Wednesday, January 27, 2010

Feds Match Local Indigent Healthcare Funds

The Standard Times highlighted $250,000 in Tom Green County indigent funds will go to Shannon Medical Center (SMC) and San Angelo Community Medical Center (SACMC). It reported:

County Judge Mike Brown said 81 percent of the funds will go to Shannon and 19 percent to Community.
Actually, the motion said up to $250,000.

Moved to approve the next Intergovernmental Transfer (IGT) pursuant to the Upper Payment Limit (UPL) Affiliation Agreement, to be reviewed quarterly utilizing 19% for Community 81% Shannon up to $250,000.00.

This agreement funnels local indigent care money to the state, where it then receives federal matching funds. In his second term President George W. Bush put a hold on expanding the program to Texas. Exactly when the arrangement began in Tom Green County is not clear from the minutes.

The Center for Medicare/Medicaid Services can multiply TGC IHC funds by 2.55. It returns the money to the state, which then gives it to the hospitals. That $250,000 could become $637,500, roughly half of the County's $1.2 million annual IHC expenditures in each of the last two years. Here's the split of those leveraged funds:

Shannon Medical Center--$516,375
San Angelo Community Medical Center--$121,125

In the late nineties and 2000 TGC spent an average of $1.7 million on indigent care, requiring hundreds of thousands in state support, aptly delivered by Rep. Rob Junell. Today's story stated:

Once indigent health care reaches 8 percent of the operating budget, which for Tom Green County would be about $1.4 million, then the state helps with the cost, Spieker said.

That hasn't happened in a decade. IHC has been a boon to Tom Green County's general revenue coffers from 2001-2009, contributing $6.3 million or $700,000 annually. Does the UPL deal have the county pulling back further, given the infusion of federal matching funds? That remains to be seen. It certainly wasn't heard.

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