WILLMAR -- Compromise legislation that will keep the general assistance medical care program alive means more changes for county family service departments that administer the program.
"We're capable and ready to respond," said Kandiyohi County Family Services Director Jay Kieft on Friday. "We've been poised flexibly."
It also means a big decision for Rice Memorial Hospital, which has been identified as one of 17 state hospitals that could serve in a new care delivery system created under the legislation.
"At this point, we're actually sifting through some numbers and information and getting a little bit more information about that concept," said Rice Chief Executive Office Mike Schramm. "At this point we have not made a decision one way or another."
Gov. Tim Pawlenty signed the compromise bill Friday that once again changes a stop-and-go transition of providing care to the poorest individuals.
The good thing, said Kieft, is that the change will mean GAMC participants will still receive care.
"The folks that are being served will stay served," he said. "But it won't be as robust a GAMC, no bones about it."
Kieft and Schramm said there are many questions yet to be answered on how the program will be administered and how it will function.
Those questions are crucial to the health-care safety net that has been in flux.
Earlier this year a veto by Pawlenty was set to kill GAMC funding by April 1
Those clients were to be moved into the MinnesotaCare program, a state-subsidized health insurance program that requires premiums and has limited hospital coverage.
Counties were in the process of doing paperwork for that transition when the new compromise was reached that extends GAMC through May 31.
After that an entirely new hospital-based system will be implemented for delivering care to GAMC recipients.
Under the new plan there are 17 eligible hospitals identified by the state that will be part of the coordinated care delivery system.
These facilities will have the opportunity share a $71 million pool of money too provide care to the individuals for 2010-11, said Kieft. That pool will increase to $131 million for 2012-13.
Because of its history of serving GAMC clients, Rice Memorial Hospital has been identified as one of those 17 hospitals.
Schramm said the concept and policies of hospitals serving in this new role present numerous questions and it's "too premature" for Rice to decide whether to participate or not.
If GAMC had been allowed to die it's estimated Rice would've lost between $700,000 - 800,000 a year, said Schramm.
The new legislation won't make the financial hit much less to Rice Hospital, he said.
While it's good to keep GAMC intact, Schramm said the low reimbursement rate will be cut even more. "It's just not a good situation," he said of the compromise bill. "It's not going to bring a lot of help to us."
Kieft said the new legislation will likely serve as a bridge until the federal health care reform "hits the ground."
He said he's glad legislators persisted in finding an alternative to Pawlenty's veto and were "diligent in making some decisions in a not-so-perfect budget world."