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Counties collaborate in effort to improve health care in rural Minnesota

Changes in health care insurance in the private sector have been undergoing changes for years and with the gradual implementation of the Affordable Care Act will evolve even more.

Cost, and a desire to better respond to community health needs, is also resulting in changes for how counties are administering public programs.


In 2003 PrimeWest Health, a system made up of 13 rural counties including Big Stone, Meeker, Pope and Renville counties, began a county-based purchasing program to provide coverage for individuals who qualified for public health care programs.

Now, a 12-county group that includes Kandiyohi, Swift, Chippewa, Redwood, Pipestone, Murray, Rock, Nobles, Cottonwood, Yellow Medicine, Lincoln and Lyon counties, is in the process of creating a health care collaborative that would utilize its own group insurance plan and tailor early health care intervention and prevention.

The customers are individuals who qualify for Medicaid, which is the joint federal-state health insurance program for the poor and disabled.

The proposal has been in the planning stages for seven years. Officials hope to win final state approval soon.

 Known as Southern Prairie Community Care, the collaborative is being developed to create a local care coordination network for the “vulnerable people living in our communities,” said Mary Fischer, executive director of the collaborative.

 Currently, those services are provided by health management organizations that have contracts with the state.

Allowing counties to serve as the insurance coordinator brings the services to the local level that includes more flexibility, especially in preventative health care programs that reflect direct needs of a community rather than the cookie cutter HMO model.

For example, if diabetes is a prominent health care issue in a region, preventative and educational programs can be developed to hit the issue head-on and potentially avoid costly problems in the future.

Blending services

The Southern Prairie Community Care program is unique because it also intends to blend medical care supervision with a client’s social issues to create a more holistic care program.

The new model will allow local health care providers who deal with a client’s medical care to work seamlessly with county caseworkers who may be overseeing the client’s other needs, like affordable housing needs or mental health care services.

Organizers believe they can coordinate those services and provide better care for less money than what’s currently being spent for Medicaid.

Joint public health board

Meanwhile, Kandiyohi County and Renville County forged a new relationship to create a joint public health board, which includes plans for sharing services, including the counties’ environmental health services that would include, for example, food and beverage inspections.

That cooperation includes working together on a required public health assessment plan that’s required this year, as well as an optional lengthy process of accreditation. The state Health Department has begun the process of accreditation, and a community health advisory board has recommended that local health departments follow suit.

It’s hoped that the cost of the assessment and accreditation will be less if they work on it as a joint powers board rather than individually.

The collaboration and “cross-jurisdictional” sharing of services between the public health departments of the two counties is part of a national trend, said Ann Stehn, director of the Kandiyohi County Family Services Department.

“It’s a movement that’s picking up a lot of steam across the country,” she said.

Carolyn Lange

A reporter for 35 years, Carolyn Lange covers regional news with the West Central Tribune.

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