Highlights: Hawaii public hospital cuts; La. struggles with state worker health program costs; aging in Ky.

A selection of health policy stories from Hawaii, Louisiana, Kentucky, New York, New Jersey, Georgia, Minnesota, Wisconsin, North Carolina, Pennsylvania and Missouri.

The Associated Press: Hawaii Public Hospitals Cut While Hurting For Cash
Public hospitals across Hawaii are finding ways to reduce staff and cut services because they don't have enough money to make ends meet. Executives from the Hawaii Health Systems Corp. told lawmakers Friday that even after layoffs they are facing a $30 million deficit in 2015. One hospital on Maui chose to close its adolescent psychology unit because it couldn't sustain the appropriate staffing levels to provide the services. It's also considering cuts to oncology and dialysis services if the situation doesn't improve (9/20).

The Associated Press: Health Insurance Program Still Hemorrhaging Cash
Despite sweeping changes enacted by Gov. Bobby Jindal's administration, the [Louisiana] health insurance program for state workers and public school employees will have to use $88 million from its reserve fund to cover its costs this year. The nonpartisan Legislative Fiscal Office told lawmakers Friday that the Office of Group Benefits will spend an estimated $7.4 million more each month on claims and operating expenses than it will receive in premium payments. A "negative burn rate" continues even after premium hikes, service reductions and higher deductibles are put in place during the current budget year that began July 1, according to Travis McIlwain, an analyst with the fiscal office. To cover its costs, the Office of Group Benefits will continue to deplete a reserve fund that once stood at $500 million three years ago, but that has dropped to $207 million and is expected to shrink to $119 million by the end of this budget year (Deslatte, 9/19). 

The Associated Press: Kentucky Aiming To Revamp Services For Elderly
Kentucky is overhauling its elderly services with the aim of stretching resources and helping aging baby boomers remain independent and live out their final years at home, rather than in an institution. The state has struggled to keep up with demand, forcing many elderly residents to remain on waiting lists for critical programs or enter nursing homes earlier than necessary (9/21).

Kaiser Health News: Too Many People Die In Hospital Instead Of Home. Here's Why.
"New York City continues to lag in serious ways with regards to providing patients with the environment that they want at the end of life," says Dr. David Goodman, who studies end-of-life care at Dartmouth College's Geisel School of Medicine. The reasons they do this are many, but most experts agree that it has less to do with the unique characteristics and desires of people in New York and New Jersey than the health care system and culture that has evolved here. The result: More people dying in the hospital, often in an intensive care unit on a ventilator or feeding tube; more doctor visits leading to tests, treatments and drug prescriptions; and more money being spent by the government, private insurers and patients themselves (Mogul, 9/22).

Georgia Health News: Kaiser Tops Georgia Rankings Once Again
Kaiser Permanente of Georgia remains the highest-ranked private health plan in the state for the 10th consecutive year, according to the National Committee for Quality Assurance. The new NCQA ratings put Kaiser at No. 19 among 507 plans nationally. The next highest Georgia insurer was a Humana plan, at 147, and Aetna, at 151 (Miller, 9/19).

Minneapolis Star-Tribune: Test Shows How Hospitals Battle To Balance Care, Cost
Results from an experimental Medicare program launched as part of health care reform efforts show that three Twin Cities health care systems all took good care of their patients, but couldn't always cut costs at the same time. Park Nicollet, Allina Health and Fairview Health Services all agreed to act as "accountable care organizations" under the Pioneer program -- overseeing the care of elderly Medicare patients, and gambling that the hospitals could profit by keeping patients healthy while lowering medical costs below expected levels (Olson, 9/21).

Milwaukee Journal-Sentinel: Chis Abele's Budget Would Add Money For Mental Health Care, Sheriff
The proposed 2015 budget of Milwaukee County Executive Chris Abele calls for no new taxes, but it would give hefty increases to two departments -- the Behavioral Health Division and the sheriff's office. Abele has proposed an estimated $3 million increase for the Behavioral Health Division, which is now run by the new Milwaukee Mental Health Board, an independent, nonelected 13-member board entrusted with overseeing the county's mental health programs and services (Pabst, 9/21).

Charlotte Observer: To Big To Be Home? Changing Medicaid Rules Force Closing Of Greensboro's Bell House
In 1979, 26-year-old Doris Lentz found a home at Bell House. Next month, she's losing it. The residents and staff she considers family, some of whom have been together for 35 years, must scatter. The dorm-like building that is home to 22 people with cerebral palsy and similar disabilities is closing because of efforts to move people out of institutions. North Carolina says Bell House is too big to qualify for federal money that's designated to help people live full lives in their community. Lentz, who is 61, says she knows what institutional life is like. When her mother died, the young woman spent more than three years in a nursing home before coming to Bell House (Helms, 9/21).

Philadelphia Inquirer: Whistleblower Suit Filed Against Abington Memorial
A former billing manager at Abington Memorial Hospital has filed a whistle-blower lawsuit accusing the hospital of Medicare fraud and wrongful termination. According to the suit, Joanne Cleighton, 55, of Roslyn, had been talking to hospital officials for nearly a year about her concerns involving blood samples at the laboratory. In March, the suit says, she was fired on the same day she was scheduled to meet with the hospital's compliance officer. In a statement, the hospital denied Cleighton's allegations and said it would vigorously defend the case in court. The suit, filed last month in U.S. District Court in Philadelphia, alleges that lab technicians were marking routine blood samples as urgent to keep the samples in-house and get paid for their testing (Parks, 9/19).

Philadelphia Inquirer: Waiting To Live: Pa. And N.J. Have One Of The Country's Longer Lists For Transplants
When Donald Johnson checked out of Hahnemann University Hospital on June 27, he and his family thought he was coming home to die. Johnson, 63, a Warminster resident and director of a municipal authority, had end-stage fatty liver disease and his kidneys had failed. He needed two organ transplants and had even considered going to Florida to increase his chances of getting help. He had good reason to be afraid. At the time, he was one of nearly 2,500 patients on liver transplant waiting lists in federal Region 2, which includes Pennsylvania and South Jersey. He was also among nearly 15,000 patients waiting for a kidney in Region 2, which tends to have longer waiting lists than other regions (Scott, 9/21).

Philadelphia Inquirer: Community Clinics Say Delayed Payments Threaten Their Survival
Community health center officials say their ability to function is being threatened by delays in resolving a long-running dispute with the state over how the centers should be paid. A federal district judge has ordered the state to change how it calculates Medicaid payments to federally qualified health centers, which serve as primary-care clinics for low-income residents. The centers sued in 2012 over changes that state officials made in how payments are determined, saying they thought the FQHCs were being overpaid. But while the courts have ruled in favor of the clinics, state officials recently asked for more time to respond to the judge's order. Meanwhile, New Jersey's 20 FQHCs say the payment changes are costing some facilities more than $1 million per year, making it impossible for them to cover their costs (Kttchenman, 9/19).

St. Louis Post-Dispatch: Dental Benefits For Missouri's Low-Income Adults Still On Hold
With the dust settled on Missouri's contentious veto session, about 300,000 low-income Missouri adults are still waiting to hear whether their government-funded health plan will cover the costs of dental care. When the Republican-controlled Legislature voted in May to restore dental benefits for most adult Medicaid recipients, it seemed like a slam dunk. Republicans had cut the dental benefits from Medicaid nine years earlier, but this year rallied behind restoring dental coverage as a means to promote cost-effective preventive care and oral health. Democrats, who lamented the earlier cuts, had been advocating to restore the funding for years. But the legislative accord over dental coverage was threatened by a budget dispute with Gov. Jay Nixon, a Democrat, over tax breaks for certain industries and lower-than-anticipated state revenues (Shaprio and Liss, 9/20).