Management and Performance Review of County Government ...

Health & Welfare/Library/Veterans Services of Jefferson County
Moreover, new patients typically must wait three to four weeks before their first
appointment. This in turn forces some indigent patients to use emergency rooms (ERs)
at area hospitals for primary care. In response to the high and uncompensated costs of
providing such care, one area hospital now has a new procedure to screen out those
seeking ER services unnecessarily, identifying about 10 to 15 such patients each day.
Although the county does not pay for service delivered to all of these indigent
patients, area hospitals do refer some patients to the county for screening to determine if
they qualify for the IHC program. If they do, the county is billed for those services.
RECOMMENDATION 5-1:
Jefferson County should contract with a physician assistant for both units.
IMPLEMENTATION
Jefferson faces some serious consequences if it cannot provide the health care
services required by CIHCP. Although DSHS is not likely to take action against the
county, the county already has regular contact with lawyers who are seeking SSI
approvals for clients of the county clinics; some of these attorneys can be expected to
look for cases of malpractice or negligence.
The county should contract with a physician assistant who would serve both clinics
as the doctor and the administrator do. The physician assistant would be able to perform
some of the work that the doctor currently handles, and help the doctor and the nurses in
attending to the patient load. This would decrease the waiting period for new patients,
reduce ER visit costs for the county and reduce the costs of chronic illnesses that may
be caused by such delays.
FISCAL IMPACT
Recommendation 5-1 2005-06 2006-07 2007-08 2008-09 2009-2010
Contract for Physician
Assistant ($52,000) ($52,000) ($78,000) ($78,000) ($104,000)
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