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Budget cuts would diminish state`s ability to provide preventative health services

Fewer funds could cause problems in health care

JACKSON — Revenue shortfalls dominate legislative concerns for the state department of health, overshadowing other issues being pitched by various health care organizations,

all gearing up for the 2001 legislative session.

Mississippi State Department of Health

Even though a $7.5-million budget cut wouldn’t cripple the state’s health agency, it would greatly diminish the ability to deliver important preventative health services to the

public, said Dr. F. Ed Thompson, Jr., MPH, state health officer for the 2,400-employee agency.

“That will be the most important legislative issue we deal with, because we obviously need adequate appropriations to operate,” he said. “For example, a cut that deep might mean

clinics would only be open three or four days a week instead of five. Of course, we hope it won’t come to that.”

At a legislative budget committee meeting this fall, the state department of health presented a $225.9-million budget for FY2002. “Revenue shortfalls are something all state

agencies will struggle with,” he said.

Legislative requests include:

• Hiring additional childcare licensure inspectors. In Mississippi, there are 113 childcare facilities to every childcare inspector. That number will increase to 120 centers by the end

of FY2002. According to the National Association of the Education of Young Children, the ideal ratio is 50 childcare centers for each childcare inspector, Thompson said.

• Hiring public health nurses, clerical staff and environmentalists for unfilled vacancies.

• Establishing an infant/toddler early intervention program designed to identify children from birth to age 3 who are at risk for development disabilities, such as hearing or vision

impairments, speech impediment or other problems that might prevent them from developing normally.

Four proposals for new legislation include:

• The establishment and funding of a tobacco control oversight commission. Even though the tobacco settlement called for one, no particular entity has been charged statutorily

with the responsibility. “In the absence of that, we’ve stepped up and shouldered some of the responsibility, with considerable assistance from other organizations. Our allies

agree that there needs to be a group to recommend and implement plans. Its composition has not yet been specified, but would involve logical entities you would expect,” said


• The requirement of insurance companies to include comprehensive rehabilitation services in health insurance packages sold in Mississippi. “Most do not. As a result, people

have not been able to afford needed rehabilitation that might follow a stroke or injury,” he said.

• The expansion of the department’s quality assurance role for HMOs and all other managed care plans; and

• The addition of the condition called congenital adrenal hyperplasia required in mandatory newborn screening.

“We also have our list of reauthorizations and technical amendments, such as one to reauthorize the board of health and its role in the state,” Thompson said.

Mississippi Hospital Association

Brent Alexander, senior vice president of the Mississippi Hospital Association, which represents more than 100 hospitals and over 60,000 health care employees, said primary

agenda items for 2001 would include working with the governor’s office, legislative leaders and the division of Medicaid to tap into federal funds that might have been previously

overlooked for the state.

“After analysis, it appears that the previous administration may not have been taking full advantage of our state’s ability to use federal matching funds for health care related

purposes, and the MHA is working…to try to find a way to modify our Medicaid program to take full advantage of what’s called the Medicare Upper Payment Limits,” he said.

“That would give us the potential to use more federal money for health care without affecting the state’s general fund. We don’t know how much that’s going to be, but it could

be very significant.”

MHA will work with the Legislature and Worker’s Compensation Commission to provide for a rational fee schedule for reimbursement under the worker’s compensation

program, Alexander said.

“The reimbursement that’s currently provided in some areas of health care delivery is insufficient to cover health care provider costs,” he said.

“We’ll also be working hard to protect the certificate of need program. In a state like Mississippi, with a diverse population that is spread out geographically, it is very important

because it allows us the revenue necessary to deliver badly needed health care services in underserved areas, and also allows the state to continue what is now a 30-year process

of health care planning,” Alexander said.

To protect the integrity of the tobacco trust fund, and to insure that revenue from the fund is used for health care related purposes, MHA wants the Legislature to maintain its

position of reserving the health care trust fund for use in providing health care related services, he said.

“We also want to work with the Legislature to make sure that health care reimbursement and coverage offered under the Mississippi State Employee Health Plan provides an

adequate level of benefits for state employees, and also provides the reimbursement health care providers need to provide care,” he said.

Mississippi State Medical Association/

The American Medical Association

Even though the MSMA could not be contacted in time for this story, the AMA issued the following statement:

“The association only provides state-level advocacy at the invitation of the local state medical association. At this time, we are not aware of any cooperative effort involving the

AMA and the Mississippi State Medical Association.”

American Heart Association:

On a federal level, the AHA has proposed legislation that would serve to fight against heart disease, Mississippi’s leading cause of death, and stroke, Mississippi’s third leading

cause of death, said Tara Newsom, advocacy director for the state of Mississippi’s chapter of the AHA.

“This year, the American Heart Association wants to strengthen the chain of survival to insure that more Mississippians survive heart disease and stroke,” she said. “The chain of

survival represents the community response designed to decrease deaths from cardiovascular disease and consists of four critical links – early access to care, early CPR, early

defibrillation, and early advanced care.”

On a state level, the AHA supports the following initiatives for the 2001 legislative session:

• The requirement of CPR training to be a part of the comprehensive school health curriculum already required for high school graduation. The estimated cost for implementing

the program is $2,500 per 150 students, with a maintenance cost of $350 per year.

• The creation of a government commission on heart disease and stroke charged with addressing the needs of reducing heart disease and stroke in Mississippi.

“On a broader scale, it is paramount that Mississippi begin to strategize on how to reduce these numbers,” she said. “Reducing death and disability from heart disease and stroke

will not only incr
survival rates but also help cut long-term health costs that the state is burdened with. The Center for Disease Control has published that for every dollar

spent on health prevent


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About Lynne W. Jeter

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