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Hospital district to bear the brunt of costs

Friday, September 16, 2005 by

Medicaid payments mainly limited to kids, pregnant women

Long term, the Travis County Hospital District—not the federal government— will bear the brunt of the local health care costs of Hurricane Katrina, the hospital district’s CEO told the board of managers at last night’s board meeting.

Just this week, the Centers for Medicaid and Medicare announced a 100 percent reimbursement for Medicaid costs of Katrina evacuees. That will mean millions to Texas, but the percentage of evacuees covered by Medicaid under current Texas guidelines is so small that the Travis County Hospital District expects to pick up the bulk of health care costs for those remaining in Austin who are uninsured or suffer from chronic illnesses.

In Texas, Medicaid is limited to a narrow minority of residents: primarily pregnant women; children up to the age of 21; and the aged and disabled. It does not provide coverage for the working poor. CEO Trish Young expects those who remain in Austin long term and don’t qualify for Medicaid or purchase private insurance to end up on the county’s rolls for its Medical Assistance Program. The program provides health care for the working poor in Travis County. At last night’s board meeting, Manager Tom Young, the former Brackenridge administrator, emphasized what that would mean.

“Even for those five months (of 100 percent reimbursement), Medicaid is for the elderly, children and women with childbirth in mind,” Young pointed out. “Clearly there is a lot of medical care – anybody with a chronic illness, anyone who requires ongoing care – where Medicaid is irrelevant to them. A lot of the care that is needed is something we’re going to be picking up because they have no coverage.”

“That will be our exposure,” Young said.

It is too soon to know exactly how broad that exposure will be, Young said. No one has been enrolled in the Medical Assistance Program to date. To enroll requires proof of residence – such as a utility bill – or verification of homelessness.

To provide some perspective, Vice Chair Carl Richie noted that the Housing Authority of the City of Austin had handed out 77 housing vouchers for evacuees at its last meeting and anticipates handing out another 300 housing vouchers at its next meeting.

The cost of Hurricane Katrina will roll out over the next few months, Young explained. First, in the September totals, should be the initial overtime shifts for clinic personnel and doctors at the Austin Convention Center. That will be short term and not something Young expects to be reimbursed. Then, as the year continues, Young expects the families that might be looking for health coverage to be added to the MAP rolls.

Chair Clarke Heidrick, as well as Young, have noted that capacity is as important as cost to the hospital district. Current resources are stretched to cover a limited number of clients. Already, the East Side clinic has added evening hours to accommodate evacuees, a move that managers applauded but which they recognize comes with a cost. Long term, that cost will include health care as well as prescription drug benefits.

Given the limitations of the Medicaid reimbursements, Richie urged the board to lobby hard for higher Disproportionate Share Hospital payments from the federal government. If hospitals in Louisiana, Mississippi and Alabama are closed, then more DSH funds should flow to Texas hospitals caring for those residents. Young promised she would be in contact with the Department of Health and Human Services to ask the state to lobby for a greater share of federal funding of medical services.

Meanwhile, a number of community health clinics in Central Texas—including the Austin/Travis County Community Health Centers—have formed a coalition to provide care for Katrina evacuees. Part of that effort is to establish a “Katrina Evacuee Health Care Help Line” to assist them in finding the services they need.

The number, (512) 324-2447, is operated by the Indigent Care Coalition and the state’s “insure-a-kid” program and will assist evacuees with finding the closest clinic, getting an appointment and arranging transportation.

In addition to the city-county facilities, other clinics participating are: AISD’s Skippy Van; Austin/Travis County Mental Health Mental Retardation Center; Blackstock Health Clinic, David Powell Clinic; El Buen Samaritano; Georgetown Community Clinic; Planned Parenthood; Round Rock Health Clinic; Seton Community Clinics; Travis County Medical Society; Volunteer Health Care Clinic and St. David’s Theo Dental Van.

ZAP subcommittee begins studying Spring condos

Baker voices concern over integrity of process

The subcommittee for the Zoning and Platting Commission formed to study the proposed Spring Condominium project at Third and Bowie streets met for the first time Monday night to begin identifying the issues they’ll address over the next few weeks. The subcommittee plans a series of meetings in September and October so that the full ZAP can make an informed recommendation on the 36-story project to the City Council. But ZAP Chair Betty Baker, who did not appoint herself to the subcommittee, expressed doubts about the whole process.

“It’s very disheartening to sit on a commission or board and you hear information coming to you from every direction, and you hear the phrase ‘We have our votes at Council’. That is just a slap in the face to this commission, Planning Commission, or anybody,” she said. A surprised Perry Lorenz questioned whether anyone from his development team had actually made those remarks. Lorenz plans to develop the building along with partners Robert Barnstone, Diana Zuniga and Larry Warshaw.

“I said I’ve heard it on other cases…and I’ve had Council members tell me they’ve been lobbied on this case,” Baker replied.

In addition to Baker’s concerns, the subcommittee heard from neighbors in the Old West Austin Neighborhood, who indicated that traffic, height, and the possible precedent the project would set will all be hot-button issues during future meetings. While subcommittee Chair Keith Jackson attempted to focus the discussion on simply identifying the issues at hand, several parties began to lay out their positions both for and against the project.

“As an OWANA resident,” said Laura Morrison, “my long-term concern is…will the neighborhood survive as a residential neighborhood? I’ve heard developers suggest that in 50 years it will be CBD all the way to MoPac. This particular decision will impact that. Within the whole context of planning, I think it’s a very, very significant decision.”

Members of other neighborhood groups warned against the traffic impact the development would have on the already crowded intersection of Sixth Street and Lamar Boulevard and of the effect the structure would have on the downtown skyline. Commissioners also had concerns along those same lines, especially about extending high-rise development west into traditionally residential areas.

“I’m concerned about context…what this would look like compared to other structures in that area,” said Commissioner Melissa Whaley Hawthorne. “I know there are some that are planned, but don’t know how far off they are and how they would transition to a lower-scale development.”

While most of the meeting was devoted to comments from neighborhood representatives and members of the ZAP, two of the principals in the project did attend to listen to their concerns and offer information.

Lorenz urged Commissioners to remember the residential nature of the project during their discussions on traffic. “The trips generated by a residential project are very, very small. It’s easy to scoff at that and just deny it, but people leave in the morning and they come back in the afternoon. They can walk to the grocery store, or get on the pedestrian bridge, or take the commuter rail or the Dillo,” he said. “I think traffic is something you need to take a hard look at, because I think it’s not as sensational as some people say.” Lorenz also pointed out that the project had received support from the Downtown Austin Neighborhood Alliance and the Old Austin Neighborhood Association.

Commissioners and the citizen representatives had several requests for more information from city staff to be presented at a future subcommittee meeting. They asked for several maps of the downtown area marking DMU zoning, DMU–CURE, single family zoning, and the Capitol View Corridor. ZAP Baker also requested a representative of Capital Metro to discuss the transit agency’s plans for the area. “I’ve heard that this might be under consideration as a TOD,” she said. “If so, I’d like to know.”

©2005 In Fact News, Inc. All rights reserved.

Granger gone . . . City Purchasing Officer Diana Granger resigned abruptly last week. Austin’s Chief Financial Officer John Stephens said Urcha Dunbar Crespo, a longtime employee of the department, has been named Acting Purchasing Officer. The office oversees all of those goods the city purchases centrally and monitors compliance with city contracts, Stephens said. The Purchasing Officer also makes presentations to the City Council on individual contracts above the City Manager’s authority to buy. Currently that amount is $46,000, Stephens said . . . Historic Preservation . . . The Historic Preservation Task Force met again this week to consider possible changes to city rules governing the historic designation of buildings and neighborhoods. The group agreed to recommend setting the bar for local historic districts at 60 percent of owners within the district, rather than the original simple majority. The group will attempt to get a legal opinion on moratoriums for next week and also take up boundary issues . . . Still waiting for a permanent home . . . According to the city’s Public Information Office, 950 people evacuated from the Gulf Coast spent Wednesday night at the Austin Convention Center . . . Sunday in the park . . . Brown McCarroll will team up this Sunday with Capital Metro, the Salt Lick and Amy’s Ice Cream to give kids currently housed at the Austin Convention Center some outdoor fun. Sandy Lar a said the transit agency would provide buses to take children between 8 and 18 years old from the Convention Center to Zilker Park. Once there, the kids will be able to play various games, climb an artificial rock wall and have a picnic. The afternoon’s games will be organized by Camp Champions counselors under the watchful eyes of 50 volunteers from Brown McCarroll . . . Sixth Street on Bourbon Street . . . Due to logistical problems, the Sixth Street on Bourbon Street benefit planned tonight has been moved to Republic Square Park. The event—benefiting hurricane evacuees, will have Austin bands on one stage and New Orleans musicians on another. Some of the artists scheduled include Mingo Fishtrap, Theresa Andersson, The Gulf Coast Playboys and the New Orleans All Star Band featuring Cyril Neville on the New Orleans stage, and Trish Murphy, Asleep at the Wheel, Jerry Jeff Walker, and Marcia Ball with Delbert McClinton on the Austin stage. Gates open at 2 pm and the music lasts until 10pm. A ticket is a minimum $10 donation; $20 or more will get a free T-shirt. Go to for more information. . . Richie to receive award . . . Carl Richie will be honored with the National Association of Housing and Redevelopment Association’s Elizabeth B. Wells Memorial Award at the NAHRO convention in Chicago next month. Richie was cited for his work to establish a scholarship program for high school graduates who live in public housing, as well as a dropout prevention program and lobbying at the Legislature against on behalf of fair housing bills. Richie, a partner at the Gardere law firm, is vice chair of the Travis County Hospital District’s Board of Managers . . . Other district news . . . Two new employees will come on board at the Travis County Hospital District next week. Carolyn Konecny will serve as financial manager and Larry Wallace will serve as the joint action team administrator, which means he will act as liaison between the district’s clinics and Brackenridge Hospital . . . Another entrant in the race . . . Commercial real estate broker Alex Castano, will formally announce his candidacy for the Republican nomination for State Representative, District 47, Saturday at Small Middle School on Saturday. Castano is seeking to take over from Rep. Terry Keel, who is running for the Texas Court of Criminal Appeals. . . Gifts to Austin . . . The Governor of the state of Coahuila will join Council Member Raul Alvarez and other city officials this morning at Waterloo Park to announce that the city is receiving two statues of Mexican revolutionary heroes. The statues represent Don Miguel Hidalgo y Costilla and Don José Maria Morelos y Pavón. Today is the anniversary of Mexico’s Independence from Spain.

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