Tuesday, October 11, 2011

TGC Indigent Health: History Rewrite

Texas County Progress has a teaser on Tom Green County's Indigent Care Program, specifically collaborative efforts that helped the county spend money more effectively.  It reported:

In the spring of 2002, Tom Green County staff helped organize a Health Access Subcommittee. The subcommittee met approximately once every six weeks to discuss local health care problems and find resolutions for those problems within the committee. The subcommittee consisted of the local chief executive officers and chief financial officers of the two local hospitals, the administrator to the federally qualified health center, the social services director, pharmacists, physicians, the Health Foundation chief executive officer, county commissioners, the county judge, and the director of indigent health care. Together, the subcommittee was able to remove barriers in communications between organizations and better coordinate benefits for indigent health care clients, in addition to understanding the educational and financial crises of the impoverished of our community. 

Unfortunately, time may have clouded the author's memory of events. San Angelo's Health Access Coalition was formed in 1999.  It had three subgroups, Access & Financing, Health Promotion and Data/Information.  The Access/Financing subgroup offered to help the county, which consistently overspent its budget the prior three years.

Community leaders, especially Shannon Medical Center's Vice President for Legacy Insurance, provided specific recommendations for stretching dollars further.  This included covering nurse practitioners (in addition to physician assistants), paying for outpatient surgery vs. one night surgical hospital stays, and paying FQHC services vs. expensive ER visits.  Leaders also recommended searching for other payor sources for patients who might be retired military or have access to other benefits.

The vision and goal for Tom Green County Indigent Health Care was to provide all eligible clients more primary care and specialist services, as well as additional optional health care services, while lowering Tom Green County expenditures.

My recollection of the vision and goal was to spend money more effectively so more people could be covered with the same resources.  The HAC hoped income eligibility would increase from "the poorest of the dirt poor."  Instead the program has become Tom Green County's cash cow, replenishing reserves on an annual basis.  As the facilitator and minute taker for all HAC subcommittees, I want to be on record with a more accurate version of history.

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