State Agencies Have Limited Resources To Implement Reform Law
Much of the responsibility for implementing provisions in the federal health reform law falls to state agencies, many of which are concerned about taking on extra activities with limited staff and reduced budgets, the Washington Post reports.
Reform tasks expected of state agencies include:
- Expanding Medicaid enrollment to include millions of additional U.S. residents;
- Converting paper medical records to electronic health records; and
- Creating statewide exchanges for various health insurance plans.
Amid these additional responsibilities, many state agencies have been affected by layoffs, early retirements, furloughs and hiring freezes, according to the Post.
Seeking Help Gets Complicated
The federal government is offering numerous grants worth more than $12 billion to assist states with depleted budgets -- such as California, Oklahoma and Virginia -- in implementing the programs. However, even the task of applying for the grants can be a significant challenge for some state agencies.
State officials first must choose which of the multiple grants to seek. Alan Weil, executive director of the National Academy for State Health Policy, said he is unsure that agencies have enough employees to apply for the grants. Workers must balance the involved application process with their daily responsibilities. Weil said, "Someone has to sit down and figure out things, write a strong proposal. What will we use the money for? What's our timeline?"
Finally, both the federal government and states must account for where the money goes once it is awarded. Diane Rowland, executive vice president of the Kaiser Family Foundation, said, "Obviously, we have concerns that the federal government not just pass out money without knowing how it's going to be spent," adding, "But it's a tricky balance of doing that and not overburdening [state] agencies."
Even if states obtain the grants, staffing continues to be a concern for state agencies. Workers must manage the new funding, according to Cindi Jones, director of the Virginia Health Reform Initiative.
HHS Confident in Process
Paul Dioguardi, director of intergovernmental affairs at HHS, is less concerned about whether states will be able to shoulder significant overhaul responsibilities. He said HHS has a "great working relationship" with the states, noting, "With the grant applications we've been putting out, we ask how can we make this as easy and streamlined as possible" (Fears/Sun, Washington Post, 9/22).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.