State gets high marks for mental health care

Monday, Feb. 2, 2004 | 10:49 a.m.

CARSON CITY -- Nevada "is a pioneer in the field of mental health" but the state falls short in providing health care for its children, a new report says.

Governing magazine, in this month's issue, looked at the health care systems in all the states and found their ability to deliver improved health is suffering because health care is not adequately funded.

The study, released Friday, was performed by the University of Richmond through a grant from the Pew Charitable Trusts, a nonprofit group that focuses on public policy. Called the Government Performance Project, it evaluated a wide range of state management and policy functions.

It said medicine in the United States is showing a surge in innovation and creativity but "the ability of the nation's health care system to deliver those improvements fairly and consistently is not only inadequate -- it is deteriorating."

Katherine Barrett, co-author of the report, said: "It's not that the states are oblivious to the problems they confront in health care but there's simply not enough money available and solutions are elusive."

In Nevada, Gov. Kenny Guinn pushed through a major tax increase in 2003 and "used a substantial chunk of money, almost $90 million, to bolster the mental health department," the report said. The budget was increased by 31 percent, one reason the report listed Nevada as a "success story."

It noted that Nevada has lagged in mental health spending, in large part because of cutbacks in the system in the early 1990s when the state suffered hard economic times. The mental health system took a major share of the cutbacks in government during that time.

Before the big budget increase in 2003, Nevada was 37th in the nation in spending per capita on mental health at $57 per person. The report did not say what the state's current ranking was.

Nevada also has just six state hospital beds for the mentally ill for every 100,000 persons, far below the national average of 33 beds per 100,000 residents, the study said.

The magazine noted the state has authorized construction of a 150-bed psychiatric hospital in Las Vegas.

Nevada is listed as a "trouble spot" by the magazine in the area of health care for children.

More than 15 percent of children under 19 were not covered by insurance in 2001-2002, ranking Nevada 49th in the nation. Less than 18 percent of the children are covered by Medicaid, the federal-state health plan for the needy. Nevada is also 49th in this category.

"While Nevada offers relatively limited benefits (in Medicaid), maintains low eligibility levels and has the second highest rate of uninsured children in the country, the state nevertheless treats its doctors with unusual generosity, reimbursing them better than most other states," the magazine reported.

Nevada "tried to pull back on its rates last year but pediatric specialists and obstetricians threatened to boycott the Medicaid program and government officials backed down," according to the magazine.

The 2003 Legislature, according to the report on Medicaid by the legislative fiscal analyst's office, allocated $16.8 million to increase rates paid to pharmacies by 12.5 percent this year and an additional 12 percent next fiscal year. The rates for hospice services were raised by 3 percent in each fiscal year.

It also approved increases for providers of therapy, transportation, air ambulance service, orthodontia and dental services. And it gave an extra $13.7 million for rate increases for health maintenance organizations to attract additional companies.

Medicaid is one of the fastest growing programs in government. Its numbers are expected to increase this fiscal year by 8.6 percent to 178,126 clients and by 9.4 percent next year to 194,847 people.

The magazine reported that in 2002 Nevada vaccinated 70 percent to 79 percent of children 19 to 35 months old, ranking 25th in the nation. Thirteen percent of the babies born in 2002 were premature, ranking Nevada 37th in that category.

In 2002, 7.6 percent of the babies born were low weight, putting Nevada as the 19th-best in the nation. In infant deaths, the state ranked 9th best in the nation, with 5.7 per 1,000 births, according to the magazine.