regarding the validity of the law.

“It encourages the expedited review of the court case because in the meantime our state is having to expend funds to meet the requirements of the federal law,” he said of the letter.

The state is a party to the lawsuit challenging the constitutional standing of the health care law,  but governor said Nevada will continue crafting its health insurance exchange.

Gibbons Seeks Bigger Budget Cutting Scenarios from State Agencies, Senator Coffin Says Premature

By Sean Whaley | 2:11 pm December 15th, 2009
CARSON CITY – In a sign that the Gibbons administration is concerned Nevada’s fiscal crisis may worsen further before it gets better, a memo to state agency officials sent out today seeks even tougher budget cutting scenarios than those outlined earlier this month.

The memo from state Budget Director Andrew Clinger asks state agencies to, “determine proposed budget reserves in the amount of 6 percent, 8 percent and 10 percent for FY 2010 and FY 2011 and submit them to the Budget Office by the close of business on Tuesday, January 5, 2010.”

Gov. Jim Gibbons has already asked for budget cutting scenarios of 1.4 percent and 3 percent from his agency chiefs. Those plans are due today and are being sought because general fund tax revenues so far this year are $53 million below estimates.

In addition, the state Medicaid budget is expected to see a deficit of $55 million by the end of the two-year budget on June 30, 2011, due to unexpected caseload growth.

Ben Kieckhefer, a spokesman for Department of Health and Human Services Director Mike Willden, said the agency will provide Gibbons with the requested budget reduction plans, but that, “we’re not talking about any easy scenarios.”

As an example, a 10 percent cut in fiscal year 2011 for the agency would equate to just over $102 million, or nearly the equivalent of the entire general fund budget of both the Health Division and the Welfare Division, he said.

The agency will follow protocol and submit the requests by the deadline. The information will remain confidential until the governor decides what to do with it, he said.

“We’re talking entirely new levels of cutting,” Kieckhefer said.

Gibbons is analyzing both tax revenues and expenditures to determine what cuts may required to balance the state budget. He is also evaluating whether a special session of the Legislature will be required to implement any cuts. He also wants input from the Economic Forum, a panel of private fiscal experts, to weigh in on the future of the state’s budget revenues.

Sen. Bob Coffin, D-Las Vegas, a member of the Senate Finance Committee, called the request for such levels of budget cuts premature.

“We don’t have any projections,” he said. “Has the Economic Forum met yet? I would want the results before I ask for a remedy because I don’t know how sick I am.”

The new budget cutting scenarios being sought by Clinger assume an effective date of March 1 for the current fiscal year.

“At this time no decision has been made as to whether these budget reserve recommendations will be implemented, however this information will be considered in the decision making process for closing the current projected deficit,” Clinger said.