Centers get final say on providers
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.”