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Aid to HMOs may leave county programs short

State Sen. Mike Fasano wants $5-million for county programs losing state funding to transport Medicaid clients.

By PHIL DAVIS
Published September 30, 2005

NEW PORT RICHEY - State Sen. Mike Fasano pledged Thursday to find financial help for transportation officials in five Tampa Bay area counties who are reeling from a last-minute proposal to slash their budgets for transporting Medicaid patients.

Under the proposed 2006 state Agency for Health Care Administration budget, a portion of the money sent each month to county transportation disadvantaged programs would be diverted to HMOs, which would take responsibility for their clients.

No one disputes the HMOs' right to take the money. But transportation officials and contractors from Pinellas, Hillsborough, Pasco, Hernando and Citrus counties told Fasano, R-New Port Richey, the math doesn't add up. County programs get their money based on actual rider fees. HMOs are paid by the number of enrollees in a county, no matter if they use the services or not.

Citrus County, for example, would lose 23 percent of its $39,000 monthly transportation disadvantaged budget with only a 3 percent reduction in the number of riders.

The hit, spread across 26 Florida counties, totals $5.4-million, according to the Florida Commission for the Transportation Disadvantaged.

"We can't take a $61,000 hit and still have most of the riders," said Darryl Minardi, a contractor who provides Medicaid transportation in Hillsborough County. "We'd probably have to opt out of the contract."

Fasano, chairman of the Senate's Transportation and Economic Development Appropriations Committee, promised Thursday to work with state officials to find $5-million to ease the hit on county programs.

"They are still providing service to most of the people but losing quite a few of the dollars," Fasano told an HMO representative at the meeting. "They are taking the hit. That's what my concern is."

Everyone agreed an additional $5-million will help, but it doesn't solve the problem.

"It's kind of like putting a Band-Aid on it," said Thelma Williams, Pasco County's transportation coordinator. "It won't solve the problem."

It will give the state time to react to the change. Williams said no one will be left on the street if the cuts go through. But she predicted a rough transition. People covered by Medicaid HMOs would have to learn a new system to get to their appointments.

"For something that's going to happen on Nov. 1, it's a long way from ready," she said. "You've got a lot of HMOs that have not contracted for transportation. Some people are going to be inconvenienced and upset. There is definitely going to be a learning curve."

[Last modified September 30, 2005, 01:35:17]