County commissioners discuss indigent fund


With the county indigent fund holding steady at a healthy $2.7 million, commissioners once again are discussing the best way to use the taxpayer funded account.

With the county indigent fund holding steady at a healthy $2.7 million, commissioners once again are discussing the best way to use the taxpayer funded account.

The .125 percent county-wide gross receipts tax pays for hospital visits and ambulance transports for county residents whose income is 150 percent below the federal poverty line.

Indigent fund administrator Barbara Baker came to the commissioners last month with some suggestions on how to reduce the fund's balance and provide more services to residents.

"There has been discussion on how to reduce the balance," Baker said. "I would like to see dental be part of indigent care."

Baker said she would also like to see the county increase the income guidelines from the current 150 percent to 175 percent.

"Basically, some of these people are just over the limit by $50 dollars. That's not fair with the economy like it is and gas prices going up," she said. "I really feel for these people."

Baker said if the county started implementing dental assistance slowly, and capping the annual amount a patient would qualify for, it was a feasible option.

"It's hard to tell how many would show up," she said. "If we cap it at $500 annually, and 200 applications are approved, that's $100,000."

Baker said if the income guidelines are increased, she would expect applications for assistance to increase.

Commission Chairman Donald Holliday suggested that, if the county wanted to reduce the balance in the indigent fund, why not reduce the tax on the residents instead of spending more?

In recent years, when the state budget has been in trouble, rumors have been floated that large indigent funds could be tapped to make up shortfalls.

So far, the state hasn't made any moves to take indigent funds out of counties, but the commissioners and administration continue to monitor the situation.

"We really want to help the people," Baker responded.

Former Commissioner Ron Gentry said he understood that desire to help, "But if we're not real careful, we could jeopardize the solvency of the fund. If we increase services and scope, as the population and applications get larger, we're going to end up with a decrease in the amount we have."

Gentry said he would like to see the county develop a policy that would hold the indigent fund at a certain balance.

"Then we could suspend the collection of taxes so long as the fund is solvent. But once it gets below a certain amount, the tax is implemented," he said. "We appreciate the citizens helping those in need, so they have some protection.

"There is always going to be a need. If we have $10 million, I can give it away."

Looking to 2014, Commissioner Mary Andersen said she was concerned about making changes to the indigent fund because of the unknown effects of the Affordable Care Act.

"We don't know what (the act) is going to do to any of us as far as medical costs," Andersen said. "I would hate to see anything damage this fund that is the last resort for people. I think there is going to be fewer people coming because of the federal Affordable Care Act."

Andersen said she didn't think this was the time to take action on the county's fund, recommending the commission table the discussion for six months to "see what the act brings."

In light of the implementation of the ACA, Baker agreed there would probably be fewer people needing assistance from the indigent fund.

Holliday said the county could "always create a need and get (the indigent fund) down to zero. I believe when it was started, it was in good faith to help people. At what point do we stop going to tax payers and saying, 'We need more."

Baker said taxpayers have always willingly paid the GRT to support the fund.

"Sure, and we could get rid of it by next week if we create the need. I want to help the people who need it. Let's make sure we know how to do it before we do," Holliday said. "Let's get some answers to these ideas before we create something. If we are collecting money we don't need, why do we keep collecting? Why create a need?"

Meadow Lake resident Bob Gostischa said the proposal to possibly increase the income eligibility for indigent funds could "invite an influx of poor people to Valencia County. I'm not sure we are ready to see an influx of people interested to get something for nothing."

Gostischa said he would like to see some residency requirements before increasing the income eligibility.

Under current indigent fund requirements, an applicant has to live in the county at least 45 days before they can apply, and they have to apply within 90 days from the date of service.

There are a number of qualifiers considered for someone requesting assistance from the indigent fund — a family's or individual's income is taken into account, as well as assets like savings, real estate and income-generating rental properties.

Baker uses a federal formula that calculates how far below the poverty line a person is, an amount that is influenced by an applicants family size.

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