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Monday, November 29, 2021  

Feeling the Budget CrunchPublished 7/7/2003

Nurses and other health care professionals will face a multitude of new challenges in the coming months, due in part to major changes that came out of this year’s state legislative session. The change from a no-fault automobile insurance program to a tort-based system will potentially affect care providers in an array of settings. Because the legislature was not able to agree on reforms to the no-fault system which was set to expire in July, the state reverted back to tort-based system. Under no-fault, medical providers caring for victims of motor vehicle accidents (MVAs) had speedy access to reimbursement, without driver "fault" having to be determined in court. The tort system will slow payments to providers, as auto accidents wend their way through laborious court processes and fault is established and/or contested. In addition, the new system will substantially limit the amount of money that can be recouped by an injured party following an auto accident. Practitioners and their patients may feel the brunt of this development both in the short-term and the long-term. It is also possible we will see a rise in injuries resulting from fire arms misuse, secondary to the relaxing of statewide gun laws. Under this year’s budget, Medicaid recipients have been limited to the concurrent use of eight prescription drugs, and significant cuts were made in the Colorado Child Health Plan Plus. (Traditionally this plan covers prenatal and labor/delivery costs for working poor women, and provides health care coverage for their children). Fortunately, Governor Owens has earmarked $5.6 million to reinstate the coverage. The money will be part of a $146.3 million federal cash infusion provided as part of President Bush’s tax-relief program. Another development involved eliminating some mandated health benefits for employees in small businesses. Also, health insurers in the state were given the green light to charge higher premiums to small businesses with sicker employees. Under the new rules, small businesses no longer have to cover mammograms or prostate cancer screenings. Given these developments, nurses will be vital in keeping up the momentum around both breast and prostate cancer awareness (*Note the American Cancer Society has been offering free mammograms in the Denver Metro area). Now more than ever, we will have to scout around for ways to get our patients’ needs met, with an eye toward prevention and early intervention for illnesses and injuries.

As would be expected, the budget shortfall will signficantly impact social services. The Centers for Medicare & Medicaid’s ULTC 100 (the assessment form used to document care needs of nursing home residents), was lengthened from seven pages to twelve. In long-term care, coverage for services is being scaled back. Legal immigrants in Colorado who previously had access to Medicaid coverage no longer have that access. And the legal system will be impacted as well, as a severe shortage of personnel in the Arapahoe County Court System is already causing probate cases to bottleneck. Care providers who work with patients around competency issues will be affected by this. Lastly, an unsubstantiated rumor has it that the Mental Health Corp of Denver’s University Hills branch is going to discharge 600 of its 700 clients. Only time will tell if this population can truly be stable without mental health care treatment.

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