Hillsborough County News
April 6, 2012
Contact: Willie Puz, Communications Department, 813-272-5314
Hillsborough County To Improve Its Health Care Plan
Hillsborough County Commissioners heard the results of an audit of the County’s Health Care Plan at their regularly-scheduled Board meeting Wednesday and an action plan from staff to streamline and improve the Plan’s client eligibility review. County Commissioner Sandra Murman called for the audit last year that led to the Plan improvements.
The evaluation of the Hillsborough County Health Care Plan (Plan) showed some current members no longer qualify, and by moving these members to other programs where they do qualify, new eligible individuals could be added. A random sampling of 380 Health Care Plan members found that 18 percent were no longer eligible and another 18 percent need better documentation to demonstrate their eligibility.
“When I requested this audit of the county’s Health Care Plan last Fall, I was concerned that some of our most vulnerable citizens, the un-insured and the under-insured, were slipping through the cracks, and not being able to benefit from one of our most important programs,” said Commissioner Murman at the Board meeting.
The County is implementing a number of changes in response to the findings. The new approach features a restructuring of duties to form a health care team dedicated solely to conducting reviews of applicants’ eligibility. This new team recently received advanced training on eligibility screening, enrollment practices, and the new data-gathering technology, as it has the potential to verify a person’s eligibility for other social service programs and county-wide services.
Though Plan participants are reviewed every six months, past enrollment practices included using an older applicant verification system. In addition, social workers were multi-tasking with each applicant to test their eligibility for many different types of social services, each with different eligibility requirements.
Hillsborough County will begin an immediate eligibility review of the approximate 14,000 Plan members using the new data-gathering technology. Should any Plan member be determined to no longer meet the Plan’s eligibility criteria, they will be notified and transitioned to other community resources in a responsible manner and timeframe. The full Plan member’s review should be complete by the end of this summer.
The Hillsborough County Health Care Plan is funded by a ½ cent sales tax. To be eligible, applicants must be a legal U.S. resident and Hillsborough County resident; have income at or below 100 percent of the federal poverty level; have assets within established guidelines; not be eligible for other health care coverage; and not be in violation of the “three strikes policy.”
The typical member is between the ages of 18-64 and single. Families with children are generally eligible for Medicaid, and do not participate in the County’s Health Care Plan.
