Cen­ters get fi­nal say on providers


Austin American-Statesman - - THE SECOND FRONT - Con­tin­ued from A Con­tact Jody Ser­rano at 912-2505.


The cen­ters get the fi­nal say on which providers will have ac­cess to the $11.4 bil­lion the fed­eral government is mak­ing avail­able to Texas. State of­fi­cials say they are ex­pect­ing any such ap­proval by May 1.

Travis County vot­ers in Novem­ber ap­proved plans that pave the way for the health district there to use up to $550 mil­lion in waiver money for projects in­clud­ing im­mu­niza­tions for peo­ple at high risk for pre­ventable dis­eases, spe­cial­ized teams to re­duce hospi­tal read­mis­sion rates for di­a­betes pa­tients and cri­sis res­i­den­tial ser­vices, which serve as an alternative to hos­pi­tals and jails, for peo­ple suf­fer­ing from a men­tal ill­ness.

Re­gion 3, which in­cludes Hous­ton and Pasadena, could get the most funds un­der the waiver — up to $2.3 bil­lion. Re­gion 6, which in­cludes San An­to­nio, can re­ceive up to $1.1 bil­lion. Dal­las is in Re­gion 9, which will have ac­cess to $1.6 bil­lion.

Three en­ti­ties — Wil­liamson County and Cities Health District, St. David’s Round Rock Med­i­cal Cen­ter and Blue­bon­net Trails Com­mu­nity Ser­vices, a men­tal health provider — are propos­ing projects for the Wil­liamson County area. The five-year waiver pro­vides as much as $1.46 in match­ing fed­eral funds for ev­ery $1 spent lo­cally. The waiver ex­pires in 2016 and could be re­newed.

The health district and the county could in­vest at least $4.5 mil­lion in five projects — ex­pand­ing ac­cess to pri­mary care, re­duc­ing im­proper use of emer­gency ser­vices, en­hanc­ing health care data col­lec­tion, pro­vid­ing nav­i­ga­tion ser­vices for the un­der­served and launch­ing a healthy life­styles cam­paign — and could see up to a $12.2 mil­lion, in­clud­ing its ini­tial in­vest­ment, re­turn un­der the waiver.

“A lot of th­ese projects at their core have the strength­en­ing and link­ing of peo­ple to a med­i­cal home,” said Dr. Chip Rig­gins, health district ex­ec­u­tive di­rec­tor. “That’s what ex­panded pri­mary care is about — serv­ing the unin­sured folks who do not have a med­i­cal home and try­ing to se­cure one for them.”

Wil­liamson County is part of Re­gional Health­care Part­ner­ship 8 and in­cludes Bell, Blanco, Bur­net, Lam­pasas, Llano, Milam, Mills and San Saba coun­ties. The area has 37 projects — six of which di­rectly af­fect Wil­liamson County — and must re­ceive state ap­proval for all them be­fore it can re­ceive fed­eral dol­lars.

The waiver ef­fort will help health care providers op­er­ate more ef­fi­ciently, which will ben- efit more than just the poor and peo­ple on Med­i­caid, said Jan­ice Eh­lert, a project man­ager at the Texas A&M Health Sci­ence Cen­ter in Round Rock. Eh­lert over­sees the waiver projects for Re­gional Health Part­ner­ship 8.

“For ex­am­ple, the com­bi­na­tion of cre­at­ing emer­gency di­ver­sion pro­grams and ex­pand­ing ac­cess to pri­mary care will al­low emer­gency di­ver­sion pro­grams to op­er­ate more ef­fec­tively,” Eh­lert said. “Trans­form­ing both of th­ese ar­eas si­mul­ta­ne­ously is es­sen­tial for di­verted res­i­dents to have ac­cess to ap­pro­pri­ate lev­els of care.”

St. David’s Round Rock Med­i­cal Cen­ter is lead­ing a project to ex­pand pri­mary and pre­ven­ta­tive care for the county’s 60,438 unin­sured and low-in­come res­i­dents, ac­cord­ing to 2009 es­ti­mates, the lat­est avail­able. Such res­i­dents of­ten use emer­gency de­part­ments as their pri­mary health care des­ti­na­tion.

The 173-bed hospi­tal ex­pects to pro­vide pri­mary care ser­vices to nearly 5,000 needy pa­tients by paying lo­cal clin­ics to pro­vide ser­vices. Hospi­tal of­fi­cials would not re­lease how much they are in­vest­ing, say­ing they are still in plan­ning stages, but said they ex­pect to see up to $15.8 mil­lion, which in­cludes ini­tial funds and the fed­eral re­turn, un­der the waiver.

Wil­liamson County had 12,078 pre­ventable hos­pi­tal­iza­tions from 2006 to 2010 and spot­ted the nearly $327 mil­lion bill for treat­ment of con­di­tions such as asthma, de­hy­dra­tion and hy­per­ten­sion, ac­cord­ing to the Texas De­part­ment of State Health Ser­vices.

Blue­bon­net Trails pro­vides men­tal health ser­vices in Wil­liamson and sur­round­ing coun­ties, in­clud­ing Bas­trop and Bur­net, and will par­tic­i­pate in the waiver pro­gram. Ex­ec­u­tive Di­rec­tor An­drea Richard­son said Blue­bon­net is in­vest­ing at least $11.3 mil­lion in sev­eral projects and could see about $22.2 mil­lion, in­clud­ing ini­tial in­vest­ment and re­turn, over the next four years.

Last year, the or­ga­ni­za­tion served 7,750 res­i­dents in Wil­liamson County. Find­ing enough fund­ing to serve in­di­gent pa­tients is a chal­lenge for Blue­bon­net, Richard­son said, and the or­ga­ni­za­tion has to turn away pa­tients.

“We look for an­other re­source for them and that usu­ally ends up over­tax­ing those other re­sources,” Richard­son said.

Blue­bon­net Trails serves eight coun­ties, and the ef­fect of the $11.5 mil­lion will be spread across the area. Projects in­clude tran­si­tional hous­ing for adults with men­tal health is­sues, emer­gency ser­vices di­ver­sion, ad­dic­tion help and treat­ment out­pa­tient ser­vices for adults and youths.

Although the waiver will last un­til 2016, Richard­son said she has faith it will be re­newed for more years.

“That’s our prayer,” Richard­son said. “We’re go­ing to do ev­ery­thing we pos­si­bly can to make it suc­cess­ful.”

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