Saturday, November 20, 2010

Federal Health Money Displaces Local Funding

The City of San Angelo joins Tom Green County in using federal health money to displace local funding. Tom Green County's Indigent Health Care Program leverages Upper Payment Limit (UPL) monies, while the City has Early Retiree Reinsurance Program (ERRP) funding. Both substitute federal dollars for local.

I had the opportunity to ask Mayoral candidates about health care in October 2009:

Jesus healed the people, not just his people. Health care reform legislation is front and center. Yet, national solutions to Texas’ legions of uninsured are at least four years away. Texas passed New Mexico as having the most uninsured years ago, clearly a badge of dishonor. In Tom Green County 23,000 people have no health insurance coverage. The vast majority reside in San Angelo. That data came from 2006, when our local unemployment rate was 4%. It’s now 7%.  How many are uninsured today? 25,000. 30,000?

The uninsured are at greater risk for debilitating deterioration from chronic disease, even for early death. Our country stands by as tens of thousands die every year, merely from their lack of health insurance coverage. Yet, at a recent candidate session held by Bishop Michael Pfiefer, health care was not identified as a critical local issue.

Congressional Budget Office projections show 25 million people remaining uninsured in 2018. San Angelo could have 14,000 without coverage, even five years after reform is implemented. This large problem is not going away in the coming decade.

The City has a health department and an employee health clinic. It distributes Community Development Block Grant money. Past CDBG funds supported primary care for low income residents. Shannon Medical Center, Community Medical Center, Esperanza Health Centers, ASU’s School Based Clinic, and the Tom Green County Indigent Health Care Program are your potential partners in making San Angelo a healthier place. Where is health care on your radar? What plans do you have in this arena?
Candidate John David Fields actually spoke to health care and the city's role at the WTOS Candidate Accountability Session.  Every other candidate showed a lack of interest or knowledge.  Alvin New fit into the lack of interest category, at least in my recollection.

The Mayoral pool presaged the City's ongoing abdication in the health arena.   Under New's leadership, Social Services joined other eliminated services, Primary Care Clinic (for public), and the City Pharmacy (which once housed pharmaceutical assistance).  All shifted to the private sector.

City leaders recommend contracting the employee health clinic to CareHere LLC.  City Manager Harold Dominguez noted two CareHere employees once worked for the City.  One set up the City's employee health clinic.  The other later ran it.  While CareHere approached the City, it's hardly the only company running occupational health clinics.  How many bids did the city get?

The City plans to pass 100% of health insurance cost increases to early retirees and workers.   Employees and retirees alone will fund the $1 million health insurance increase for 2011.  The City of San Angelo plans to save a projected $650,000 in ERRP funding for 2012.  Leaders will bank 19 months of ERRP funding before sharing any savings with early retirees and current workers.

Health care is a target on local radar, where federal monies displace local dollars.  County Judge Mike Brown is on record suggesting indigent health is a Medicaid, not county, responsibility.  Mayor Alvin New said "there is no new money" for City health insurance for 2011, completely ignoring ERRP.

Bishop Mike Pfeifer called government leaders together in September to discuss collaboration, doing so after sitting next to Mayor New during a flight  The Bishop spoke to the plight of the least of these, as he continues to do.

Currently, the City has 1,211 policies covering some 1,400 people.  How many will there be after the New Year?  How many dependents will join the ranks of San Angelo's uninsureds?

The City shed 100 dependents through greater cost sharing, during my time with San Angelo's Health Access Coalition.  State changes saw Tom Green County's CHIP enrollment fall nearly 50%.  Representative Drew Darby expects more CHIP cost sharing, the very thing that caused rolls to plummet.

How much pain will Round Two bring?  I hope Bishop Mike's Justice Lady is watching.

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