Latest news with #EdCharbonneau
Yahoo
28-04-2025
- Politics
- Yahoo
Here's what died – and got dropped in – during the final hours of the Indiana legislative session
Sen. Ed Charbonneau talks to colleagues late Thursday, April 24, 2025. (Leslie Bonilla Muñiz/Indiana Capital Chronicle) Controversial language targeting homeless Hoosiers, regulating marijuana-like products and cracking down on illicit massage parlors perished late Thursday — even as Indiana lawmakers crammed changes to a new property tax reform package into an unrelated agency bill to end the session. And despite big health care reform talk, few fixes survived a breakneck session marked by a dismal revenue forecast. The time of death was 10:12 p.m. That's when House Speaker Todd Huston announced a package of technical corrections would be the last to make it through a critical procedural step. Community advocates celebrated the defeat of shuffled-around language they maintained would have criminalized homelessness. Sleeping or sheltering on government property would've been a Class C misdemeanor. One version would have required local law enforcement to consider emergency detention, offer transportation to temporary shelter and contact crisis intervention specialists before making an arrest — an attempt to connect homeless Hoosiers to help, supporters maintained. But the original, long-dead bill only provided a legal defense: no nearby shelter. It was the work of the Cicero Institute, a Texas think tank pushing such policies around the country. 'In these times of economic volatility, the most vulnerable Hoosiers and the community organizations who serve them can sleep a little better knowing their elected officials chose not to force local law enforcement to fine and jail people just for not being able to afford a place to lay their heads,' Prosperity Indiana policy head Andrew Bradley wrote in an early Friday news release. His organization was among the proposal's fiercest opponents. Some lawmakers joined in, too. 'I worked hard to ensure this legislation never became law,' Sen. Ron Alting, R-Lafayette, said in an early Friday statement. 'The solution to homelessness is not incarceration.' The General Assembly also snuffed out a contentious set of regulations for marijuana-like products, after seven rounds of substantial edits failed to ease concerns. Products with legally low concentrations of delta-9 tetrahydrocannabinol have proliferated in Indiana, alongside those containing delta-8 THC and other isomers. Although lawmakers have repeatedly failed to regulate the nascent industry, they seemed poised to do so this session through Senate Bill 478. But it never emerged from closed-door negotiations over a final version. Critics, including Indiana's attorney general and anti-marijuana groups, maintained the language would expand existing loopholes instead of closing them. 'I just think we couldn't get to a place of agreement, you know?' Huston told reporters early Friday. '… I just don't think we were ready yet.' Senate President Pro Tempore Rodric Bray said it was 'tricky' to 'get it absolutely right,' adding, 'We just wanted to be certain that we didn't move forward in a way that wasn't in the state's best interest.' Lawmakers had hoped to 'get some small piece of that across the line,' like a 21-plus age restriction, he told reporters, but 'ran out of time.' He cited young children who may rely on cannabidiol, a non-psychoactive anticonvulsant, to treat seizures. 'We'll come back, I can promise you, next year, and get something passed,' Bray said. And one legislator's attempt to fight human trafficking in massage parlors — following arrests in his district — was stripped out of an awareness measure. Rep. Wendy McNamara, repeatedly dubbed the detailed regulations appended to House Enrolled Act 1416 overly 'prescriptive' before cutting them. McNamara, R-Evansville, is an influential force in criminal matters and was among the co-authors. Sen. Mike Bohacek, R-Michiana Shores, vowed to find another place for it in comments to the Indiana Capital Chronicle. But he admitted defeat — for now. 'This is something I'm going to continue to work on through the summer and into the next session, so we get some good language around this,' Bohacek said on the Senate floor. 'The practices that are happening there (in massage parlors) is something we need to address for human trafficking in the future.' One concept that did cross the finish line? A ban of mysterious origin on government-supported 'obscene performances.' And 'any person' could seek injunctive relief. Indiana already has detailed obscenity laws on the books, and no one gave any examples of problematic performances being paid for by government. It was first spliced into legislation cracking down on child sex abuse materials, with the lawsuit provision inserted on the House floor. Then, as the end of session loomed, it was wedged into House Enrolled Act 1014, which previously focused on misdemeanors. 'Your shoulders have to be really aching from all the water that you're carrying on this bill,' Sen. Rodney Pol, D-Chesterton, told sponsor Sen. Sue Glick, R-LaGrange. He and other opponents feared the language would have little practical effect, instead 'chilling' activities some simply may 'disagree with' and putting local governments at legal risk. Republicans also made eleventh-hour changes to a Department of Local Government and Finance (DLGF) measure, baking in trailer language to a contentious property tax bill that passed — and was signed into law — a week prior. The final version of House Enrolled Act 1427 approved by the House and Senate in the last hours of the session deletes an increase in the business personal property tax exemption for 2025 that was previously approved in Senate Enrolled Act 1. Instead of jumping to $1 million in 2025, the exemption will remain at the $80,000 in current law and rise to $2,000,000 starting with the 2026 assessment date and beyond. 'One of my biggest concerns with our initiatives this year was the movement with business personal property tax, and I know that the $2 million exemption is for the 2026 assessment,' said Rep. Chris Jeter, R-Fishers, hours before the end of session. He discussed the trailer language, briefly, in the House Rules Committee. 'What I'm hoping for, as we get closer to that point in time, is we're going to take a real hard look and get some local runs to see what that looks like for our local communities,' he continued. 'My district is very heavily reliant on business personal property. This is kicked down the road a little bit, so we can't really see a lot of trouble in the runs now. But going forward, as we get closer … I would hope that we would be able to talk about what those runs look like as we narrow in on that time.' Indiana Senate sends finalized local property, income tax plan to governor The property tax legislation already sign by the governor also created an exception to allow certain new depreciable personal property placed in service after Jan. 1 to avoid the 30% minimum depreciation floor. The trailer bill walked that language back 'if property tax revenue that is attributable to the depreciable personal property is pledged as payment for bonds ,leases, or other obligations.' Under House Enrolled Act 1427, the agricultural base rate in Senate Enrolled Act 1 additionally will not apply for the January 2025 assessment date for land that is considered 'inventory.' Another part of the legislation deals with disabled veterans. Although Senate Enrolled Act 1 repealed traditional property tax deductions for veterans and replaced them with local credits, trailer language repeals those new local credits and reinstates the traditional veteran deductions that existed previously. Huston maintained early Friday that post-passage changes to Senate Enrolled Act 1 weren't the result of a rushed legislative process on property tax reforms. 'One of the reasons we wanted to move (Senate Enrolled Act 1) was to continue to get that feedback — and we're glad we got the feedback around the business personal property tax. We still have the long-term vision of it. We just want to make sure in those areas where it's being bonded against, those bonds are protected,' he said. 'And then on the veterans credit, I think there's a little miscommunication with what the policy is, and with the veterans organizations. We want to make sure we're listening to their concerns and adjust to it, and we'll have that conversation again next year. I imagine it was probably not the last time we'll talk about that topic.' But Senate Democrat leader Sen. Shelli Yoder, of Bloomington, said additions in House Enrolled Act 1427 were needed, in part, because lawmakers moved too quickly before the state's April budget forecast was released. 'The Senate Democrat caucus has been saying to slow down. Let's make sure we get this right. Let's not get to a place, especially when we've had real concerns. But when we got that budget forecast — and all of a sudden, we're having to do some serious back-stepping — no, this was no surprise,' she said. 'What we did quickly see is sort of wide-eyed like, 'Oh gosh, what did we do? How are we going to fix this, and maybe slow down the rollout?'' Yoder added, referring to Senate Enrolled Act 1. 'But again, no matter you know how you spin it, it was kind of a bait and switch. It was a shell game for Hoosiers. You know, here's property tax relief that never really came as relief.' After years of targeting Indiana's health care prices, Indiana lawmakers started the session by introducing several comprehensive reforms — but where did they end? Many new laws will follow in the footsteps of their predecessors by requiring more reporting and transparency. Whether it's the 340B drug program, the average cost of hospital services or disclosing ownership ties, health care providers across the spectrum will have more paperwork in their future. One of the biggest packages was reversed after the initial effort was criticized for setting 'price caps' on five nonprofit hospital systems. Violators would lose their tax-exempt status with the state. Now, such a move wouldn't occur until 2029 at the earliest, following a state-sponsored study to determine average prices. Numerous studies have already done such analysis only to be dismissed for being slanted to one side of the debate or another. Authors hope that having a state agency perform the calculations will bring clarity. A long-sought tax: For years, health care advocates have sought an increase to the state's cigarette tax, notching a win this session after a grim financial forecast. Cigarettes will now be $2 more expensive, with proportional increases for other forms of tobacco. 'We have to have a healthier Indiana. We have to have people that are healthier,' said House Speaker Todd Huston about the tax increase. 'This is something that I think will have long, long-term impacts for helping people make positive choices.' One particular disappointment for health advocates was the decision to slash funding for local public health departments from $100 million annually to $40 million. 'Indiana has had abysmal health care rankings over the years … that was the whole idea of finally putting some money behind doing something,' said House Minority Leader Phil GiaQuinta. ' Now just to basically take the rug out is, I think, just not the way to go.' But Bray rejected the notion that such a cut undid that previous work. 'Absolutely, unequivocally, no,' he said. 'If you look across the counties of the state, there was about 45% of those funds that went unspent. Not because they weren't using it correctly or anything, but because they were … rolling out program and trying to develop them. 'Everybody's left this budget wanting a little bit more,' he continued. 'But this still continues to fund public health projects. And it is our hope that in a couple years, we'll be able to fund that at a stronger level.' Another big strike to the state's overall health: curbing enrollment on Indiana's Medicaid expansion program. The Healthy Indiana Plan serves low- to moderate-income Hoosiers and, like similar programs across the country, has increased access to preventative care services and decreased emergency department visits — though such progress could be derailed if a significant number of Hoosiers lose their health care coverage. Gov. Mike Braun indicated his support for many of the measures above, naming health care as one of his core targets ahead of the 2025 session. But he said that there was more work to be done. 'I think we got a good start on it,' Braun told reporters on Thursday. 'I think health care will be a big agenda item for next year.' SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
14-04-2025
- Health
- Yahoo
What is 340B and how does it impact hospitals' bottom line?
() A somewhat obscure federal program designed to reduce drug prices for health providers is getting scrutiny from lawmakers this year, with many questioning whether those savings are being used effectively for underserved patients. As designed, the 340B program requires participating manufacturers to sell discounted drugs to providers seeing low-income and underserved populations. Between 2005 and 2023, the program's total drug purchases grew from $2.4 billion to $66.3 billion — with the explosive growth exposing a rift between the pharmaceutical companies supplying the discounts and the hospitals receiving them. In response, state legislators are considering a bill to establish reporting requirements on qualified 340B entities, with a special focus on the dozens of hospitals accessing low-priced medications. 'Transparency has been kind of a key word for everything we've done this session — for the last couple of sessions — and this is focusing a light,' said Sen. Ed Charbonneau, who authored the proposal. 'What's going on is legal, but it is far askance from the purpose of what the whole thing was — to provide low-cost medications to the indigent people needing help.' Senators opted not to concur with House amendments, sending Senate Bill 118 to a conference committee to finalize negotiations. But the latest version would require certain health providers under the program report: aggregate drug acquisition costs and payments, pharmacy dispensing payments, claims, how 340B savings were used, patient makeup and more. But for some of the small hospitals using the program, every dollar saved is vital to continue their services. 'We don't have the economies of scale that larger tertiary centers have. We have to make do with very little oftentimes,' said Brenda Reeta, the CEO of the Greene County General Hospital. 'The cuts are getting deep enough now that it's going to be bordering on … not just cutting service lines but, 'Can we even stay open?'' In committee testimony, much of the program's criticism can be summarized by William S. Smith, a senior fellow overseeing life science initiatives at the Pioneer Institute think tank in Boston. Smith presented roughly 15 slides before both Senate and House committees in January and March describing how hospitals, clinics and pharmacies can acquire medications at a 'deep, deep' discount and then bill private insurers the full price — keeping the difference in a practice known as arbitrage. 'Arbitrage drives this and that creates all sorts of bad incentives for the program because hospitals have every reason to bring in fully insured patients and not to treat uninsured patients,' Smith told senators in January. As evidence of this practice, Smith pointed to the opening of contract pharmacies affiliated with 340B entities in wealthy communities with high rates of private insurance. 'Jeff Bezos could walk into a 340B pharmacy and get a 340B drug,' Smith said. 'It should be targeted for low-income patients or uninsured patients, in my view.' An Indiana one-pager from Pioneer concludes that more than half of these contract pharmacies are in affluent neighborhoods, dispensing drugs on behalf of 340B entities. Some of the state's largest nonprofit hospitals use contract pharmacies based in California and Hawaii, a point of contention for Pioneer. Additionally, Smith criticized a decline in reported charity care. Lawmakers have amended the bill to exclude reporting requirements for 340 entities like Health Resources and Services Administration clinics. Programs under that umbrella include programs like the Damien Center's services for Hoosiers with HIV or the Indiana Hemophilia and Thrombosis Center. Such clinics testified that they are already subject to stricter reporting requirements and auditing than hospitals. 'I think clinics are different than hospitals. The clinics, generally, run things better. They're audited on their charity care,' Smith said. '… and some hospitals are under-reimbursed by Medicaid and they really depend on 340B. That's why I like (Senate Bill 118) because it doesn't undercut the program. It just says, 'What's going on? How much money are you making?'' Before House lawmakers in March, Smith doubled down, targeting larger hospital systems for additional scrutiny. 'They're cutting back on their charity care and … collecting tens of millions of dollars in revenue from 340B. I'd like to find out which hospitals are doing the right thing and which ones are not and a little transparency would help,' Smith said. Such concerns have reached Gov. Mike Braun as well, who issued an executive order in January ordering Health and Family Services Secretary Gloria Sachdev to examine the program and determine what oversight the state could pursue. Such a review is set to be finalized by the end of October. Pushing back, hospitals said the savings from 340B weren't ever meant to go directly to patients — something Smith also said. But rather, hospital administrator said, it offsets other programming. 'If we focused on charity care, it suggests that our savings should be solely used to support charity care versus stretching scarce resources,' said Dawn Moore, a vice president and chief pharmacy officer with Community Health Network testifying on behalf of the Indiana Hospital Association. Moore additionally noted that charity care 'only' considered services that were billed and then written off, leaving out free clinics, patient navigation services and more. 340B savings were generated when billing a private insurer, since the program can't be applied to medications under Medicaid — hence why contract pharmacies may not be located in low-income areas. An obscure drug discount program stifles use of federal lifeline by rural hospitals 'We set up or provide services all throughout. However, because we generate a savings from locations where we have commercially insured patients, we take those savings and reinvest them where they're needed,' Moore said. Reetz, with the Greene County hospital, estimated that her hospital got roughly $500,000 in benefits from 340B but spent nearly half of that on self-auditing and administration. Though comparatively small, having that cushion allowed her system to keep its obstetrics and gynecology service lines open as well as cardiopulmonary rehabilitation. 'We are one of the few rural communities that still has full OB services … It's very costly to keep an OB department open and we have chosen to do that because, for us, it would be over an hour away for most of our community members to travel to deliver a baby,' said Reetz. 'Within the last couple of weeks, we had a person come in that did not plan to deliver at our hospital but the baby was coming right now. 'It was a complicated pregnancy and had she not been able to have an emergency (caesarean) section right then and there, the baby would have most definitely not made it. And most likely the mom too,' Reetz continued. Additional reporting requirements could eat into that money recouped from 340B, Reetz worried, on top of the other reporting and transparency requirements imposed on hospitals. Unlike other programs, no tax dollars are spent under the 340B program. 'I don't necessarily get why they're trying to push for more transparency, because I believe it's already as transparent as we can possibly be with it. It is just going to further dip into how much we actually are able to benefit from the program by making the administration of it even more costly,' Reetz said. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
12-04-2025
- Health
- Yahoo
Public can comment on proposed hospital merger May 1
The Indiana Department of Health will take comments from the public regarding the proposed application for the merger of Union Hospital and Terre Haute Regional Hospital on May 1. That town hall event will be from 5:30 to 7:30 p.m. at Ivy Tech Terre Haute's Oakley Auditorium, 8000 S. Education Drive. Residents of Vigo County and surrounding communities are invited. The two hospitals have filed with the state for a Certificate of Public Advantage. That process — often called COPA — allows the merger application to go through state agencies rather than the Federal Trade Commission. The Indiana Department of Health is to rule on the Union/Regional request by Aug. 13 of this year. To view the Union/Regional joint application, visit The state health department announced the May 1 public comment session in a flier sent Friday afternoon. Earlier this week, a bill that would shut the door on further COPA applications in Indiana after May 3 this year cleared the Indiana Senate. The Senate, on a 46 to 1 roll call Tuesday, accepted House amendments to SB 119. The following day, the speaker of the House and the president pro tem of the Senate signed the bill, which sends it to the desk of Gov. Mike Braun. SB 119 was authored by state Sen Ed Charbonneau, who also was an author of the 2021 legislation that created the COPA process in Indiana. 'I didn't think I was doing 100% the right thing last time,' the Valparaiso Republican who chairs the Senate health committee, said of the 2021 COPA law. 'I do think I am this time.' SB 119 as originally submitted this year appeared to endanger the Union/Regional merger effort. Terre Haute area officials and organizations — including Republican state Sen. Greg Goode, Union CEO/President Steve Holman and the Terre Haute Chamber of Commerce — testified against the bill in its original form. But they got behind the bill after Charbonneau added an amendment that allowed the Union/Regional effort to live on. Indiana is one of 19 states with COPA laws, which allow hospital mergers that the Federal Trade Commission otherwise might prohibit because they could reduce competition and create monopolies. In a COPA application, the merging hospitals typically agree to meet a number of conditions to mitigate the potential harms of a monopoly. Still, some healthcare economists and the FTC argue that state oversight cannot replace competition. Union and Regional submitted their first application in 2024, but withdrew it November of that year, with Union saying it wanted to resubmit after further work with the Indiana Department of Health. The application was resubmitted Feb. 5. Union has argued the merger is necessary to maintain and improve the standard of healthcare in the Wabash Valley. Union says it was the only buyer coming forward when Tennessee-based HCA Healthcare looked to sell Terre Haute Regional. Were this merger to fall through, Union says it's possible no one would buy Regional and its associated offices, and both the physical hospital and 500 to 600 healthcare jobs would be lost to the area.
Yahoo
31-03-2025
- Health
- Yahoo
Health First Indiana set to receive less funding as legislators debate its impact
The Lake County Health Department partnered with organizations to address chronic illnesses, disease prevention and gun safety. The Porter County Health Department partnered with organizations to address disease prevention, heart health and mental health for first responders. As the state legislature discusses the future of Health First Indiana funding, Lake and Porter County health officials would like to see the state continue funding the program. Health First Indiana was created by Senate Enrolled Act 4, which the legislature approved in 2023, to address public health in Indiana. The program establishes a public health infrastructure through a state and local partnership where each county, after choosing to opt in, can determine which health services to invest in based on community needs. The state funded the program $75 million in fiscal year 2024 and $150 million in fiscal year 2025, said Sen. Ed Charbonneau, R-Valparaiso, who authored the bill to establish the Health First Indiana program. In the upcoming two-year budget, the program has been slated to receive $100 million in fiscal year 2026 and $100 million in fiscal year 2027. But, as the budget has been discussed in committee, some legislators have voiced concern about continuing to fund the program. While Health First Indiana has been successful, Charbonneau said its funding, like the funding for all programs, has been closely examined this budget session as the legislature grapples with a nearly $1 billion Medicaid shortfall. 'Not everyone is 100% convinced that it's working. A part of the issue, the problem, that we're dealing with is the fact that this isn't like an economic development project where you invest $100 million … and you have an almost immediate return on your investment. This is a long-term commitment, and it's not going to provide any measurable results for many years,' Charbonneau said. In Lake and Porter counties, health officials said the program was created as former Gov. Eric Holcomb's administration realized how far behind Indiana lagged in public health measures nationwide. The money they have received, officials said, has gone toward improving public health, the effects of which won't be seen for a few more years. 'We strongly believe that good public health and good preventative care is going to be very good in terms of overall health of the county. That will reduce the number of people who need the emergency room, it will require less hospitalization,' said Lake County Health Officer Dr. Chandana Vavilala. Lake County received approximately $190,500 in 2023, approximately $6 million in 2024 – of which approximately $1.2 million was split between the East Chicago and Gary health departments – and approximately $11.6 million in 2025 – of which approximately $2 million was split between the East Chicago and Gary health departments, said Lake County Health Department Administrator Sheila Paul. The Lake County Health Department has spent its funds toward 20 partnerships, including the Indiana University School of Medicine with disease prevention education, the Purdue Extension to address chronic disease prevention, and the Food Bank of Northwest Indiana for medically tailored grocery supplies for at-risk pregnant women and those with anxiety and depression, Vavilala said. Michelle Arnold, the Lake County Health First Indiana program director, said the Purdue Extension partnership focuses on chronic disease management, like diabetes, and its Be Heart Smart program, which focuses on food label education, nutrition and physical activity. Through the Food Bank of Northwest Indiana partnership, the health department will receive a locker that has a refrigerated section to provide food and a separate section for hygiene products, diapers, coats and other items, Arnold said. The Lake County Health Department has partnered with the St. John Fire Department to help people prevent falls and reduce emergency room visits, Vavilala said. The department also used the funds to purchase a mobile clinic to increase access to health services, she said. Further, the department partnered with Methodist Hospital to support maternal and infant well-being, safe sleep and car seat education and breastfeeding instructions, Paul said. The department has also partnered with Mental Health America for safe sleep education for at-risk parents and caregivers, and for gun safety education for families with young children, Paul said. It has also partnered with Sounds of Sarah to provide education and awareness on dangers of illicit drugs, addiction prevention and access to life-saving services, she said. The Health First Indiana funds have helped the county increase access to preventative care and health screenings, strengthened community partnerships, expanded home visiting and case management services for vulnerable populations, among others, Paul said. If the funding were reduced, Paul said, it would 'significantly limit our ability to provide and expand our services.' A potential reduction would result in the roll back of the mobile clinic to rural and underserved communities and home visiting programs would be scaled back, which would increase avoidable hospitalizations. Reducing public health funding won't benefit the county or the state in the long run, Vavilala said. Funding public health improves people's lives, reduces hospitalizations and has economic impacts as businesses prefer to establish themselves in healthy communities, she said. 'If we don't spend enough on public health, or the preventative care, in the beginning, we will be paying a much higher price in the long run anyways. Spending the money towards the preventative health care is much better than spending the money on the negative effects that we can have in the long run by not investing adequately into public health,' Vavilala said. Porter County received $135,768.41 in 2023, approximately $1.8 million in 2024 and approximately $3.4 million in 2025 in Health First Indiana funds, said Porter County Health Department Administrator Carrie Gschwind. In Porter County, funds have gone toward a health fair, which allowed community health organizations to gather to offer free health screenings and services from vision to heart health and provide IHSA sports physicals, among other services, Gschwind said. The Porter County Health Department partnered with the Portage YMCA, Purdue Extension and Powers Health to work toward chronic disease prevention, which included blood pressure and diabetes screenings, and connecting people with resources they may have needed, she said. Further, Porter County also worked with food pantries to provide diapers and baby wipes to those who need them, Gschwind said. The department has also partnered with area school districts and Northwest Indiana No Child Hungry to address food insecurity in children, she said. The funding also went toward reviewing trauma and fatalities, offering harm reduction kits – with items ranging from seasonal wound care to hygiene products – throughout the county, and working toward becoming a Heart Safe county, which includes CPR training, installing AEDs in county buildings and a certain number of Heart Safe community sites, Gschwind said. The Porter County Health Department also hired a psychoanalyst to work with the Porter County Sheriff's Department to offer mental health support to county first responders, Gschwind said. The 2024 funds went toward other programs as well, including a mobile health clinic, Gschwind said. In 2025, the funds will go toward the programs established in 2024 as well as addressing four areas of need for the county, she said. For 2025, the Health First Indiana funds will go toward reducing adult obesity over the next 10 years, reducing emergency room visits for asthma attacks by 2027, reducing the suicide rate by 2027, and increasing the number of required immunizations in children by 2027, Gschwind said. The Health First Indiana program has let county health officials work with community partners to identify the health needs within the community, Gschwind said. Losing funding, she said, would be 'devastating to the work' the department has begun. 'Without the funding, we wouldn't be able to offer these expanded services, this type of outreach. We wouldn't be able to further these programs that we've started to be able to see that needle move,' Gschwind said. 'This was an amazon state investment in public health. We just ask that we're able to continue and expand upon even more this great work.' As the Senate Appropriations Committee holds hearings about the budget, the Health First Indiana funding has been placed under a microscope. During a committee meeting earlier this month, Committee Chair Sen. Ryan Mishler, R-Mishawaka, said he and other legislators received pressure from constituents to cut or eliminate the program because they question how the money has been spent. In the same meeting, Sen. Liz Brown, R-Fort Wayne, questioned allocating more funds to the program because the state hasn't seen 'significant results' in the last two years. Charbonneau, a member of the Senate Appropriations Committee, said in an interview with the Post-Tribune that he's concerned about funding the program amid the Medicaid shortfall. But Charbonneau pointed to the irony of facing a Medicaid shortfall and its rising costs while discussing funding for preventative care. 'The problem is going to continue to grow unless we stop the front end, unless we stop people from getting sick,' Charbonneau said. 'What this is doing is focusing on the front end and addressing issues before they become serious problems.' Charbonneau said he's hopeful that the program will retain its allocation of $200 million over the next two years. 'We may, at a minimum, put some guardrails on it as to how the money can be spent. I can live with some guardrails, as long as they are reasonable, if that's what it takes to continue the funding,' Charbonneau said. Specific guardrails haven't been discussed, Charbonneau said. The Health First Indiana program is a paradigm shift for the state, he said, and should receive funding. 'The return on investment will be incredible, but it's going to take time,' Charbonneau said. Vavilala agreed, saying the program will have lasting benefits into the future. 'We are investing not just for now,' Vavilala said. 'We are investing this money for generations to come.' akukulka@
Chicago Tribune
31-03-2025
- Health
- Chicago Tribune
Health First Indiana set to receive less funding as legislators debate its impact
The Lake County Health Department partnered with organizations to address chronic illnesses, disease prevention and gun safety. The Porter County Health Department partnered with organizations to address disease prevention, heart health and mental health for first responders. As the state legislature discusses the future of Health First Indiana funding, Lake and Porter County health officials would like to see the state continue funding the program. Health First Indiana was created by Senate Enrolled Act 4, which the legislature approved in 2023, to address public health in Indiana. The program establishes a public health infrastructure through a state and local partnership where each county, after choosing to opt in, can determine which health services to invest in based on community needs. The state funded the program $75 million in fiscal year 2024 and $150 million in fiscal year 2025, said Sen. Ed Charbonneau, R-Valparaiso, who authored the bill to establish the Health First Indiana program. In the upcoming two-year budget, the program has been slated to receive $100 million in fiscal year 2026 and $100 million in fiscal year 2027. But, as the budget has been discussed in committee, some legislators have voiced concern about continuing to fund the program. While Health First Indiana has been successful, Charbonneau said its funding, like the funding for all programs, has been closely examined this budget session as the legislature grapples with a nearly $1 billion Medicaid shortfall. 'Not everyone is 100% convinced that it's working. A part of the issue, the problem, that we're dealing with is the fact that this isn't like an economic development project where you invest $100 million … and you have an almost immediate return on your investment. This is a long-term commitment, and it's not going to provide any measurable results for many years,' Charbonneau said. In Lake and Porter counties, health officials said the program was created as former Gov. Eric Holcomb's administration realized how far behind Indiana lagged in public health measures nationwide. The money they have received, officials said, has gone toward improving public health, the effects of which won't be seen for a few more years. 'We strongly believe that good public health and good preventative care is going to be very good in terms of overall health of the county. That will reduce the number of people who need the emergency room, it will require less hospitalization,' said Lake County Health Officer Dr. Chandana Vavilala. Lake County – Health First Indiana Lake County received approximately $190,500 in 2023, approximately $6 million in 2024 – of which approximately $1.2 million was split between the East Chicago and Gary health departments – and approximately $11.6 million in 2025 – of which approximately $2 million was split between the East Chicago and Gary health departments, said Lake County Health Department Administrator Sheila Paul. The Lake County Health Department has spent its funds toward 20 partnerships, including the Indiana University School of Medicine with disease prevention education, the Purdue Extension to address chronic disease prevention, and the Food Bank of Northwest Indiana for medically tailored grocery supplies for at-risk pregnant women and those with anxiety and depression, Vavilala said. Michelle Arnold, the Lake County Health First Indiana program director, said the Purdue Extension partnership focuses on chronic disease management, like diabetes, and its Be Heart Smart program, which focuses on food label education, nutrition and physical activity. Through the Food Bank of Northwest Indiana partnership, the health department will receive a locker that has a refrigerated section to provide food and a separate section for hygiene products, diapers, coats and other items, Arnold said. The Lake County Health Department has partnered with the St. John Fire Department to help people prevent falls and reduce emergency room visits, Vavilala said. The department also used the funds to purchase a mobile clinic to increase access to health services, she said. Further, the department partnered with Methodist Hospital to support maternal and infant well-being, safe sleep and car seat education and breastfeeding instructions, Paul said. The department has also partnered with Mental Health America for safe sleep education for at-risk parents and caregivers, and for gun safety education for families with young children, Paul said. It has also partnered with Sounds of Sarah to provide education and awareness on dangers of illicit drugs, addiction prevention and access to life-saving services, she said. The Health First Indiana funds have helped the county increase access to preventative care and health screenings, strengthened community partnerships, expanded home visiting and case management services for vulnerable populations, among others, Paul said. If the funding were reduced, Paul said, it would 'significantly limit our ability to provide and expand our services.' A potential reduction would result in the roll back of the mobile clinic to rural and underserved communities and home visiting programs would be scaled back, which would increase avoidable hospitalizations. Reducing public health funding won't benefit the county or the state in the long run, Vavilala said. Funding public health improves people's lives, reduces hospitalizations and has economic impacts as businesses prefer to establish themselves in healthy communities, she said. 'If we don't spend enough on public health, or the preventative care, in the beginning, we will be paying a much higher price in the long run anyways. Spending the money towards the preventative health care is much better than spending the money on the negative effects that we can have in the long run by not investing adequately into public health,' Vavilala said. Porter County – Health First Indiana Porter County received $135,768.41 in 2023, approximately $1.8 million in 2024 and approximately $3.4 million in 2025 in Health First Indiana funds, said Porter County Health Department Administrator Carrie Gschwind. In Porter County, funds have gone toward a health fair, which allowed community health organizations to gather to offer free health screenings and services from vision to heart health and provide IHSA sports physicals, among other services, Gschwind said. The Porter County Health Department partnered with the Portage YMCA, Purdue Extension and Powers Health to work toward chronic disease prevention, which included blood pressure and diabetes screenings, and connecting people with resources they may have needed, she said. Further, Porter County also worked with food pantries to provide diapers and baby wipes to those who need them, Gschwind said. The department has also partnered with area school districts and Northwest Indiana No Child Hungry to address food insecurity in children, she said. The funding also went toward reviewing trauma and fatalities, offering harm reduction kits – with items ranging from seasonal wound care to hygiene products – throughout the county, and working toward becoming a Heart Safe county, which includes CPR training, installing AEDs in county buildings and a certain number of Heart Safe community sites, Gschwind said. The Porter County Health Department also hired a psychoanalyst to work with the Porter County Sheriff's Department to offer mental health support to county first responders, Gschwind said. The 2024 funds went toward other programs as well, including a mobile health clinic, Gschwind said. In 2025, the funds will go toward the programs established in 2024 as well as addressing four areas of need for the county, she said. For 2025, the Health First Indiana funds will go toward reducing adult obesity over the next 10 years, reducing emergency room visits for asthma attacks by 2027, reducing the suicide rate by 2027, and increasing the number of required immunizations in children by 2027, Gschwind said. The Health First Indiana program has let county health officials work with community partners to identify the health needs within the community, Gschwind said. Losing funding, she said, would be 'devastating to the work' the department has begun. 'Without the funding, we wouldn't be able to offer these expanded services, this type of outreach. We wouldn't be able to further these programs that we've started to be able to see that needle move,' Gschwind said. 'This was an amazon state investment in public health. We just ask that we're able to continue and expand upon even more this great work.' Legislative debate As the Senate Appropriations Committee holds hearings about the budget, the Health First Indiana funding has been placed under a microscope. During a committee meeting earlier this month, Committee Chair Sen. Ryan Mishler, R-Mishawaka, said he and other legislators received pressure from constituents to cut or eliminate the program because they question how the money has been spent. In the same meeting, Sen. Liz Brown, R-Fort Wayne, questioned allocating more funds to the program because the state hasn't seen 'significant results' in the last two years. Charbonneau, a member of the Senate Appropriations Committee, said in an interview with the Post-Tribune that he's concerned about funding the program amid the Medicaid shortfall. But Charbonneau pointed to the irony of facing a Medicaid shortfall and its rising costs while discussing funding for preventative care. 'The problem is going to continue to grow unless we stop the front end, unless we stop people from getting sick,' Charbonneau said. 'What this is doing is focusing on the front end and addressing issues before they become serious problems.' Charbonneau said he's hopeful that the program will retain its allocation of $200 million over the next two years. 'We may, at a minimum, put some guardrails on it as to how the money can be spent. I can live with some guardrails, as long as they are reasonable, if that's what it takes to continue the funding,' Charbonneau said. Specific guardrails haven't been discussed, Charbonneau said. The Health First Indiana program is a paradigm shift for the state, he said, and should receive funding. 'The return on investment will be incredible, but it's going to take time,' Charbonneau said. Vavilala agreed, saying the program will have lasting benefits into the future. 'We are investing not just for now,' Vavilala said. 'We are investing this money for generations to come.'
