State highlights: Iowa invests in autism program; rural docs feel the pinch of Wisconsin's low Medicaid payments

A selection of health policy stories from New York, Missouri, Texas, Massachusetts, Maine, Georgia and Pennsylvania.

USA Today/Des Moines Register: Iowa Puts $5 Million Into Autism Program
[T]herapist Kara Jorgensen, was trying to correct the fidgety boy's habit of spewing out his thoughts without starting a conversation properly. When she turned away, he hesitated, looking perplexed. Then she tapped her own shoulder and made a suggestion. "Say, 'Hey, Kara,' " she instructed, still looking away. [Eight year old Sidney Trees] understood immediately and did just that. After swinging back to face him and smiling, Jorgensen rewarded Sidney by listening enthusiastically and playing trains with him. The simple interaction -; cheerful reinforcement of a seemingly normal behavior -; is significant for families of autistic children like Sidney. The method, known as Applied Behavior Analysis, has shown such promise that Iowa is pouring nearly $5 million into it (Leys, 7/20).

The Milwaukee Journal Sentinel: State's Low Medicaid Payments Pinch Doctor Practices In Low-Income Areas
Mohammad Qasim Khan, a primary care physician who oversees a private practice in a low-income neighborhood, well knows the discrepancy between what private insurance pays for his services and what the state's Medicaid program pays. Khan, who works with another physician and three nurse practitioners at the Family Medical Clinic, 5434 W. Capitol Drive, estimates that the program's payment rates are half -; and in some cases, less than half -; those of private insurance. "If I was to go out and try to recruit a primary care physician," he said, "I doubt I would be able to find anyone who would be willing to practice in this area." Medicaid's payment rates are one reason (Boulton, 7/19).

NPR: As New York Embraces HIV-Preventing Pill, Some Voice Doubts
AIDS researchers and policymakers from around the globe are gathering in Melbourne, Australia, for a major international conference that starts this Monday. They'll be mourning dozens of colleagues who died in the crash of Malaysia Airlines Flight 17. But the work of the conference will continue, and one of the major topics to be discussed is expanding the use of [Truvada,] a pill that prevents HIV (Rose, 7/19).

The New York Times: Missouri Alone In Resisting Prescription Drug Database
Not having the database has not only hampered Missouri's ability to combat prescription drug abuse, but also attracted people from neighboring states looking to stockpile pills and bring them home to take themselves or sell to others, according to law enforcement officials, legislators and data compiled by a prescription drug processing firm (Schwarz, 7/20).

The Texas Tribune: Lawmakers Push To Consolidate Women's Health Programs
Texas lawmakers are looking for ways to fill the gaps in access to health care for the state's poorest women, three years after making sharp cuts to the state's family planning budget and rejecting a federally financed women's health program in favor of their own. The state has slowly worked to restore services, though somewhat haphazardly, allocating millions of dollars to new programs that focus more broadly on women's health care in general and less specifically on reproductive health since the Republican-led Legislature slashed the state's budget for family planning by two-thirds in 2011. The cuts were a move aimed at preventing health providers even loosely affiliated with abortion providers, like Planned Parenthood, from receiving state tax dollars (Ura, 7/20).

The Associated Press: Partners HealthCare Deal an Issue in Governor Race
Attorney General Martha Coakley is coming under increasing fire from her Democratic and Republican rivals in the governor's race over an agreement her office hammered out with Partners HealthCare, Massachusetts' largest hospital and physicians' network. Coakley said the deal resolves her antitrust investigation into Partners and fundamentally alters the organization's negotiating power for 10 years while barring Partners from raising its costs by more than the rate of inflation through 2020. The deal paves the way for Partners to acquire South Shore Hospital and Hallmark Health Systems, which owns Lawrence Memorial Hospital in Medford and Melrose-Wakefield Hospital. Under the agreement, Partners would be blocked from additional hospital expansion in eastern Massachusetts, including Worcester County, for the next seven years unless Coakley's office reviews and approves the expansion (LeBlanc, 7/19).

The Associated Press: Maine's Nursing Home Funding Challenges To Continue
Maine officials are relieved they found a way to provide the state's nursing homes with an additional $13 million but warn that a long-term strategy must be developed to aid the facilities in the nation's oldest state. Officials hope the one-time money will stem the tide and prevent the closure of more nursing homes for now but emphasize that uncertainty remains as the state attempts to undo years of underfunding and grapples with a rapidly graying population (7/19).

Georgia Health News: State Agency Loses Federal 'Family Planning' Grant
A federal health agency has awarded a three-year, $7.8 million Georgia "family planning services" grant to a coalition led by an Atlanta-based community health center. Family Health Centers of Georgia will work with other federally qualified health centers in the state, Grady Health System and Planned Parenthood to deliver these services to individuals, primarily low-income women. The services are funded through the federal Title X program, and the funds come from the U.S. Department of Health and Human Services. It's the first time in 30 years that this family planning grant did not go to Georgia's public health agency, though the agency did apply for it (Miller, 7/18).

Des Moines Register: Rural Iowa Hospital Courts Urban Patients
A small-town northern Iowa hospital hopes Des Moines-area residents seeking weight-loss surgery will drive 90 miles to undergo the procedure in its new operating rooms. The Iowa Specialty Hospital in Belmond is partnering with a Des Moines surgeon to provide the operations, which reduce the size of patients' stomachs so they can't eat as much. The new business, called "Iowa Weight Loss Specialists," is led by Dr. Todd Eibes, who worked at Iowa Methodist Medical Center in Des Moines until earlier this year. The new arrangement represents a rare effort by a rural hospital to compete directly for business with big-city counterparts. Most Des Moines-area residents wanting bariatric surgery go to Iowa Methodist or to Mercy Medical Center (Leys, 7/20).

Philadelphia Inquirer: Health System To Close Mental Health Facility, Change Care Plan
After years of losing millions of dollars on its outpatient mental health program in Willow Grove, Abington Health is making big changes. It is sending notices this week to 2,200 patients who use its Creekwood Center that the program will close Dec. 1. About one-third will be routed to primary care offices in the system, where they will be treated by new, integrated teams of doctors and social workers. Integrating mental and physical primary care in the same office is a trend that has been building for 15 years. More popular in public sector settings, it has been growing in private systems like Abington as the government and other insurers have begun rewarding efficient, high-quality care for populations of patients, rather than paying purely by the visit or procedure (Burling, 7/20). 

Houston Chronicle: Harris Health Considers Charity Care Policy Change Only 27 patients in Harris County's public health system have signed up for insurance under the Affordable Care Act - meaning the county will continue subsidizing treatment for thousands of patients eligible for private insurance. The situation illustrates a problem nationwide, as health care systems re-evaluate the financial help they provide to uninsured low-income patients who qualify for insurance coverage under the program often called Obamacare (Hines, 7/19).

Minneapolis Star Tribune: State Tests New Fingerprinting System For Caregivers An ambitious effort to intensify criminal background checks for tens of thousands of Minnesota caregivers will roll out this month as state officials respond to reports that people with criminal histories were caring for the elderly and other vulnerable populations. At five nursing homes across the state, from Sauk Rapids to Eveleth, the Minnesota Department of Human Services will test a new electronic system of fingerprint-based background studies (Serres, 7/19).