Red Willow County commissioners Monday morning asked for assistance from Nebraska Health and Human Services to rewrite the county's guidelines for requesting funds from the county's medical assistance program.
While some parts of the program will be revised, the base gross monthly income at which a single person qualifies may be increased by only $29.
Several Nebraska counties have over the past several years increased the base income at which applicants qualify -- thereby qualifying more people -- but, commission chairman Earl McNutt said, Lincoln County also reduced that amount again due to increased pressure on already tightly-stretched county budgets.
Red Willow county's medical assistance program is seen as an assistance of last resort, McNutt said. The bottom line is, he said, he does not want Red Willow's guidelines so relaxed that everyone is eligible. "They're stringent for a reason," he said.
Commissioner Leigh Hoyt is concerned that the county's guidelines are so strict that they disqualify someone too easily. "Does it matter what amount of income we set if so many other guidelines can disqualify an applicant?," he asked. It appears, he said, "the only way to qualify is not to work at all."
However, voluntarily reducing hours or quitting a job also disqualifies an applicant.
Social worker Barb Hinz, social worker supervisor Kerry Hopkins and Barb Ostrum, coordinator of McCook's office of Community Action of Mid-Nebraska, agreed that if someone is not eligible for county medical assistance, other assistance programs -- state and federal -- are generally available.
County Attorney Paul Wood said that that is "by design over many decades," as state and federal governments have taken public assistance off the counties.
Hoyt suggested increasing income guidelines to at least reflect federal poverty guidelines, increasing the county's income guideline for one person from a gross one-month salary of $446.66 to $475. Commissioners rejected Ostrum's suggestion to increase income guidelines by 2 percent because of the lack of any adjustment in more than 20 years.
Hinz suggested that commissioners reduce the period of time over which qualifying income is based from six months to three months. If someone has a life-threatening illness, a three-month income guideline might be advantageous for him/her, she said.
At Wood's request and on a motion by Hoyt, Hinz will contact legal authorities from HHS to revise the county's medical assistance guidelines, making necessary adjustments in gross income for family size and net income.
Commissioners will discuss the revisions at their Nov. 9 meeting, at 10:15 a.m.
In other action:
* Commissioners agreed to place Red Willow County in third place on the real estate after TierOne Bank and the Small Business Administration in loans to Quality Urgent Care, the new emergency care walk-in clinic on North U.S. Highway 83 in McCook. Wood told commissioners that he was comfortable with the county's change from first place to third place on the real estate, as its five-year $70,000 revolving loan is "well collateralized" with clinic equipment and individual signatures of borrowers.
Troy Brandt, commercial lender from TierOne, said that Quality Urgent Care showed a good income for the first month, with healthcare professionals seeing 50 patients per day for several days. Wood said that showing a profit the first month is tremendous. "The flu has helped," Brandt said.
* Commissioners purchased 45,000 pounds of motor grader cutting blades (1/2"x6"x8') from Midwest Service and Sales Co. of Schuyler for $5.21 per foot, $27,092 for the load. It will be delivered within two to three weeks.
Other bids were received from: Valk Manufacturing of New Kingstown, Pa., $5.46 per foot, $28,217.28; Nebraska Machinery Co. of North Platte, $5.52, $28,256; and Murphy Tractor and Equipment, North Platte, $5.83, $30,316.
* Commissioners decided to open bids for a new road grader for District 2, (eastern Red Willow County) on Monday, Nov. 23, at 10 a.m.
* Commissioners approved an interlocal agreement with Danbury for the enforcement of municipal ordinances by Red Willow County sheriff's officers. Danbury will pay $150/month, or $1,800 a year, for Sept. 1, 2009 through Sept. 1, 2010.
* Commissioners approved Red Willow County's participation in a state-wide courthouse food drive challenge started by Adams County (Hastings). Non-perishable foods delivered to the Red Willow County courthouse in McCook from Nov. 1 through Nov. 24, for Thanksgiving, and from Dec. 1 through Dec. 22, for Christmas, will be delivered to the McCook Pantry.