Health project raises doubts

Councilman suggests redirecting funds for access program due to limited enrollment in first month

December 11, 2008|By Larry Carson | Larry Carson,larry.carson@baltsun.com

The small number of residents found to be eligible for Howard's new health access program for the uninsured during the initial enrollment period has prompted a call from a County Council member to consider redirecting some of the money for the initiative.

Given the difficult economic climate, part of the $500,000 set aside for Healthy Howard this year could be of more use going to traditional nonprofits, Councilman Greg Fox said Monday at a budget briefing for the council.

During October, the first month of enrollment, about 1,100 people registered for Healthy Howard. All but 45 qualified for existing federal or state health insurance, county officials said.

"Does it make sense to provide $500,000 for health coaches for [45] people?" said Fox, who represents the Fulton area and is the only Republican on the council.

During the council briefing, Raymond S. Wacks, the county budget director, pointed out that enrollment for Healthy Howard continues. In a subsequent interview, he said the county has transferred $250,000 to the program.

Later, Fox also called into question whether enough research was done before money was allocated for the program to find out how many people without insurance would qualify for existing programs.

"Instead of fire, ready, aim, they needed to do this research," he said.

Healthy Howard is an effort to provide access to health care for the roughly 20,000 limited-income county residents who do not have insurance. Using existing programs as much as possible is a primary goal, Dr. Peter L. Beilenson, the county health officer, has said, but those who enroll in Healthy Howard would pay $50 to $115 a month for care that includes preventive and specialists' services.

The first year, which was to be limited to enrolling 2,200 people, is intended to produce enough data to determine whether the program is workable.

Fox argued that since fewer than 5 percent of the first month's applicants have qualified, it might make more sense to divert the county money to programs serving the homeless, hungry or those without heat during tough times.

"We were told 2,200. We're not even seeing 2,200 eligible," he said. "Maybe we should give it to others more in need."

Though he did not oppose creation of the program, Fox has raised pointed questions about county funding for it since last spring's budget review, as he has about other new programs established by County Executive Ken Ulman.

Beilenson disagreed with Fox's perspective.

"This is the first month," Beilenson said, "We got 1,000 people into health insurance, which is tremendously helpful to those individuals."

Beilenson said that although enrollment sessions were suspended Oct. 31 because of the deluge of applications, enrollments continue and the program is hoping to attract small-business owners and workers who have no benefits. The goal is about 200 people per month, he said.

As the economic downturn results in people losing their jobs and health insurance, the program will be more important.

"This is absolutely not the time to shut down this kind of program," Beilenson said. "I never said we'd have 2,200 in the first month. We said the first year."

Council member Courtney Watson, an Ellicott City Democrat who has also expressed worry about county revenue, said she is confident that the administration will act prudently.

"I'm sure if the executive feels they don't need that much this year, he'll redirect it," she said.

Wacks told the council that through September, the county share of state income tax revenue is slightly higher than last year at this time, but no one knows what effect the economic turbulence that began in October will have. A new state revenue projection expected to be released Tuesday should reveal more, he said.

"Each month, as I come to visit you, things seem to be a little bit worse," said Wacks, who was asked by the council to provide monthly budget updates. "It could get appreciably worse. It could stay where it is."

Wacks and fire Chief Joe Herr told the council about other cost-saving measures under way.

Herr said he has saved $100,000 by having firefighters train via computer rather than taking work time to travel to other training sites. Wacks said that 18 firefighter positions are vacant, which could mean a savings of up to $750,000 this fiscal year. He said recruiting for those jobs will begin in the spring, however, to avoid incurring overtime costs to fill required shifts. The recruit costs won't come due until after the new fiscal year starts July 1, he said.

"I do lay awake at night thinking about this," Wacks told members. "Who knows what's going to change?"

returns from the state

Distribution of income tax revenue for Howard last month showed an overall 5.2 percent increase, compared with November 2007. This amount includes:

* A 13.5 percent increase in income tax returns from delayed estimated payments in calendar year 2007.

* Receipts for the third quarter (July-Sept.) of 2008, which is 1.92 percent higher than last year. That amount roughly matches revised projections.

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