Legislative acts create work for Forslund and Health Department

By Ron Feemster
— March 3, 2014

Legislative committees are meeting morning, noon and night this week to set topics for the joint interim committee meetings, when House and Senate committees meet together to draft bills that could become law when the Legislature reconvenes in 2015.

But almost every time a committee suggests a topic, a request for another report may fall on the desks of an agency director. And no director seems more likely to get a report request than Tom Forslund, director of the Department of Health.

At a meeting of the House Labor Health & Social Services Committee on Friday, Forslund stood up and announced that he was at the committee’s service, but said that he already had nine reports to submit by the Nov. 1 deadline.

“That’s nine reports in the first 10 months of the year,” Forslund said with a wan smile after the committee meeting. “Maybe we have a free month.”

Some of these reports are holdovers. In Cheyenne earlier this year, the department introduced a mammoth study on needed improvements in three of the state’s residential health facilities: the State Hospital in Evanston, the Wyoming Life Resource Center in Lander, and the state veterans’ retirement home in Buffalo.

But other reports are new. Sen. Charles Scott (R-Casper) requested a report on cost shifting in hospital care. Many health-care experts believe that hospitals seek to raise costs for some payers to compensate for shortfalls in revenue from Medicare, Medicaid and the underinsured or uninsured patients. How much revenue is cost shifted to insurance companies and others?

“I think the senator wants to know the percentages from each group,” Forslund said. “How much from Medicaid, Medicare and the uninsured?”

At least one project stems from Rep. Elaine Harvey (R-Lovell), chair of House Labor Health and co-chair with Scott of the joint interim committee. Harvey asked for a conference to study developmental disability waiver, especially as it relates to employment for disabled persons.

“In other states, disabled people have jobs,” Harvey said. “In our state we need to work on that.”

Among the other reports and plans that Forslund’s teams must generate is a public health nursing task force, a diabetes care strategy, a study of the new enrollees in Medicaid sorted by the programs they enroll in, and an examination of how managed care might be used in the state’s Medicaid program.

But the big study — arguably enough work for an interim session on its own — is the plan for Medicaid expansion that Forslund must undertake with Gov. Matt Mead and the insurance commissioner, Tom Hirsig. The three were empowered to negotiate with Centers for Medicare and Medicaid Services to negotiate a Medicaid expansion plan for the state.

The study is required by the budget amendment that passed the House and was adopted in amended form by the budget conference committee last week. The budget committee weakened much of the strongest language in the bill, suggesting that the governor may negotiate with CMS.

“But there are plenty of ‘shall’ passages left,” Forslund said. “The Department of Health ‘shall’ report,” Forslund said. “The waiver ‘shall’ be cost neutral for the state. We’ll have our work cut out for us.”

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