TWO DISTINCT WAYS OF LOOKING AT LEADERSHIP

posted by Michael Chihak

Republican leaders in the Arizona Senate may unveil their state budget proposal today, and early indications are it would have more drastic cuts in it than Gov. Jan Brewer has called for.

The Arizona Republic reported that on Sunday, saying there could be $600 million more in cuts than the $1 billion or so that Brewer has called for. Cuts would come in health services, the Department of Economic Security and all levels of public education. One lawmaker said the Department of Corrections would be off limits to cuts.

We will watch the developments closely. Look for more reports here and for development of the state budget as the topic for this week's program.

The other possibility as of now is the Flinn-Brown Civic Leadership Academy, which opens its first class on Friday in Phoenix. A partnership of the Flinn Foundation of Phoenix and the Thomas R. Brown Foundations of Tucson, the academy will begin educating 25 Arizonans on the state's most important issues.

The Academy's Website describes its mission thusly: "The Arizona Center for Civic Leadership’s Flinn-Brown Civic Leadership Academy is intended to help expand the cadre of future state leaders with the skills to address Arizona’s long-term issues. The Civic Leadership Academy complements existing local and regional leadership-training programs in Arizona, but is differentiated by its focus on state-level issues and leadership and emphasis on mentoring, plans, and follow-up support."

We plan to take a look at this innovative program, either this week or next, and we hope to talk with some of those who have been selected to take part.

AZ'S FRAGILE ECONOMY WILL BE HURT BY MEDICAID CUTS

posted by Michael Chihak

Arizona, more so than many states, relies on its vast Medicaid program as a bolster to the economy, in that the health insurance program provides coverage for workers in numerous small businesses, says an executive with Banner Health.

Dennis Dahlen, senior vice president and CFO of the state's largest health-care system, said in an interview for Friday's Arizona Week that the cuts Gov. Jan Brewer proposes in Medicaid will contribute to the "economic malaise the state is facing."

He said Banner might have to lay off employees and will consolidate services plus put off capital projects if the cuts go through.

Dahlen also said that the quality of health care will decline for many in the state, including those using Banner's 13 hospitals because of service consolidations and people losing primary-care physicians and thus having to rely on emergency rooms for care.

Medicaid, or as it is known in Arizona, ACCCHS, is a good deal for the state because it means Arizonans get $7 or so in federal money for every $2 or $3 in state-generated money, Dahlen said. Thus, he said, cutting state Medicaid funding as the governor and Republican legislators have proposed would have a "negative multiplier" of up to $4 in lost federal money for every $1 or so in cut state money.

Dahlen's interview will be part of Friday's Arizona Week on Medicaid cuts in the state, at 8:30 p.m. MST on KUAT-TV in Tucson and 10:30 p.m. MST on KAET-TV in Phoenix. It also may be viewed online at azweek.com.

GAUGING THE IMPACT OF ARIZONA'S MEDICAID CUTS

posted by Michael Chihak

Friday's Arizona Week will present an in-depth look at the effects of the impending cuts to Medicaid, the health-care system for poor Arizonans.

The cuts, announced as the biggest part of Gov. Jan Brewer's 2011-12 budget balancing act, would total $541.5 million and trigger the loss of another $1 billion in federal matching money. Between 250,000 and 280,000 adults in the state, many of them working class people earning less than the federal poverty rate, would lose coverage.

Brewer this week met with U.S. Secretary of Health and Human Services Kathleen Sebelius to ask for modifications to the state's Medicaid program so she can reduce the amount she needs to cut. Sebelius asked for a written plan. This came two weeks after Sebelius told Brewer in a letter that it is up to Brewer, without need for federal permission, to make the cuts to the program. That left Brewer holding the blame bag rather than her and the Legislature having the option of blaming the Obama administration if the cuts had to be made.

On the program to discuss the impact on his organization will be Dennis Dahlen, senior vice president and CFO of Banner Health, the state's largest health-care system with 13 hospitals and 35,000 employees, mostly in the Phoenix area.

Also scheduled to appear is Alison Hughes, director of the Rural Health Office at the University of Arizona College of Public Health. She will help gauge the impact on rural areas, including the state's rural and small-town population and rural hospitals and other health-care facilities.

Providing journalistic analysis and commentary will be Arizona Public Media's Luis Carrión, the Arizona Republic's Mary K. Reinhart and the Arizona Capitol Times' Jeremy Duda.

The program will air Friday at 8:30 p.m. MST in Tucson on KUAT-TV Channel 6 and at 10:30 p.m. in Phoenix on KAET-TV Channel 8. It also will be available at azweek.com.

IS BREWER FINALLY DOING HER MEDICAID MATH?

posted by Michael Chihak

Gov. Jan Brewer wants to make changes in the Medicaid program to reduce the number of people that must be dropped from the health-care program for the poor.

She came out of a meeting with U.S. Health and Human Services Secretary Kathleen Sebelius on Monday saying she will submit a plan to Sebelius next week on changes that could make the cut less onerous. Under her current proposal, the governor would cut up to 280,000 Arizonans from health-care coverage.

She said the cut, amounting to $541.5 million in state money and $1 billion in matching federal money, is needed to balance Arizona's budget for 2011-12.

Brewer, according to a report in today's Arizona Republic, said, "We're hoping to avoid such a drastic cut. We'd still have to cut but not by as much."

Less than two weeks ago in an interview for Arizona Week, Brewer said, "We just simply don't have the money."

In that same interview, Brewer expressed surprise at hearing that an Arizona State University economist estimated 46,000 jobs lost as a result of the Medicaid cuts and at word from the head of the state's biggest business organization that the cuts would seriously hurt small businesses.

Those facts and Sebelius' stance that Brewer doesn't need federal permission to make that big Medicaid cut may have brought about a sense of reality for the governor, the reality being that if drastic cuts are made, the responsibility is hers and the Republican-controlled Legislature's. She won't be able to blame the Obama administration.

MEDICAID CUTS HAVE BIG HEALTH, ECONOMIC REPERCUSSIONS

posted by Michael Chihak

Gov. Jan Brewer hoped to meet today in Washington, D.C., with Kathleen Sebelius, secretary of Health and Human Services, to discuss changes in Arizona's Medicaid programs.

Sebelius has already told Brewer that the cuts the governor wants to make in Arizona's health-care program for the poor are up to the state to make, and federal permission isn't needed. With that, state officials say they plan to move ahead with cuts to save$541.5 million in state funding to balance the budget for 2011-12. That also would lead to a loss of $1 billion in federal matching money to the state.

Those cuts would:

• Drop from coverage 280,000 adults, many of them working in businesses that don't provide health care coverage.

• Affect up to half the patients whose doctors practice in rural areas, causing hardship on the doctors and rural clinics and hospitals.

• Cause the loss of 46,000 jobs in the state, most of them in the private sector, according to a study by Arizona State University economist Tom Rex.

To get perspective on it, we will seek to talk to several experts for Friday's program, including:

• Laurie Liles, president and CEO of the Arizona Hospital and Healthcare Association.

• One or more physicians whose practices and patients would be affected.

• Journalists who cover health care in the state.

FOR A LAWYER, HE WAS SUCCINCT

posted by Michael Chihak

Attorney General Tom Horne walked in for our interview appointment Thursday morning, sat in his assigned chair and had the microphone connected in quick fashion. Then, just as quickly, he answered a dozen or so questions and was done with it.

Quick handshake, microphone off, out of the chair, and he was gone. It practically took a crew member longer to dab the glistening spot off his forehead than it did for him to be interviewed. (Watch the interview video, and you'll see that the crew spent no time with the glistening spots on my forehead.)

His brevity seemed a departure to me from how he handled interviews in the past, at least the interviews I was in on. Perhaps he had other pressing business. Perhaps he said what he wanted.

The conclusion was a succinct interview, fairly easy to edit for tonight's episode of Arizona Week. Watch it at 8:30 MST on KUAT-TV Channel 6 in Tucson and at 10:30 MST on KAET-TV Channel 8 in Phoenix. It also will be on our Website, azweek.com, by 8:30 MST, and the unedited interview with Tom Horne will be there, also.

One interesting aside from the short time with Horne. As he was settling in and last-second camera checks were under way, he volunteered that his Spanish had gotten so good from lessons he was taking that he now conducts his interviews with Spanish-language media in Spanish.