HCMC to shut out nonresident poor

  • Article by: KEVIN DUCHSCHERE , Star Tribune
  • Updated: October 5, 2010 - 8:54 PM

Starting early next year, the state's largest public hospital will no longer give nonemergency care to out-of-county residents who are uninsured. HCMC estimates the move could save $600,000 a year.

In an ongoing effort to fight the effects of state cutbacks, Hennepin County Medical Center starting early next year will turn away poor and uninsured patients who live outside the county and are seeking nonemergency treatment.

Such patients would still get emergency treatment, which the hospital is mandated by federal law to provide regardless of residence or resources. The hospital also will continue to treat nonresidents who are insured.

The County Board passed the new policy 6-1 Tuesday, with Commissioner Jeff Johnson casting the dissenting vote.

HCMC estimates that the new policy might save about $600,000 a year by denying treatment to an average of 1,000 destitute patients annually, based on 2008-09 statistics. Board Chairman Mike Opat acknowledged that's not a huge impact on the hospital's bottom line.

What the policy will do, Opat said, is send "a message to the other counties in the state that we're a statewide resource, and we need to be supported a bit, particularly in the [nonemergency] situation."

HCMC sent letters to 12 neighboring counties, tallying the number of their uninsured residents who received both emergency and non-emergency treatment at the hospital from 2008 through the middle of 2009. With regard to six of those counties, HCMC was shorted $6.6 million for its treatment of 11,200 patients from outside Hennepin County.

"We do not believe it fair to ask the taxpayers of Hennepin County to support the care that HCMC provides to the indigent from other counties such as yours," wrote Arthur Gonzalez, the hospital's CEO.

The County Board rejected amendments offered by Johnson that would have restricted care to U.S. citizens or immigrants with a green card, and that would have tracked how many of them got treatment. Most commissioners judged those policies either unworkable or unfair.

Johnson said that illegal immigrants shouldn't get help from HCMC if the hospital is going to deny care to taxpayers from other counties.

"There are many things that we don't provide as a county for people who either want or need them, and we do that because the pockets of our constituents aren't bottomless," Johnson said. "We have to draw lines, and I think probably the standard should be different for people who are here illegally."

Commissioner Gail Dorfman responded that such a policy ultimately would be costly, not to mention inhumane. Should the hospital turn back a pregnant woman seeking preventive care, she asked, only to take her on an emergency basis when she's in trouble or about to deliver?

Commissioner Randy Johnson agreed. "I don't like spending money on people who shouldn't be here, but I'm not sure that denying them care is really going to save Hennepin County property tax payers any money," he said.

Gonzalez said that the hospital doesn't note the legal status of patients unless it's voluntarily provided.

While absorbing massive cuts in the state's General Assistance Medical Care program, which compensated hospitals for treating the state's poorest and sickest residents, HCMC has been on the mend in recent months. It has improved its collections operations and slashed expenses, saving millions.

Though HCMC is no longer expected to operate at a loss this year, it seems unlikely that the state program designed to replace GAMC -- Coordinated Care Delivery Systems -- will be able to cover all the poor patients who have typically turned to Hennepin County's hospital for help.

Kevin Duchschere • 612-673-4455

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