[4alabama] Alabama Medicaid Commissioner Said

[Judy R. Roy]

Medicaid's fiscal outlook remains uncertain
Thursday, November 01, 2007
DESIREE HUNTER
Associated Press Writer
MONTGOMERY - Poor and disabled Alabamians who rely on Medicaid for health
care will have to wait a little longer to find out if any services will be
cut, but the financial outlook may not be as dire as it was this summer, the
agency's head said Wednesday.

Commissioner Carol Steckel told a legislative committee that Medicaid's
budget won't be completed by the deadline today, when it was to be submitted
to the governor, and her earlier estimate of a $600 million deficit in
federal and state funds was premature.

She also didn't have details about negotiations with the Centers for
Medicaid Services over federal funds and if the agency would need at least
the same amount of funding it asked for last year.

That frustrated committee members who attended the hearing hoping to learn
the agency's financial needs for fiscal year 2009, which begins next Oct. 1.
But Steckel said there was no need for alarm.

"This was a budget dialogue for 2009. It is now October 2007. This is
something we go through every year with Medicaid," she said after the
sometimes tense hearing.

"We'll work through these issues, but to have a very public debate that
scares people I think is inappropriate. It's always darkest before the
dawn."

Members of the joint committee said they wanted to become more hands-on in
the process and asked to take part in the CMS negotiations, which Steckel
said have been going on for two years.

Steckel said she welcomed their participation and already was considering
some of the members' suggestions to look into reducing the amount of money
spent on nursing homes and exploring other options.

Rep. John Knight, D-Montgomery, chairman of the House Government
Appropriations Committee, said he called Wednesday's hearing because he was
worried that time was running out before the Legislature reconvenes in
February.

Medicaid provided medical services to more than 777,374 poor and disabled
Alabamians in the 2006 fiscal year, and the legislators said they already
have started hearing from constituents who are worried about having their
services cut back.

"I want to know what does it take to provide at least what we are providing
at the present time and some assurance that we're not going to be taking
anybody off the Medicaid program," Knight said.

Steckel said in August that the agency would need about $200 million more in
state funds - which would be matched by nearly $400 million in federal
money - to continue current operation levels. Medicaid is receiving about
$470 million in state funds in the 2008 fiscal year that began Oct. 1.

Some of the numbers she used to calculate those estimates have since
changed, she said, and there's a chance the shortfall could be smaller than
originally thought.

"Some of the trends seen going one way are now going a different way. Some
of the projections are not coming in," she said. "Those were preliminary at
that point in time."

Kimble Forrister, executive director of Alabama Arise, said concerns like
the ones raised Wednesday have unfortunately become expected.

"For the last 15 years, there's always been Medicaid funding shortfalls and
I think it's built into our system," Forrister said. "We don't provide the
level of funding that other states do and that's what's going on. Some day,
we're going to have to face up to the need for more funding for Medicaid.
Whether this year is it, I don't know."

Judy R. Roy
Independent Living Resources of Greater Birmingham
206  13th Street S.
Birmingham, AL  35233-1317
Phone  205.251.2223  ext 102
Email  bhamilc1 at bellsouth.net
There are only four kinds of people in the world: those who have been
caregivers; those who are currently caregivers; those who will be
caregivers; those who will need caregivers. - Rosalynn Carter

-------------- next part --------------
Medicaid's fiscal outlook remains uncertain
Thursday, November 01, 2007
DESIREE HUNTER
Associated Press Writer
MONTGOMERY - Poor and disabled Alabamians who rely on Medicaid for health care will have to wait a little longer to find out if any services will be cut, but the financial outlook may not be as dire as it was this summer, the agency's head said Wednesday.
Commissioner Carol Steckel told a legislative committee that Medicaid's budget won't be completed by the deadline today, when it was to be submitted to the governor, and her earlier estimate of a $600 million deficit in federal and state funds was premature.
She also didn't have details about negotiations with the Centers for Medicaid Services over federal funds and if the agency would need at least the same amount of funding it asked for last year.
That frustrated committee members who attended the hearing hoping to learn the agency's financial needs for fiscal year 2009, which begins next Oct. 1. But Steckel said there was no need for alarm.
"This was a budget dialogue for 2009. It is now October 2007. This is something we go through every year with Medicaid," she said after the sometimes tense hearing.
"We'll work through these issues, but to have a very public debate that scares people I think is inappropriate. It's always darkest before the dawn."
Members of the joint committee said they wanted to become more hands-on in the process and asked to take part in the CMS negotiations, which Steckel said have been going on for two years.
Steckel said she welcomed their participation and already was considering some of the members' suggestions to look into reducing the amount of money spent on nursing homes and exploring other options.
Rep. John Knight, D-Montgomery, chairman of the House Government Appropriations Committee, said he called Wednesday's hearing because he was worried that time was running out before the Legislature reconvenes in February.
Medicaid provided medical services to more than 777,374 poor and disabled Alabamians in the 2006 fiscal year, and the legislators said they already have started hearing from constituents who are worried about having their services cut back.
"I want to know what does it take to provide at least what we are providing at the present time and some assurance that we're not going to be taking anybody off the Medicaid program," Knight said.
Steckel said in August that the agency would need about $200 million more in state funds - which would be matched by nearly $400 million in federal money - to continue current operation levels. Medicaid is receiving about $470 million in state funds in the 2008 fiscal year that began Oct. 1.
Some of the numbers she used to calculate those estimates have since changed, she said, and there's a chance the shortfall could be smaller than originally thought.
"Some of the trends seen going one way are now going a different way. Some of the projections are not coming in," she said. "Those were preliminary at that point in time."
Kimble Forrister, executive director of Alabama Arise, said concerns like the ones raised Wednesday have unfortunately become expected.
"For the last 15 years, there's always been Medicaid funding shortfalls and I think it's built into our system," Forrister said. "We don't provide the level of funding that other states do and that's what's going on. Some day, we're going to have to face up to the need for more funding for Medicaid. Whether this year is it, I don't know."
Judy R. Roy
Independent Living Resources of Greater Birmingham
206  13th Street S.
Birmingham, AL  35233-1317
Phone  205.251.2223  ext 102
Email  bhamilc1 at bellsouth.net
There are only four kinds of people in the world: those who have been caregivers; those who are currently caregivers; those who will be caregivers; those who will need caregivers. - Rosalynn Carter