Social Services director discusses future of health care

SIKESTON -- The future of health care in Missouri was among the chief topics for discussion during a visit Friday from Gary Sherman, director of the Missouri Department of Social Services.

Sherman said he was in Sikeston to tour the Southeast Missouri Health Network's Sikeston Family Clinic and to discuss government in general, Gov. Matt Blunt's administration in particular, and current health care issues including Medicaid and Part D Medicare.

"The issue of health will be the No. 1 issue for the next decade, next two decades," Sherman predicted.

Cheryl White, CEO of the SEMO Health Network, discussed with Sherman ways Medicaid reform has affected the patients they serve in a six-county area.

"It's not a free clinic, its a federally-qualified health center," White clarified about the Sikeston Family Clinic.

The clinic offers low-cost health services based on a sliding scale determined by documented family income.

White said federal money which helps the clinics operate is limited while the number of families needing assistance continues to grow.

"More and more of the working class ... are qualifying for that sliding fee," she said.

Sherman said officials in his department and the Blunt administration are looking at ways of dealing with "the crisis in health care that is in our nation."

While medical advances have made a growing list of treatments possible, rising health care costs and health insurance premiums have made them increasingly unavailable for many Missourians.

"I think its an exciting time and a bit of a scary time," Sherman said.

Due to a sunset provision, Medicaid as we know it in Missouri ends in 2008. "We will have a new Medicaid program in Missouri," he said.

Measures to encourage wellness, preventive health care measures and personal responsibility for health will be a part of the new Medicaid for Missourians, Sherman said, and will include "incentives for them to take care of their own health."

White asked if there will be any expansion in the support of community health centers like the SEMO Health Network's.

Sherman said community health centers will be an important part of the new plan.

A draft plan from the executive branch for Medicaid should be ready in May, Sherman said, after which the state legislature will look at it and come up with their version.

In defending the governor's cuts to Medicaid, Sherman recalled that when Blunt took office, he was faced with a Medicaid program that would spend $400 million with only $200 million in revenue coming in.

"In Missouri, we've stabilized the program," he said, "and we reduced the cost."

With cuts, the governor achieved a balanced budget and even accumulated a small surplus while maintaining the "safety net" of Medicaid, according to Sherman.

"We have to maintain our compassion for citizens that need help," he said, while not wasting any resources that are available for this purpose. "We have to be vigilant about spending our dollars wisely."

The administration is also continuing to look for ways to eliminate waste and fraud.

Sherman said money wasted in any one department "affects all other parts of government and your quality of life."

Four out of 10 babies in Missouri are born on Medicaid, according to Sherman.

"Medicaid is growing and resources are having a hard problem keeping up," he said.

Sherman said he has heard stories of senior citizens distributing their assets to family members so they can receive Medicaid benefits.

"That's not right," he said. "Medicaid is not for the middle class. It is to help poor seniors get care in their failing years."

Despite problems many are experiencing with Part D Medicare right now, "this is going to be a great program for seniors," Sherman predicted.

Sherman said Blunt has initiated stopgap funding for medications until the snags in the Part D Medicare program are worked out "to protect our seniors."

In addition to the Division of Social Services, there are three other divisions under Sherman in the Missouri Department of Social Services: family support, youth services and child welfare.

"We're doing well in juvenile justice," Sherman said, noting that Missouri is now serving as a national model for youth services after keeping programs alive while other states were closing them down.

The child welfare division is one that receives constant criticism, Sherman said, as every decision made regarding a child's removal from a home or placement in foster care that results in a tragedy is second-guessed.

"In that division, we have to become a national model," he said. "I worry a lot about the child welfare issues."

While the state has a hotline for child welfare issues, "it has sadly become the weapon of choice in marriages that are failing," Sherman said. "The hotline is to protect children, not conduct your marital issues."

Also attending and offering comments during the discussion were state representatives Peter Myers, 160th district, and Lanie Black, 161st district.