FARMINGTON — San Juan County is not required to shift $3 million from a county program used to pay for indigent care into a newly created statewide safety-net health care fund — as is planned — but officials say there was no other logical way to make the mandated payment.
"We don't have any other source of funding," County Executive Officer Kim Carpenter said.
On Tuesday, county commissioners approved cuts to the county's newly named "health care assistance program," which partially pays health care providers' and patients' uncompensated health care bills. It was previously known as the indigent health care program, and the cuts are the county's attempt to comply with Senate Bill 268.
The bill, which became law after the recent legislative session, created the Safety Net Care Pool. Counties are required to fund the safety net pool, according to the law, by paying one-twelfth of 1 percent of their gross receipt taxes. The statewide fund also is designed to help finance hospitals' uncompensated health care claims.
It's not clear how much, if any, San Juan Regional Medical Center will received from the new statewide fund. And the county's fund also paid for other mental-health and medical programs for low-income families and individuals in the area.
The recent cuts the county made to find money for the payment reduced health care providers' reimbursements from 70 percent to the averaged Medicaid rate of 33 percent — chopping some payments in half — and narrowed program eligibility.
Providers have made forbidding predictions. Kristine Carlson, Totah Behavioral Health Authority director, told the commission in mid-June that 10 percent of her clients would die.
Commission Chairman Jack Fortner has said the cuts were not a good option, but they weren't the worst.
Either the county pulls the mandated payment from its health care program, Carpenter said, "or this — we go find $3 million in the general fund and impose a tax to recover it."
Carpenter has said that the county will need to raise taxes, even with the cuts and restrictions placed on the county's health care assistance program. Once projected reserves are depleted the county's health care fund is expected to have about a $900,000 deficit by fiscal year 2016, according to county documents.
The senate bill "intended" since its inception that county health care programs — or indigent programs — fund the safety net pool, Carpenter said. "Because this whole thing is centered around the indigent program, this was the logical way to go," he said.
He said also that the safety net pool and the county's health care program provide similar services — both pay uncompensated care costs.
"It's just a matter of which funding stream we would have to use," he said.