New battle over indigent care funds affects patients and safety net agencies in Kansas City

Good questions are being raised about how to properly use $31 million raised through Kansas City’s health levy. For the second straight year, funding for safety net agencies that care for indigent patients is an essential conversation at City Hall.

Last year the City Council properly restored funds that had been initially wrested from the agencies to funnel into excessive costs at the Fire Department. But it took a big fight by health care providers to get that outcome.

This year, Health Department Director Rex Archer and city-hired consultants have looked deeper into reports by the providers of how they spend their money.

Archer and his staff have prepared several proposals that could dramatically change funding for the agencies, based on how many encounters they have had with patients and how much the city thinks the agencies should be paid for dealing with those patients.

In an interview last week, Archer bluntly said that the recently released 2016-17 budget from Mayor Sly James and City Manager Troy Schulte is “not correct” when its shows patient visits to health centers have increased since two years ago. The centers provide those numbers.

In fact, Archer said, investigators have found that patient encounters have fallen by quite a bit at some providers. In addition, he said, the city questions whether some agencies are correctly billing the city for patient services.

“We owe the taxpayer due diligence on their funds,” Archer said, adding that he’s wondered for years about how the city could better allocate funds to safety net agencies.

On Tuesday, the proposed allocations for these organizations — including Truman Medical Center, Swope Parkway Health Center, Samuel U. Rogers Center, Children’s Mercy Hospital, Northland Health Care Access and Kansas City Care Clinic — will be discussed at a public meeting.

The goal is for the Health Commission’s budget and contract evaluation members to submit a recommendation to the full commission, which in turn will pass its findings to the City Council.

Council member Alissia Canady is also a commission member. She has concerns about the proposed city funding for some agencies and said she hopes Tuesday’s meeting will help resolve them.

Hilda Fuentes, president and CEO of Samuel Rogers, said last week she’s not pleased by a proposed reduction of $320,000 a year in her group’s funding. She questions some of the city’s methodology regarding figures being reported for patient encounters at the health centers.

A spokesman for Truman Medical Centers, the largest beneficiary of the health levy’s property tax revenues, at $26.4 million a year, said it is satisfied with funding proposed in the new city budget.

In an interview, Schulte said that the city needs to use a “fact-based approach” as it hands out public funds to the providers. Some may be getting too much money and others not enough, he added.

It’s clear that Schulte, Archer and other city officials think this may be the year to start upending the usual way of doing business with indigent care agencies.

But as that happens, the fate of high-quality indigent care for thousands of Kansas Citians hangs in the balance.

This story was originally published February 28, 2016 at 6:01 AM with the headline "New battle over indigent care funds affects patients and safety net agencies in Kansas City."