State roundup: Caregivers face 'burnout' threat as need grows, Kansas nursing home staff inadequate?

A selection of health policy news from Connecticut and California, North Carolina, Kansas and Wisconsin.

Wisconsin Public Radio: Health Officials Look For Savings From Long Term Care Program
Long term care advocates say they're concerned about caregiver burnout. And they say Wisconsin may be overestimating projected savings from uncompensated care that relatives provide. State health officials need to find nearly $80 million in savings from a popular program that keeps the elderly and disabled out of nursing homes. The administration wants to know what assistance friends and family are giving so that care isn't replaced by Medicaid services  (Mills, 3/13).

California Healthline: Who Cares for the Caregivers?
Caregivers make up a sizable volunteer workforce in California -- people who put in about 1.7 billion hours of care last year and didn't get paid for it. If they did, all of that work is valued at more than $20 billion. In California, where more than 10,000 people turn 65 every day, the need for that workforce will only grow. That's according to a raft of testimony yesterday at the Capitol Building in Sacramento ... The state doesn't do much for this vast and contributing population, and is about to do even less, according to Michelle Pope, executive director for Alzheimer's Services of the East Bay (Gorn, 3/14).

The Associated Press/Raleigh News & Observer: NC Personal Care Services For Thousands May End
Thousands of North Carolina residents mostly living in North Carolina adult care homes could lose Medicaid personal assistance services this spring as regulators comply with federal mandates to align service qualifications with people living in their own residences. ... Residents in adult care homes historically have had to meet less stringent eligibility requirements to qualify for Medicaid help (Robertson, 3/13).

Kaiser Health News: Connecticut Weighs Its 'Nurses Only' Medication Policy For Homebound Seniors
Connecticut, like every state trying to reduce health care spending, is looking closely at how it cares for people with chronic conditions. Gov. Dannel Malloy has promised to move more than 5,000 poor and disabled patients out of nursing homes in five years. But the Democratic governor says there's an expensive obstacle in the way – Connecticut law says nurses have to give medications to people in the Medicaid system living at home, and that costs a lot of money (Cohen, 3/13).

Kansas Health Institute News: Advocates Push For Increased Staffing At Nursing Homes
The administration of Gov. Sam Brownback is working to expand managed care to all currently on Medicaid, including those in nursing homes. ... In Kansas, nursing homes are required to give direct staff care for at least 1.85 hours per resident per day, and to average at least 2.0 hours per day throughout the week. The minimum staffing level is one qualified employee per 30 residents, which translates to 2.06 hours per resident per day. ... Several people who testified cited a 2002 study by the Centers for Medicare & Medicaid Services that recommended at least 4.85 hours of combined staff time per resident per day (Cauthon, 3/13).

California Watch: Developmental Centers' Police Need Immediate Fixes, State Officials Say 
Investigations of patient abuse by in-house police at California's institutions for the developmentally disabled have been unacceptably poor for years and must be fixed immediately, state officials and patient advocates agreed during a hearing today. ... In a series of stories, California Watch has reported that detectives and patrol officers at the state's five board-and-care institutions – home to about 1,800 severely disabled men and women – routinely fail to conduct basic police work even when patients die under mysterious circumstances (Gabrielson, 3/13).

In other state health policy news --

San Francisco Chronicle: Mental Patients Who Refuse Drugs Must Get Hearing
In a ruling that could affect thousands of mental patients in California, a state appeals court has ordered Marin County to provide judicial hearings before administering drugs to patients who have been held in the county hospital longer than two weeks. Patients who refuse their medication are entitled to legal representation at a hearing that will determine whether they are able to make the decision on their own, the First District Court of Appeal in San Francisco said Friday (Egelko, 3/14).

The Sacramento Bee: Steinberg To Introduce Change To Sacramento County's Kids' Dental Program
Seeking to break managed care's monopoly on dental care for Sacramento County's poor children, state Senate President Pro Tem Darrell Steinberg plans to introduce legislation to allow more choice in dentists, his aide told the Sacramento County Board of Supervisors on Tuesday. More than 110,000 Sacramento County children on Medi-Cal participate in a mandatory dental managed care model (Bazar, 3/14).

The Connecticut Mirror: Donovan Launches His Final Push For Pooling 
Flanked by fellow legislators and advocates for health reform, Speaker of the House Christopher G. Donovan launched what's likely to be his final push for the state to adopt one of his favorite causes -- opening the state employee health care pool to the public. ... Gov. Dannel P. Malloy's administration has been cool to the concept, which has drawn opposition from the insurance industry and some business groups (Levin Becker, 3/13). 

The Connecticut Mirror: Malloy Administration: Basic Health Program "Premature" 
The Malloy administration is urging lawmakers to hold off on creating a health program for low-income adults who don't qualify for Medicaid under federal health reform, saying action now is premature. As it did last year, the administration is arguing that more information needs to be available from the federal government before the state can make a decision on whether to create a "basic health program" (Levin Becker, 3/13).