Related Stories

FARMINGTON — State officials say San Juan Regional Medical Center will get money from a statewide fund that collects county gross receipt taxes for uncompensated health care coverage, but the exact sum is uncertain.

"When the county keeps talking about a zero-percent allocation, they're really not giving the whole story," said Brent Earnest, New Mexico Human Services Department deputy secretary.

The Safety Net Care Pool, which the department has been managing since it became law after the recent legislative session, mandates all counties dedicate one-twelfth of 1 percent of their gross receipts taxes to the fund. That means San Juan County must pull about $3 million from its indigent health care fund, leaving local officials concerned about programs that will suffer from the funding deficit.

San Juan County officials have said the change will bankrupt the indigent fund, which partially pays health care providers' medical bills from uninsured county residents. And that has far-reaching effects, they say.

"People's lives are going to suffer because of this. The people that are impacted are struggling. That's what frustrates me," County Executive Officer Kim Carpenter said. "You heard Totah (Behavioral Health Authority) say that they might lose 10 percent of their (clients') lives because of this program. People are going to die because of this? Are you kidding me?"

Carpenter said he is also frustrated because the state health department gave the county no notice it should budget for this legislation. But Earnest said department staff have had "numerous conversations" with Carpenter and his staff.

In June, San Juan Regional closed its Bloomfield clinic because it anticipated the loss of $9.5 million in funding.

Carpenter said the hospital hasn't been told enough to properly budget. Rick Wallace, San Juan Regional's CEO, was unavailable for comment on Friday. Efforts to reach other officials in the hospital were unsuccessful.

The Daily Times' repeated efforts to reach state health department officials by phone for four previous stories on this subject were unsuccessful. When reached on Friday, Matt Kennicott, the department's spokesman, said he never received any of The Daily Times' calls. Kennicott was interviewed during a Friday conference call with Earnest.

The safety net fund now has about $69 million, and 29 hospitals statewide are currently applying for those funds to bolster care they provide that is not paid for, Earnest said.

A formula decides how the department will distribute 60 percent of the safety net fund to hospitals with fewer than 25 beds. Three hospitals in the state with more than 200 beds — Las Cruces's Memorial Medical Center, Santa Fe's CHRISTUS St. Vincent Regional Medical Center and San Juan Regional Medical Center — aren't slated to receive any funds.

But Earnest said San Juan Regional and the other two hospitals will receive money for uncompensated care from the safety net fund. Many San Juan County officials have said their understanding is that the hospital won't.

Hospitals need to qualify for the safety net funds, and the money from smaller hospitals that don't qualify, Earnest said, will become available to larger hospitals.

He estimated the three larger hospitals will get 5 or 8 percent of the safety net fund.

"He can say it," Carpenter said, "but until we see it from them, we have no way of knowing what it's going to be."

Kennicott later said the state health department doesn't know yet how much money the three hospitals will get and that Earnest provided the estimates only as examples.

Earnest said Medicaid rates for patients who spend the night also are being significantly increased. Initial estimates, he said, predict San Juan Regional will get $7 million in inpatient Medicaid reimbursements. Kennicott said that sum is likely to fluctuate because it's based on claims billed.

"That's interesting," Carpenter said. "That's the first I've ever heard of it."

He also said increasing those inpatient reimbursements contradicts the Affordable Care Act because the federal government wants to eliminate unnecessary overnight stays.

"This change is difficult. We appreciate that," Earnest said. "But it's one that's as fair as it could be."

Carpenter disputed Earnest's definition of "fair."

The three larger hospitals with the most uncompensated health care claims are going to receive no safety net funds "at all," he said, basing his statement on what he called the "current distribution formula." And more safety net funds are going to hospitals with fewer health care claims, he said, adding, "I'm not buying it."

"That's not the definition of fair," he said.

Dan Schwartz covers government for The Daily Times. He can be reached at 505-564-4606 and Follow him @dtdschwartz on Twitter.