Mower County thinks a regional plan for alternative medical assistance coverage has gone awry, and wants to get out.

Saturday, January 20, 2001

Mower County thinks a regional plan for alternative medical assistance coverage has gone awry, and wants to get out.

The issue will be decided in court. A judge will decide if the South Country Health Alliance (SCHA) joint powers agreement has changed so much that it is invalid, as Mower County maintains. If the judge rules the SCHA is the same organization, Mower county will have to pay its share of start-up costs, and follow the joint powers guidelines for removing themselves from the alliance.

If the judge determines that the joint powers agreement is invalid, no member would be bound to it.

&uot;If our case prevails and in fact the joint powers agreement was not valid, then any county could pull out,&uot; Miller said.

The SCHA is a managed care system that will replace traditional medical assistance providers. Freeborn is one of nine counties in the joint powers, and other counties hope to join once they are up and running this spring, said Dodge County Commissioner Dave Erickson, Joint Powers chair of the SCHA.

Miller and Erickson spoke to the Freeborn County board of commissioners Thursday, to explain the SCHA and current legal situation.

The alliance was formed to give counties more local control over covered services and providers. Proponents say data indicates the SCHA will enable counties to cover more services to medical assistance recipients for less money than is currently being paid.

But Mower County commissioners say things have gotten out of control. Rather than an intergovernmental contract that would allow counties to purchase health services, the SCHA is turning into an insurance vendor just like the Prepaid Medical Assistance Program (PMAP) program they are set to replace, Miller said.

&uot;Basically what you’re doing here is PMAP anyway, it’s PMAP on a regional basis,&uot; Miller said. &uot;The state issues the contract, the state negotiates it. The state has all of the control, we don’t.&uot;

Counties in the SCHA are taking on all financial risk in the venture, rather than sharing it with the state, as other counties have. Continuing with the SCHA costs too much money to spend for no solid guarantees, he said.

&uot;It’s just gone awry, you don’t have any control,&uot; Miller said. &uot;You’re just going to be pumping money into it.&uot;

To say the SCHA is no longer county based purchasing because it is being organized through the state is a &uot;philosophical argument,&uot; Erickson said.

&uot;We, as a county, can operate this pretty much the way we want,&uot; he said.

Figures show that the counties remaining in SCHA brings in $33 million annual revenue to PMAP, but only had $27.7 million in expenses. Those number indicate the venture should be profitable, and extra money will be set into reserves used to decrease re-insurance expenses and to reimburse counties’ start-up costs, Erickson said.

&uot;We felt that we could locally administer the programs better, provide better service and make sure these people were getting the health care they need,&uot; said Freeborn County Department of Human Services Director Darryl Meyer.

If counties are unhappy with SCHA after five years, they can go back to PMAP, Erickson said.