State highlights: Calif. eyes health care for immigrants; New scrutiny for N.Y. home health firms; Examining Ore. insurers' choice on smokers

The New York Times: California Pushes For Immigrant Health
When Congress passed President Obama's health care overhaul, a critical compromise provision was that immigrants living in the United States illegally would not be allowed access to publicly subsidized health insurance. Even now, as lawmakers in Washington are debating an overhaul of immigration laws, leaders from both parties are arguing that no federal money should be spent on health care for immigrants on their way to obtaining citizenship. But not in California, where there are an estimated 2.6 million illegal immigrants (Medina, 6/23).

The New York Times: State Rewards Home Care Firms Once Rebuked
Hunting for ways that the incoming governor could close a $2 billion budget deficit late in 2010, New York State officials scrutinized Medicaid spending on home health care, and made some startling discoveries. The cost of caring for frail elderly and disabled people at home had more than doubled from 2003 to 2010, to $1.3 billion, even though fewer people were being served. And that huge cost increase had been driven by just a half-dozen certified home health agencies out of 140, most located in Brooklyn (Bernstein, 6/23).

Oregonian: Oregon Smokers Face New Costs: Most Health Insurers To Charge More For Habit
Health experts have long contended that smoking significantly boosts health care costs due to increased rates of lung cancer, heart and pulmonary disease. Next year, for the first time in more than a decade, Oregon insurers will be able to charge smokers more for health coverage. Some will, and some won't. The federal Affordable Care Act will kick in next year, requiring insurance for most people. The new law bans insurers from considering pre-existing health conditions in granting coverage, including even drug or alcohol abuse -- with one notable exception: tobacco use. The law allows insurers to charge smokers as much as 50 percent more than non-smokers. The change applies to small business as well as individual policies for those who buy their own insurance (Budnick, 6/21).

The New York Times: Legislature Approves Bill Allowing Pharmacists to Give Meningitis Vaccination
The State Legislature has passed a bill permitting pharmacists to give meningitis vaccinations, a measure aimed at a deadly outbreak among gay and bisexual men in New York City (Hartocollis, 6/23).

San Jose Mercury News: Cost Of Dying: A Shift In How We End Our Lives
The experience of death is changing in America, gradually shifting from costly, high-tech battles against death in hospitals into hospices that gently accept the inevitable end. A new national database shows that 25 percent of Medicare patients died in a hospital in 2010, down from 28 percent in 2007. More than 47 percent died in hospice environments, often at home, up from 42 percent. The Bay Area mirrors the trend, but hospital deaths still exceed the national average: Medicare patients' death rates in Bay Area hospitals range from about 30 percent in the Contra Costa, Alameda and San Mateo regions to 33 percent in San Francisco's, a modest decline since 2007 (Krieger, 6/22). 

Kansas City Star: In-House Nurse Program Lowers Jailhouse Ambulance Calls At KC's Police Headquarters
Shortly after Kansas City police booked a man into jail Wednesday for an outstanding warrant from Independence, he complained of chest pains. He'd been in pain for a day and a half and had consumed a "half-pint" that morning. A jail nurse took his vital signs, examined him and concluded he was simply drunk and didn't want to be in jail. … But now police have an in-house nurse, and she determined he was suffering from nothing other than "jail-itis." He was sent back to the tank until Independence police could pick him up. Before the nurse program, police put five to seven inmates with similar complaints onto ambulances each day, racking up hundreds of thousands of dollars in medical costs and lost work time for police, firefighters and doctors (Vendel, 6/23).

Arizona Republic: Home-Visit Program Aims To Cut Cost Of Health Care
Vicki Merrick was hauling a bale of hay on a flat-bed truck to her ranch in Hereford when a car slammed on its brakes in front of her. An emu had wandered on the road. Merrick stopped the truck and told her grandson to find a rope. … Merrick gently roped the long-legged bird and craned her neck toward her grandson when she felt her arm pull in the opposite direction. The emu scrambled away and sliced her left calf with a spur. … Merrick is among the first people to join an experimental program under the nation's health care law that aims to keep people healthy and out of the hospital. The program dispatches hospital-trained nurses to patients' homes to do whatever is necessary -- manage prescription drugs, take blood-sugar readings, teach healthy eating habits or even arrange delivery of a motorized wheelchair (Alltucker, 6/22).