Disqualifying indigents won’t make health care costs go away

Clark County Social Service needs money to help indigents get medical care, yet state law forbids counties shifting money from another fund to cover social service programs.

So repeal the law.

It makes common sense, especially if Gov. Brian Sandoval succeeds in taking more property tax dollars away from Clark County, which seems to be the pirate’s plan. Except there are consequences.

That’s why, in order to cover this year’s $13 million deficit in the medical assistance program, Clark County Social Service Director Nancy McLane reluctantly suggested making it harder to qualify. By raising eligibility standards, about 2,100 people in Clark County would no longer be eligible.

Tears were shed at Tuesday’s County Commission meeting by people who feared their friends and relatives may die if they are booted off the county medical assistance program. These folks don’t have any other coverage.

A few made it to the commission meeting.

There was the man with the oxygen tank who wondered whether he will live until he is 65 and qualifies for Medicare.

There was the daughter who said her father, who has lymphoma, would lose his chemotherapy and radiation treatments.

She didn’t attend, but there is a 101-year-old woman, the oldest person on the program, who gets by at home with the help of a home health care worker who spends two hours each week helping her with bathing and grocery shopping.

Right now, a single person is eligible if they make no more than $1,435 a month. The stricter standard would be $1,065. A couple can now have a monthly income of up to $1,925, but the lower standard would set a cap of $1,433.

Half the people who benefit through the popular Homemaker Home Health Aide Services program would be ousted from the program, which keeps them out of long-term care facilities.

Right. Let’s cut the less expensive program that works.

My property tax bill showed I paid not quite $50 this year into the medical assistance to indigent persons fund. I don’t begrudge a penny to help the 30,000 poor people a year who use the program.

The county medical assistance program cost $75 million last year and was cut to $55 million this year. Next year it’s expected to drop to $44 million if the eligibility standards are reduced. It could be even less depending on whether the state raids the county’s property taxes again.

One proposal to cover this year’s $13 million deficit was to move money from the county’s capital construction fund. But state law doesn’t allow that. Years ago, lawmakers wanted to limit social services and blocked that flexibility.

McLane shot holes in my suggestion to repeal the law.

“The potential for the county to have unlimited demand for the money could put the county in the position of not meeting other obligations,” she said. “We want to take care of the indigent, but not to the extent of draining the general fund.”

Under President Barack Obama’s health care bill, the population the county serves would be eligible for Medicaid.

“That puts it in one program, but where they get the money to serve the extra people is a huge unanswered question,” McLane said.

Commissioner Chris Giunchigliani proposed that the county try to declare emergency status to get around the legal restriction against shifting money into social services.

Despite County Counsel Mary-Anne Miller’s insistence that the current situation wouldn’t qualify legally as an emergency, McLane will do as asked and try to craft another proposal.

The indigent who aren’t covered will turn to emergency rooms, driving up the county-owned University Medical Center deficit. One problem creates another.

Either way, you pay.

Jane Ann Morrison’s column appears Monday, Thursday and Saturday. E-mail her at Jane@reviewjournal.com or call (702) 383-0275. She also blogs at lvrj.com/blogs/morrison.

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