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Gregg County joins regional health care plan

By Glenn Evans
Oct. 23, 2012 at 1:51 a.m.

Gregg County commissioners on Monday moved their health care system to a new model designed by the state legislature to rein in the cost of care for people who cannot pay.

Under the so-called 1115 Waiver, Texas was divided by the 2011 Legislature into 20 health care delivery regions.

Gregg County is one of 28 counties in Region 1. The University of Texas Health Science Center at Tyler was selected as the Region 1 anchor, serving as a kind of clearinghouse for hospitals and medical clinics in the 28 counties.

County Judge Bill Stoudt said participation in the program should result in larger reimbursements to the county for money spent on indigent care. The program is under the Medicaid system, a federal/state funding formula with Texas bearing the smaller burden.

Daniel Deslatte, executive director of planning for the health science center north of Tyler, said the waiver program was designed to give local health care providers more say-so in what they may do with the government dollars. It also allows them to share best practices with each other, he said.

For instance, he said, the waiver would financially equip a physicians clinic to expand its hours to increase local access to primary care. Regular doctor visits should cut down the number of emergency room visits, which in turn should lower the amount Gregg and other counties pay for uncompensated health care, Deslatte said.

"A lot of what it will mean locally is our reliance on uncompensated care will go down," Deslatte said. "I expect a lot of hospitals across the region will look at ways to expand primary care. ... So, we reduce the overall cost of uncompensated care to our community."

The waiver program, so-called because it is one of several waivers available under the Social Security Act, also expands the list of permitted expenses to the mental health arena.

That aspect could help this and surrounding counties devise - and fund - a regional mental health facility. That should lower other costs, especially the expense created when mentally ill people are put in jail because they pose a potential threat to themselves or others.

Commissioners on Monday also OK'd Sheriff Maxey Cerliano's request to create a full-time county fire marshal position.

"We're not asking for additional funding," the sheriff said, explaining the funds will come from a position that is duplicated in his budget as both jail and contract services line items.

The court later approved Cerliano's choice for the fire marshal job, Chad Hogue, the public service officer at East Texas Regional Airport.

Also Monday, the court agreed to hold Cerliano harmless in the loss of some $1,600 mistakenly handed to a jail inmate who used it to bond out.

Byron Deshun Ector, 22, of Liberty City, had been arrested on a misdemeanor theft charge by Kilgore police on Aug. 25. Cerliano said a bookkeeping error resulted in Ector having many times more money in his inmate account than what he had checked in during the booking process.

He said the inmate noticed the error and used the money to bail out the same day.

"They got him two days later in Austin," Cerliano said. "We have since re-arrested him. He is charged with theft."

The sheriff said any restitution Ector might eventually be ordered to pay will reimburse the jail account the loss affected.

Ector was being held Monday under $55,000 bond on his original theft charge and the new count.



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