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Cedar Lake Lays Off 19, Fears More Medicaid Cuts

One of Kentucky’s largest providers of residential care for people with intellectual and development disabilities has cut five-percent of its staff – and hopes further cuts won’t be necessary. Officials at Cedar Lake have seen in increase in costs, a decrease in donations and are worried about the state reducing its Medicaid funding.

Cedar Lake President James Richardson says the facility gets more than 90% of its funding from Medicaid’s Supports for Community Living program. He says they haven’t seen an increase in funding since 2002, which makes sustaining care at 2008 rates difficult.

But increases in health coverage costs for employees and a decline in charitable donations has left them with a one-million dollar shortfall. Richardson is still hopeful state lawmakers won’t cut more.

“Further cuts to this population has life-threatening implications, I’m confident they’ll want to do the right thing, once they’re convinced there’s not fat that can be trimmed,” says Richardson, “and there is no fat.”

Governor Steve Beshear is in the process of cutting about $456-million out of the state’s budget – to make up for a projected revenue shortfall.

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Humana Drops Medicare/Medicaid Drug Plan Members

In a Securities and Exchange Commission filing this week, Louisville-based insurer Humana announced it needed to drop prescription drug care coverage for hundreds of thousands of people in order to make profit goals.  The company reported it was spending too much on a particularly vulnerable population, who will be reassigned to other drug coverage plans. They include more than 300,000 Humana customers who receive both federal assistance through Medicare and state assistance through Medicaid.  These so-called “dual eligibles” are low income people who don’t pay premiums but often a small co-pay.  Humana will notify participants that their coverage is changing as of January 2009.  Kaiser Family Foundation medicare expert Tricia Neuman says the problem people will face is not a lack of other insurance plans.

“The challenge is really trying to understand how these plans work, making sure the plans cover the drugs that they need, and that’s not necessarily a sure thing,” Neuman says.

Neuman also says that this population tends to be older, taking many medications, and in poor health.  And she says the concern is that changing plans could be stressful.  However, she says they should check to make sure their new plan covers all the medications they take.

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Oakwood Reapplies for Federal Medicaid Funding

Kentucky health officials are working to get federal funding restored to the state’s largest care facility for the mentally disabled. The Communities at Oakwood in Somerset lost its federal Medicaid funding in May. That resulted from two investigations by the state after a patient died there in 2005.

State Health and Family Services Secretary Janie Miller says some changes have been made at Oakwood, including splitting the complex into four units.

“Being able to do that as four facilities allows us to focus on specific issues that you need to address,” says Miller. “For example, if you have an area in one of the units where you have an issue you need to address, you can simply focus it on that one unit.”

The Cabinet announced this week is has reapplied for federal Medicaid certification. After that, the Centers for Medicaid and Medicare Services will conduct two surveys of the center, to make sure it’s in compliance.

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New Pilot Program to Help Pregnant Smokers

The Centers for Disease Control found that nearly 35 percent of women between the ages of 18 and 44 in Kentucky smoke.  That’s compared to 24 percent in Ohio, and 27 percent in Indiana.  State smoking cessation program coordinator Irene Centers says the number of pregnant women who smoke is also high, particularly in eastern Kentucky.  New grant money is allowing her to pilot some health care and counseling programs in the region.

“The nine county pilot uses a case management model to help the pregnant women with a multitude of problems, but one of them being smoking cessation,” Centers says.

Centers says Kentucky has a disproportionately large population of pregnant smokers. They’re at risk for premature births, low birth weight babies, and other serious problems. Nationwide, the Centers for Disease Control estimates that neo-natal health care costs connected with maternal smoking top more than $366 million a year.  In Kentucky, taxpayers bear much of this cost because of the high percentage of pregnant smokers in the Medicaid program.