County partners with Centennial: Project Access finds federal dollars for indigent care

The Collin County Health Care Foundation joined forces with Centennial Medical Center last week to provide medical treatment for qualified adult indigent patients, a move the county hopes will decrease what it's been spending on the uninsured.

In an agreement between the foundation and Project Access Collin County (PACC), the private, nonprofit health organization will become the county's official provider for qualified indigent patients, serving as a clearinghouse to connect patients with practitioners.

The Commissioners Court (which makes up the health care foundation) approved funding for $485,000 to provide administrative space for one year; in return, the program will be responsible for providing health coverage for those enrolled in the indigent plan.

The county's Health Care Services department will continue to verify patient eligibility requirements, which limits eligibility to legal U.S. residents who are earning 100 percent or less of the Federal Poverty Level.

PACC was created through efforts of the Collin County Medical Society, which represents more than 600 physicians in Collin and Fannin Counties, its main goal being to help curb the amount of money the counties spend on indigent care. Centennial's ability to utilize county expenditures in its reporting to the state will, in essence, enable it to be reimbursed with federal dollars, said Collin County Judge Keith Self.

"It should reduce [county spending], theoretically, since it's a set amount contract," Self said. "For that set amount, they will be providing health care for our indigent citizens. Centennial will be paying our bills. When they spend money on our indigent folks, they can then pull down some federal dollars. That's not a direct tie to the county, but that's their benefit."

By law, Texas counties are required to provide up to $30,000 per year in health care benefits for each eligible adult patient. Last year, the county spent approximately $1.1 million on indigent health care ($2.7 million in 2010), which included outpatient healthcare, inpatient hospital care, lab services, pharmaceutical services and primary care.

Once declared eligible, patients will have their medical issues handled through Project Access, whose staff will coordinate care with primary physicians, specialists, laboratories, community clinics, hospitals and other medical service providers.

Project Access is based on a similar program in Dallas County that provides community-based health care for the uninsured. Collin County's partnership, however, signals the first time a county government has drawn up this kind of partnership to help meet state-mandated requirements for indigent care. Existing indigent patients who are already registered with the county will be shifted to Project Access in the coming months.

This partnership is one of two big changes that occurred in 2011, the other being the state legislature's removal of its requirement that county indigent programs cover resident aliens who came to the U.S. on a sponsor application.

"In the past, resident aliens immediately enrolled in the indigent program upon moving to the United States," county administrator Bill Bilyeu said. "Now, the resident alien has to have worked 10 years before they become eligible for this benefit."

Centennial has been able to pull down approximately $17 million in Medicaid funds through its partnership with Dallas' Parkland Hospital, said Self, who added that Collin County's participation in the program will hopefully bring some federal dollars their way, as well.

"We were starting to spend a whole lot money, it was going up rapidly," Self said. "Our Health Care Foundation dollars were decreasing, and we were not gaining any interest either. We have since reduced what coverage we provide for our indigent citizens down to the minimum required by the state, and now started Project Access to further reduce costs. We hope this will preserve the Health Care Foundation for years to come in the future."

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