For the uninsured and economically vulnerable in Hennepin County, the number of healthcare options available may be dwindling. Last spring, Gov. Tim Pawlenty vetoed the General Assistance Medical Care program for the state, which provided $43 million in revenue to the Hennepin County Medical Center, the county’s safety net hospital that provides health care to vulnerable populations. The county has since proposed a 3 percent property tax to address this cut funding, but the 3 percent would provide only $18.7 million, leaving a $24.7 million funding cut to be absorbed by the center.

Dave Lawless, the Director of Budget and Finance for the county, says the 3 percent increase is likely to pass, though he added that it has yet to go through the reviewing process by the county commissioners.
Without regular access to health care, people allow their conditions to worsen until it becomes a catastrophic situation.

Lawless says the 3 percent increase was decided upon because it will cover roughly half of the vetoed $43 million. Though the county saw a need to address the funding cuts, there was a desire to have HCMC deal with the problem, according to Lawless. The county “is not willing to pay all of it,” he says.
Mike Harristhal, vice president of public policy and strategy at HCMC, underlined the ill effects of the funding cuts.

“The people who’ll be affected are people who are in very little position to help themselves,” he says. Many of those affected make less than $8,000 a year and are likely to be more concerned about paying for food than paying their medical bills.

Many people receiving General Assistance Medical Care through the state were able to use the insurance at private hospitals or clinics – the Hennepin County Medical Center is only used by about 30 percent of those who receive insurance through state general assistance funding. The choice to go to private facilities will no longer be available. As a result, more people will seek health care at public institutions like HCMC.

According to the Hennepin County Web site, the general medical care program provided care for around 26,400 low-income Hennepin County adults who didn’t qualify for other insurance programs in 2007.
Harristhal estimated that the number of uninsured in Hennepin County is around 100,000. In addition, Harrisal says he expects that more uninsured will end up in emergency rooms. Without regular access to health care, people allow their conditions to worsen until it becomes a catastrophic situation and they go to an emergency room, he explained.

State law requires emergency rooms to provide medical care regardless of whether the patient has insurance or money to foot the bill.

The cuts “could affect not only the uninsured but also the insured” that use the county facilities, Harristhal says, explaining that the trimming of various programs offered by the center could increase the time a patient has to wait to be seen. “We believe it doesn’t save money in the long run,” says Harristhal of the funding cuts, noting that the cutting of the general medical assistance may mean a tax increase for the public.

To address the funding cuts, HCMC is looking at the entire breadth of its programs for ways to reduce costs. The center’s CEO Arthur Gonzalez told the Twin Cities Business Journal they are considering shrinking or cutting programs such as medical education, behavioral health, medicine used to treat carbon monoxide poisoning, and its burn center. Additionally, Harristhal says it is likely that the health center will no longer accept uninsured people from other counties except for emergency room care. In 2002, the center served more than 25,722 unique patients from the other 86 Minnesota counties.

Lawless says that HCMC has done a fairly good job of cutting costs in past years.

General Assistance Medical Care will end on April 1, 2010. The program covers homeless people, who cannot receive state assistance via MinnesotaCare, a joint-funded state/federal health care program, because the program requires the patient to have a residence.

The Hennepin County Medical Center serves largely vulnerable populations – 64 percent of their outpatient registrations and 54 percent of inpatients are on Minnesota public programs.
The three percent property tax increase that would go to the county medical center is part of a slimmed down county budget. The 2010 $1.6 billion budget is down from $1.7 billion in 2009 and includes 163 job cuts, a hiring freeze, and the elimination of the Solid Waste Management Fee. Most county departments will have smaller budgets than in 2009. “These times have forced, but more importantly fostered, innovation within our organization,” says Hennepin County Administrator Richard Johnson on the budget.

As for the 3 percent property tax increase, Lawless says the county is being cautious with property tax revenues. He explained increasing numbers of building owners are trying to reduce the valuation of property. The owners file petitions that contest the county’s appraisal of the property. In 2007 there were 900 petitions, last year there were 1,200, and this year there are 1,800. The petitions take a few years to go through the court system, and while many won’t pass, they have the potential to decrease the county’s revenue from property tax.

Tags: Budget, General Assistance Medical Care, HCMC, Hennepin