State highlights: Los Angeles' new mental health program; N.C. considers Medicaid expansion; N.Y. nurses push for more staff

A selection of health policy stories from California, North Carolina, New York and Texas.

Los Angeles Times: Mental illness Program Could Transform L.A. County Justice System
The $756,000 initiative marks one of the county's most significant attempts to find a better way to treat people who have mental illness and wind up in the criminal justice system by offering them transitional housing, medical treatment and job-hunting help. Officials say the pilot program will start in Van Nuys and initially help 50 people at a time, but it is expected to spread throughout the county and could accommodate up to 1,000 people at once (Gerber, 9/17).

The Associated Press: North Carolina Reviews Options For Medicaid Expansion
North Carolina's health secretary said Wednesday her agency is collecting information for Gov. Pat McCrory to offer him possible ways to expand Medicaid coverage to more people under the federal health care overhaul. The Republican-led General Assembly and McCrory declined to accept expansion last year because they said the state Medicaid office consistently faced shortfalls in the hundreds of millions of dollars. A state audit and other troubled operations led McCrory to call the $13 billion program "broken." But Health and Human Services Secretary Dr. Aldona Wos told a legislative committee the agency's financial and structural improvements make offering credible options doable (Robertson, 9/17). 

The Associated Press: New York Nurses Press For Higher Staffing Levels
About 700 nurses and supporters rallied Wednesday outside the offices of the Greater New York Hospital Association to press for higher staffing levels at hospitals. The demonstration by the New York State Nurses Association was intended to rally support for a bill in the state legislature that would set minimum staffing levels for nurses. Advocates say required staffing of one nurse for every two intensive-care patients and 1-to-4 ratios in regular medical-surgical units would improve patient care and reduce deaths. But hospital administrators have said the ratios would cost them and nursing homes about $3 billion annually. In a statement Wednesday, the hospital association said that "rigid" nurse staffing ratios would undermine patient care decisions and "deny hospitals the workforce flexibility they need to respond to emergencies" (Matthews, 9/17). 

San Jose Mercury News: Californians Mostly Aware They Have Mental Health Benefits
Most Californians are aware that their health care plans offer mental health services -- aimed at treating ailments ranging from depression to drug abuse to alcoholism -- and they believe such services help people lead productive lives, according to a new Field Poll. But the survey also revealed a lack of understanding about the breadth of mental health assistance available. The poll, done for the California HealthCare Foundation, also showed that many Californians are reluctant to seek mental health counseling or help with substance abuse even if pursuing those services would not hurt them financially. With the advent of the Affordable Care Act, commonly called Obamacare, the poll's basic purpose was to find out if the public had a general understanding of the broad scope of coverage now required by the law, Field Poll Director Mark DiCamillo said (Early, 9/17).

The New York Times: New York City Council Hears Push For Benefits By Jazz Veterans
Unlike Broadway pit musicians and symphony orchestra players, who receive pensions, health insurance and other benefits through their unions, many jazz musicians receive no such benefits. For the last few years, the union has argued that owners of clubs -- namely Birdland, the Blue Note, Dizzy's Club Coca-Cola, Iridium, Jazz Standard and the Village Vanguard -- reneged on a promise they made in 2006 to pay pension benefits in return for a sales-tax break passed by the Legislature. But the union and the clubs never reached a formal agreement (Schlossberg, 9/17). 

Kaiser Health News: When A Hospital Closes
In a scenario playing out in rural areas across the country, the closing has left local doctors wondering how they will make sure patients get timely care, given the long distances to other hospitals, and residents worrying about what to do in an emergency and where to get lab tests and physical therapy. "Half of them aren't going anywhere," Dr. Charles Boyette said about people who already seem reticent about driving farther for medical treatment. "They're taking a chance on if they'll be alive or dead after the emergency passes. The disaster has already started" (Gillespie, 9/18).

Dallas Morning News: Texans At Risk Of Big Unexpected Bills After Hospital Stay, Report Says
Some Texans with private health coverage are susceptible to a nasty surprise after a hospital stay -- bills for thousands of dollars -- according to a new report. Consumer protections against "balance billing" are inadequate, despite a new regulation last year by the Texas Department of Insurance, the Center for Public Policy Priorities found. Most Texans with private insurance have preferred provider organization policies, or PPO plans, the center-left think tank's study says. Patients save money if they obtain treatments from providers within a specified network -- those that have reached agreement on reimbursements and signed contracts with the insurer. But at hospitals, many doctors and labs are not "in network," even though the hospital itself may be (Garrett, 9/15).