June 28, 2012 -- County governments are expected to play a critical role in the delivery of healthcare services under Oregon’s healthcare reform.
However, two counties covered by AllCare Health Plan, Inc., a newly certified coordinated care organization -- Josephine and Curry— face unprecedented funding cuts that are seriously undermining their criminal justice systems.
Most of the land in those timber-dependent counties is owned by the federal government, and for decades, revenues raised from logging went toward funding county services. But subsequent restrictions on logging prompted federal payments to the counties to come up with the lost revenue.
The last of those payments was attached to the 2008 federal legislation that also bailed out struggling financial institutions, and counties have received the last of those federal funds, forcing drastic cuts.
Josephine County voters rejected a public safety levy in the May 15 primary election. Sheriff Gil Gilbertson verifies that 65 out of 98 employees in his department have been laid off, most of whom were patrol deputies. The jail, with a capacity of 262 beds, now houses 60 inmates. Half are federal inmates, meaning that only 30 jail beds are available for local offenders.
Last week, the juvenile detention facility closed its doors. Describing the situation as “pretty dire,” Gilbertson said deputy patrols are down to a single eight-hour shift five days a week.
Yet, the calamities facing these counties won’t have an adverse effect on healthcare reform, said Gail Hedding, manager of AllCare’s network development.
“The process doesn’t require any funding from the county,” Hedding said. AllCare is owned by the Mid-Rogue Independent Physicians Association, and expects to begin enrolling 25,000 Medicaid members on August 1.
Funding for healthcare services will start to be blended in January, which could help cash-strapped counties, Hedding said. The CCO structure will pull together the management of local health programs for a more cost-effective and efficient way to generate savings.
“It’s a matter of not duplicating services and coordinating services,” she said. “That’s the underlying goal in all of this, and that’s particularly important in counties that have shrinking services and shrinking budgets.”
AllCare has entered into a memorandum of understanding with Josephine County for mental health services, and is contracting with Options for Southern Oregon, a non-profit organization that’s been providing care since 2006.
Since Options doesn’t receive any money from the county, its services shouldn’t be impacted, said Karla McCafferty, executive director.
Josephine County basically will act as a pass-through entity, with federal and state funds going directly to Options. “These are folks that we’ve been working with all along,” McCafferty said. “That’s what’s really nice about this.”
Despite the bleak circumstances surrounding some counties, Hedding sees the reform efforts as very positive. “The fact that they have financial challenges isn’t going to create any burden. This doesn’t change the concerns about what’s happening in the counties. It doesn’t step up their requirements. It just requires that we work together.”
Like Hedding, McCafferty is optimistic the CCO structure and healthcare reform efforts will lead to more efficiency and reduce costs. “It’s possible to do some consolidation around administration and some service delivery for counties that may only need a little bit of a certain specialty, and share specialties across counties,” she said. “I know that CCOs like AllCare that stretch across counties are looking at where the efficiencies are in service delivery and administration.”
The whole situation is “not without challenges,” McCafferty said, but “we’re feeling positive about the future. We have a lot of work to do. But we’re really breaking new ground in terms of integrating and coordinating care here. It feels pretty good.”
Meanwhile, PrimaryHealth of Josephine County, a new partnership between Care Oregon and Oregon Health Management Services, anticipates getting under way on September 1 and enrolling 7,000 members, said Jeanie Lunsford, CareOregon spokesperson.
Image for this story appears courtesy of The Oregonian.
