Role of Local Government in Healthcare

Meeting Notes, May 28, 2014

Session #1

What does funding mean?

  • County should not have a role in funding health care
  • For those that have no other resource
  • Taxpayers should not take responsibility
  • Feels individuals should have healthcare
  • State and Federal has enough funding
  • Believes taxpayers should help the people
  • County is in position to monitor and develop plan
  • Function is to protect local citizens.

Individuals (23,000) that do not quality

  • Are they all citizens?  Low end is covered by Medicaid


Yes, what is their expertise to carry it out?

  • Government should be a partner.  Are they a partner?
  • Government and community can contribute an amount
  • Community needs to contribute
  • Refer to model from 1968 (medical model)
  • Government has big role in making sure we can attract potential physicians
  • Waive cost for mental health in jails
  • Profile for the people who are not covered
  • Government play role in reaching out to all demographics
  • Rural Health - why is it not working?
  • Creating members of collaborative alliances creating solutions
  • Make sure government has providers
  • Government should play a role in educating individuals on healthcare
  • County governments should get a little bit stronger and not put things on the back burner


  • Welfare is key component of taking care of citizens
  • Should be left as individual choice and should not have a role
  • Government has to be involved.  Needs to be a coalition of people in community
  • Should find ways to make it more efficient
  • Addressing federal poverty guidelines.  Where can you get the information on the 200%-100%?
  • Rural Health Center in providing healthcare? (What?)
  • Find staff that can address the poverty guidelines
  • Who are citizens as opposed to healthcare provider here present at meeting to share their opinions
  • Constitution law – who is covered?
  • Questions tonight seem to address idea for county go come up with plan


  • Should accountability on every level of local government
  • Act as partner and act as leaders
  • Should identify and fill gaps where private and non-profit sector does not provide
  • Government should plan how they will fill gap
  • Role should be to management budget, not just watering how it is spent
  • Management budget/control money, i.e., for mental health
  • Managing county dollars
  • Group to plan and develop ideas and find gaps
  • Collect data/research/statistics
  • Partnership means hardship for physicians already providing free health care
  • Some should not be forced to pay through their taxes
  • Addressing Care of mental county citizens
  • Need strict criteria
  • Who is qualified as a citizen, criteria has been to laxed
  • Proof of residency
  • Duration of living in county  (Had a friend move from Mississippi asked to sign a residency affidavit when she doesn’t live in this county

Meeting Notes, June 3, 2014

Session #1

  • Should Government have a responsibility in healthcare
  • Use to have Department of Health  - Rural Health Care  - should partner with plan already in place
  • Local Government function to protect citizens budget is running deficit.  Where will money come from?
  • Already Agencies in community to catch those that fall through cracks
  • Amerigroup and Prestige are only two options.  What happens when county runs out of funds?
  • Sales tax not advertised enough last year
  • Government could help to reduce costs
  • Churches should be involved
  • Citizens on welfare should refocus what they spend their dollars on and develop budget to afford health care
  • Yes, Government should be involved in the tax.  No, they should not be responsible for developing programs.  Yes, Government should be responsible for qualifying individuals.
  • How many people are falling through the cracks?*A great number of homeless people
  • Government is not qualified and should not have a part in it
  • Only participate as a facilitator.  Government will just get in the way
  • Medicare is Government program.  Many people are satisfied
  • Alternate plans to cover indigent care

Session #2

  • Role is to hear what citizens really want
  • Civil society we have a duty to take care of ourselves
  • County has a long history of helping
  • Task force within the community needs to rise up
  • Government not equipped to handle/maybe facilitate
  • More confident in local leaders than those in Government
  • Not everyone needs to be cared for by County forever
  • County should act as a safety net
  • How do you care for those with chronic illness?
  • Mental health an issue as well as homeless population
  • Government programs to help citizens get back on their feet
  • Assist in helping  citizens get signed up
  • Before County begins plan locally, need to fully understand Federal programs
  • Could possible supplement fee schedule to make it more comparable to Medicaid for physicians
  • Medicare claims are a part of some fraud.  This is Government in action
  • Commissioners should have a plan in effect by the next budget cycles
  • Reason why money has been depleted?
  • Offer citizens an incentive plan
  • Opportunity now that funds are depleted to develop a plan as a community Does the community have an approach?

Session #3

  • Government has a role in addressing issues that affect citizens.  They should not be responsible for addressing it alone
  • Community should be helping Government
  • There is a mentality of entitlement.  County has reputation of entitlement
  • Government should identify problem
  • Elected officials/stewards of tax payer $ doesn’t seem that it is taken serious
  • Better accountability  - Government/providers/citizens
  • How Government can control costs/accountability.  Seems Government aren’t doing
  • Develop proposal
  • Government should create science based curriculum to educate teachers
  • Not enough thinking outside the box
  • Doesn’t trust Government.  Government not being held accountable
  • Will this go any further than just conversation here at the Forum?
  • Government needs to take a hard look at what is being provided by hospitals, to the indigent as opposed to the Government
  • Obama Care should take care of all the indigent costs
  • Hospital is a great place to cover primary but should be a partnership with Government to address costs
  • What needs to be provided is family practice within County.  Running out of providers
  • Concerned the County is stating that it is a forced charity
  • Hospitals should look at it as an out of the box
  • Convening the public in a safe setting on topics that impact all residents, business and communities providing information, resources and research on topics