Management and Performance Review of County Government ...

Health & Welfare/Library/Veterans Services of Jefferson County
In the past, HWD had some unnecessarily costly practices and lacked adequate
controls in some areas. But the department seems to have learned from those
experiences and the savings from its controls seem to justify a great increase in
administrative paperwork.
Federally Qualified Health Clinic Designation
Jefferson County has considered obtaining Federally Qualified Health Clinic
(FQHC) designation from the federal Bureau of Primary Health Care. A FQHC
designation provides many benefits, including annual funding of up to $650,000 a year;
cost-based reimbursement for Medicaid and Medicare services; drug pricing discounts
on pharmaceutical purchases; and access to medical malpractice coverage, among
other benefits.
Obtaining the designation, however, involves a number of difficult requirements,
including the formation of a governing board, more than half of whose membership must
be made up of clinic users. Public entities wanting to convert their clinics to FQHC status
could be structured with a combined, co-applicant board (made up of county
commissioners and FQHC board). The chief executive officer for the clinic, however,
would answer to the FQHC board, even as the clinic employees would remain county
employees.
Furthermore, FQHCs by law must serve any area resident asking for service
although they can require payment for services. Additional federal funding for the FQHC
may not supplant current spending and service. FQHCs also must provide many
required services, including dental and mental health services, which Jefferson County
does not currently provide.
Jefferson County has many designated medically underserved areas, and
presently has only one FQHC, the Gulf Coast Health Center, Inc., (GCHC) located in
Page 5-15