Special Meeting Minutes: February 22, 2019

Special Meeting Minutes: February 22, 2019

Indian River County Hospital District
February 22, 2019
1:00 PM

ATTENDEES: Miranda Hawker Pat Knipper
Vicki Soule Rose Parker
Marie Andress Nick Coppola
Ann Marie Suriano Jennifer Frederick
Michelle Genz Marybeth Cunningham
Kate Voss

Convene Meeting – Marybeth Cunningham, Chairwoman

Mrs. Cunningham convened the special meeting at 1:00 PM by welcoming those in attendance. She explained that the purpose of this meeting is to discuss the Health Departments announcement that they will be transitioning out of providing primary care and dental health services to the county. The District invited the leaders of local health agencies to discuss and share ideas to help facilitate this transition in the most effective way, while making patient care the number one priority.

Mrs. Hawker addressed the group and stated that the Health Department will continue to provide their core public health services such as immunizations, family planning, and communicable disease control. Originally, Mrs. Hawker notified the District that they would be consolidating services to the main health department on March 1. However, at the request of the District Board, they will now be transitioning primary health care services to the Gifford Health Center. This would be a short-term resolution to cut costs as they explore options for the long-term necessity to transition out of providing Primary Care and Dental services, which have become unsustainable. She explained that primary care and dental funding to the Health Department has diminished over the past several years, from multiple funding sources. Therefore, over the past several years they have been scaling down on services due to changes in the fiscal environment, as well as a decrease in revenues. The Health Department is now looking at options in the community for providing primary care services for those Health Department patients. Mrs. Hawker prepared a report of the Health Departments current volumes for reference for the other agency leaders to review.

There was further group discussion concerning new pathways for patients who were utilizing the Health Department as a primary care provider. It was discussed that patients covered by Medicaid could easily be reassigned to other providers to receive their primary care. This would be facilitated by the Health Department notifying Medicaid of the transition. The group then discussed the capacity the other agencies have, to treat the patients being transitioned. Mrs. Soule and Mrs. Andress indicated that both of their organizations have capacity to provide primary care services to those additional patients that would be transitioned from the Health Department at their current locations throughout the county. Mrs. Hawker stated that this transition will affect self-pay patients below 100% of the Federal Poverty Level, the most as they have been on a sliding fee scale, that is a $0 pay. There was group discussion surrounding the lengthy process of credentialing Medicaid providers to provide health services at a different facility other than the one where they are currently credentialed. Mrs. Soule explained that due to HRSA regulations, two separate Federal Qualified Health Centers are not permitted to provide services out of the same location, therefore they would be unable to split up the days in which a provider would be at the Gifford Health Center, which had been suggested.

Mrs. Knipper stated that the VNA mobile unit could also be available for those self-pay patients during the transition and that they would be willing to have the mobile unit parked at the Gifford Health Center an additional day during the week. There was discussion surrounding the need for a collaborative effort from all the agencies during this process. Mrs. Cunningham stated that the District would like any feedback from the providers concerning their needs during the transition.

It was further recommended that the District hire an independent person or persons to assist with qualifying those self-pay patients who have had struggles with the District qualification process. Additionally, they could also provide assistance with qualifying individuals for Medicaid. Everyone agreed that this person should be independent from all agencies and neutral. Mrs. Cunningham requested that the Health Department provide the District with an action plan concerning the discussed transition, and that the District would ultimately consider all of the options to ensure proper access. She explained that there needs to be thoughtful, concise and informative communication to the Gifford community during this transition. Although there may be some time period when primary care services are not located at Gifford, Mrs. Cunningham stated that it is a top priority of the Board to support the Gifford community by ultimately providing access to quality and sustainable health care.

Public Comment- There was no public comment.

Adjourn- The meeting was adjourned at 2:30 PM