Twenty-one Texas counties received approximately $5.1 million in state matching funds in 2005 to help offset the cost of indigent health care, said Jan Maberry, County Indigent Health Care Program (CIHCP) manager for the Texas Department of State Health Services.
The Indigent Health Care and Treatment Act of 1985 requires counties that are not completely covered by a hospital district or public hospital to provide basic health services to indigent residents through a county-run CIHCP; there are approximately 142 CIHCPs in the state. Each fiscal year, a county is liable for $30,000 or 30 days of hospitalization or nursing-home care per eligible resident, whichever comes first.
Once a county spends 8 percent of its general revenue tax levy (GRTL) on indigent care, the county can then tap into state matching funds, with the state paying 90 percent of all costs and the county paying the remaining 10 percent. If the department fails to provide state assistance funds, the county is not liable for payments for health care services provided to its eligible residents after the county reaches the 8 percent expenditure level, Maberry said.
This year, FY2006, the department has just under $5.2 million to dispense to county programs, a portion of approximately $11.2 million allotted by the state for the 2006-2007 biennium.
Trinity County has already tapped into state funds, hitting a 9 percent expenditure level in November 2005, said Andrea Musick, Trinity County Indigent Health Care Program coordinator.
Counties typically report to the state when they hit a 6 percent expenditure level, Musick said, which is about $39,000 for Trinity County. In October the county spent $29,111, and by November that number had jumped to just over $57,700, or 9 percent of the GRTL. The sudden increase was due to one client’s back surgery, the largest single expenditure to date recorded by the county program.
Trinity County is unique in that it is partially covered by a hospital district.
“We have to make sure that the clients fall under our realm of responsibility, as opposed to the hospital district,” Musick said.
Senate Bill 44
The eligibility requirements and services provided by hospital districts, public hospitals and county indigent health care programs will be the objects of study by a newly created Indigent Health Care Advisory Committee, mandated by the 79th Texas Legislature.
Senate Bill 44 required the executive commissioner of the Health and Human Services Commission to establish an 11-member advisory committee “to advise the commission on rules and policies concerning indigent health care services.”
The committee received several other charges including:
conduct a feasibility study and develop recommendations regarding the implementation of a pilot program for the regionalization of county indigent health care services and assistance and hospital district services and assistance; and
review and propose recommendations regarding the allocation method used for distributing state assistance funds and county reporting requirements and enforcement by the Department of State Health Services.
Taylor County Commissioner Stan Egger was appointed to the advisory committee.
“My role as a committee member is to keep an open mind, while helping my fellow members understand the impact of indigent health care on county services and budgets, and consider solutions and proposals,” Egger said.
The committee, which divided into work groups in December 2005, is scheduled to meet March 30.
The Health and Human Services Commission is required to submit a report to the Legislature by Nov. 1, 2006, detailing the recommendations from the Indigent Health Care Advisory Committee.
Julie Anderson, Editor