HomeMy WebLinkAboutResolutions - 1994.05.26 - 24216REPORT (Misc. #94113) May 26, 1994
BY: General Government Committee, Donald Jensen, Chairperson
RE: MR 94113-Health Care Reform Amendments
TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS
Chairperson, Ladies and Gentlemen:
The General Government Committee, having reviewed the above
referenced resolution on May 16, 1994, reports with the
recommendation that the resolution be adopted with the following
amendment:
Insert the following after the third WHEREAS paragraph:
WHEREAS. support of these four amendments does not indicate
support. or non-support, of any Federal Health Plan; and
Chairperson, on behalf of the General Government Committee, I
move acceptance of the foregoing report.
GENERAL GOVERN11EN7 COMMITTEE
MISCELLANEOUS RESOLUTION #94113
BY: Commissioners Lawrence Pernick and Donn Wolf
IN RE: HEALTH CARE REFORM AMENDMENTS
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS, the Congress of the United States is presently
considering comprehensive health reform legislation, and
WHEREAS, as both health service providers and as major
employers, county governments throughout the Nation will be greatly
impacted by these health reform proposals, and
WHEREAS, the National Association of Counties, NACo, has
identified four critical areas of the President's Health Security
Act (HR 36005. 1757) which create deleterious obstacles for
counties, and have recommended the following amendments:
1) parity between public and private employers in their
ability to continue to self-insure or benefit from a federal
guarantee that no more than 7.9% of the public payroll would
go toward meeting the employer share of the new health
premium;
2) essential community health service provider designation for
counties to guarantee health plan reimbursement during the
transition to a national health plan;
3) coverage of detainees and their dependents while in jails
or other detention facilities;
4) guaranteed source of funds for public health, and
WHEREAS, because Michigan counties have a long and successful
history in fulfilling the responsibility to promote community
health, prevent disease and epidemics, and to provide health
services to their low-income and uninsured citizens, it is
imperative that Congress not ignore the concerns of these local
health delivery systems—the Counties--whose decades of experience
and expertise should be utilized in the development of any health
reform.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of
Commissioners does hereby support NACo in its efforts to address
the shortcomings of the Health Security Act as outlined above, and
petitions Oakland County's federal legislative delegation to amend
the proposed health care legislation to correct these inequities.
BE IT FURTHER RESOLVED that the County Clerk be directed to
send certified copies of this resolution to all Oakland County
State and Federal Representatives and Senators, the Governor, NACo,
MAC, and the Michigan Association for Local Public Health.
Chairperson, we move the adoption of the foregoing resolution.
NATIONAL
ASSOCIATION
of
COUNTIES
440 First Si. NW, It'ashrugton. nc 2(xx);
2,72/39.3-6226
STAFF CONTACT: Tom Joseph
2021942-4230
JAIL HEALTH REFORM
PRESIDENT CLINTON'S PROPOSAL
The President's health reform proposal would deny health benefits to any
individual incarcerated in jails, prisons, or detention facilities. These
individuals would be denied coverage even while they are awaiting triaL
NACQ POSITION
NACo supports universal coverage, including individuals in jail. At the very
least, those persons who are detained and cannot make bail should continue to have
"benefits that can never be taken away". The U.S. Supreme Court, in the 1976
Estelle v. Gamble decision, ruled that inmates have a right to health care.
Denial of benefits as soon as an individual is detained will cause disruptions
in coverage for a significant number of individuals and their families. Their
continuum of care will be severed and the administrative process to reinsure them
will be burdensome at best.
Background and Facts Supporting the NACo Position
The Eighth Amendment to the Constitution which guarantees the right against
cruel and unusual punishment has been used by the courts to establish county
government's obligation to provide medical care for those whom it is punishing by
incarceration. Courts have also ruled that inmates awaiting trial have the right to medical
care under the Fourteenth Amendment's guarantee of due process. The landmark case was
handed down in 1976.(Estelle v. Gamble, 429 U.S. 98, 97 S. Ct. 285, 50 L. Ed. 2d 251
(1976)).
(over)
NATIONAL
ASSOCIATION
of
COUNTES
4,40 First St. NW, washington, DC 20001
202.'393-6226
STAFF CONTACT: Tom Joseph
202/942-4230
PUBLIC HEALTH
PRESIDENT CLINTON'S PROPOSAL
The President's health reform proposal contains at least two significant public
health initiatives. Core health functions ( e.g. environmental health, health
education, data collection) would receive authorizations in the form of state
grants, and special health problems of a regional or national significance
would be authorized on a competitive basis. County governments would be
eligible to compete for the special disease prevention grants; the core health
grants may be given by states to county health departments.
1STACo POSITION
NACo supports the attention to public health but has the following concerns:
1. An authorization to appropriate funds instead of a set-aside leaves no assurance
that the initiatives will indeed be funded, particularly under the current
Congressional budget rules and deficit constraints.
2. State governments are required to document current state and local funding
when applying for core funding, but are under no federal requirement to involve
counties in the development of the grant application.
Background and Facts Supporting the NACo Position
* County health departments form the largest group of local public health facilities,
with 76 percent of the 2,932 departments affiliated with county government.
* 87 percent are active in collecting, analyzing and reporting disease.
(over)
NATIONAL
ASSOCIATION
of
CDUNTES
-440 First St. ,VW, Washington, DC 2(XX)I
202719.3-6226
STAFF CONTACT: Tom Joseph
202/942-4230
PUBLIC/PRIVATE EMPLOYER INEQUITIES
PRESIDENT CLINTON'S PROPOSAL
The President's health reform proposal gives private employers options
unavailable to counties for providing health coverage to their employees. The
public sector is not able to self-insure. The public sector also does not receive
the private employer's guarantee that no more than 7.9 percent of total payroll
will go towards meeting the employer share of the health premium. The 7.9
percent payroll safeguard would not be available to counties until 2002. Only
those county governments which pay for early retiree health coverage or pay
more than 80 percent of the insurance premium would benefit from the
employer proposals.
NACo POSITION
NACo opposes the inequitable treatment between public and private
employers. Public servants should not be treated any differently than their
neighbors who work for the private sector. There are numerous, cost-effective
health plans operated by counties which guarantee health benefits equal to or better
than the President's proposaL Systems that have been successful should not be
dismantled. County taxpayers should be assured that their local taxes will not fund
another mandate that funds public employee benefits differently while the federal
government subsidizes private sector costs exceeding 7.9 percent.
Background and Facts Supporting the NACo Position
(Information is being collected through a short NACo survey sent to the 100 largest urban
counties.)
NATIONAL
ASSOCIATION
of
COUNT IES
440 First St .VW, Washrngton, DC 2(1001
202/_39.3-6226
STAFF CONTACT: Tom Joseph
202/94274230
COUNTY SERVICE PROVISION
PRESIDENT CLINTON'S PROZOSAL
The President's plan recognizes the critical services provided currently by
federally-funded facilities providing health care to the uninsured. The
provision automatically designates specific providers which are now receiving
Federal discretionary grants, but requires others to apply to HHS for
designation. The status guarantees health plan reimbursement to traditional
providers of care to the uninsured during the five year transition to reform.
NACo POSITION
County facilities must be automatically designated as essential community
providers. Public health departments, public hospitals and mental health and
substance abuse treatment facilities operate to serve those individuals who have no
private insurance. Their expertise must be used to ensure a successful transition to
reform. After the transition period, all county facilities are prepared to compete to
become part of health plan networks or discontinue direct provision of care.
Funding must be assured for enabling services such as transportation,
outreach and interpreting services. While this initiative is separate from the core
funding and special disease initiatives, local health departments may be expected to
deliver these services with no support. The legislation authorizes federal funds and,
in another section, gives states the option to fund them. Neither alternative is likely,
given federal and state budget pressures.
(over)
Resolution #94113 May 26, 1994
Moved by Jensen supported by Pernick the General Government Committee
Report be accepted.
A sufficient majority having voted therefor, the report was accepted.
Moved by Jensen supported by Pernick the resolution be adopted.
Moved by Jensen supported by Pernick the resolution be amended to conform
with the recommendation of the General Government Committee Report.
A sufficient majority having voted therefor, the amendment carried.
Discussion followed.
Moved by Powers supported by Taub the resolution be amended in the NOW
THEREFORE BE IT RESOLVED as follows:
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of
Commissioners does not support National Health Care, however in the spirit of
protecting Oakland County, does hereby support NACo in its efforts to address the
shortcomings of the Health Security Act as outlined above, and petitions Oakland
County's federal legislative delegation to amend the proposed health care
legislation to correct these inequities.
Discussion followed.
Vote on amendment:
AYES: Law, McCulloch, Miltner, Moffitt, Obrecht, Palmer, Powers, Schmid,
Taub, Wolf, Crake, Dingeldey, Douglas, Garfield, Gosling, Huntoon, Jensen,
Johnson. (18)
NAYS: Kingzett, McPherson, Pernick, Aaron, Kaczmar. (5)
A sufficient majority having voted therefor, the amendment carried.
Vote on resolution, as amended:
AYES: Law, McCulloch, Miltner, Moffitt, Obrecht, Palmer, Powers, Schmid,
Taub, Wolf, Crake, Dingeldey, Douglas, Garfield, Gosling, Huntoon, Jensen,
Johnson. (18)
NAYS: McPherson, Pernick, Aaron, Kaczmar, Kingzett. (5)
A sufficient majority having voted therefor, the resolution, as amended,
was adopted.
STATE OF MICHIGAN)
COUNTY OF OAKLAND)
I, Lynn D. Allen, Clerk of the County of Oakland, do hereby certify that the
foregoing resolution is a true and accurate copy of a resolution adopted by the
Oakland County Board of Commissioners on May 26, 1994 with the original record
thereof now remaining in my office.
In Testimony Whereof, I have hereunto set my hand and 4a ixed the seal of the
f1/4_5
County of Oakland at Pontiac, Michigan this 26th day o y 1 ri.
LynyD. Allen, County Clerk DOES UOT REQUIRE COUNTY EXECUTIVE ACTION