Hays County approved payments to Central Texas Medical Center (CTMC) in accordance with its Indigent Care plan during its August 22 meeting.
The county approved a motion to pay $900,000 to CTMC, part of an annual two million dollar agreement established in 2011 for the county’s indigent care costs.
“Hays County was approached by CTMC in 2011 regarding the Upper Payment Limit (UPL) program,” said Lon Shell, Hays County Chief of Staff. “The UPL program allowed a governmental entity to affiliate with a local hospital; in the affiliation agreement the hospital agreed to perform some level of indigent care in the community.”
The process was initiated by using the Texas 1115 Medicaid Transformation Waiver, which allows the state to expand Medicaid managed care while preserving hospital funding.
“Around the time Hays County and CTMC were discussing the affiliation, the State of Texas and the federal government were negotiating a waiver that would soon assume the UPL program,” Shell said. “In 2011 the state passed legislation providing that claims for Medicaid services would be covered by managed care companies. Once managed care was incorporated state-wide a new waiver was necessary. “
Funds used for indigent care claims and funds used for the operation of the Hays County Health Clinic could be matched and used for improvements to healthcare for indigent and uninsured citizens.
“CTMC would establish the Community Clinic that would become a ‘medical home’ for many un-insured residents,” Shell said. “Matching funds would be used to not only increase healthcare services, but improve the delivery of healthcare services. “
Hays County no longer operates the clinic, but the county maintains responsibilities for indigent program enrollment, operation of the TB clinic, administration for Department of State and Health immunization services, and responsibilities in emergency preparedness and epidemiology, according to Shell.
CTMC continues to pay indigent healthcare claims as proposed during the development of the UPL program.
Through its affiliate, Live Oak Health Partners, CTMC began operation of the well child clinic, women’s health clinic, and the family clinic on Jan. 1, 2013.
“CTMC’s operation of the Community Clinic has brought efficiencies to and improved the delivery of healthcare services for the uninsured citizens of Hays County,” Shell said. “CTMC is able to utilize its existing resources to help improve clinical services through the use of electronic health record systems (EHR), access to primary and specialty physicians, access to labs, and the overall knowledge of a professional organization with many years of experience.”
According to Shell, combining tax dollars with CTMC’s resources also helps to serve a population that would otherwise use expensive ER services for basic healthcare needs.
Indigent residents who are able to use clinics instead of ER services decrease the tax payer’s financial responsibility.
“Even though our population and health care costs continue to grow, by using 1115 DSRIP and UC funding, Hays County has been able to fund statutory indigent healthcare costs at the same level since 2011,” Shell said. “During the past year we have added over 200 indigent residents into the program. The county’s responsibilities for indigent health can be found in Chapter 61 of the Texas Health and Safety Code. “
