HomeMy WebLinkAbout04-20-2000 Meeting
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INDIGENT CARE
SUB COivllv1ITTEE
COMNUTTEE ROOM - April 20, 2000
3:30 P.M.
PRESENT: 1. Brigham, Chairman, L. Beard, A. Cheek, members, Dr. F. Rump, Director
Health Dept., L. Johnson, Director DFCS, 1. L. Read, C. Lunsford, R. Taylor, D. Belkost,
E. Burr, C. Slade, University Hospital, E. Doss and D. Hooten, Rural Metro, C. Alpin,
DFCS, D. Jones, Gracewood SSH, E. Guilfoye-Wehma, AMCC, L. Bonner, Clerk of
Commission.
ABSENT: R. Colclough, member.
ALSO PRESENT: S. Eidson, Metro Spirit, G. Eskola, Channel 6, T. Corvin, Augusta
Chronicle, C. Wilson, concerned citizen.
Opening remarks - Chairman.
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I think the Commission has charged this committee with looking at Indigent Care
and what the governments role in indigent care is going to be. I'm not sure of what that
role is, when we finish with our series of meetings and committee hearings we will make
a recommendation back to the Finance Committee which will in turn make it back to the
Commission. I want to avoid the breakdown that we've had the last several years in the
budget process the way we let indigent care drive our budget process. I want us to come
back with a recommendation to the Finance Committee as to what the role of this
government needs to be in the way of indigent care. I told Mr. Reed this yesterday and
these are my feelings, it does not necessarily mean that ~e're going to write a check to
the University Hospital, but it does not necessarily mean that we're not going to write a
check to the University Hospital. I asked Dr. Rump to be here today because I think
public health needs to be involved in that and I'm looking for Ms. Johnson from DF ACS.
We have a simple agenda. The next thing that we'll probably agree to is that we will
meet again. I don't look for this to be a short process. I don't look for it to be an overly
long taxing process. I hope to have a decision prior to July or August as to what our role
will be so that we'll have plenty of time to factor this into our budget process.
Discuss subcommittee's goals and objectives.
Mr. Brigham: Some of the goals and objectives that I'm looking at for this
committee are: (1) I want to look at the way the clinics are operated, (2) whether or not
we need to participate in them. (3) I'm very interested and I thank Ms. Slate for
arranging a visit to the Westside Urban Health Center in Savannah. we'll do that in June.
We want to look at the way some other communities are dealing with indigent care. I'm
looking for input not only from my Committee members but also from the public as to
what the public wants to see in indigent care.
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Mr. Beard: I would like to make a general statement and I make that statement I
guess because of the district that I represent in this city. I understand what you're saying
and agree with most of what you've said here in that we need to come up with some types
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of methods of assisting and funding indigent care. As I read literature and look over
things, I realize that a lot of people in the 30901 area don't have the means and method of
getting or receiving health care, and we have a lot of people out there. I think between
the two bodies of people who are service providers of health care and also the
government, we have an obligation to see that these people receive the best health care
that we can afford. What I would like to see is somewhere down the line the people that
are involved in health care give us some methods and some means of how we should
support them in this endeavor. We have to understand that the government nor those
providers of health care can fully extend this to all of our citizens as individuals. But I
think as a body coming together and working together with the mental power that I is in
this room we should be able to come up with something that would provide our citizens
with the proper health care.
Mr. Cheek: This is a problem that we all share. It doesn't just involve the hospital
and the poor folks this is a common problem in all the cities in this country. I would like
to see us look at all sources and try to come up with a solution to this problem. MCG the
Health Department, University Hospital, who ever we can bring to the table to help us
solve this problem to look at other funding sources from the state and federal government
possibly or private sector any where we can find additional funds to help fix this problem.
To look at what other cities have done, what has failed and what has succeeded.
Mr. Brigham: Ms. Johnson, can you define the word indigent and give me some
idea of what percentage of our population that we're talking that fits this criteria.
Ms. Johnson: Carrie McAlpin is the indigent care supervisor for the DFCS office
and she will give you those figures.
Ms. Alpin: I really can't say what percentage of the population you would
consider as indigent but I know from 1995 which is when DFCS took over the indigent
care program up to the current time the applications are increasing. There are a lot of
people applying that are not eligible due to their resources. One of the criteria is that
their resources not exceed $1500. There are also people that do not meet the residency
criteria of six months that are being denied. A lot of the people that we are seeing are
not, I guess most people would think that there are like homeless people, those people
that are not working, but we're seeing people that are working everyday. We see people
that work everyday and because insurance premiums are so expensive they cannot afford
the coverage. These are people that work everyday making maybe $150 to $200 a week
and still have no coverage.
Mr. Beard: I'm glad you brought that out because that is a factor that most people
don't understand. And you're correct that when you talk about indigent care, the
majority of the people think that these are people who are not trying to help themselves,
not making any contributions to the city and these people are.
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Ms. Johnson: Currently we have 459 active indigent care recipients. Since we I
started in 1995 there has been 12,476 applications taken. The number approved has been
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small since that time is 3,924, 10,683 have been denied, 35 have been revoked in terms of
individuals not fulfilling all of their obligations, in terms of not bringing their paper work
back and applying for other benefits.
Mr. Brigham: Jim, is there a state definition in the code anywhere of what an
indigent person is and is our criteria that we have outlined in accordance?
Mr. Wall: I'm not sure I can answer that question off the top of my head. There is
a provision dealing with indigent care trust fund, whether it defines indigent, I'm not
sure.
Discuss possible funding sources for Indigent Care.
Mr. Brigham: I'm trying to make sure that we cover our entire basis and I know
that this is going to be debated in other places and I want to be sure that we are being
consistent.
Mr. Taylor: That definition is used in the state of Georgia to define access to
Medicaid/Medicare. Georgia at the state level has chosen to use the federal criteria. For
Peach Care for instance, they use a multiple for access to peach care they use something
like one hundred eighty-five percent of the poverty level as family income in order for
folk to qualify for the peach care program.
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Mr. Brigham: I think from the discussion that we'~e had already you all can see
what we're trying to do. I want to lay a thought pattern out on the table and I would like
participation. I want to involve this community in making a decision in what this
communities level of indigent care is going to be. I want that decision, once we decide
what's its going to be. I want us to decide how we're going to fund it. I know that we
can't continue to do what we've done in the past. Each entity at this table has budget
constraints. Being in government we all know that our constraints are going to get tighter
each year. I'm looking for a solution that we can agree to.
Mr. Beard: I was reading some of the material from the state level and it appears
that this is a state problem. I'm wondering, because a lot of this that will affect us will
affect the state, is it possible that at our next meeting we can get some of our
representatives or someone from the state to come in?
Mr. Brigham: I agree with you. I'm not ready to do this now. We will have to
bring some of the representatives in. I want to hear from some of the state agencies that
deal with Medicare benefits.
Mr. Beard: It appears that the Medicaid and Peach Care will be sources of funding
from the state level.
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Mr. Brigham: I think if we find people that qualify for Medicare when they apply
for this process, we're making sure that they get their application in.
Mr. Beard: The numbers that were given a few minutes ago means that a lot of
people are not benefiting from this. When you talk about the number of people that
qualify, what is happening to the six or seven percent of the people that do not qualify as
indigents?
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Ms. Alpin: Those people are being seen by University Hospital. They don't deny
anybody, but those people are being billed. Whether the University is being paid or not is
the question. Because those people that are not eligible for indigent care and still receive
services. Some of the people that we see in indigent care are those people that would not
qualify for MedicarelMedicaid. Because they are basically adults from age nineteen
through sixty-four that are not elderly or disabled, they have no children so they will not
qualify for any of those other Medicaid programs.
Mr. Brigham: We will not get into funding today, but I would like
recommendations on funding from any group that wants to give us a recommendation.
Not only do I think we need a meeting with some legislatures I think we'll end up with a
citizens committee to extend our reach. I think all we'll do is provide guidance. The
next thing I think we need to do is set a date when we'll try and come back and have
some ofthis written as to what we're going to try and do. I think we need to meet at least
twice before we visit the clinic in June.
Other business
Site visit Westside Urban Health Center, Savannah, Ga.
Monday, June 26 at 4:30 p.m.
With no further business to discuss, the meeting was adjourned.
Lena J. Bonner
Clerk of Commission
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