State kidney program failure 

Former Livingston Democratic Rep. Michelle Lee’s effort to recall Gov. Judy Martz failed to materialize (see “Total recall,” by Jed Gottlieb, Nov. 14, 2002). What have materialized, and gained steam, are funding concerns about state health and human service programs that gave Lee the recall idea in the first place. Most recently, a state program that assists 105 people suffering from kidney disease has exhausted its annual funding. Back when Lee was campaigning for the recall, this was one of the programs Lee claimed Martz wasn’t working to sufficiently fund.

“This could be an instant death sentence for some of these folks,” says Lee. “Without that state funding it is that dire. It’s just an example of how little the governor seems to care about these programs.”

The state-wide End Stage Renal Disease (ESRD) Program is presently notifying kidney patients, dialysis centers and pharmacies that it has spent its budget for the 2003 fiscal year and patients will need to look elsewhere for treatment help. Since very few of the patients enrolled in the program have private insurance, it is still in question where patients will find help. Some scramble to find pharmacies that allow deferred payments, others get assistance from drug companies. But with more and more people dependent on treatment each year, it’s getting harder to find creative solutions.

“I have ten more patients this year than I had last year,” says program officer Maxine Sharette. “And in fact, we have the same funding that we had in 1976.”

Throughout the program’s history, funding has not been increased from $200,000 per biennium—excepting a slight increase in the late ’90s, which was subsequently stripped in 2000.

“If you just figure the drug inflation alone, well, that’s been over 500 percent inflation since 1976,” says Sharette.

Of the more than 100 individuals in the ESRD program, all require drugs and 98 percent are covered only by Medicare. While Medicare usually covers dialysis, it rarely covers drugs. For most, drugs-and-dialysis is the one-two punch that keeps them alive.

The ESRD program typically runs out of funding in mid-year due to high demand, but running out this early is a first, says Sharette. Currently, the program’s $200,000 hasn’t been cut for next biennium, but the budget chopping is far from over in Helena.

Even if that $200,000 comes through, Lee considers a budget that runs out mid-year inadequate. She’s hoping the state will up its contribution to the program.

“I had no indication that it would come from the departments, the budget office or the governor’s office,” says Lee. “I am hoping that this would come from the legislative end and that both parties would put this as a priority.”

Lee retired from the House last year because she is a single mom and didn’t want to pull her son out of kindergarten to go back to Helena, but she says she’ll return eventually. In the meantime, Lee is watching the action from the sidelines and working with two independent groups—which she won’t name—that are considering seeking an injunction against the budget on constitutional grounds if health and human services programs aren’t funded at a level the groups consider humane.

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