Stop unhealthy cuts to Kansas City’s indigent care providers

Truman Medical Center provides care for thousands of indigent patients.
Truman Medical Center provides care for thousands of indigent patients. Truman Medical Center

Truman Medical Center and other agencies that provide health care to thousands of less fortunate residents are reeling because of recent moves to slash their public funding.

The decreases for the safety net agencies are unreasonable and should be restored.

That’s the right move, especially after what happened in early 2013.

Kansas City Mayor Sly James and others urged voters to renew a property tax that helped finance indigent care. One campaign ad warned: “Some crucial health care programs — such as mammograms, childhood immunizations, nutrition programs that control obesity and early childhood interviews — will be discontinued if this portion of the health levy is not renewed.”

Voters then extended a portion of the health levy that year.

But now it’s early 2015, and institutions that help the indigent are being punished. The biggest reasons are that the city hasn’t adequately boosted ambulance revenue collections in the Fire Department or done enough to reduce the agency’s personnel costs. Essentially, the Fire Department’s gains in city funding are the health care providers’ losses.

The two new fiscal blows affecting the safety net agencies:

▪ City officials in late January told Truman and other health care providers they would not get $2 million they had expected from this fiscal year’s city budget, which ends April 30.

▪ James and City Manager Troy Schulte then unveiled their proposed 2015-16 budget, starting May 1. It would continue the $2 million reduction, which is about 6 percent of the providers’ city-supported budgets.

Truman Medical Center would lose the most — $1.5 million in both the current and next fiscal years. That would drop its city funding to $24.3 million annually, the lowest since 2006.

The city also plans to strip $500,000 this fiscal year and next from agencies such as Children’s Mercy Hospital, Samuel U. Rogers Center, Swope Parkway Health Center, Northland Health Care Access and KC CARE Clinic.

The city’s Health Commission last week said it was outraged at the cuts. A letter signed by co-chairs Lora Lacey-Haun and City Council member Ed Ford got right to the heart of the matter: “The purpose of the health levy is not to balance the Fire Department’s budget or pay for their unbudgeted overtime and/or poor collection rates.”

The agencies sent their own letters telling of consequences such as reduced staffing and inability to serve patients.

“This decrease could potentially result in adverse health repercussions for over 350 Kansas City, North residents who have a critical need for health care services,” wrote Karen Dolt, CEO of Northland Health Care Access.

The providers also made the excellent point that they care for uninsured patients who might otherwise go to private hospital emergency rooms, driving up health care costs for insured people.

In an interview, Schulte acknowledged the fiscal pain being inflicted on the agencies. He held out hope he could restore funds for the current and future years if the Fire Department’s ambulance billing collections continue at an accelerated pace. New software was installed late last year to help that process. Unfortunately, the City Council earlier in 2014 rejected his reasonable plan to completely revamp the billing procedures by using a private manager.

James, who supported that bid, said last week, “We said at the time of the ambulance billing discussion that failure to change that process would blow a hole in other services. And now that projection has proven to be true.”

There are other ways to free up money for indigent care. Fire Department overtime and personnel costs could be reined in during current negotiations with the fire union. Or, the department could close another station or two.

Kansas Citians have good reasons to question City Hall’s priorities. Officials must reverse the drain of health levy funds from safety net providers.