Massive Cut Proposed in State’s Biennial Budget for Indigent Care in Jefferson County. Time for a new game-plan?
I knew I was going to have to write something more about the Quality and Charity Care Trust (QCCT) when I saw that the Governor’s budget was slated to decrease the annual appropriation substantially from $21 million to $9.5 and $6.15 million in fiscal years 2015 and 2016 respectively. That represents a 70% reduction and would surely be a body blow to University of Louisville Hospital.
I am unaware of the rationale behind the proposed reduction, but together with the decreasing contributions from the city of Louisville, it is clear that our state and local legislators are rethinking the appropriateness of the QCCT funding mechanism as the principal means to support the care of medically indigent of our community. I have argued that they are correct to do so.
The QCCT fund to support inpatient care at a public University of Louisville Hospital may have made sense in the early 1980’s, but I do not think it does any more. Much has changed, including the amount of funding and the rules regarding its use. Our healthcare providers and our community itself have also changed. This was never a funding system that should have been considered to operate in perpetuity. Perhaps the Governor’s Office knows something that we do not. Continue reading “QCCT Funding for Indigent Care: Back in Play Again.”
A few weeks ago, Louisville’s Metro Council approved with only few changes the 2012-13 Budget prepared with Mayor Fischer’s administration. The University of Louisville had protested strongly over what it called a “reduction” in the funding of the QCCT fund that goes solely to UofL for indigent care, and incidentally makes it possible for the hospital to transfer large sums to the University for other undisclosed purposes. In reality, the net amount for the University’s benefit was the same as it has been. The Mayor and Council rightly refused to play the same misleading bookkeeping game of payment and rebate. Looming over our local deliberations was a threat by some state legislators to reduce their contribution to the QCCT fund by the same amount as any reduction by local government. This despite the fact that Frankfort has been playing its own version of a shell game with UofL for just as long, and indicates that many in state government are also losing their patience with current University leadership. We are left with having to parse the meaning of the word “reduction.”
Initial reports of the Councils deliberations told of added language to the effect that if the City’s income were better than projected, additional funds might be given to the University through of the QCCT. No demands were made on the University to become more transparent and accountable in its use of the money as others, including Metro Council have requested. It seemed that once again, the University had gotten what it wanted through bully and bluster. I waited to see the final budget language, and now that it has been published, I am quite surprised. Here is the exact language added as it appears in the Public Health and Wellness portion of the approved budget. Continue reading “UofL Required to Trade Sports for Indigent Care!”
Level Funding for Quality Community Care Trust (QCCT)
Last night the Louisville Metro Council passed a budget for 2012-2013 with very few and relatively minor changes from the proposed budget they and the Mayor had put together over the past few weeks. For the purposes of this Policy Blog, the controversial QCCT fund for inpatient care of the underserved at University of Louisville Hospital received funding of $7.00 million. This is the same net amount the University has received in recent years but which the University claims is a decrease. The Courier-Journal’s report today states that a clause was added that if city income projections are better than projected next year, that additional funding would be considered. [The official published budget is not yet available to me. When it is, I will quote the language of the clause, the final numbers, and comment further.] Below are the figures from the proposed budget. A neater tabulated copy is available. Continue reading “Louisville Metro Council Passes Budget for 2012- 2013”
Is the University of Louisville losing its grip on the messages?
Yesterday was a big news day for most of the threads that this policy blog has pursued over the last few months. You can follow the discussion by using the Topic Links below or at the right. The thing that ties them together is the involvement of the University of Louisville which has vested interests in the outcomes. Continue reading “Big News Day Yesterday!”