Rio Arriba County officials may have a hard time providing certain services for the County’s less fortunate residents. A new state law mandates the County divert a portion of its gross receipts tax to help fund the state’s Medicaid expansion.
County Commissioners unanimously passed an ordinance that redirects one-twelfth of the one percent of the sales tax the County collects, to fund the indigent program to pay for the state’s Safety Net Care Pool Fund.
The County originally set up the Indigent Program in conjunction with the state’s Indigent Hospital and County Health Care Act. The purpose of the law is to help support indigent patients by providing funds to sole community provider hospitals such as Española Hospital, Christus St. Vincent and Los Alamos Medical Center, to pay for the county-supported Medicaid Fund pursuant to the Statewide Health Care Act.
The commissioners passed the law in conjunction with a provision of the recently signed Safety Net legislation requiring county governments to adopt an ordinance transferring one-twelfth of the gross receipts tax a county collects to support hospital services.
County Manager Tomas Campos said he doesn’t understand the logic behind Gov. Susana Martinez’s legislation.
He said the new law forces the County to pass an ordinance redirecting one-twelfth of the County’s gross receipts tax to fund Medicaid, but he explained the law was not necessary because the County’s indigent program already helps eligible area residents cover medical and other expenses.
“Taking one-twelfth of our one-eighth tax and using it to fund Medicaid is something that the County was handling and handling it adequately,” he said. “We still don’t understand at this state, the logic and the purpose of this ordinance deviating the one-twelfth tax.”
Rio Arriba County Human Services Director Lauren Reichelt said the governor’s legislation creates uncertainty for Rio Arriba and the state’s other 33 counties. The new Safety Net Act effectively absorbs the majority of the $500,000 indigent fund, leaving just about $166,000 to cover the cost of indigent burials, inmate healthcare and health care for senior citizens with high co-pays for Rio Arriba County residents.
It is unclear what type of impact redirecting the gross receipt tax will have on the state’s remaining 32 counties.
Reichelt said she is in the process of scheduling meetings with Española Hospital Administrator Brenda Romero, in an attempt to find a solution for what her office sees as the unavoidable problem of not having enough money to provide much-needed services.
“I spoke with Brenda Romero (Española Hospital administrator) last night and she’s aware of the impact to us,” she said. “I spoke to her specifically about providing nursing and other services in our jail.”
She said she and Romero also have a meeting scheduled with the Presbyterian Healthcare Services official to discuss ways to reduce the impact the legislation will have on both the hospital and the County. The goal of the meeting would be to explore the various options and cost structures for providing medical services to the County’s indigent citizens.
But before any of that happens, County officials must figure out how many people will not be covered under the new state and federal rules.
“First we have to figure out how much money we have and which of the residents will not be covered by the new Medicaid rules,” Reichelt said. “We also covered certain services with that, such as medical direction for the ambulance services, medical care for our inmates.”
The governor’s decision to expand Medicaid as part of the Affordable Care Act known as Obamacare, allows approximately 150,000 uninsured New Mexicans access to health care.
Campos said the funding shortfall creates a need for reviewing the County’s policies regarding the indigent fund.
“What we have left is a losing proposition and how we are going to cover our needs with the small money left,” Campos said. “State statute still makes us responsible for the indigent — that hasn’t changed. We took a hit from $500,000 to $166,000.”
The Safety Net Pool will be administered through the Human Services Department and will consist of public funds transferred from the counties, so the Human Services Department can make payments to qualified hospitals, according to an agreement with federal Centers for Medicare and Medicaid Services.
The ordinance will take effect July 1 and dedicate one-twelfth of the taxable gross receipts tax from the previous fiscal year.
In her memo that accompanied the signed legislation, Martinez acknowledge that her plan raises about $24 million, which leaves a $10 million to $11 million shortfall to pay for the $36 million legislation.
This shortfall could mean hospitals receive less money to fund the program.