Commissioners move forward on expanding indigent care

BRADENTON - It's about integrity and dignity, County Commissioner Carol Whitmore said Tuesday in pressing for the expansion of indigent care.

That's why she wants to see funding for indigent care expanded to include outpatient IV and chemotherapy, she said, noting that one of her husband's patients lost her job, health insurance, home, had to leave the state and had to stop getting treatment for cancer. "Chemo and dialysis, you either die or the hospitals pay for it," she said.

The expanded payments would cost the county $400,000 from its Health Care Fund, said Fred Loveland, the county's Community Services Director.

The fund has $48 million, but it will be exhausted by 2015 as more people are declared indigent in the next few years and medical costs continue to rise.

Moody Chisholm, the CEO of Manatee Memorial Hospital, said he's seeing increasing traffic from local people who have lost their job and health coverage, lack the money to pay for services and cannot qualify for Medicaid.

He said he's seen people in their mid-20s with leukemia, for example, and has approved treatment even though they can't pay, and said he thought the voters might agree with that approach.

"I didn't get into this business to turn away a 26-year-old who needs chemotherapy," Chisholm said.

"I don't tell my bosses," he added. "It's a moral standing."

County Commissioner Joe McClash dissented in the 6-1 vote to approve the measure, saying that he had been told it wouldn't cost more. The problem, he said, is that the state has been cutting its spending and funding for health care.

"Fiscal conservatives dumped this on the county," he said. "I'm all for proactive health care, but I think it's wrong to continuously subsidize what the state has failed to fund. The state is derelict in its duties."

Commissioner Larry Bustle said the time to start acting is now.

"The issue of revenue in the state is of great concern to a lot of people. We're in a crisis mode, where trust funds don't mean anything," he said. "I'm appalled at what's going on in our state and federal government. But we can't solve these problems, but do what we can to deal wth the issues in our county. We have six years to solve the problem with the fund. We have time to work on it, so let's get on with the job."

Chisholm said 12.6 percent of county residents are at or below the poverty line, there are people who can't pay their mortgage and have lost their jobs, and that's being felt at Manatee Memorial, which has seen a 55 percent increase in qualified indigents admitted and a 42 percent increase in outpatients.

He said his hospital doesn't turn away indigent psychiatric patients, as does Manatee Glens, which has lost state funding and has a limited number of beds for the uninsured. Manatee Memorial Hospital generally provides 11 days of care, even though the county only pays for two, he said. The third day would help to offset a bit more of the cost.

McClash insisted that the problem was at a higher level than the county.

"It's just patching one more hole in the dike," he said. "You're going to be back because you're spending more than you should because of the realities of federal and state funding."

In other work

The County Commission approved the following 7-0 on the consent agenda:

• Gulf Coast Latin Chamber of Commerce Day - October 20, 2009
• Family Week - October 31-November 7, 2009
• Tampa Bay Regional Council - Adopt Resolution R-09-241 supporting the Tampa Bay Regional Planning Council as hosts of the 2012 National Association of Regional Councils Annual Conference
• Workers Compensation Claim (John R. Kearns) - Authorize County Attorney's Office to settle claim for $125,000
• Non-Profit Agency Funding - Execute agreements totaling $155,759 with Hope Family Services, Inc., Myakka City Community Center, and We Care Manatee (2) for programs funded through General Revenue
• West Coast Inland Navigation District (WCIND) - Execute agreements (7) totaling $89,858 with recipients of WCIND project funding
• 17th Street West Road and Utility Improvements - Award IFB 09-1583OV to McLeod Land Services in the amount of $3,403,403.16 (Option A-460 calendar days), and authorize County Administrator or designee to execute contract and related documents
• Budget Amendment Resolution - Adopt Budget Resolution B-09-042
• Budget Amendment Resolution - Adopt Budget Resolution B-10-008
• Court Surcharges - Authorize setting public hearing to consider adoption of Ordinance 09-48 establishing new surcharge on non-criminal traffic cases*
• Health and Dental Plan Rates - Approve 2010 monthly premiums for eligible former employees electing to participate in the Manatee County Health Plan and 2010 Dental Plan rates for all covered employees, dependents, and retirees
• Accounts Receivable - Authorize write off of accounts receivable amounts from 16 accounts totaling $23,294.78 dating from April 1998 to May 25, 2005
• Perico Preserve - Authorize Chairman to sign Cooperative Funding Agreement with Southwest Florida Water Management District for Perico Preserve Environmental Restoration for an amount not to exceed $452,372
• Americorps VISTA Program - Execute agreement for $34,000 with Volunteer Services of Manatee County, Inc., to provide assistance with various projects within Neighborhood Services Department
• Housing Trust Fund - Adopt Resolution R-09-230 supporting elimination of the cap on the State and Local Housing Trust funds and supporting full appropriation of the Housing Trust Funds for Housing Programs
• Monteux at the Villages of Avignon - Execute Amendment One to Land Use and Deed Restriction Agreement with Avignon Holdings, LLC
• 57th Street East (Morgan Johnson Road) - Accept and record Pedestrian Sidewalk Easement and Utility Easement from St. Mark's Orthodox Church Inc., Affidavit of Ownership and Encumbrances, Joinder
• University Parkway at Airport Circle - Accept and record Utility Easement from SRQ Innovation Green, LLC, Affidavit of Ownership and Encumbrances
• Hazardous Materials Emergency Response Plan - Adopt Resolution R-09-233 accepting agreement from State of Florida Department of Community Affairs, Division of Emergency Management, for funds of $7,960 with no match required, for the State Hazardous Materials Emergency Response Plan update, and authorizing Chairman or Vice-Chairman to execute all appropriate documents
• Imagine Charter School at the Woods - Execute Agreement for Payment in Lieu of Construction of Required Improvements with Woods Charter School Development, LLC, for payment of $7,000 in lieu of construction of interim traffic signal at intersection of Moccasin Wallow Road and Artisan Lakes Parkway
• Fee Waiver - Waive $879.45 in service fees assessed to utility customer accounts for returned bank items
• Uncollectible EMS Accounts - Adopt Resolution R-09-232 to remove uncollectible accounts for ambulance services totaling $268,202.34
• Dashboard Reports - Accept into the record the Dashboard Report for month of September 2009
• Responses to Board Inquiries - Accept into the record responses from various County departments to inquiries of the Board of County Commissioners: 1) Comprehensive Plan Thoroughfare Roadway System; 2) Radio Towers
• Robinson Preserve Restoration - Adopt Resolution R-09-247 accepting grant from National Fish and Wildlife Foundation in the amount of $37,000 for restoration activities, and authorize Chairman to execute all award documents
• CRA Boundary Expansion - Authorize staff to complete blight study on potential boundary expansion area, and prepare budget amendment to provide funding to complete blight study