Healthcare Plan

Meeting Notes, May 28, 2014

Session #1
 

  • No primary system – ER – Preventive Care
  • Plan needs to get people in to a primary plan
  • Who screens the people?  How?  Income based
  • Integration need expand RHS – to meet needs of everyone
  • Better job private and public sectors save $
  • People without insurance – provide a co-pay to generate $
  • Nothing in place for special services, like dialysis needs
  • Why don’t government entities go into a self-insured mode?  Sarasota Memorial did this
  • Can we have another MCRHS or One Stop Center that is not as overburdened, Manatee Glens?
  • Private practice pro-bono assistance
  • We need a well-defined action plan that covers indigent care patients
  • Define what to pay for and cost (Medicaid level)
  • Better job lobbying legislation

Session #2
 

  • ER for indigent care?
  • Study to provide suggestions?
  • Study needs to be done by tax payers?
  • MCRHS – Federal, State, County Clinics – Where is the problem? Capacity?
  • No Medicaid services at PHD
  • People coming from other counties to MCRHS for services
  • People not in poverty have trouble affording health care
  • Affordability/Accessibility to health care
  • MCRHS – not what people think it is – it is a for profit business
  • Heath Care Task Force – other group – North County plan: sliding scale shot down, needs to be looked at again
  • Where does the affordable care act fit into this?

Session #3
 

  • Plan has to have accountability
  • Assess the needs to determine need
  • Plan to ask providers how to take care of patients – health care preventative
  • Who is going to pay for it?
  • Do it ourselves or send our Rep to the community?
  • Needs assessment agreement – needs how to address them – accountability
  • How much of 24 million?
  • Section of the public that we need to take care of don’t qualify for Medicaid
  • Want to see what next year looks like
  • Health care plan look at whole community
  • Look into the affordable care act – where is it going
  • One stop clinic
  • Doctors can’t provide free health care – continuation
  • What is the funding source
  • Health care needs proper reimbursement
  • Work group think tank – preventative primary care – need a patient contribution

Session #4
 

  • When funds run out – tax payers should not give to the profits of the hospitals and not be forced to pay for indigent
  • Use 15 million remaining – place in a fund for inmates – bare minimum of the law
  • Plan based on need – where is the need – look at the best practices throughout the world – look at long term issues
  • Prevention and accountability – physician costs shop around
  • Patient accountability to take care of themselves – personal wellness
  • Don’t cure – treat symptoms – refer out for treatment
  • No charities can help currently
  • Government should not have a role in health care
  • Don’t need a plan
  • Need to control health care costs

Meeting Notes, June 3, 2014

Session #1
 

  • What is mandated?
  • Stop the contract – No renewal or extension, no renegotiation, no new agreement.
  • Funds left over
  • Should formulate a written action plan for community.  Public is uninformed about Health Care.  We have a spending plan-need an over reaching plan.
  • Piggy back with Health Dept to see what we need to do.
  • Polk County/ Miami Dade Plans- Need to look at.
  • Metrics on negative impacts of not being insured.
  • Head start Model of a Medical Home- outcomes
  • Levels of care- preclusions – without County Assistance Program didn’t qualify
  • Cases need to prove medical need-qualifiers

Session #2
 

  • Don’t want Health Care fund to continue
  • Don’t give funding to For Profits
  • Don’t force people to fund this
  • People can’t afford preventative Health Care.  We will pay either on the front end or Back end.  Rather pay for prevention than on Backend $.
  • Charitable care - Taxpayers don’t need to pay.
  • Plan need prevention
  • Needs assessment is needed- Researchers.   Top 5 or 10 then chip away over time.
  • Emergency Rooms are inundated.
  • Need attentive Providers – Don’t have just 3- Emergency Care is not free - people are not going until on death bed, desperate for care.
  • Plan – Continuum of Care, Home Health, Pharmacy.
  • Rural Health is a business
  • Transportation is a major part of a plan.
  • Who are we planning for?  Indigent can have enough and Medicaid free.  How much you pay to providers?
  • Effective way to tell who is indigent
  • How you qualify people?

Session #3
 

  • What kind of plan are we operating from now?
  • There is contractual obligation
  • The current plan is a Crisis Plan – Default needs to say how we are going to get beyond crisis.
  • Incorporate how do we help our citizen’s wellbeing as a whole?  Starting point for community/county.
  • Who are you planning for?  Indigent not me.  200% is not my definition.
  • What is the definition of Indigent and what should they be charged?
  • Who is going to pay for the plan?
  • Start at the end – what is the goal – 5year/10 years?
  • Define the problem – is it a system managed by the County?
  • County needs to say – this is what the focus is.
  • Ways to push people away from crisis – hospital.  Less expensive diversion.  Urgent Care Clinic.
  • Need a list of providers and prices
  • Rule if going to participate – need to follow rules.
  • Learn from other counties – what is working
  • Community needs to participate
  • Government could encourage private providers to do after hours, tax breaks.