Copyright 2000 The Houston Chronicle Publishing Company
The Houston Chronicle
September 13, 2000, Wednesday 2 STAR EDITION
SECTION: THISWEEK; Pg. 1
LENGTH: 994 words
HEADLINE:
Improving indigent health care ;
County task force to
address issue
SOURCE: Staff
BYLINE: BETTY MARTIN
BODY:
Galveston County commissioners have asked an advisory committee to develop a
plan to meet indigent residents' health-care needs.
The
Indigent Health Care Task Force will focus on addressing the
plight of the estimated 250,000 county residents who can't afford medical
services.
Providing comprehensive, quality managed care to poor and
uninsured residents will be expensive, County Judge James
Yarbrough said.
But he predicted the committee - which includes elected
officials and health-care professionals - will reach a more
effective solution than the county's previous short-term remedies. "Sometimes, a
crisis has to be created in order to get good, long-term solutions," he said. "A
lot of times, we Band-Aid our problems. We throw a little money at it or make a
little change here or there."
The committee will be guided by the
Galveston County Medical Society, which had suggested forming the group.
The task force, led by Dr. M. Reza Jahadi, will coordinate efforts with
the county's health-care agencies.
Yarbrough said he hopes the committee
will address cost factors in realistic terms as it examines how the county will
organize and provide health care to the uninsured and indigent.
"I
certainly hope the committee will do its best effort to give us base-line data -
what populations are out there to be served, what the projected costs are for
these areas," Yarbrough said. "We can't just go out there and create several
millions of dollars overnight."
This spring, commissioners learned that
the county's health-care costs were projected to total $ 4 million for the year,
which is $ 2 million over budget. They reduced indigent eligibility for
non-primary care needs from the federal poverty level of $ 8,350 to $ 1,420 - a
cut of 87 percent.
Eligibility for primary care, such as is provided by
family physician, was left at the federal poverty level. But eligibility was
reduced for other types of care, including that provided by medical specialists,
at county hospitals and clinics.
On June 19, medical society members
recommended to commissioners that the county create a hospital district to serve
indigent residents.
Other recommendations were that the district
coordinate its work with public and private health-care providers and conduct
annual audits.
In a printed statement to commissioners in June, the
medical society suggested that the district provide health services on a
sliding-fee scale to eligible residents. The statement also said the district
could issue bonds and assume responsibility for contracted county agencies, and
have access to state, federal and tobacco-tax funds.
Yarbrough said he
would like to see the task force develop a model for health care similar to a
plan in Hillsborough County, Fla., for indigent health-care delivery.
The Hillsborough model was created 10 years ago when that county faced a
17 percent annual increase in the cost of treating the poor. The county joined
for-profit and non-profit hospitals, private physicians, government clinics,
dentists and ambulance services under a single umbrella, an agency funded by
sales- and property-tax revenues.
The county and the advisory board
administer the plan.
"What made the Hillsborough model work was the
ability to get part of the sales tax out of the legislature," Yarbrough said.
One of the designers of the Hillsborough model has expressed interest in
helping Galveston County in create a similar plan, Yarbrough said.
Before April, the county's indigent health-care program provided care
through the Galveston County Coordinated Community Clinics, known as the "4Cs,"
to county residents at 100 percent of the federal poverty level. The 4Cs,
budgeted at $ 3.5 million, cannot refuse treatment to anyone because of income
level or ability to pay, since they are partially funded by federal money.
The April cut by commissioners court reduced from about 9,300 to 640 the
number of residents who could receive other than primary care from the county
through its contract with the University of Texas Medical Branch and with the
Sisters of Charity-run Christus Health Gulf Coast Region.
The
commissioners decided to cut back on health-care eligibility after the Christus
system announced that while it would continue to run its two main hospitals and
several community outreach programs, it would shut the doors of St. Mary's
Health Center Oct. 1 and stop its annual $ 850,000 allotment to the county for
operating the facility.
During the June workshop, Dr. Kirk Calhoun,
UTMB's corporate medical director, said because of recent federal cutbacks in
its employment and services, "UTMB has had to take actions to ensure its
survival."
He said the task force recommendations could provide "an
entity the county can turn to."
According to information from the
medical society, the 1999-2000 budget for indigent health care in Galveston
County is $ 5 million, less than 5 cents per $ 100 of taxes. In Harris County,
the tax rate is 15 cents per $ 100, while in Dallas County it is 19 cents per $
100, according to a medical society handout.
Of the 22,000 who went to
one of the county's 4C clinics for primary health care or dental care in 1999,
95 percent were at 200 percent or less than the federal poverty level, 67
percent were at 100 percent and 80 percent had no public or private insurance.
More than 30 percent were from Texas City; 29 percent were from
Galveston, 10 percent from La Marque and 6 percent from Hitchcock.
Task-force members will include state representatives and senators who
represent the Galveston area. Physicians on the board are George W. Cox, Ben
Raimer, Bryon Bailey, Kirk Calhoun, Robert Matteson and Ralph Morris.
Medical administrators and community leaders in the task force will
include John Konikowski, Chuck Doyle, Izola Collins, Mary Harvey, Fushsia
Elliott, Tedd Olkowski, Doug Frazier, Kevin Tilman, Maura Walsh, Charles Kelly,
Jan Coggeshal and Susan Steudebaker.
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November 20, 2000 
