“On Thursday, the Budget Office will be releasing budget instructions for the next biennium as we prepare for the 2013 Legislature. In order to avoid cuts to education and other essential services, revenues from the sunset taxes will need to be continued. While taking into account mandatory caseload growth, primarily in Health and Human Services, federal mandates such as the Affordable Care Act, and critical infrastructure needs, my budget instructions will call for “flat” budgets which will rely on some or all of the revenue from the sun setting taxes.
“Let me be clear, as I’ve said before, the economy is improving, but I believe we must begin this budgeting process with all the information available. In addition to avoiding further cuts to education, this decision means there will be no need for tax increases in the next session. Nevadans will pay no more than they are in the current biennium.
“The budget building process remains ongoing, but we must begin today.”
Senate Majority Leader Harry Reid is warning House Republicans they’ll be setting themselves up for another Tea Party-inspired government shutdown fight, unless GOP leaders buck their conservative rank and file and hew to the terms of last summer’s hard-fought debt-limit deal.
House Republicans are prepared to introduce their budget resolution next Tuesday, and some signs suggest they’ll call for cutting federal programs below the levels both parties agreed to in last August’s debt-limit fight. On Tuesday Senate Majority Leader Harry Reid laid down the Democrats’ marker in no uncertain terms: Dream on, we’ll never let you buck the deal.
“This wasn’t a handshake, it was a law we passed,” Reid told reporters on Tuesday at a weekly Capitol briefing. “And now, the Republican right wing in the House is trying to change the agreement we made as a matter of law. I guess they love government shutdowns, or at least the threat of them … If they renege on the law, the agreement, they’ll be forcing yet another government shutdown and a fight with the American people. That’s ridiculous.”
“I support Gov. Sandoval and his budget instructions that will not impose new taxes on the people of Nevada,” [Senator Michael] Roberson [R-Henderson] said. “I will continue to lead the fight against new tax increases while working with Gov. Sandoval to improve public education. I will not support additional cuts to public education.”
Roberson opposed extending the sunsetting taxes in the 2011 session, arguing that the Nevada Supreme Court ruling did not create the huge financial hole in the budget that others had suggested.
“Gov. Sandoval has outlined a prudent and fiscally responsible preliminary budget framework,” Roberson said. “I am grateful for his tremendous leadership. I will stand with him and support him.”
Sen. Ben Kieckhefer, R-Reno, announced his support for Sandoval’s proposal via Twitter.
“I applaud the decision by Gov. Sandoval to do what is necessary to protect education from cuts,” he said, adding that what that means in the 2013 session is yet to be determined.
I find it quite interesting that Roberson, who was once quite the "tea party darling" himself last year, is directly refuting Grover Norquist's assertion that Sandoval passed "new taxes" by merely agreeing to extend the 2009 tax deal. And I find it quite interesting that both Sandoval and Legislature Republican leaders are running away from the tactics used constantly by their counterparts in DC by settling the matter of the 2009 tax deal and making an easy 2013 budget deal more likely.
However, I suspect Brian Sandoval isn't just rebuking the radical "tea party" right in his own party in making this move. Both progressive populist Kermitt Waters and conservative "business establishment" powerhouse Monte Miller have been pushing to put tax reform on the ballot, and the Nevada AFL-CIO may soon enter the playing field with the corporate margin tax that everyone's been expecting them to put into a ballot initiative. As Sandoval's team has become more concerned about what may happen if any (or a combination) of these initiatives makes it on our ballots some time soon, as well as what may happen if Republican chances of retaking the (state) Senate continue to dwindle, this may also be Sandoval's attempt to thwart the drive by both progressive Democratic legislators and tax initiative supporters to force major tax reform next year.
So far, it sounds like Democratic Senators aren't ready to settle for the status quo.
While we applaud Republican State Senators and the Governor’s change of position to prioritize education in Nevada, we don’t believe it does enough to address the challenges that Nevada faces. These are challenging financial times and it is critical that we rise above partisanship and find solutions that place the needs of our children and families first.
Last year, Senate Democrats fought to protect education funding, believing that providing opportunity to our children must be the cornerstone of any plan to revitalize Nevada’s economy. Nevada deserves leadership that will fully fund education, while also taking on the challenge of solving our budget shortfall. Only together, can we facilitate solutions to help Nevada families and businesses succeed.
Unfortunately, by not addressing the long-term problem and clinging to stagnant levels of education funding, the Governor is only postponing the inevitable crisis that our schools and our state face.
“What we need are long term solutions to resolving our budget problems, not postponing them for another 2 years” said Senator Mo Denis. ”We must address tax fairness for middle class families, cut wasteful spending in our government, and provide Nevada business with an educated workforce that can help compete in the national and global marketplace.”
Dennis also added “In order to diversify our economy and attract new businesses and industry to Nevada, we must show them we are serious about investing in a well educated workforce. We can’t do that if education funding remains stagnant.”
And we'll have to see if Sandoval's big move will be enough to stop Monte Miller, Kermitt Waters, and the Nevada AFL-CIO from gathering signatures for their respective initiatives later this year.
Over the course of the month, we've been looking at the tragic case of James Flavy Coy Brown, the Rawson-Neal Psychiatric Hospital patient who was "released" from the hospital, only to be thrown onto a Greyhound bus and dumped into Sacramento, California. Growing outrage over this heinous case of patient dumping resulted in state and federal investigations into Nevada's patient dumping habit. And we now Nevada has busedover 1,500 patients out of state since 2009, sending at least one patient to each and every one of the 48 continental states.
Recently, Governor Brian Sandoval (R-Denial) has been boasting about increasing the state government's budget, and especially education and health care funding, "without raising taxes" (and the accuracy of this statement actually depends on how one categorizes extending "The Sunset Taxes" of 2009 & 2011). Yesterday, The Las Vegas Sun's Andrew Doughman explained how Governor Sandoval has been able to do this. Surprise, surprise, there's a method behind his "magic"!
This month, he found $25 million for education programs and even released a handy slogan: “Increasing funds for education without raising taxes: Check.”
The next day, he said he found yet another $25 million for health programs for the state’s most vulnerable populations. Then, he announced $12 million more for eliminating furloughs for state workers by mid-2015.
How, exactly, did those presents end up under Nevada’s Christmas tree?
The majority of the money comes from regular state accounting adjustments, and it’s not necessarily good news. Nevada gets a portion of this new money because the federal government now projects the average American’s income will grow faster than the average Nevadan’s income. [...]
But in this case, economic growth isn’t fueling increases to the budget.
Besides getting more federal money because it’s getting poorer than other states, Nevada also is benefiting from revisions to the number of state residents enrolled in government health programs and a nationwide trend in lower-than-projected health care costs.
“Those are both pretty standard adjustments we’d make,” said Jeff Mohlenkamp, the state’s budget director. “They just happen to be working in our favor right now.”
So Sandoval has been able to increase the state's budget by claiming poverty and showing the number of Nevadans in need of some sort of federal/state aid. And there's technically nothing wrong with that in and of itself. It just becomes a problem when he and fellow Republicans demand austerity out of one side of their mouths... While simultaneously using the other side to milk the feds for more money!
It's also a problem that Sandoval wants to use these additional federal funds to claim he's "increasing funding without raising taxes"... And silence criticism of the shortcomings of Nevada's social safety net. Even with the additional federal funds, the state's mental health care budget still allocates much less per patient now than in 2007. And even the 2007 budget was not keeping up with 20 years worth of tremendous population growth.
And that leads us back to the patient dumping scandal. Yesterday, The Sacramento Bee published a stinging editorial on Nevada's patient dumping. And they cut right to the heart of this matter.
If they truly had the interests of the patients at heart, Nevada health officials would have contacted mental health authorities in locales that were receiving the patients. No mental health official in any city, county or state contacted by The Bee had heard of Nevada's practice of busing mentally ill patients – unescorted, no less.
Sandoval, thought to be one of the Republican Party's rising stars, has not acquitted himself well. When the Las Vegas television reporter caught up with Sandoval and asked about the "policy" of busing patients, he pushed back by saying, "I disagree with the premise of the question."
Exactly what Sandoval disagrees with is not clear. Nevada long has had a written policy to bus patients to their home states. The policy stated that one of its goals was to relieve the "burden" on Nevada taxpayers of the patients' care, though the state dropped the word "burden" from a revised policy after The Bee quoted from it.
"If there is a problem, we're going to correct it," Sandoval told the reporter.
Mr. Sandoval, you've got a problem. You need to correct it. [US Health & Human Services] Secretary [Kathleen] Sebelius, you need to make sure he does.
Especially since Sandoval is using additional federal funds to plug holes in the state's budget, he needs to come clean on this. After all, if he doesn't, the state may ultimately lose at least some of those federal funds. Accreditation of Rawson-Neal is now at risk. And on top of this, Los Angeles and San Francisco are considering suing Nevada over patient dumping.
So we can't just (mis)use additional federal funds to sweep our problems under the rug and deny their existence. After all, these federal funds are supposed to be used to help people in need! And Nevada will likely pay a heftier price if the state continues to neglect people in need of treatment.
So why live in denial any longer? Let's admit we have a problem. And then, we can truly fix it.
SHOCK! Progressives aren't jumping for joy over the state budget deal.
Nevada's stunning budget agreement will continue to impose a much higher tax burden on the poor than on the rich while severely underfunding education and humane social services, thus inflicting immediate and long-term damage to Nevada's already hopelessly wrecked economy.
But judging from the sparkling headlines and gushing praise, perhaps the most wonderful thing about this "true leadership," this "triumph of leadership," is that lawmakers are cooperating to expedite Nevada's irreversible downward spiral politely and on time.
SHOCK! More progressives are thinking aloud about possible 2012 ballot initiatives.
There you have it. Sandoval saved our schools. He suddenly cares about class sizes. What a crock of public relations bullshit. Sandoval’s no new tax pledge was a mistake. He made it so the drooling far right wing of the Republican party would vote for him, and so they did, and now we’re all paying the price. How will Nevada students stack up to schools in states where funding per pupil is twice what it is in Nevada? Where will the best teachers look for jobs?
I wish God’s speed and best of luck to any coalition of citizens that wants to put tax questions to voters. The Democrats tried to broaden and update the state’s revenue base with a margin tax on large corporations and a sales tax on services, but the Republicans would have none of it. They sat on their hands with their fingers in their collective ears. The Governor and Republicans in the Legislature proposed no other solution than cuts to the state budget. They heard the testimony. School administrators and professors and teachers and students and parent across the state described the terrible effects of the Governor’s proposed budget on our already grossly underfunded school systems, yet Sandoval and his keen advisors decided schools could withstand the cuts. And what’s worse, our system of taxation is still broken. Our state budget will continue to yoyo, and next session we can balance the budget on the backs of schools and the poor to protect narrow corporate profits once again. Sandoval says we will grow our way out of revenue problems, but an unstable state budget and worst in the nation schools are not incentives for companies to move here. I have no faith in the governor’s promises. He works for the board room and not our state’s citizens.
I am hopeful a group of concerned Nevadans will form and gather the necessary signatures to put similar tax reforms as proposed by Democrats this session to a vote of the people in November 2012. Through the Governor and Republican lawmakers, the entire state is held hostage by a radical minority of antigovernment nut cases in the Republican party, but if given the opportunity, the citizens of Nevada will make the right choices, even if their Republican representatives will not.
SHOCK! Nevada's most powerful and influential corporate citizens are also not overjoyed with this budget deal, and they may be willing to join labor unions and other progressive organizers to pass some sort of progressive tax reform next year. Wait... HUH??!! OK, this one actually IS a shocker!
Lobbyists representing major Nevada industries are talking with labor and education leaders about putting taxes in front of voters in 2012.
The target right now is a question or questions that will revive some of the taxes Democrats unsuccessfully proposed this session, sources said.
The conversations are built on a consensus among business leaders and labor representatives that major tax reform will never come out of the Legislature.
“I’ve lost all faith in the ability of the Legislature to fund government,” said Danny Thompson, executive secretary/treasurer of the AFL-CIO, the state’s largest labor group. “The only solution is to go to the people.” [...]
According to sources with knowledge of the discussions, the coalition could end up backing a number of separate questions, including on the “margin tax” and sales tax on services. If the teachers union is involved, as is likely, there would also be some sort of mechanism to ensure that a portion of funding goes to education, a lobbyist said.
Gaming and mining, the state’s two major industries, are the most obvious funders for a campaign. The thinking for them is this: If the public gets too upset at cuts and inadequate funding for education, they will target the state’s two prominent industries.
For years now, the state’s establishment has warned against going to the ballot to set tax policy.
But as the Nevada 2011 session comes to a close with another muddling solution of temporary taxes and spending cuts, the frustration is obvious.
“The environment is ripe for those conversations (with industry leaders) to happen after this session,” said one business lobbyist, speaking on the condition of anonymity.
Of course, there has to be a catch somewhere. In this case, the powers that be in Nevada's gaming-mining-lobbying industrial complex are afraid the angry mob of plebes just might come after them for years of pulling the puppet strings of "the best state government money can buy" that never seemed to care about the people very much. So now, out of desire not to bear the brunt of the people's wrath, these powers that be now want to help pass some kind of broad-based tax reform.
Republicans here always make scary comments about this state becoming some sort of "Little California", but their very obstruction on the budget and diabolical brinksmanship games with state government are turning us into California!
Sometimes, I really do wonder if Republican legislators are spending time that should be used working on a budget deal to instead study up on how California Republicans have turned Sacramento into an endless game of "Mortal Combat"... Where the folks who get killed off are kids in need of education, and seniors & disabled in need of health care. Read Calitics' budget diaries and notice the strange air of familiarity to them.
It seems like both at the federal level and in other states, Republicans are exporting the California model of obstructing their way to broken government to the rest of the country.
Either way, Nevada's governance will start to look a lot more like California's, and more like other Western states (such as Arizona) that have become accustomed to partisan turf wars, ballot box budgeting, and "direct democracy gone wild". It's now a question of whether Nevada will keep sputtering on its way to the bottom, or if progressives can turn this around and take advantage of this unique opportunity to inject more common sense into our state government. The days of Kenny Guinn and Barbara Buckley and Bill Raggio making "grand bargains" seem to be long gone. Term limits are taking away experienced legislators. Meanwhile, the power vacuum is being filled by corporate lobbyists, party central committees, and other outside forces.
So what can we do? In the long term, I still believe it's in our best interest that progressives work toward reforming state government to make it more responsive to the people and less beholden to special corporate interests. But in the mean time, we can't wait on the sidelines for the next two years while Nevada's people continue to suffer inadequate public education, health care, transportation, and other infrastructure necessary to make our state whole again.
So now, we have to ask ourselves not whether and when we will go to the ballot and ask the people to save our state, but how we will do so and who we will build coalitions with. Should we work with gaming and mining on a broad-based business tax? Should we work with other progressive activists on a corporate income tax? Should we push for some sort of mining tax reform? 2012 may seem like a long hike away, but it really isn't. We need to start planning now to take the first necessary steps to save our state and bring real progressive reform to Nevada government.
Brandi Stengeland and her husband, Eric, told how they had gotten autism treatment for their son Zander, who turns 4 in two weeks, with the help of $1,500 a month from the state's self-directed autism funding.
That money would be cut under Sandoval's budget, Brandi Stengeland said, leaving the total $3,000-a-month treatment to the family. She described how her son had gone from developing normally to becoming non-verbal, refusing to make eye contact.
With the help of the state funding, Zander was now speaking and labeling things.
"After four months of treatment, he put his hands on my face and looked me in the eye and said, 'Mom,'" she told the Legislature. "He told me he was in there. My little boy. What kind of a state would we be if we didn't help people like that?"
"We're in the unenviable situation of having to tell the sickest of the sick that we cannot give them rent assistance," said Barbara Aranosian, a Clark County social worker, at the budget hearing in Las Vegas. "My fellow social workers and I find this abhorrent."
Heather Richardson, who works with foster children, said her caseload is now up to 40 children, or double what's recommended by experts.
Curtis Heald, a former construction worker now at the College of Southern Nevada, said he's on a Ramen diet and a Ramen budget, referring to the inexpensive noodle dish. "Until I asked for financial aid, I never asked for anything in life but opportunity." He said he fears further budget cuts at CSN would hurt his chance at an education and a new job.
I was there. I could feel the pain of the families there. They've learned the hard way that cuts really do hurt, and that continued cutting won't allow our state to heal and grow again.
The [Reno] meeting lasted 5.5 hours and attracted at least 600 citizens. A similar meeting in Las Vegas attracted about 800 people, said Assemblywoman Debbie Smith, D-Sparks, and chairwoman of the Ways and Means Committee.
"There is a tremendous amount of interest both north and south," Smith said. "The attendance was probably double from the last town hall we had. People are very concerned about the budget, and there are a lot of different opinions."
Many of the speakers were students, concerned about Sandoval's proposed cuts to the higher education budget. Others were concerned about K-12 education and health issues, such as the elimination of mental health triage centers in Reno and Las Vegas. Some expressed dismay over the cutting of funds for children with autism.
"It is always a good reality check when people speak," said state Sen. Sheila Leslie, D-Reno, and chairwomen of the state Senate Revenue Committee. "What I am taking away from this is generally people are not in favor of the governor's budget. They are very concerned about education and the cuts to mental health and they think we can do better." [...]
Many college students are concerned that tuition will be raised and they will be driven out of college before they earn their degrees, said Charlie Jose, the president of the Associated Students of the University of Nevada.
"We have students who have incurred years worth of loans to pay for school but may not finish their programs and not have a means to pay back those funds," Jose said. "We have first-generation students who may not finish their degrees and become the symbol of hope and prosperity for their families."
Paulette Batayola, the student body president of Great Basin College in Elko, recalled one of Sandoval's lines in a speech.
"I keep hearing, 'Let's make Nevada Nevada again' but I can't help but ask myself and ask you how is Nevada going to be Nevada again when I can feel we are headed to a Nevada of no return?"
Ain't that the truth.
Our state is hurting, and the last thing we need right now is even more cuts to the very lifelines we are depending upon for a better future. The people of Nevada made that known yesterday, and it seemed some of the legislators in Vegas and Reno were listening. Will they remember when the legislative session begins soon in Carson City?
They have to. We can't let them forget. We won't let them forget. Our state's survival is at stake. Our kids' future is at stake.
Can Nevada ever be Nevada again if our people are cut to death? That's what these budget cuts mean. That's what happens when schools don't function, when people can't access the health care they need, when infrastructure continues to be neglected. How about letting our state and our people heal for a change?
As the 77th session of the Nevada Legislature comes to a close, the mad dash to send a budget to Governor Brian Sandoval (R) continues. This morning, the Senate rushed to pass school funding and the long awaited "Sunset Tax" extension. And now, #NVLeg is poised to go out with a bust bang as Governor Sandoval's budget is nearing complete final approval.
Both legislators and the governor got what they wanted in the $2.5 billion schools budget: more money for Nevada’s schoolchildren.
But Democrats won’t reach the funding level they thought was appropriate. Last month, Senate Democrats publicly spiked their payroll tax hike in a contentious Senate floor debate. That tax plan would’ve added money to the budget for more education programs.
“We had a debate earlier this session about where we stood and what we’re doing for our kids, and we should be proud,” said Sen. Ben Kieckhefer, R-Reno.
While Democrats had earlier argued that education programs deserved more money than Sandoval had included in his budget, they now said that it’s good that the governor agreed where the state should spend the money it does have as it comes out of a lengthy economic recession.
“I’m glad that the governor funded our priorities,” said Senate Majority Leader Mo Denis, D-Las Vegas. “We’re not going to have to cut (the budget) this time.”
Now legislators, some begrudgingly, are on track to pass a payroll tax cut for businesses.
Sen. Debbie Smith, D-Sparks, wore a resigned expression as she headed toward the Senate floor late Sunday night to pass various budget-related bills.
“We’ve done some really great things, but we’re also lacking in some areas,” she said.
The public education budget is already on the Governor's desk, and the rest will soon follow. So game over? Everyone can go home happy? Not so fast, say Nevada teachers. They're getting ready to rumble... At the ballot box next year.
[Outgoing President of the Nevada State Education Association Lynn] Warne said that "incremental" increase in k-12 funding won’t do much. It won’t be enough to really solve any problems. Class sizes will continue to be too large in the early grades, Nevada’s English language learners will still struggle. Nevada’s dropout rate will continue to be a national leader.
“They (governor and legislature) all recognize we don’t fund public education properly in this state, but what they are proposing to put into it, what we are coming out with, is not going to move the needle anywhere.”
The margins-tax plan calls for 2 percent tax on a business’ “margin,” the money left after the business either deducts its overall cost of goods or the its overall compensation paid to employees.
Warne said she was not surprised that state lawmakers sat on their hands when considering the margins tax.
“Looking at the characters in this building, the personalities, the make-up of both houses, the number of Ds and Rs, the governor rhetoric on no new taxes – we didn’t necessarily think it would move," Warne said. "And again, that is why we chose the strategy we did in the first place – the initiative process.”
The initiative process is the only viable way to raise taxes for education in Nevada’s hamstrung poltical process, Warne said.
“The two-thirds (vote requirement in both houses to raise taxes) has done nothing but hamstring the Legislature,” Warne said. “There are some legislators in this building who really want to see k-12 funded properly in the state. But unfortunately, they haven’t and their constituents they represent have not been able to see any improvement in education funding.”
Who will ever forget the hearing The Education Initiative received before its quiet death? Well, it turned out that IP 1 (The Education Initiative) didn't actually die. Rather, the corporate margins tax proposal will be landing on our Fall 2014 ballots.
Today, the Legislature finally succumbed to Governor Sandoval's request for underfunded schools and inadequate public infrastructure. They may not be quite as underfunded as they were in previous sessions. Yet even Governor Sandoval's own President of the State Board of Education, Ms. Elaine Wynn herself, has described Nevada public schools as "grossly underfunded". This poorly kept secret is becoming increasingly difficult to deny.
So now, someone has to deal with it. Someone has to start fixing this structural problem. And since we saw no solutions from "leaders" in Carson City this spring, We the People must provide leadership and get it done in the fall of next year.
You know, Rachel Maddow has a point. This wasn't really "unimaginable". It's been happening all over the country...
So might the next horrifying American massacre happen here in Nevada? At UNR? Near an Elko mine? At a casino on Las Vegas Boulevard? At a brothel in Pahrump? Perhaps so.
On July 7, 1995, Senate Bill 299 was signed into law, and soon afterward, thousands of Nevada residents took advantage of the law that allowed them to carry a handgun concealed upon them. A steady stream of Nevadans have been obtaining carry of concealed weapon permits ever since. In 1999, Assembly Bill 166 made legal concealed carry possible in more public places.
Registration
Clark County requires registration of handguns only. All other counties have no registration of any guns.
Background Check
All Nevada counties implement the national background check through the Nevada Highway Patrol. By state law, any private party may access Nevada's background check system for the purpose of checking the background of a potential gun purchaser. Currently, the check costs $25.
Open Carry
In Nevada, you may carry a loaded or unloaded firearm on your person without a permit so long as the firearm is fully exposed (known as "open carry"). An example of open carry is when a handgun is carried in an "outside the pants" hip holster. Full or partial concealment (such as a purse, jacket, etc.) is considered concealed carry.
And here's what's been happening.
With more guns sold and registered per capita than anywhere in the U.S., Nevada is a gun state - always has been.
It also is the gun-death state. According to the Center for Disease Control, since 2000, Nevada has led the nation with an average of 26 gun-related deaths per 100,000 people.
War-torn Iraq averaged 32 gun deaths per 100,000 people last year, according to the same study.
At least once a year, an accidental gun death here makes national headlines.
And here's the frightening reality of how incredibly easy it is for some mentally disturbed person or deranged sociopath to obtain lethal firearms in Nevada.
According to the latest scorecard by the National Brady Campaign to Prevent Gun Violence, Nevada fails miserably when it comes to curbing illegal firearm trafficking, conducting background checks, promoting child safety, banning assault weapons, and keeping guns out of public places.
Nevada received only 11 points out of a possible 100. [...]
While there is no state law requiring a waiting period for first-time handgun buyers, [Gun store owner Bob] Irwin says Clark County has a 3-day restriction.
Yet anyone can buy a handgun or assault weapon on the spot at a Nevada gun show — no questions asked.
“I can’t believe that’s allowed. It’s putting people at risk,” said Maria Outcalt with Domestic Violence Prevention.
It’s that easy access that has Outcalt convinced that stronger gun control laws would help curb violence.
While our gun laws are not nearly as lax as Arizona's, they're certainly "forgiving" enough for someone who otherwise shouldn't be carrying guns to access them.
Yes, yes, I've heard that famous clause: "Guns don't kill. People do." But you know what? When mentally disturbed people can access extremely lethal "weapons of mass distruction" so easily at the neighborhood gun store or local gun show, that's a serious problem.
Nevada's mental health director says this state ranks near the bottom of per person spending on services. And it's just about to get worse with deep budget cuts.
Jared Loughner's mindset and motives before the Tucson shooting are now under scrutiny. Those who know him these past years paint a picture of a mentally disturbed young man, describing his as ranting, destructive and threatening. Fellow students feared he might bring a gun to the school. [...]
[Las Vegas/Clark County] Metro police say there are around 6,000 cases of mental health detainments every year. Those detainments last up to 72 hours and then the state may get involved if there's and issue.
State mental health services face a 14 percent cut and program eliminations this year which is in addition to cuts they have suffered in previous years. UMC's Emergency Chief Dale Carrison spoke to the I-Team last fall about the backlog.
"We've medically cleared them. Now, there's a big line, and if southern Nevada adult mental health for some reason can't turn the patients over, than it builds up."
Nevada's budget cuts this year are likely to include mental health court. It's a program designed to get convicted mental ill people into treatment programs so jail is not their only option.
Back in December, then Governor-elect Brian Sandoval didn't wince as news was leaking of severe budget cuts in the pipeline. And if that wasn't bad enough, The Nevada View reported just last week my new State Senator, Michael Roberson (R-Henderson), hinted at the renewed "tea party" effort to push a "cuts only" budget agenda that would gut the very mental health resources that can possibly prevent another mentally unstable person from taking to violence here in Clark County, as Jared Lee Loughner did in Tucson last week.
Sure, Loughner's homicidal outburst might have been affected by anti-government rhetoric and political diatribes on the Internet or on the airwaves. But we're missing the point if that's all we focus on.
Arizona has implemented dramatic cuts in mental health services in the last few years, as have states across the nation. And if the national healthcare reform bill is repealed, as government-shrinking crusaders are promising, more mental health services will be lost.
Loughner was able to buy a gun — the gun authorities said he used to shoot Rep. Gabrielle Giffords and 19 others at a supermarket — despite numerous interactions with authorities suggesting he was unstable. If you're surprised, you shouldn't be. Many in this country have worked hard to make it easier to get guns than mental health services, even after the Virginia Tech massacre of 2006, in which 32 people were killed by a young man who was mentally ill.
Now let me pause here to clarify something, because the last thing I want to do is make the stigma surrounding mental illness worse than it is, or to suggest that you ought to pick up the phone and call authorities every time you see someone who acts a little peculiar.
The vast majority of people with mental illness aren't dangerous. But a small minority will become violent, especially those with severe symptoms that go untreated. Ironically, one reason so many don't seek help is because of the stigma, along with the fact that this country has never given mental health treatment the priority it deserves. If you doubt that, just take a look at recent reports on the military's disinclination to diagnose and treat traumatic brain injury in soldiers from Iraq and Afghanistan.
What the Arizona tragedy ought to spark is not a hysterical conversation about politics, but an honest conversation on the need for earlier diagnosis and better education about mental illness. Since the first signs of delusional behavior often emerge in the late teens and early 20s, teachers and staff at high schools and colleges should be trained to recognize the signs of mental disorders and intervene effectively.
I know from experience that it isn't always easy to convince someone to seek help or to predict the behavior of someone who has severe mental disorders. But although mental illness can't be cured, it can often be treated and managed in a way that relieves suffering for those afflicted, as well as for their families, and helps prevent tragedy.
While California's own mental health resources have been strained due to budget cuts there, they at least have something. Both Arizona and Nevada have next to nothing. Strangely enough, it's far easier here to buy a gun than to get help. This is nothing short of frightening.
As usual, Desert Beacon sheds more light on this pressing issue.
The consequences may be not always be nationally tragic, but for families and individuals trapped by the debilitation of mental diseases the results are always tragic. And not always addressed -- as demonstrated by this commentary from a nurse: "Having spent many years of my life working in a locked psychiatric unit as a nurse, I can attest that the majority of our schizophrenic clients, though sometimes frightening, especially to those not familiar with the illness, were not dangerous. However, clients diagnosed with paranoid schizophrenia will sometimes act on their paranoid delusions. I have personally seen how difficult our mental health system can be to navigate. Family members would call me and beg for help, but help is available only under a very special set of circumstances. Sometimes people will seek treatment voluntarily, however, in order to commit a person involuntarily they have to meet certain criteria, either DTS (danger to self), DTO (danger to others) or GD(gravely disabled). The greater problem is that now it is very difficult to obtain any type of outpatient treatment, as insurance generally will not pay for it, or pay only a very small amount. Most people simply cannot afford any more to pay for mental health treatment."
We know that Loughner appears to have some traits associated with mental illness, including confused and distorted thought patterns, implying his receptivity to conspiracy theories, both internally and externally derived. We may infer that he acted on these, which adds another layer to the overall diagnosis. Those who had contact with him at Pima Community College report that he was removed from a math class by a counselor and a police officer, was suspended, and later agreed to withdraw from school in October. [WaPo]
What help he might have sought, or what assistance might have been sought for him, have yet to be revealed publicly. However, it's clear that obtaining mental health services is at least as difficult as the nurse-commenter referenced above. Google "state mental health budget cuts" and you'll get at least 22,200,000 results. Mental health advocates in Texas are worried about the impact of decreased funding, [KHOU] advocates in Mississippi are worried as well, they may be facing cuts of 15%. [LaurelLdr] Mental health budgets have been slashed in Oklahoma. [KRMG] At the top of the list of NAMI's Ten States Hurt by the Mental Health Budget cuts, is Arizona. Nevada stands 7th on that listing. [...]
Before anyone in Nevada is tempted to pass judgment on Arizona's situation in terms of mental and behavioral health services, we should note that in 2006 Nevada received a "D" grade from the National Alliance for the Mentally Ill, and the same "D" grade three years later in 2009. In health promotion and measurement terms (evidence based practices, emergency room waiting time, quantity of psychiatric beds) Nevada got an "F." Nevada got a 45% "D" for financing, Medicaid reimbursements to providers to evidence based providers, and more; another "D" for measures such as consumer and family access to essential information from the state, promotion of consumer run programs, and family/peer education and support. There was another "F" for state support of activities requiring collaboration among state mental health agencies and other state agencies and systems. Among the "urgent needs" suggested by the NAMI: (1) restore inpatient staffing levels; (2) increased support for case management, medications, and therapy; and (3) increased resources for supportive housing options.
Interestingly enough, this week's news was supposed to be dominated by upcoming Congressional debate over repealing health care reform... The very same health care reform legislation that included efforts to improve mental health care.
The law signed by President Obama last week expands parity to a much wider pool, making it possible for millions more people to get the same coverage for substance abuse and illnesses like bipolar disorder, major depression and schizophrenia as they would for, say, diabetes or cancer. There are no exact figures, but the mentally ill are more likely to be uninsured than the general population, advocates and researchers say.
“A lot of this still has to play out in terms of how parity works,” said Michael J. Fitzpatrick, executive director of the National Alliance on Mental Illness, or NAMI, an advocacy group. But the new law “can change the mental health system in America and really give families and individuals an opportunity to get a level of access to care we could only fantasize about before this became law,” he said.
Parity means that deductibles, co-payments and limits on the number of visits or days of coverage must be no more restrictive for coverage of mental illnesses and substance abuse than for coverage of medical and surgical treatments. If a plan provides for out-of-network medical benefits, it must provide out-of-network mental health benefits.
Under the new health law, employees of companies with 50 or fewer workers, whose employers were not required to comply with the existing parity law, would receive equal mental health benefits if their employers opt for the state-run exchange plans, available in 2014.
Health care reform also means expanded coverage for mental health care in Medicare and Medicaid programs. Considering what just happened last weekend, perhaps House Republican leaders need to do more than just postpone their planned vote on repealing health care reform. Since repeal is unlikely and the reform legislation now looks more necessary than ever before, perhaps repeal needs to be permanently shelved. Instead, wouldn't it be refreshing to see Congress actually address the pressing issues of today by examining why it's easier to obtain a gun than to access mental health care? And wouldn't it be encouraging to see Governor Sandoval and The Nevada Legislature also address these pressing issues by looking at our own budget and our own problems in taking care of our fellow Nevadans?
We've known for some time that this is the case. Yet since the Steven Brooks scandal broke, his plight has shed light on the state of mental health care here in Nevada. So what's the state of mental health care here in Nevada? It can easily be described in one word: Awful.
The [Nevada Division of Mental Health & Developmental Services] suffered a 12.5 percent cut in its budget over the past two years and a 13.9 percent decrease in general fund revenue, resulting in a loss of 150 positions. The lost jobs included those in inpatient and outpatient treatment centers. Like other state agencies, those employees who kept their jobs also endured 2.5 percent salary reductions and mandatory unpaid furloughs.
From fiscal 2009 through fiscal 2012, Nevada saw its mental health budget decline by 28.1 percent, the nation's fifth highest drop during that time.
"The cuts have raised concerns regarding meeting client needs," the report stated. "Budget cuts and elimination of positions and services has been a trend since the last comprehensive Needs Assessment in 2008."
One hurdle facing the division is that Nevada already ranks poorly in mental health spending per resident in comparison to most other states. Nevada also was dead last in Medicaid spending per resident from fiscal 2004 through fiscal 2009 and was 49th in 2010. That year, Medicaid spending averaged $1,224 per U.S. resident but only $505 per Nevadan.
Any wonder why Governor Brian Sandoval (R) suddenly found an extra $25 million for mental health services?
Well, here's another reason. The Sacramento Bee has been investigating the story of James Flavy Coy Brown since March. And the Northern California paper has since uncovered the terrifying truth of the mental health system here in Nevada.
It was 6:30 a.m., 15 hours and 11 stops after a taxi had scooped him up in front of Rawson-Neal Psychiatric Hospital in Las Vegas, where he had spent the previous 72 hours, and deposited him at a bus station.
During the long ride to Northern California, Brown had rationed the peanut butter crackers and Ensure nutritional supplements that a staff member at the mental hospital had given him, along with his discharge papers and a bus ticket to Sacramento. His food was gone, and he was nearly out of the medication to treat his array of mood disorders, including schizophrenia, depression and anxiety.
As the bus door opened in Sacramento, Brown, 48, stepped out into the pre-dawn gloom. It was 30 degrees, and his windbreaker was no match for the chill.
Brown, a native of the American South with a distinct accent and a healthy head of salt-and-pepper hair, had arrived in the capital city with no concrete plan for survival. He had no friends or relatives in Sacramento. He had lost his ID, Social Security and insurance cards somewhere in Las Vegas. He had no idea how to fill the prescriptions that helped tame the voices and anxiety that clouded his mind.
Brown was discharged from Rawson-Neal... And thrown onto a Greyhound bus. And 15 hours later, he was in California. And he was clearly still suffering from severe mental illness. James Flavy Coy Brown needed more treatment, yet Nevada just decided to dump him into California.
Obviously, several officials in California are furious. And the Nevada Division of Mental Health & Developmental Services is now facing state and federal investigations. So far, it's already been discovered that Brown was not the only dumped out of state. Far from it, there were many more cases of patient dumping to California and other states.
In February alone, at least three other mental patients were discharged from Rawson-Neal Psychiatric Hospital in Las Vegas to far-flung destinations, including California, with a small supply of medications and a few cans of Ensure for nourishment, according to a report issued Monday by the Nevada State Health Division.
Those four represent just more than 10 percent of the 30 sample files reviewed by state investigators in response to concerns about Brown's care. [...]
Nevada recently has made a practice of busing mental patients out of state. The state sent 99 psychiatric patients to California between July 1, 2012, and the end of February, Nevada health officer Tracey Green told state lawmakers during last month's hearing. She said 81 percent were California residents who wanted to go home.
By contrast, an official with Arizona State Hospital told The Bee that facility has not sent a patient out of state by bus in recent memory. Oregon State Hospital discharged one patient to family in California between July 2012 and January, according to a hospital spokeswoman.
The federal Center for Medicare and Medicaid Services is working with Nevada authorities to investigate the state's treatment of mental health patients.
Some patients have been sent as far away as Oklahoma and Massachusetts (??!!). And of course, many were simply packed into Greyhounds and dumped into California. And they were done so despite needed further treatment. And they were only given a few cans of Ensure and a tiny supply of medicine.
So is this what Nevada considers to be "proper mental health treatment"? No wonder why Steven Brooks was allowed to wither on the vine for so long. And no wonder why Governor Sandoval suddenly found another $25 million for mental health care. (Yet that still doesn't completely erase the previous 4 years worth of budget cut, let alone help the state catch up with 2 decades worth of growing case loads.)
So what will it take for Nevada to fully fund the kind of mental health care that our state needs? How many more embarrassing scandals must emerge before the state fully funds mental health care?
Today, KNPR's "State of Nevada" touched the issues that are always on our minds... Even if it sometimes feels like they are never really part of our agenda:
- Are we really investing too little in public education?
- Just how over-dependent are we on tourism?
- What must we do to diversify our economy?
Oh yes, and...
- Considering Clark County pays for over 80% of the State of Nevada's budget and is home to over 70% of the state's population, do we really get our state tax dollars' worth?
How many more times must reality bite us in the ass before we realize our collective Nevadan ass is bleeding so profusely that our underwear is being dyed red?
In case you missed it last week, I want to show you what Desert Beacon wrote last week that explains Nevada's economic conundrum in a nutshell. We've been underfunding higher education for far too long, and this problem only continues to worsen as we continue to force UNLV and UNR to cut investment even more. Yet when we look at our most promising areas for economic growth, they're areas that require an educated workforce. We have plenty of growth potential in high tech (especially when it comes to green technology), as well as in biotech & medical research, but we're cutting the very programs at our institutions of higher learning that could give us a much needed leg up in these sectors.
I've said it before, and I'll say it again: Tourism alone can no longer save us.
What makes this even worse is that over many years and many legislative sessions, "the powers that be" in this state have mostly looked the other way despite all the growing evidence pointing to these serious problems. "The Great 2000s Real Estate Bubble" was always doomed to burst, but hardly anyone in Carson City wanted to talk about how to get past it until it was too late. Of course, they probably didn't want to talk about it because the bulk of the state's budget was built upon the bubble, and that everything from fire stations in Tonopah to community centers in Eureka to freeway projects in and around Reno depended on tourist dollars from the Las Vegas Strip. And even as the state had been able to fund some public infrastructure in Central and Northern Nevada thanks to "bubble" money from the last decade, Clark County still lacks sufficient higher ed opportunities at UNLV, sufficient health care, and plenty other areas of infrastructure that are critical to a successful community. Strangely enough, money from the primary economic engine of Nevada (Clark County) hasn't been used to properly maintain that engine. And because that engine has been neglected, the entire vehicle (Nevada) is in trouble.
And this brings us back to Dr. Robert Lang's segment on KNPR's "State of Nevada" this morning. The typical "powers that be" in Carson City have failed the entire state, but especially Southern Nevada has been neglected, and that's ultimately been to the detriment of everyone in Nevada. As this election season heats up and we eventually hear candidates talk about what they want to do in Carson City next year, we need to make sure that they follow through on their promises once elected, and that they finally stop avoiding what has to be done to heal our state and let Las Vegas become more self-sufficient.
Nevada’s budget crisis became a bit less severe Monday with word that the general fund will be enriched by a previously unplanned $274 million, a bit of a windfall that will benefit the beleaguered education and health and human services budgets — and maybe undermine the argument for tax increases.
Business leaders meeting as the state’s Economic Forum — the state’s official crystal-ball people on matters financial — projected a slow but steady uptick in the ailing economy. It won’t be great, they said, but it will be better than the dark days predicted in December, when Sandoval was putting together his budget.
Rejoice! We have an extra drop in the bucket. Our budget is "only" horrendous, and just a little less disastrous.
Nevada has some $247 million more in general revenue than previously predicted [LVSun] ergo cuts to education and health programs won't be so onerous. This is supposed to be good news. This is also what happens to deficits when the economy perks up a bit; there is more revenue available -- a point which doesn't always seem to register with the Right. A deficit is not the exclusive result of profligate spending. Deficits are commonly associated with downturns in economic activity, especially when revenues are tied to sales taxes, a regressive form of taxation linked firmly to consumer spending.
So, the good news is that revenue projections are increasing. The bad news is that the Assembled Wisdom is still far from recognizing that the cuts wouldn't be onerous at all if Nevada would modify its taxation system to require that Big Box Retailers pay their fair share. Small, independent, retailers are paying more at the moment so that the Big Box Retailers can pay less. If Nevada would acknowledge that the mining industry is saying one thing to its shareholders and singing a far different tune in the hallways in Carson City.
Ain't that the truth!
Seriously, this is NOT the way to run a state! Only because we're slashing education and other state services to the bone instead of slashing them to the bone AND sucking out the marrow does not a sensible budget make.
Our kids deserve better. They deserve schools that can provide them with real opportunity, not schools that don't have to cut as many sports and music programs. They deserve colleges that prepare them to be great leaders and thinkers, not colleges that "only" have to cut 5 or 10 majors instead of 20. They deserve a Nevada that leads the way on creating a truly lean and green sustainable economic powerhouse, a Nevada that leads the way on renewable energy, green design, medical research, gaming technology, and more... Not a Nevada that will be a little less depressed and devastated a year from now than it is at present.
If Brian Sandoval doesn't "get it", then we must grasp it. If Sandoval doesn't cease and desist with the cheap political games being played with Nevada's future, then we must end these games. And if The Legislature is still afraid to take action to stop this madness and stop the petty argument over whether to cut to the bone or cut all the way into the marrow, then we have to make them act.
Gov. Jim Gibbons and Nevada legislative leaders announced at a news conference in front of the legislative building this evening that a final deal had been reached to close a budget deficit that ended up being about $805 million. But they warned that recession-plagued Nevada still faces tough times ahead.
“No one likes everything in this” deal, Gibbons said. “Everyone had to yield something, and everyone came to the table.” [...]
Assembly Speaker Barbara Buckley — who kicked off the session on Tuesday urging the Legislature to reduce the cut to education — said the state also managed to avoid some of what she called the worst cuts to health and human services. But she added that the state’s financial system needs to be overhauled.
“I think we need to tear down the financial structure we have now and start over,” said Buckley, who is term-limited and ending her service in the Legislature.
For his part, state Senate Majority Leader Steven Horsford warned that the “challenge ahead is just as great,” and said the next Legislature, which meets in 2011, could face a 50 percent reduction without new revenue. He challenged “those corporations that were not able to be part of this solution” to be part of the next. It was a reference to the casino industry and other businesses, which flatly refused in a Senate hearing to agree to contributing more to help the state solve its deficit problem. (Nonetheless, the final budget plan includes an increase in the fee for new casino licenses.) [...]
Among other things, the final budget plan includes:
A reduction in the cut to K-12 education from $211 million to $116.8 million.
A reduction in higher education from $76 million to $46 million.
Eliminating a list of proposed cuts to services for the elderly, children and the disabled.
Putting most state offices on a four-day, 10-hour work week.
Cutting state contracts by $10 million.
Avoiding further pay cuts to state employees pay or benefits.
“Sweeping” state boards, commissions and agencies for nearly $200 million.
Raising the per-claim mining fee, based on the number of mining claims a person or corporation has filed. The new fees will be $70, $85 and $195.
And as you can see, there's already talk about 2011. Nevada will then be facing an even scarier deficit, and even a few Republicans are hinting about possible major tax reform in the next biennium.
But anyway, back to this budget this year. While Democratic legislators succeeded in trimming the proposed cuts to education and the social safety net, there will still be painful cuts and difficult decisions to be made.
And in addition to the budget, there's still the water issue.
Lawmakers also seemed loath to allow the water rights bill to push them past midnight.
“If we don’t feel those questions are answered and this bill is the right way to proceed, we won’t,” Assembly Speaker Barbara Buckley, D-Las Vegas, said while opening a late-night hearing on the water rights bill. “But seriously, we don’t have much time, and we don’t want to make a mistake.”
That bill, pushed by the Southern Nevada Water Authority, sought to change a recent Nevada Supreme Court decision that has thrown more than 14,000 water rights into limbo.
Yes, SNWA really wants to use this special session to push its Great Basin Water Grab. As if they couldn't think of a more inappropriate time to demand more of someone else's water to fuel more unsustainable suburban/exurban sprawl, legislators are still planning to take a vote this week on reversing the Nevada Supreme Court ruling that halted the water grab.
So obviously, this special session will be remembered for all the tough decisions made on this year's budget... But it may also turn out to be a foreshadow of what's to come on next year's budget, sustainable development, water rights, workers' rights, and much more.
Last week, we noted the channeling of growing angst over inequality into the still maturing Occupy/99% movement. This week, I want to remind you that #Occupy was foreshadowed right here in Nevada. Remember "Sandoville"?
Remember the largest protest in Carson City's history?
How many more times must I explain this? With inadequate schools, new companies won't move here. Businesses are now looking for a more educated workforce, and Nevada can't provide that with underfunded, overcrowded, underperforming, overburdened, and all around collapsing K-12 schools and colleges. Without good schools, we'll never have the foundation needed for a more stable economy and lasting jobs.
But do enough legislators understand this? Do they really want to continue being penny wise and pound foolish? Do they want to force Clark County School District to sue them for inadequate funding? Do they really want to "beggar thy neighbor" by forcing unfunded mandates onto local governments? Or are they finally ready to make a change and do the right thing?
Everything we "know" on the budget is wrong. The revenue is there. The mining industry can certainly afford to pay its fair share, and so can other large multinational corporations taking advantage of our consumer dollars while refusing to pay what we pay. Our system is broken, our state is failing, and we can no longer afford to ignore this crisis.
As we've talked about before, many thousands of students from throughout the state have begged Brian Sandoval and The Legislature to let them continue learning. Under Sandoval's proposed budget, entire departments are set to be eliminated from UNLV and UNR, UNLV will likely go bankrupt, and entire colleges, like Western Nevada College in Carson City and Nevada State College in Henderson, may be permanently closed. Now what would that say about our state planning ahead for a better economic future?
As I've repeatedly exclaimed here before, the ONLY way for Nevada to survive is for us to diversify our economy and bring in companies looking for an educated workforce. But as long as we continue to defund our schools, Nevada will be nothing other than a third world society slowly unraveling as casino conglomerates look elsewhere to profit off gambling going global.
This year's budget really is a life or death decision for Nevada. Will we decide on economic and social murder-suicide by way of destroying what little public infrastructure we have? Or will we choose life? Will we decide to build on that very public infrastructure that the vast majority of the private sector has told us is critical for them to do business here?
Sadly, Brian Sandoval continued to drown out the crying and raging masses while the Legislature continued to suffer under partisan stalemate (thanks to the more extreme G-O-TEA caucus). On May 26, I asked how much longer "we the people" could be ignored.
For far too long, we have been told to "suck it up" and "celebrate the free market". Look where that has taken us. Even though we have the cheapest state government and one of the lowest tax burdens in the nation, we have the highest unemployment rate in the nation and an economy unraveling due to casinos investing more offshore and the real estate bubble bursting. The Nevada "success story" of the past has been found to be just a mirage, an illusion, a trick.
Can we be ignored?
We know what we need to fix our economy and put our state back on track. While Sandogibbons continues to dream of making it big time, many Nevadans' dreams of making it to the next day fade away. There were so many people in Grant Sawyer yesterday testifying of how they're trying to do the right thing by staying in school, working on college degrees, and aspiring for real, stable jobs. But as Sandogibbons and his merry band of cannibalistic teabaggers continue to pull the rug out from under them (by way of forcing class eliminations, school closures, further health care rationing, etc.), they don't know if they can survive here. [...]
Can we be ignored? Or is Nevada about to get a brutal wake-up call?
And funny enough, on that exact same day a "Deus ex machina" appeared... In the form of a Nevada Supreme Court ruling that was almost literally released at the 11th hour and just barely in time to stop the Legislature from collapsing without a budget agreement. Yet despite that, we only ended up with the usual political games of how much more to cut and how little to tax to keep funding schools at the ridiculously low levels they've always been. However, not all hope is lost. As we discussed at the start of this series, there may be efforts in the new year to finally get Nevada to invest in its people again. It may ultimately have to go to the ballot box, but at this point we may need to do that just so we no longer have to endure Carson City dragging its feet on making our schools work.
Democrat Kathy Hochul defeated Republican state Assemblywoman Jane Corwin in New York’s special election to replace former Rep. Chris Lee (R-NY). Despite the $2.36 million spent by groups like Karl Rove’s American Crossroads and the U.S. Chamber of Commerce to keep the district red and the $60 per vote Corwin spent herself, Hochul secured a clear victory in a traditionally Republican district [...]
Viewed as a referendum on House Budget Chairman Paul Ryan’s plan to end Medicare, Hochul’s victory exemplifies the American public’s overwhelming disgust with the GOP push to force seniors to bear the burden of increasing health costs. Expecting a loss, several Republicans — including Corwin herself — tried to assert the election had nothing to do with Ryan’s Medicare plan. But DCCC chairman Rep. Steve Israel (D-NY) outlined the three reasons that Corwin lost the election: “[I]n alphabetical order, Medicare, Medicare and Medicare.”
"We can ensure we do not decimate Medicare," Hochul said. "We will keep the promises made to our seniors who have spent their lives paying into Medicare, so they can count on health care when they need it most."
If Democrats have their way, there will be a lot more speeches along those lines come November 2012. The chairs of both legislative election committees made clear on Tuesday that they believe they have found a winning formula they intend to use elsewhere.
"The election last night showed that Democrats have the keys to drive the budget debate and play offense in 2012," Sen. Patty Murray (D-WA), chair of the Democratic Senatorial Campaign Committee, said in a statement. "The implications of this election extend to Senate races in battleground states and red states across the country. The results provide clear evidence that Democratic senators and senate candidates will be able to play offense across the country by remaining focused on the Republican effort to end Medicare and force seniors to pay thousands more for health care costs."
Rep. Steve Israel (D-NY), chair of the Democratic Congressional Campaign Committee, said that the party had "served notice to the Republicans" that the Medicare issue could hurt them.
"Even in one of the most Republican districts, seniors and independent voters rejected the Republican plan to end Medicare," he said. "The American people will continue to hold House Republicans accountable for their plan to end Medicare from now until election day 2012."
For Rob Zerban, a Democrat running against GOP budget guru Rep. Paul Ryan (R-WI) in 2012, the Hochul race was an instructive boost to his campaign hopes.
"I just am overwhelmed at the results from this election. It's a harbinger of things to come," he told TPM over the phone on Tuesday night. "I'm certainly going to make this a key issue in the 1st Congressional District in Wisconsin. ... Democrats are going to focus on how we can actualy shore up, strengthen, and keep Medicare solvent, and this will be a clear distinction in the 2012 cycle."
So can this be another factor that shakes up the already zany special election in Nevada's own 2nd Congressional District? The legal drama over how the election itself will be conducted ("Ballot Royale?" Or behind closed doors?) is proving to be a giant hot mess with none other than Dean Heller at the center of it. For quite some time, the focal point of the NV-02 special has been the (at times hilarious) cast of characters running. But now, is there a chance this will change and... GASP! ... the election may actually be decided on policy?
Don't laugh just yet. Notice these numbers (via DB).
Republicans falsely claim Nevada seniors will not be impacted by the GOP’s plan, but starting next year, more than 26,700 Nevada seniors will be forced to pay $15 million more in prescription drug costs [if the Ryan Budget is passed]. The Republican budget also slashes billions in health care through Medicaid, putting seniors at risk.
Specifically:
The Republican plan to end Medicare will increase out-of-pocket health care costs for a typical 65 year-old Nevada senior by $5,862 in 2022 – more than double the cost under current law.
The Republican plan could force at least 7,800 Nevada seniors to pay over $828,000 more for annual wellness visits in 2012.
In Nevada, more than 26,700 seniors would pay $15 million more for prescription drugs in 2012 alone under the Republican plan.
By turning Medicaid into a block grant program, the Republican plan could cost Nevada at least 9,600 private-sector jobs over the next five years.
In Nevada, the Republican plan could cut $1.7 billion in federal health care funding for seniors and the disabled through Medicaid, including life-saving nursing home care.”
Amodei says he likes the "honesty" of the deep spending cuts found in the 2012 budget proposal from U.S. Rep. Paul Ryan, the Wisconsin Republican and House Budget Committee chairman, whose plan clashes with President Barack Obama's competing proposal. Brower likes the Ryan proposal, too, and says its plan to reduce corporate taxes while keeping President George W. Bush's tax cuts for the rich "could spur the economic activity we so desperately need." Lippold, a retired Navy commander, says Ryan's plan is a good blueprint that "sets forth some aggressive goals."
When we were in Carson City last month, we took a glimpse at Nevada's plan to implement a major facet of the Affordable Care Act (ACA). Despite ongoing federal budget woes and treacherous politics, the ACA (aka Obamacare) has somehow managed to survive... And its health insurance exchanges are still scheduled to start this October.
Against this backdrop and continuing state budget challenges, the Silver State Health Insurance Exchange is set to begin this October. Yet in chugging along to meet this goal, Nevada has done something unprecedented. In this regard, Nevada has actually become a leader in health care policy!
“Nevada is one of the cases we looked to,” said Mike Nunez, executive director of the New Mexico Health Insurance Alliance, a working group that did early-stage fact finding about state health care exchanges before the legislature approved an exchange for New Mexico in late March.
Nunez couldn’t elaborate how Nevada’s example might ultimately resonate in New Mexico, because the board that will make those decisions is now being appointed.
But he hinted at geographic and demographic similarities that made Nevada a more attractive example for New Mexico’s designs than many other states with independent exchanges. Like Nevada, New Mexico has a high proportion of uninsured residents (in both states, approximately 23 percent of the population is uninsured), and a large complement of native American tribes that must be seamlessly integrated into the exchange’s IT system.
“We have limited time and a new law and a new board that’s about to convene,” Nunez said. “We looked at what Nevada had done because as they described things to me, they were available for other states, to save cost and time.”
In Idaho, Nevada’s influence has been far more regular: The state has hosted Idaho representatives eager to see Nevada’s exchange construction in action, and late last year, Silver State Exchange officials made trips to Idaho to brief the state’s exploratory Health Care Exchange Working Group. According to national health care experts, Idaho appears all but poised to copy the Silver State’s example whole, once the membership of their board is finalized this month.
“We contacted them over a year ago…we knew they were ahead of us, so we wanted to ask: ‘What mistakes did you make so that we do not,’” said Tom Shores, state president of the Idaho Association of Health Underwriters and a member of the Idaho Health Exchange Working Group.
So what's been the secret to Nevada's surprising success? The state subcontracted design of the exchange to Xerox. No, I'm not even kidding. The state decided it was easier to use Xerox's existing exchange model than to create one entirely from scratch.
However, it doesn't end there. Nevada has made its own mark on the exchange program. The program is set to be very consumer friendly, as it's integrated with Medicaid and taking a "no wrong door" approach to connecting consumers to the most compatible insurance, whether it's private or public. Nevada is also the first state to fully aggregate premiums instead of just leaving cost calculation to the insurance companies. This should make it even easier for consumers to figure out which insurance policy works best for them.
Amidst all the continuing challenges in fully implementing the ACA, Nevada's health insurance exchange program is already becoming an unlikely success story. And it's not even online yet.
It's amazing what happens when Nevada complies with federal law and actually makes an effort to provide affordable health care to its people. Great things can happen. Perhaps our state should try doing this more often.
