The State of Texas has committed to a transformation in delivery of healthcare to the poor, and in return, the Centers for Medicaid and Medicare have committed some matching funds to help establish the necessary programs.

“How do we improve health in our communities while also reducing costs?” said Cope Health Care CEO Allen Miller, a consultant for John Peter Smith Hospital, during last week’s workshop with the Ellis County Commissioners’ Court.

Miller was discussing the State’s “1115 Medicaid Waiver,” which is the mechanism to provide these matching funds.

“The goal is a different system for delivery of services statewide,” said County Judge Carol Bush, during Monday’s regularly scheduled meeting of the Court. “Moving from ‘pay per click,’ or visit, to a more desirable managed care program – preventive rather than reactive to whatever presents itself in the emergency room.”

The State’s vision for the transformation of its Medicaid programs is similar, at its core, to the County’s existing system in the Indigent Health Care Program.

“We contracted with Hope Clinic to provide primary care and case management,” said Human Services Director Diana Buckley. “We have proven that through this ‘medical home’ type of system we did improve health outcomes, reduce unnecessary emergency room usage, and lower the cost to the taxpayer. It’s good for everyone involved.”

As part of the 1115 Waiver, the State is developing “Regional Health Partnerships” throughout the state to bring stakeholders together in the planning process. Ellis County has been preliminarily placed in RHP10, along with Erath, Hood, Johnson, Navarro, Parker, Somervell and Tarrant Counties. John Peter Smith Hospital, Tarrant County’s public hospital, will serve as the “anchor” for the region, coordinating the planning effort and communicating to the State.

“We will be affiliated in name, and potentially some programs at some point, but we still maintain local control of dollars,” Bush said. “We are still deciding what persons qualify for our indigent health care program and how we reimburse, so there is nothing different at this point.”

The memorandum of understanding with the Tarrant County Hospital District, approved unanimously by the Court during Monday’s meeting, formalizes Ellis County’s participation in the planning process.

“We are saying to the State that we recognize the fact they will be placing us in an RHP, because that’s what they are doing across the State, and that Ellis County wants to be in region 10. Should we choose to develop innovative programs that qualify under the State’s system, it will allow providers such as Ennis Regional Medical Center or Baylor Waxahachie to be entitled to matching Federal funds.”

At the end of the five-year period specified in the 1115 Waiver, the State and the Centers for Medicaid and Medicare will change the method of payment to all hospitals for care provided to Medicaid beneficiaries. Waiver funding equates to an advance on the savings the State expects to realize by transforming the system to a model that improves the health of those consumers in a profound way.

“It is a matter of being on the front end for planning,” said Bush. “To make sure our people are getting the best medical care, we are sitting at the table, along with our providers, helping to develop the programs to achieve that.”

Alternatively, Ellis County might have been placed in the planning region with Dallas County.

“There are certainly some benefits to region 10,” Bush added. “Ellis County is very different from Dallas County. We are more similarly situated to Johnson, Tarrant, and Navarro Counties.”

Bush noted that records in the indigent health care program show more of the clients receiving care at Johnson and Tarrant County providers than at Dallas County providers as well, but stressed that all providers remain eligible for reimbursement under the parameters of the indigent program.

Tax Assessor/Collector John Bridges received approval for installation and use of a computer program designed to streamline the titling and registration of motor vehicles, pursuant to Chapter 502 of the Texas Transportation Code.

“There are two facts you need to know,” Bridges said. “One, it doesn’t cost the County anything, and two, it simplifies our titling that we receive from the dealers.”

Preliminary trials show that work previously requiring up to 15 minutes of a clerk’s time in the Tax Office will now be accomplished in as little as one minute, and with much less confusion and effort on the part of automobile dealers as well.

“This is a great tool,” said Commissioner Bill Dodson, pct. 2. “This is where the world is going today. I appreciate you, John, and the work you’ve done.”

Commissioners took a moment to hear from Suzanne Pylant of Mothers Against Drunk Drivers about community support for victims of violent crime.

“We are fortunate to be living in a community full of caring people,” Pylant said. “Commissioners, encourage your constituents to reach out if they become the victim of a violent crime, and the first place to turn is the District Attorney’s office.”

The Court approved a proclamation supporting the community’s efforts in implementing programs and service to assist the innocent victims of violent crime.

In other business, Commissioners:

• Approved closure of a portion of Highview Drive, located in Sunrise Village in precinct 1 (not precinct 2 as posted);
• Awarded a bid for limestone flex base material to Lone Star Aggregates;
• Approved reimbursement for uniform expense in Constable Precinct 4, correcting a clerical error made in 2009;
• Approved four items aimed at obtaining additional funding for the County’s successful vehicle emissions enforcement program, operated by Constable Precinct 2;
• Accepted a letter from Aerowave Technologies that rescinds the maintenance agreement with that company for radios;
• Heard an update on the progress of narrowbanding of Ellis County public communications (see attached timeline);
• Took no action on a proposal to sponsor South Ellis County Water Supply Corporation in its application for a Texas Community Development Block Grant in the 2013/2014 program cycle;
• Took no action regarding a ban on outdoor burning.

The Court will begin informal budget hearings at 8:30 a.m. on Tuesday, April 24, concluding on Thursday, April 26.