Where once community consternation and angst ruled the public dialogue about Manatee County payments for indigent health care, there are several not just encouraging but specific signs that civic leaders intend to gain the upper hand on this insidious obstacle. One new development, though, a consultant’s study, mostly delivers affirmation of familiar factors, that is, weaknesses in the county’s health care systems.
The economic drain on county resources has been painfully evident as the once deep-pocketed, multimillion-dollar trust fund earmarked for indigent care dwindled down to mere pennies. For several years, millions in taxpayer dollars have been reimbursing — only partially, not in totality — private hospitals and physicians for the free health care given to the working poor — not the homeless and jobless who qualify for Medicaid, but job-holders earning paltry wages who do not qualify for any federal or state government health care assistance.
This community has long known the day of reckoning was coming — an inevitable crash into a funding wall. That time has come. Too many years of community discussions, as agonizing as those have been, finally led to some solid and sound progress.
Here’s the newest advance, one with great potential toward diverting the medically needy into less expensive, appropriate health care: community paramedics. This new division of Manatee’s Public Safety Division is starting out small while the philosophy is large: prevent unnecessary hospitalizations (a huge cost in emergency-room admissions alone); lower hospital re-admissions (also wasteful of vital services), and, perhaps best of all, increase primary care access. The latter benefit would be a huge plus to residents rudderless on securing meaningful and preventive medical care. One of the most important missions of these new community paramedics is pointing residents in the right direction of available resources that now exist here in Manatee County.
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We don’t need to build a medical and mental health infrastructure. We have one. We’ve gnashed our teeth about that very thing, slighting all the health care programs here now:
We Care Manatee is an organization of volunteer physicians who provide free, quality medical care and referral services to low-income, uninsured and under-insured adults. Kudos to the doctors giving their time and talent. MCR Health Services (formerly Manatee County Rural Health) is a nonprofit with 25 healthcare centers, two mobile units, nine pharmacies and more. Kudos to low-cost and free health care for the underserved and uninsured. Manatee Memorial Hospital serves as the county’s primary safety-net hospital for the indigent. Kudos to writing off millions in free health care (and shame on the idea that private enterprise should bear the burden of a societal, public responsibility for caring for the least of us).
Then there are those physicians who have just joined Turning Points in the very needed effort to provide some weekly specialty care for the homeless and near homeless as well as all-day primary care. Adell Erozer, the executive director of Turning Points, announced this inspiring development just days ago. The specialists treat pulmonary, gynecology, gastroenterology and audiology. The daily primary care is a major boost to preventive medicine. Kudos to all those docs.
The $125,000 study commissioned by county government, issued just two weeks ago and designed to provide a blueprint for the development of a road map to health care for the uninsured county residents, did not yield any kind of Holy Grail. The consultants’ report, titled “Manatee County Health Care Plan for Low-Income Uninsured Adults,” could have been written by anyone familiar with the local scene. Some conclusions were indeed produced years ago by experts inside the medical community. For example:
▪ The county’s new community paramedicine program addresses several report recommendations, particularly in prevention interventions targeting behaviors that contribute to chronic disease.
▪ We have a deficiency in the number of doctors, and we need more primary doctors. We knew that so many years ago. That’s one of the reasons both Manatee Memorial Hospital and Blake Medical Center launched residency programs for doctors — in order to keep doctors here to reduce the physician shortage and boost the economic benefits those professionals bring, as proven by study after study.
▪ And, the consultants state, we need more mental health and substance abuse services for the uninsured. And better access to all manner of health care to the incarcerated. No surprise here. Centerstone of Florida and the Suncoast Behavioral Health Center are the county’s major mental health facilities, and their missions need bolstering.
▪ And we need to track data on the uninsured. This, ostensibly, would point to “achievable results.” We’re all for that tracking. It’s pivotal. How can we do that without running afoul of the federal privacy rule, as implemented by the Health Insurance Portability and Accountability Act of 1996? That rule does allow the release of certain information needed to provide and promote high-quality health care while protecting every individual’s health information.
The Manatee Healthcare Advisory Board, meeting for the 10th time several weeks ago, is yet another sign the county is pushing hard toward a solution.
The consultant’s report fails to identify a new revenue model for covering some of these costs. Moving forward, that will be the community’s tallest hurdle. With so many positives occurring, we’re confident that question mark will be answered.