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County considers health care change

Fri, Jul 6th, 2007
Posted in Government

PRESTON - Social Services Director Thomas Boyd again discussed with the commissioners the possibility of joining Houston, Mower, and Winona counties in County Based Purchasing (CBP) at their July 3 meeting. In 1999, the CBP model of managed care was implemented under Minnesota statutes.

Statute 256B.692 states, "County boards or groups of county boards may elect to purchase or provide health care services on behalf of persons eligible for medical assistance and general assistance medical care...Counties that elect to purchase or provide health care under this section must provide all services included in prepaid managed care programs." The county board is the governing body and in the proposed multi-county program, the governing body would be a joint powers board.

Boyd presented statistics and estimated scenarios for over a five year period. The four counties would pay in a total of $2,000,000 with each county paying in their portion proportional to their population. The counties would need to work together since each of them on their own would not have adequate populations to make the program feasible. The initial investment would be reimbursed over time through federal payments. However, the reimbursements will not exceed what are determined to be reasonable costs for the county or region. The county will be doing a great deal of additional administrative work.

The statute requires the group to ensure covered services and provide a choice of providers and health plans. The county in essence would be acting as an insuring body.

The conclusion of the report was that it could be financially feasible only if there is a single competitor or a substantial competitive advantage allowing enrollment greater than 50% of the market.

Commissioner Chuck Amunrud explained that a private insurance company can pick and choose people more profitable to insure. The state mandates that the county must take care of all those who qualify for the programs. Amunrud noted that Fillmore County has a relatively high number of elderly residents. He added that other counties have already used CBP successfully and efficiently.

Boyd complained that the problem is that the state does not work with the counties as partners in the process, but see the county as a provider. Commissioner Duane Bakke stated that he has actually heard the county being referred to as "a special interest group." Boyd said that this needs to change at the legislative level. The county cannot be seen as a special interest group or an agent for the state, but rather needs to be seen as a partner.

Other Business

• After considerable discussion, the employment requirements of a paralegal were decided. The current employee qualifies because of her long experience. Any future applicants will need a minimum of an AA degree or four years experience as a paralegal. The position will be considered a Grade 6 as recommended by the county's consultant Robert Bjorklund. Prestby was the only vote against.

• Duane Bakke noted that the Planning and Zoning Commission will meet on July 19 and there is expected to be a discussion on the ordinance regulating campgrounds.

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