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County Auditor: No money for unpaid indigent medical bills

Hidalgo County auditor Ray Eufracio told county commissioners this week funds to pay indigent care medical bills for 2011 was no longer available in the accounts where they had been located. He explained that at the end of each year funding that is left in different budget categories is rolled over into the general budget for the next year instead of being left in the categories where they were previously designated.

The auditor’s opinion came during a discussion where Eddie Olivarez, Director of the Hidalgo County Health Department, and attorney Jim Darling, representing Doctor’s Hospital and Renaissance, spoke about funds for indigent care owed by the county to the hospitals, pharmacies and doctors of the area for services rendered in 2011. The amount Hidalgo County was required to set aside for 2011 was $8.5 million. The county only paid $6.1 million because the state was waiting for instructions from the federal government on the money and would not accept the money until instructions were given.

Olivarez told commissioners there was approximately $2.4 million in unpaid bills for 2011.

He also said the cost for the first quarter of 2012 was $687,000. The state works on a different calendar that begins in September while the county works on a calendar year. The commissioners were warned to be ready to pay according to the state calendar.

Eufracio repeated the county had a policy to rolling all leftover monies into the new general fund budget at the end of any fiscal year. The money was no longer in the budgets that Olivarez said they were in and could not be given to the hospitals.

Olivarez argued there was a commitment for a total of $8.5 million to be paid, a sum the state capped at eight percent of the budget in 2012 and the money should not have been rolled into the general budget because only $6.1 million had been paid. The last quarter was not paid. Olivarez explained part of the problem was due to the state waiting for the federal government to say how it wanted the county’s money to be used.

Attorney Jim Darling explained when Texas went to a managed medical program in 2011, the federal government changed the way it dealt with Texas on payments for uncompensated medical claims. Prior to this change, hospitals billed the federal government directly for costs of uncompensated care. Now people must get insurance for medical costs. Now the state will not take the money for costs until the federal government says it is going to pay for treatment. Thus the money sits in the account until the federal government asks for payment. Darling said that once the owed money is paid, it would come back to the county to be used for future indigent care.

Eufracio again said the money was no longer there and could not be paid.

Judge Ramon Garcia argued the county should pay the money if it was due. Eufracio said the money would have to come from the general budget and an emergency situation would have to be declared. No action was taken on the request until the details of how the money could be paid would be worked out.

Nominations of firms for architectural services to provide schematic designs for the proposed new Hidalgo County Courthouse were taken. ERO, Dannenbaum, Alcocer & Garcia and Associates and Gignac were nominated by commissioners.

Under courthouse renovations, the commissioners were told requirements to modify the modulars being added to the Hidalgo County Courthouse to be in accord with the Edinburg City Beautification Code will add another $472,500 to the cost of installing the modulars, bringing to total cost of the job to $2.7 million. The extra work will require an additional eight weeks to complete the project. Since the money was not budgeted, it will have to come from the general fund or reserve funds.

In other action, Elections Administrator Yvonne Ramon asked the commissioners to set aside April 18 or 19 to meet with Lubbock commissioners on their recommendations for establishing vote centers in Hidalgo County. The Lubbock commissioners are coming at their own expense to explain how the voting centers work.

Under salary considerations, OWLS (Objective Watchers of the Legal System) member Virginia Townsend questioned why a clerk III position under Precinct 3 Roads and Maintenance was to be changed from a salary of $28,840 to a salary of $42,000, an increase of $13,160. The reason given was increased responsibilities due to a position being eliminated.

In Precinct 3, Hinojosa Engineering was approved for professional surveying services at the Penitas Landfill Project.

Precinct 3 Commissioner Joe Flores was absent.

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