A while back, I was listening to one of the Somervell County commissioners meetings in which Larry Shaw of the Somervell County Hospital Authority board (then an appointed board answering to the commissioners) and Mike Ford talked about the indigent money that was budgeted. Ford explained that in order to abide by state law, a certain percentage of money had to be kept aside in the budget and not touched to pay for indigent care. This might be, for example, where a resident of Somervell County is treated at John Peters Smith in Fort Worth and JPS then bills for the money. Larry Shaw said that he wanted all that money that right then was being held aside. I looked up to see if hospital districts had different rules about paying for indigent care and they do; there is not a constraint about needing to keep aside a certain amount. We don't have much indigent care expense in this county, so essentially both Ford and Shaw pushed the point that that money would be able to be used when not in the county budget.
Thought about this some more and you can't really compare one budget to another. If you, my neighbor, decided to budget 500 per month for food, 200 for utlities, 100 for gas, etc (Yes, I know those numbers sound completely unrealistic) but I have a budget that does 550 for food, 150 for utilities, 200 for gas, etc, it's out of our own pool of money and I can't compare how you spend to how I spend. Saying that it's not as if there is a concrete set of money that gets physically moved over from one governmental entity to another but just frees money from one budget, and the hospital now takes over indigent care and can decide how to do it.
That said, first, you would think that since that freed up money that the county no longer has to budget for that the county budget would be lower to give US back the break since now we are ALSO paying for the district to do the same thing. No. One item that has not changed is the 14.4 million that Judge Ford, then commissioner, pushed an illegal vote for, that is still in the county name. Now the hospital has to pay BACK the county for that money but it did not remove the debt from the county. The indigent money pool, however, is gone, as well as M&O expenses.
What I was told today in a conversation about this, is that the hospital district can now set rules on who actually should be considered an indigent person.
Suppose someone owns land, or has a car, or a television set, in other words, set even more restrictive guidelines on just what criteria qualifies an indigent person. Update: To put a fine point on it, the difference in what the hospital district proposes to do with indigents does not set new rules or law that does not follow the state of texas law on how to treat indigents (See Health and Safety Code Section 61.006) . It's more that the county has been more lenient in its enforcement of what an indigent person was in the past and now the hospital district will do strict enforcement.
Here, for example, from the last time when Gary Marks was pushing the hospital district, is Dr Davis talking about how GRMC was not doing efficient screening to determine whether someone was indigent
and here was Foy Edwards asking about those indigent costs
It's ridiculous in comparison with the hospital spending money in another district for rich people, in which the spending of money has NO public purpose.If the district is so fired up to squeeze out every nickel FROM cutting down the number of indigent people in Somervell County (and, as you can hear from the videos above, Hood and other surrounding counties as well) , by cutting out the leniency and hewing strictly to the line, then why the heck are they so blithely turning a blind eye breaking the law by sending Somervell County taxpayer money to Pecan Plantation? Hypocrisy, thy name is Somervell County Hospital District.