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Health & Fitness

Committee Recommends Responsible Medicaid Reforms

After weeks of examining the budgets for departmental programs and expecting outcomes to measure their effectiveness , the Appropriations – Health, Mental Health, and Social Services Committee has finalized its funding recommendations for fiscal year (FY) 2015.

The committee voted in favor of substantial Medicaid reforms that will improve the services available to current recipients, control or reduce costs, and prevent fraud and abuse. Rather than blindly expanding Medicaid and forcing future Missourians to pay for a program we cannot sustain, the legislature can help the truly vulnerable by enacting changes to improve health and wellness while providing a return on taxpayers’ investment and human benefits.

To proactively limit the misuse of Medicaid funds, the committee voted to fund a state-of-the-art healthcare fraud, waste, and abuse detection system to help the Department of Social Services (DSS) identify improper payments before they are made. When departments “pay and chase,” or make payments and then try to recoup the money if needed, they waste valuable time and taxpayer money and provide a poor return on investment.

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Since foster children often face uncoordinated care and incomplete electronic medical records, we recommended appropriating $500,000 to implement a pilot program in St. Louis that will deliver integrated healthcare services to these children. SSM Cardinal Glennon Children’s Hospital’s pilot will provide foster children with access to a primary care physician, and Nurse Navigators will compile their medical records and help them receive recommended services.

Hospitalizations caused by asthma cost our state approximately $100 million each year, but trips to the emergency room can be limited by teaching families how to prevent and treat their children’s flare ups. The committee included an increase of over $1 million for asthma and allergy education and home assessments.

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The amended budget bills also contain funding for complex rehab therapies, which includes services like wheelchairs modified to suit a particular individual’s needs, for Medicaid eligible individuals.

Currently, preventative dental services are not available to adults on Medicaid even though individuals without access to oral care are more likely to suffer from pain and infections that can force them to seek temporary relief in the emergency room. Offering preventative care to adults that are aged, blind, disabled, or eligible for Temporary Assistance for Needy Families (TANF) will save the state money by preventing ER visits and improving the wellness of Missouri’s most vulnerable citizens.

DSS’s most important obligation is protecting and finding a safe residence for children that must be removed from their homes. To recruit and maintain high-quality workers for these difficult tasks, the committee appropriated almost $5 million to fund computer and software updates to allow staff to access files on the go, a loan forgiveness program to encourage college graduates to remain at DSS, advanced training to better prepare staff, and a Career Ladder initiative to offer more internal promotion opportunities.

In addition to these reforms, the Appropriations Committee recommended increasing funding for the Meals on Wheels program, Mental Health First Aid training for law enforcement officials, sexual and domestic violence grants for services such as crisis hotlines and interventions, and Child Advocacy Centers that coordinate with child abuse investigations.

I presented the committee’s recommendations to the House Budget Committee for further consideration on Thursday.  This is only the beginning of the budget process, and I will continue working with the rest of the Budget Committee to craft a balanced budget that responsibly allocates taxpayer resources while meeting the needs of Missouri’s most vulnerable citizens.

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