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Health plan for poor can't evict smokers

The county attorney also rules out a six-month residency requirement for the Hillsborough program.

Published March 23, 2005

TAMPA - Hillsborough County's indigent health care program can't kick smokers out to save money, the county attorney told Commissioner Jim Norman on Tuesday.

County Attorney Renee Lee also says another proposal from Norman - to institute a six-month residency requirement - also can't be done.

The county's program, backed by sales tax revenue, can no more deny health care to new arrivals than it can bar people from schools, parks or libraries. It's the third time the attorney's office has analyzed a proposal like this.

"Any time you need those basic human services, you can't have a residency requirement standing in the way of it," Lee said.

As for smokers, commissioners would have to press for a change to the state law that allows counties to set up such health plans, because it spells out eligibility requirements.

Lee said the county could require smokers seeking health care through the plan take a cessation course. Failure to successfully complete the course might then be grounds for removing someone from the plan, though the opinion mentions that policing such a requirement could be difficult.

"This leaves open the door to assign people who are smoking into clinics to enter treatment," said Norman, trying to salvage some victory from Lee's opinions.

Norman's suggestions came as commissioners are staring at a projected $6-million deficit for the program that provides stop-gap health care for some of the county's poorest residents, and people who don't have insurance or qualify for other government programs. The Hillsborough HealthCare Plan has a $97.5-million budget paid through a half-cent sales tax.

Commissioners have already voted to strip away some care previously covered by the program, including eye and dental treatment. Norman has also suggested a three-strikes-and-you're out rule for people enrolled in the program who are convicted of three or more felonies or first-degree misdemeanors.

Last week, county workers who run the program told Norman that they are likely to pursue another idea he suggested. Currently, the health plan repays medical facilities that treat poor people who are not on the program, but are later shown to meet its eligibility requirements.

In the future, there would be no retroactive repayment. Norman said he has been told that could result in anywhere from a $7-million to $10-million savings.

The county staff estimates the likely savings at less than $4-million. The proposal is likely to draw hospital protests.

[Last modified March 23, 2005, 00:54:07]

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