State eyes shifting McNeil Island health costs

DSHS exploring how to move SCC residents’ expenses to Medicaid under the federal Affordable Care Act

Staff writerApril 13, 2014 

The state’s prison system already anticipates saving more than $1 million this year on inmates’ medical bills because of the federal Affordable Care Act.

Now, state lawmakers want to see if Washington’s home for violent sex offenders can find similar ways to benefit from the federal health care reform law.

This year’s supplemental state budget contains a provision requiring the state Department of Social and Health Services to explore ways to cut health care costs for residents of the Special Commitment Center on McNeil Island.

Among the possibilities: Seeing if the center’s population of civilly committed sex offenders can qualify for Medicaid under the ACA’s expanded eligibility rules.

It’s an approach already being taken by the state Department of Corrections, which expects to save about $2.2 million in the 2013-2015 budget cycle through expanded Medicaid coverage for inmates. The agency spends $113 million per fiscal year on health care for inmates, spokeswoman Norah West said in an email.

Previously, the state Department of Corrections used state funds to pay for most inmate medical procedures that required admission to a hospital, said Ronna Cole, the agency’s finance program administrator for health services.

But under provisions of the Affordable Care Act, most inmates’ in-patient stays at hospitals can now be paid for using federal Medicaid dollars, Cole said.

Since many prisoners are single and have no income, many of them meet the poverty requirements to qualify for Medicaid under the new law, Cole said.

“Prior to Jan. 1, any in-patient procedure could have (only) been covered if you were aged, blind, disabled or pregnant,” Cole said. “After Jan. 1 it opened it up to everyone.”

State Sen. Jim Hargrove, a lawmaker from Hoquiam who is the top Democrat on the Senate’s budget-writing committee, said it makes sense to see whether the Special Commitment Center can also use Medicaid to cover residents’ health care costs. The facility right now houses 270 sex offenders, according to DSHS.

“If there is some way to shift the cost to the feds, I think that could be a good idea,” Hargrove said.

Even lawmakers who aren’t huge fans of the federal health care reform law think it is worthwhile to find ways it can save state agencies money.

“It seems reasonable,” said state Sen. Steve O’Ban, a Tacoma Republican who sponsored unsuccessful legislation this year that would have let Washington residents get their pre-ACA insurance plans back.

DSHS must report back to the Legislature and the state Office of Financial Management by Nov. 1 about the feasibility of using Medicaid to reduce medical costs at the Special Commitment Center.

Lawmakers also asked DSHS to study whether the Special Commitment Center can save money by getting residents signed up for health insurance through the insurance exchange the state set up as part of federal health care reform.

“We’re just trying to test the waters,” said state Sen. John Braun, R-Centralia. “We’re constantly looking for how to get our best bang for the buck with state government.”

DSHS spokeswoman Mindy Chambers wrote in an email that the agency also is exploring other ways it could lower the costs of residents’ medical care, including reducing the costs of prescriptions. The Special Commitment Center spent $3.3 million on health care for residents in fiscal year 2013. The center’s total annual budget is about $37 million.

“DSHS fully recognizes we must be good stewards of taxpayer dollars as we provide effective and efficient services for our clients,” Chambers wrote.

Melissa Santos:360-357-0209

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