San Mateo County Grand Jury
• 2007-2008
Issue | Background | Findings | Conclusions | Recommendations | Responses | Attachments Funding Health Care for
⚠️ Translation Notice: This content has been automatically translated. The original English text is the official version. Translation may contain errors.
⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Findings and Recommendations 10 findings
F1
The Grand Jury finds that:
The Blue Ribbon Task Force has recommended that all current County-sponsored programs for uninsured adults, such as WELL and ACE, be consolidated into the San Mateo ACE Program.
No recommendations for this finding
F2
The Grand Jury finds that:
A yearly expenditure of approximately $100 million will be needed to meet all of the goals set out by the BRTF, which includes funding that the County will continue to direct to meeting the healthcare needs of the indigent. The County, the Health Plan of San Mateo and Ravenswood Family Health Center competed to receive a State funding award of $7.5 million per year for three years that has enabled the launch of the Blue Ribbon Task Force Pilot Program, called San Mateo ACE. Other new funding sources have not yet been determined.
No recommendations for this finding
F3
The Grand Jury finds that:
The Blue Ribbon Task Force’s proposed funding structure is built on a principle of shared responsibility among individuals, employers and the community. Explored sources include: • increased contributions from the county’s private non-profit hospitals • contributions from the two health care districts • monthly payment by enrollees
No recommendations for this finding
F4
The Grand Jury finds that:
The Blue Ribbon Task Force has also analyzed funding sources that require voter approval: • tax or fee on employers • sales tax increase • parcel tax
No recommendations for this finding
F5
The Grand Jury finds that:
The six private non-profit hospitals in San Mateo County (Kaiser-Permanente Redwood City and South San Francisco, Seton Daly City and Moss Beach, Mills Peninsula Burlingame, Sequoia Hospital Redwood City) participate in HPSM and play different 3 roles in serving the uninsured. Non-profit hospitals are required by IRS code Section 501(c)(3) to provide “community benefit” in order to retain their tax-exempt status. In July 2007, the IRS noted that: “The lack of consistency or uniformity in classifying and reporting uncompensated care and various types of community benefit often makes it difficult to assess whether a hospital is in compliance with current law.” 8
No recommendations for this finding
F6
The Grand Jury finds that:
The County’s health care needs are also served by another private non-profit organization: Palo Alto Medical Foundation (PAMF), which currently operates clinics in Redwood City and Redwood Shores, has committed to building a new campus in San Carlos. PAMF already provides some care for HPSM members.
No recommendations for this finding
F7
The Grand Jury finds that:
By March 2008, two private providers had agreed to support the BRTF plan by increasing care for HPSM members: • Kaiser had agreed to accept up to 360 pregnancies per year for prenatal care and delivery at Kaiser Redwood City. • PAMF had agreed to increase its quota from 500 to 1,500 patients.
No recommendations for this finding
F8
The Grand Jury finds that:
Additionally, San Mateo County has two health care districts, Peninsula Health Care District (PHCD) and Sequoia Healthcare District (SHD). PHCD receives approximately $3.8 million annually, and SHD receives approximately $6.9 million from property tax monies. PHCD has approximately $34 million in reserves and SHD has approximately $69 million in reserves.9 These two health care districts have distributed a percentage of their annual tax income through their grant process, which is not coordinated with any other health care plan or organization. There is now a countywide program (San Mateo ACE) through which distribution of these tax monies could be coordinated rather than continuing with the current ad hoc method of distribution by grants.
Related Recommendations (1)
R2
Sequoia Healthcare District and Peninsula Health Care District: • Enter into a formal agreement to support the San Mateo Access and Care for Everyone Program. • Re-evaluate the need for substantial financial reserves, since the health care districts no longer have hospitals to manage or maintain. 5
F9
The Grand Jury finds that:
While HPSM has been able to recruit enough providers for its current membership, some access gaps exist. HPSM has been paying these providers at or above Medi-Cal rates.10 HPSM is concerned that a reduction of state and federal funding may impair its ability to continue paying its current rates and/or attract new providers, which would be necessary to achieve coverage expansion.
Related Recommendations (1)
R1
San Mateo County Board of Supervisors encourage the Health Plan of San Mateo to: • Continue to pay fees at current levels in order to retain and attract providers. If funds are limited, consider paying higher rates to providers in critically needed specialties. • Use all available options (County resolution, support of state and federal legislation) to encourage the six private non-profit hospitals in San Mateo County (Kaiser-Permanente Redwood City and South San Francisco, Seton Daly City and Moss Beach, Mills Peninsula Burlingame, Sequoia Hospital Redwood City) to give significant and ongoing financial contribution and operational support to the San Mateo Access and Care for Everyone Program.
F10
The Grand Jury finds that:
By May 2008, enrollment of more than 3,000 patients in the San Mateo ACE pilot program had exceeded the target of 2,100. The Blue Ribbon Task Force will regularly review the effects of the San Mateo ACE program. 8 http://www.irs.gov/newsroom/article/0,,id=172416,00.html 9 http://www.peninsulahealthcaredistrict.org/pdfs/annualfinancials.pdf http://www.sequoiahealthcaredistrict.com/sequoia_healthcare_bfs_07.pdf 10 http://www.hpsm.org/Documents/Providers/Provider%20Manual%20Full%20Copy%202008.pdf pp.48-50. HPSM pays as much as 133% of Medi-Cal rates (June 2008). Conclusions The Grand Jury commends the County Board of Supervisors and its Blue Ribbon Task Force for their efforts to plan and design health care coverage for the uninsured adults in San Mateo County. The BRTF has developed an ambitious, comprehensive, and well researched approach to provide health care to the County’s uninsured adults. The Grand Jury concludes that the BRTF has identified potential funding sources to cover the estimated $100 million annual cost of their plan, but has no firm commitments for funding. However, if all of the hospitals and health care district’s participants adopt the BRTF’s
No recommendations for this finding
Conclusions 1
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CL1 Page 5The Grand Jury commends the County Board of Supervisors and its Blue Ribbon Task Force for their efforts to plan and design health care coverage for the uninsured adults in San Mateo County. The BRTF has developed an ambitious, comprehensive, and well researched approach to provide health care to the County’s uninsured adults. The Grand Jury concludes that the BRTF has identified potential funding sources to cover the estimated $100 million annual cost of their plan, but has no firm commitments for funding. However, if all of the hospitals and health care district’s participants adopt the BRTF’s recommendations, if enrolled patients contribute up to $100/month for their coverage, and if grant distributions are used to meet the goals of the BRTF, a significant portion of the needed funds can be realized. The Board of Supervisors could also go to the voters for an increase in sales and/or parcel taxes for additional funding. The availability of providers is of concern if HPSM cannot continue to pay fees at current levels.
No Responses Found 2
Government entities assigned to respond to this report. No response documents have been linked in our database.
County of San Mateo
Agency
San Mateo County Board of Supervisors
Elected County Office