The Grant County Commission continued its meeting by adjourning and reconvening as the Grant County Indigent and Health Care Claims Board.
Beth Allred of Gila Regional Medical Center explained to the commissioners and the public the process of funding what is called the Grant County Health Fund.
"Several years ago, we recognized the negative connotation to the word indigent, so we changed the name," Allred said. "The fund was formed in the 1980s for the 'working poor.' The voters of Grant County approved a small piece of the gross receipts tax, which goes into the Health Fund.
"We made an arrangement with the county, since the hospital is county-owned, so that when requests for funding outstrip the county portion, we can match the funding," she continued. "We have been able to grow the fund."
Qualifications to be eligible for the fund include being a county resident for at least 90 days. The income level for eligibility changes annually as a percentage of the federal poverty level, Allred said.
After a person has services at the hospital, he or she will see the staff at the business office, where proof of residency and proof of income will be processed. The designation as qualified is good for one year. The forms are also on the grmc.org website. The person submits the bill back to the hospital and the hospital creates the forms to fill out.
"We send the payment to the state; the state sends it off to Medicaid," Allred said. "Medicaid money supports the claim."
County Manager Jon Paul Saari asked Allred if GRMC has already incurred the loss, and the funding offsets that loss partially.
"Yes, we are being paid for services we have already performed," Allred said. "Between the indigent fund and bad debt we incur about half a million dollars a month. So we provide each month about $1 million in services with no insurance."
Commission Chairman Brett Kasten said: "So you, through this fund, are paid about half the debt."
Saari said the gross receipts tax portion that covers the indigent fund is two 1/8ths and one 1/16th, with another 1/8th available, but it would require voter approval.
"The hospital also gets several supplemental payments a year because some communities cannot meet the match," Saari said. "I ask people to talk to the representatives and senators, state and federal, not to make changes, because that would be detrimental."
Allred said the hospital sits on the Human Services Committee. "Things are on the table and changes are coming. It's good to be proactive. Our match is usually about 40 percent, but it fluctuates. If we send a patient to another facility, we get some reimbursement."
Kasten asked if other hospitals ever reimburse Gila Regional for patients treated from elsewhere.
"Rarely," Allred said.
Saari said Mimbres Memorial Hospital in Deming asks Grant County for $70,000 to $80,000 annually, but doesn't ask for payment of claims.
Allred said through statute the hospital can also pay struggling physicians. "We developed an agreement, under strict regulations, to pay physicians partially for services at the hospital."
Commissioner Ron Hall, who had asked for the explanation, thanked Allred for her presentation.
Kasten asked about the process for determining whether a patient is deserving.
"We have two people in the business office who do the process," Allred said. "It's a rigorous qualification process. Once a person has service, the individual visit has a number, and we use no names because of the (Health Insurance Portability and Accountability Act – HIPPA) requirements. It's a multi-step process, with as many internal controls as possible."
After commissioners reconvened as the Board of Commissioners, they heard county reports.
Sheriff Raul Villanueva had no report.
Assessor Randy Villa said he thinks the D.A.R.E. program is great, but "I'm concerned that there were a lot of females, but only one male."
Villa explained that if a veteran has an existing exemption for property taxes, there is no need to reapply. However, those 65 years of age and older must reapply each year because of the need for proof of household income.
Treasurer Steve Armendariz thanked the voters who voted for him. "Our office stands ready to serve all residents and property owners. We continue to have issues with mobile homes. People are not rendering on an annual basis." He said the issue will be discussed at the upcoming New Mexico Association of Counties Treasurers' Affiliate. He pointed out that there is a difference between mobile and manufactured homes.
Clerk Robert Zamarripa said early voting for the school board candidates would begin in the Clerk's office on Friday, Jan. 11, from 8 a.m. -5 p.m. Early voting ends Feb. 1, and Election Day is Feb. 5.
Saari announced a special meeting tentatively set for 5:30 p.m. Monday, Feb. 4, to look at the sole community provider issue and for an update from the Forest Service on the Travel Management Plan.
No second meeting of the County Commission will be held in January, because of the legislative session.