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Yahoo
02-06-2025
- Business
- Yahoo
Washington overdose deaths decline after years of growth, data show
(Photo by Darwin Brandis/iStock Getty Images Plus) Washington is showing promise in its work to combat the epidemic of drug overdose deaths that has ravaged the state and country in recent years. In 2024, fatal overdoses in the state dropped nearly 11% from the previous year, from 3,512 to 3,137, according to preliminary data released by the federal Centers for Disease Control and Prevention. 'There's been not a lot of good news in this space, and this is good news,' said Dr. Herbert Duber, regional medical officer at the state Department of Health. 'I think that we need to get more time, though, to see how it sticks.' Last year's total is still nearly 14% higher than the deaths recorded in 2022. Washington saw the downward overdose trend reversed in the last few months of 2024, noted Duber. The past month has also seen a significant increase. Washington's decrease last year was far below the national average of more than 25%. Only two states saw upticks in overdose deaths: Nevada and South Dakota. Nationally, overdose remains the leading cause of death for Americans ages 18 to 44, health officials say. Fatal overdoses had been rising quickly in Washington. In 2019, fewer than 1,300 residents died, according to state data. Highly potent fentanyl drove that rise, along with increased drug use during the pandemic. In 2019, just over 300 people in Washington died from synthetic opioids like fentanyl. By 2023, that had skyrocketed to more than 2,600, according to the state Department of Health. Federal health officials cite the Overdose Data to Action program as a way to continue reducing deaths through statistic-guided prevention efforts. The state Department of Health, as well as the King and Snohomish County health departments, have received federal money under Overdose Data to Action. In Washington, Duber sees increasing access to treatment as a catalyst for the improvement seen last year, especially to the medication buprenorphine meant to treat opioid addiction. Duber, an emergency department physician, will prescribe Suboxone, a medication containing both buprenorphine and naloxone that reduces opioid withdrawal symptoms. 'There's just been an increasing level of comfort and education and engagement on opioids, trying to figure out a way where the healthcare community can really impact this epidemic,' Duber said. The state is looking to keep the progress going. The two-year state budget Gov. Bob Ferguson signed last week included money for a new hotline to facilitate access to services and medication like buprenorphine. The earliest that could be launched is in September, a Department of Health spokesperson said. The goal is to lower barriers as much as possible to give people the chance to get treatment. But the so-called 'big, beautiful bill' the U.S. House passed last month could threaten the progress. The Medicaid program for low-income Americans is the largest payer for opioid use disorder treatment in Washington, according to the state Health Care Authority. The Republican-backed legislation proposes cutting Medicaid by hundreds of billions of dollars over the next decade, a move that could cost Washington about $2 billion over the next four years and force around 194,000 to lose coverage, local leaders have warned.
Yahoo
30-04-2025
- Health
- Yahoo
Medicaid cuts could rock state's budget, provider pay, and the care being delivered
(iStock Getty Images Plus) Amid political dysfunction in Tallahassee, advocates for the poor are more worried about potential Medicaid budget cuts in Washington, D.C., than the fallout that could happen over the next few days and weeks in the Florida Capitol. Deep reductions in spending on Medicaid and food programs for low-income families would have a crushing effect on Florida — from state government, which would have to absorb more of the financial burden; to health care providers who could see their reimbursement rates cut; to the 4.2 million Florida residents who rely on the health care safety net for some form of health care coverage. Congressional Republicans are intent on deep cuts to Medicaid — $880 billion in the House plan over the next decade and $4 billion for the Senate. The money would extend President Trump's 2017 tax cuts. But with a recent poll showing no appetite across the political spectrum for cutting Medicaid to pay for tax cuts, Florida advocates hope to convince Congress to reconsider. The uncertainty comes as Florida lawmakers remain at odds over a new state budget and whether to go forward with a substantial cut in the sales tax rate. Senate President Ben Albritton has said he is unwilling to go along with deep tax cuts for fear of substantial 'shortfalls.' Florida contributes a significant portion of the taxes collected at the state level to pay its share of Medicaid. Florida Policy Institute Chief Strategy and Development Officer Holly Bullard appeared during a webinar along with Joan Alker, executive director and co-founder of the Georgetown University McCourt School of Public Policy Center for Children and Families (CCF) and a research professor at the Georgetown McCourt School of Public Policy; Lynn Hearn, advocacy director, Florida Health Justice Project; and Asheena Moses, statewide outreach and advocacy manager, Florida Impact, to discuss the pending cuts and how they would undermine the state budget if enacted. Alker shared statistics that underscore how large the Medicaid program is in Florida. In all, she said, Florida receives about $19.5 billion in federal funding for Medicaid, 44% of all federal funds that come into the state. 'That's an important context, because Medicaid cuts, federal Medicaid cuts, will have a huge impact on the state's budget — obviously, on Medicaid itself but more broadly on the state's budget and ability to finance other priorities such as education, infrastructure, public health — whatever it is,' she said. In Florida, Medicaid pays for 58% of nursing home stays and 42% of births. Nearly 52% of Florida children living in small towns and rural areas are covered by Medicaid or the Children's Health Insurance Program (CHIP). Similar to Medicaid, the federal government helps pay the costs of the CHIP program. 'This is extremely meaningful coverage that is really providing just a safety net for so many people, so it covers our most vulnerable individuals at the most vulnerable stages of their lives. So obviously, these aren't just statistics. They're real-life people,' said Hearn, whose organization advocates for health care access for all and equity. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX Florida established its Medicaid program in 1970. As of February, the latest available data, the program covered 4.2 million people, mostly through Medicaid managed care plans. The $38 billion program is one of the largest in the nation, but it's conservative in its approach and who it covers. 'We are pretty frugal when it comes to per capita and per enrolled spending in the Medicaid program,' said Justin Senior, who served as secretary of the state Agency for Health Care Administration (AHCA) for former Gov. Rick Scott and the state's Medicaid director before that. He is now CEO of the Safety Net Hospital Alliance of Florida, which represents some of the largest hospitals in the state, including Jackson Health System, Orlando Health, and Tampa General Hospital. 'If you're looking for states that don't spend a lot of money on Medicaid, then Florida has been an excellent steward of taxpayers' dollars,' he said. Indeed, Florida legislators maintain that the safety-net program should serve those who need assistance most, such as people with developmental and intellectual disabilities, including 'Polly,' who lives in Jacksonville. Polly's sister Betsy Dobbins, participated in the webinar with Bullard and Alker to discuss the proposed Medicaid cuts. They would be devastating for Polly, who after nine years on a waiting list was enrolled in the Medicaid waiver program for people with developmental disabilities known as the iBudget program, Dobbins said. Polly uses iBudget for home and community-based services that keep her living outside of an institution, and attends a day program at the local social services facility run by The Arc. She relies on Medicaid for traditional health care services such as doctor appointments, too. 'Medicaid cuts would be hugely detrimental for Polly in any shape or form,' Dobbins said. 'Not just for Polly, but for us and for all of these people who are working every day to take care of people in these health care and systems of care for people like Polly.' There are really huge cuts that could completely miss Florida and there are big cuts that could hit us. – Safety Net Hospital Alliance of Florida CEO Justin Senior Although Republicans in the House and Senate have decided upon deep cuts, the particulars remain unsettled. Without knowing those details, Senior said, it's difficult to see how the reductions will land. 'There are really huge cuts that could completely miss Florida and there are big cuts that could hit us,' Senior said. KFF analyzed potential repercussions for the states and found Florida would experience a $4 billion recurring reduction in federal Medicaid spending over the next decade if the full $880 billion House cut becomes law. The KFF analysis is illustrative and assumes the federal cuts are proportionally applied to states based on their share of federal spending, and not on policy decisions. 'In practice, cuts would almost certainly not be allocated proportionately, and some states would be disproportionately impacted depending on the specific policy proposals pursued. Without specific policies yet under consideration by Congress, this illustrative analysis is a way of understanding the magnitude of the potential Medicaid cuts,' the authors note. One proposed reduction that wouldn't harm Florida involves the federal Medicaid match for states that expanded the program to low-income working adults under the Affordable Care Act. The federal match for that population is 90% — more generous than the traditional Medicaid match which for Florida is roughly 58% (it's higher for CHIP). That means the federal government pays 58 cents of every Medicaid dollar spent in Florida. Another way to reduce federal spending is to crack down on so-called 'health care provider taxes,' which the state uses as its required match to help fund the program. Nursing homes, hospitals, and intermediate care facilities for people with developmental and intellectual disabilities assess these 'taxes' upon themselves, rather than run them through the state fiscal system. This allows the state to book lower social services spending while supplying cash for the federally mandated Medicaid match. The mechanism is common among the various states. The Congressional Budget Office has argued that Congress could save hundreds of billions of dollars by altering or eliminating provider tax options. The discussions generally center around lowering the 'safe harbor' that allows states to use hold-harmless arrangements when the provider taxes don't exceed 6% of net revenue from treating patients. Hold-harmless arrangements ensure that the taxes collected are returned to providers in the form of higher Medicaid payments. Hospitals' provider taxes run well below that 6% safe harbor, so if Congress adjusts that slightly downward it shouldn't beggar those providers, Senior said. His association has been lobbying Congress, trying to ease any hit on Florida's Medicaid program. So, too, has the Florida Health Care Association, which represents a large swath of Florida's nursing homes. 'With over two-thirds of our residents relying on Medicaid to cover the cost of their long-term care, reductions to the provider assessment could limit options for our frail elders and their families,' FHCA spokesperson Kristen Knapp said in a written statement. 'We're working with the American Health Care Association to help Congress understand that Medicaid is a key safety net for our most vulnerable and it must remain strong as our aging population continues to grow,' she said. The first Trump administration tried to crack down on Medicaid provider taxes. Then–Florida Medicaid Director Beth Kidder wrote a letter opposing the move, saying it would 'cripple' the state's Medicaid program. Senior, though, is a little more hopeful than Kidder. 'We got to see where it all lands. You could see a package of reductions that would impact Florida or you could see a package that wouldn't have much of an impact on Florida or Florida hospitals at all,' he said. With some economists predicting a 60% chance of a recession during 2025, Alker also wants to know: Why now? Medicaid is a counter-cyclical program, meaning enrollment increases during economic downturns. Congress, recognizing that, has generally increased federal matching funds during recessions, Alker noted. 'The fact that Congress would be contemplating one of the biggest cuts in Medicaid that we likely have ever seen at a time when, if the country is going into recession, normally Congress would be increasing Medicaid funding, I think, is a really important point.' Advocates also warned about reductions to SNAP, the federal Supplemental Nutrition Assistance Program, which serves 2.9 million people in Florida. Since the program's inception, the benefits have always been federally funded, although the state has had to pay half the costs of administering the program. As part of the budget process, the House agreed to trim $230 billion in agricultural spending. However, there are widespread doubts Congress would cut farm subsidies and will look to cut the SNAP program instead, said Bullard, of the Florida Policy Institute. 'We want to lift up that this additional care program that is also counter-cyclical that is also something that our communities rely on that it is under threat as well.' Hearn says the federal government is considering requiring the states to help pay for the costs of the benefit. 'And states have never had to do this before, nor are they prepared or have had conversations to do so. And so, just straight math is pretty easy to understand what this would do to the states' budgets,' Hearn said. A 10% cost shift to the state would increase costs for Florida by $657 million annually, Hearn said. Asheena Moses, outreach and advocacy manager for Florida Impact, said there's a strong connection between good nutrition and good health. Florida Impact is a statewide organization dedicated to advancing health equity by eliminating hunger. 'If SNAP is provided to families and families are able to provide nutritious meals to their children, they are less likely to get sick and be dependent on Medicaid programs, Moses said. 'SNAP also lifts families out of poverty. It frees up funding for them to get out of debt and it also frees up funding for them to establish themselves in a way that they can be self sufficient — like paying for trade programs or paying for different certifications so that they can get jobs where they make enough money to be lifted out of poverty and difficult situations,' she said. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
24-03-2025
- Politics
- Yahoo
Is it really parole-eligible if inmates can't get a hearing? Time to modernize Maryland parole
(Illustration by Pict Rider/iStock Getty Images Plus) Maryland's parole system has fallen far behind national standards, refusing eligible individuals parole hearings and allowing department staff – rather than appointed parole commissioners – to conduct the majority of parole hearings. Two bills that passed the House this session, House Bill 1147, sponsored by Del. Elizabeth Embry (D-Baltimore City) and others, and House Bill 1156, sponsored by Del. N. Scott Phillips (D-Baltimore County), aim to correct these fundamental issues and ensure that parole operates as intended. In Maryland, state law does not explicitly state that a parole-eligible person ever has to get a parole hearing. It has been the practice of the Parole Commission (parole board) that incarcerated people are given at least one hearing and, if they are denied, must apply for all future hearings. Maryland Matters welcomes guest commentary submissions at editor@ We suggest a 750-word limit and reserve the right to edit or reject submissions. We do not accept columns that are endorsements of candidates, and no longer accept submissions from elected officials or political candidates. Opinion pieces must be signed by at least one individual using their real name. We do not accept columns signed by an organization. Commentary writers must include a short bio and a photo for their bylines. Views of writers are their own. Maryland is one of only four states that requires applications for subsequent hearings – alongside Delaware, Idaho, and Utah – and the Parole Commission routinely refuses these hearing applications. Over the past two years, the commission has refused hearings to more than 1,000 people each year (1,126 in 2023 and 1,159 in 2024), including hundreds of hearings for people in prison for nonviolent offenses. These aren't parole denials, these are denials of the request for a hearing. The Parole Commission is effectively refusing parole eligibility to thousands of people whom both the legislature and courts have already determined to be eligible. It's currently within the Parole Commission's authority to refuse people's request for a hearing each time they apply, effectively changing a parole-eligible sentence to one without parole. This practice was not the intent of the legislature. Is a sentence really parole-eligible if the law doesn't state that you actually get a parole hearing? HB1147 would establish a schedule for subsequent parole hearings, ensuring eligible people are considered at specific intervals and providing the commission with a predictable cadence for scheduling. Additional provisions in HB1147 would clean up some basic housekeeping: removing administrative delays for providing a person their records, making sure all victim-impact statements are considered by the commission, ensuring recordings of hearings are retained throughout a person's incarceration and ensuring a prompt official decision on parole, alongside justifications for each decision. Further, it's a common misconception that parole commissioners conduct all parole hearings in Maryland. By law, parole commissioners are only required to conduct hearings for people convicted of a homicide or serving a parole-eligible life sentence. The majority of incarcerated people (~60%) will have their parole hearing in front of a hearing examiner, a department staff member who conducts a hearing alone and decides whether to recommend release. These hearing examiners are selected by the secretary of the Department of Public Safety and Correctional Services – the governor and Senate never review or approve their names. It is a system without checks and balances rife for abuse. Parole is a crucial step toward successful re-entry and release is an important decision: Is the incarcerated person ready to transition to community supervision? HB1156 would swap out hearing examiners for an expanded Parole Commission, ensuring the people appointed to make release decisions meet with every person who is eligible for release. No department staff member should be conducting parole hearings alone. These bills do not change parole eligibility laws – they simply ensure that parole-eligible people get parole hearings, parole commissioners conduct their hearings, and adequate records and justifications are kept in their file. House Bills 1147 and 1156 would help modernize parole in Maryland, a move that is long overdue to ensure eligible people have the chance at parole that both the legislature and courts provided to them.
Yahoo
14-03-2025
- Politics
- Yahoo
Washington bill seeks to prevent bail bond agents from enforcing immigration law
(Photo by Kameleon007/iStock Getty Images Plus) Tucked away in a corner of Washington's Yakima Valley is the small town of Sunnyside, made up of roughly 17,000 residents, a majority of whom are Latino and some lack legal status. In January, shortly after President Donald Trump took office, U.S. Immigration and Customs Enforcement raised fear in the local immigrant community when they arrested two people in the parking lot of Fiesta Foods, the largest Latino grocery in town. Local leaders later held a meeting to address some of these concerns. In that public meeting, a person who claimed to be a 'bounty hunter' said ICE would soon use bail bond agents to arrest people in the U.S. without legal authorization and pay them $1,000 for every arrest made. Washington lawmakers have since introduced Senate Bill 5714, which seeks to prevent bail bond agents from enforcing civil immigration warrants and sharing a defendant's immigration status with anyone outside their business. It would expand the list of unprofessional conduct for the agents to include those activities and enable the Department of Licensing to enforce disciplinary action if agents are found to be in violation. The bill passed the Senate last week with bipartisan support and will next be heard in the House Consumer Protection and Business Committee. 'It's needed because sometimes people can operate right on the boundaries and clarification of boundaries can help ensure that everyone knows exactly what they are and exactly what will happen if folks step over them,' said the bill's sponsor, Sen. Yasmin Trudeau, D-Tacoma. A bail bond agency is a business that sells and issues bonds to guarantee a criminal defendant will appear in court. The agents are not considered law enforcement officers and they must be licensed by the state's Department of Licensing. Agents are subject to discipline by the department for unprofessional conduct. Consequences can include revoked or suspended licenses, probation or fines. 'I really dislike seeing people acting as law enforcement when they are not truly law enforcement,' said Sen. Nikki Torres, R-Pasco, one of the co-sponsors of the bill. 'They're pretty much a glorified bill collector is what a bail bond agent recovery appears to be.' For weeks after the incident in Sunnyside, stores were emptier than usual, employees didn't come to work, and kids didn't show up to school, said Mike Gonzalez, the city manager. He said while things have gotten better, people are still worried. In a small town like Sunnyside, this can affect the local economy. If fewer people are out making purchases, sales taxes can decline and that can eventually undermine services. Meanwhile, in Missouri, the Legislature looked into awarding a $1,000 bounty for tips resulting in the arrest of an immigrant without legal authorization to be in the U.S. The bill would also have allowed for bounty hunters or bail bond agents to track down people identified using the information. This Missouri bill failed to move forward. ICE did not respond to a request for comment about whether they plan to use bail bond agents to enforce immigration law. 'We're going to just make it crystal clear that sharing information and collaborating, whether that is contracting or any other form of collaboration with U.S. Immigration and Customs Enforcement is outside the scope of professional conduct,' Trudeau said. The person who made the comments at the public meeting in Sunnyside was not a bail bond agent, Torres and the Washington State Bail Agents' Association confirmed. In written testimony to the Senate Law and Justice Committee, the president of the association, Courtney Wimer, said bail bond agents do not currently have authority to get involved in immigration enforcement. Gonzalez still has concerns. 'The problem is when there's dollars to be made, people will try to make the money and in this particular case I think it's particularly egregious to target individuals to make money off them because of their immigration status.' 'We need to eradicate these types of endeavors,' he added.
