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FRIDAY, JANUARY 30, 2004

NATIONAL REPORT CRITICIZES KENTUCKY

FOR HEAVY-HANDED CUTS TO LONG-TERM CARE

WASHINGTON, D.C. (January 30, 2004) – An assessment of health care in the 50 states, released here today, faults Kentucky for pulling back substantially on long-term care services by changing eligibility criteria. The report appears in the February 2004 issue of Governing magazine.

“Kentucky is an example of the ‘damned if you do, damned if you don’t’ situation many states find themselves in while trying to deal with tough budget times,” says Katherine Barrett, the study’s co-author. “While a number of other states focused on children’s care to make cutbacks, Kentucky looked more to its elderly population. And that was only after a number of initiatives to avoid this kind of extreme, and potentially painful, solution.” The result: 1,400 people who were formerly deemed eligible for nursing home care were denied benefits, and 3,000 people are on a waiting list for the state funded home care system.

Barrett notes, however, that Kentucky has done more than many states in promoting home care services and alternatives to nursing homes. It has also tried for the past several years to bring down its Medicaid costs in subtler ways--by going after accounts receivable, for example.

The state was also among the more successful at holding down prescription drug costs in 2002, although the magazine does criticize it for backing away from a mandatory pill-splitting initiative that would have saved the state about $6 million. This technique for saving money, which takes advantage of the fact that pills often cost the same in varying strengths, has been successfully used in other states, but was rejected by the Kentucky Board of Pharmacy in favor of a voluntary program, which will save half as much.

Governing’s analysis of state-funded health care is part of the Government Performance Project, a six-year-old effort, funded by the Pew Charitable Trusts, to evaluate a wide range of state government management and policy functions. This year’s special report focuses on six critical health care problems facing states: long-term care, public health, mental health, prescription drugs, access to care for the uninsured, and care for children.

The Government Performance Project found and documented the inability of the 50 states’ health care system to deliver improvements in medicine fairly and consistently to many of their citizens. Health care in most states is not just inadequate, the study concluded--it’s deteriorating. “After exhaustive analysis and hundreds of interviews,” says Peter Harkness, Governing’s publisher and editor, “it became clear that there is a health care crisis in America. But it is in no way a medical crisis. It is a fiscal crisis.”

Governing is a policy and management magazine aimed at high-level state and local government officials. An online version of this report will be available at http://www.governing.com/gpp/2004/intro.htm as of January 29. Press releases for each of the 50 states can be found at http://www.governing.com/gpp/2004/press.htm.

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