Wednesday, November 28, 2012

Health Dept. to refuse non-locals

By Nick Tabor, New Era Senior Staff Writer 
Beginning in January, indigent clients who want contraceptives or cancer screenings won’t be able to get them from the Christian County Health Department unless they live here.
The alternative is for their home counties to sign a contract with Christian County before Jan. 1. They would reimburse Christian County for each service rendered, and the exchange could go both ways.

The policy won’t affect any services that depend entirely on federal or state funding. It will only apply to those that depend on local property taxes.

Mark Pyle, director of the Christian County Health Department, said residents of Todd and Trigg counties often seek services here. Those who don’t have insurance can buy contraceptives or cancer services on a sliding scale. Those with low enough incomes don’t pay anything.

Christian County residents sometimes seek services from health departments in those counties, but the volume is much lower, Pyle said. He announced the policy change Monday evening at a Christian County Board of Health meeting.

There’s nothing in state law saying the health departments have to serve anyone who comes in, regardless of where they live, he said.

Allison Beshear, spokeswoman for the Pennyrile District Health Department, which comprises Trigg County, said she hadn’t heard about this new policy before a phone interview with the New Era.

“This is complete news to us,” she said. She added that she’s willing to discuss the issue with Pyle. She understands the tight spot he’s in.

Jen Harris, director of the Todd County Health Department, said she hadn’t heard of it either. But it might cause problems for the residents of her small county, she said.

“There’s a reason why they’re not going to their own county health department if that’s where they live,” she said. “There may be girls, or guys, who are in need of some type of contraceptive or family planning service that they don’t feel comfortable coming to our health department for, because maybe a relative works here or maybe a family friend works here.”

Christian County Health Department’s budget is in trouble. Pyle estimates the revenue is down $192,000. Some of this comes from lagging reimbursements for contraceptives it has supplied. But the vast majority, $153,000, is delayed payment from the Medicaid provider Kentucky Spirit.

Kentucky Spirit is ending its contract with the state by July 1. No one can say yet whether the Christian County Health Department, and all the other organizations awaiting payments from the company, will ever get their money, Pyle said.

It would help the department’s bottom line to treat fewer indigent patients. In the 2010-11 fiscal year, the department spent $50,441 from local taxes to buy contraceptives and fund counseling related to family planning, according to financial records.

It’s only fair to this county’s taxpayers to restrict that money to local clients, Pyle said.

“We would love to be able to serve everyone,” he said. “But we have financial constraints that won’t allow us to.”

Pyle said health officials in Todd and Trigg counties are facing similar budget struggles, so they understand. So far their discussions of a contract haven’t gotten serious.

To further alleviate budget problems, the Christian County Health Department won’t accept Kentucky Spirit payments as of Jan. 1. This way Kentucky Spirit clients who already have appointments in the next six weeks can leave their plans intact.

The Lake Cumberland Health District Health Department, which covers 10 counties, is awaiting about $2.3 million in Kentucky Spirit payments.

In other business:

  •  Pyle outlined the new Community Health Assessment and Improvement Plan in significant detail for the board members. He reminded them of his promise that board meetings will focus more on public health now and less on finances.
  • Pyle announced St. Luke Free Clinic will hire a new director to replace Betsy Bond, who recently resigned. Because the health department will cut its formal ties with St. Luke next year, Pyle wants the clinic’s board to have charge of the hiring process.
  • Pyle said that whenever school nurse positions open in the future, he’ll fill them with registered nurses instead of licensed practical nurses. Because of a policy that took effect this fall, only RNs can bill to Medicaid. The health department currently has six LPNs in its schools, so it will lose about $6,000 in annual reimbursements because of the policy, he said. But it would be impracticable to replace the six LPNs in a sweep.
  • The health department has received two state grants — $100,000 for colon cancer outreach and colonoscopies and $39,226 for abstinence education. As usual, the department will pay Alpha Alternative to provide the education.

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