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THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Adopted this Order on January 21, 1986 , by the following vote:
AYES : Supervisors Fanden, Schroder, McPeak, Torlakson, Powers
NOES: None
ABSENT : None
ABSTAIN: None
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SUBJECT_: Proposal for a Health Equity Local Pool
William Walker, M.D. , Co-Chairman, Public/Private Task
Force on Indigent Care (Contra Costa Health Coalition) , presented
to the Board a proposal for a Health Equity Local •Pool (H.E.L.P . )
that would provide an approach to sharing the burden of uncompen-
sated health care between the public and private sectors. Dr.
Walker commented on the merits of the proposal which would assist
those individuals who have no form of medical coverage. He advised
that the Pool would provide a minimum safety net for general acute
and some physician hospital services for low income uninsured resi-
dents in the County and would remove the option of dumping chroni-
cally ill patients on the County Hospital . He noted that the
proposal recommends a mandated equity surcharge of $7 .94 per occupied
bed day for all area hospitals. Dr. Walker in his report (dated
January 16 , 1986 ) to the Board provided a summary profile of the
proposal and of the availability of a grant from the Robert Wood
Johnson Foundation to fund the administrative expenses of this pilot
program over a two-year period.
Several persons spoke in support of the proposal and of
the work of the Task Force in developing this approach. Concerns
were expressed as to the impact the surcharge would have on a
patient' s hospital bill, the application of the surcharge to a
select few, and the need to have all citizens share equally in the
cost of providing health care for the poor.
Board members discussed the merits of the proposal but
expressed reservations relative to the impact it could have on a
patient' s insurance premium, the characterization of the $7 .94 per
occuplied bed day as a tax, possible impact on providing trauma care
for- -patients, and participation of Merrithew Memorial Hospital in
the proposed program. Board members agreed that the matter should
be set for public hearing to enable the public to comment on the
proposal.
IT IS BY THE BOARD ORDERED that March 11, 1986 , at 10:30 a.m. ,
is FIXED as the time for hearing on the proposal of the Contra Costa
Health Care Coalition.
IT IS FURTHER ORDERED that the County Administrator and
Health Services Director are REQUESTED to review the report and
other options that may be available relative to the development of a
shared risk pool for uncompensated patients health care.
hereby certify that this is a true and correct copy of
an action taken and entered on the nninutes of the
Board of Supery sors on the date shown.
ATTESTED: __'��
CC: County Administrator PHIL B TCHELOR, Ce'rk of the Board
Health Services Director of Supervisors and County Administrator
County Counsel
By �� .. ��... , ..... +,Deputy