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HomeMy WebLinkAboutResolutions - 2023.10.17 - 40623 October 27, 2023 RESOLUTION #2023-3432 _ 23-147 Sponsored By: Gwen Markham, Angela Powell, Charles Cavell Executive's Office - Appropriating American Rescue Plan Act – Local Fiscal Recovery Funds for Medical Debt Relief for Oakland County Families Chair and Members of the Board: WHEREAS the United States Treasury allocated Oakland County $244,270,949 of Local Fiscal Recovery Funds (LFRF) established under the American Rescue Plan Act (ARPA) of 2021; and     WHEREAS under the initial guidance of the Final Rule, the County may use these funds at their discretion to support eligible investments in public health expenditures, address negative economic impacts caused by the public health emergency; replace lost public sector revenue; provide premium pay for essential workers; and invest in water, sewer, and broadband infrastructure; and WHEREAS nine percent of adults in Oakland County have medical debt in collections, with medical debt being the leading cause of bankruptcy and more prevalent in communities of color; and WHEREAS a medical debt relief project would reduce or eliminate the burden of medical debt for Oakland County residents with income levels up to 400% of the federal poverty line to address another lasting economic impact from the COVID-19 pandemic; and WHEREAS RIP Medical Debt is a 501(c)(3) national charity that acquires and abolishes medical debt for people experiencing financial hardship, relieving individuals from payment for the debt purchased; and WHEREAS a one-time allocation of $2,000,000 to RIP Medical Debt could benefit 80,000 families in Oakland County and eliminate as much as $200 million in debt, considering the average amount of medical debt per person is $2,500; and WHEREAS American Rescue Plan Act – Local Fiscal Recovery Funds will support efforts to address the social determinants of health in Oakland County through investment in programs to address economic hardship. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners authorizes a one-time appropriation of American Rescue Plan Act – Local Fiscal Recovery funding in the amount of $2,000,000 to RIP Medical Dept to acquire and relieve medical debt for Oakland County residents with income levels up to 400% of the federal poverty line. BE IT FURTHER RESOLVED that the Director of Health and Human Services Department shall act as contract administrator and shall be authorized to enter in a contract for services with RIP Medical Debt, subject to review by the Purchasing Division and Corporation Counsel. BE IT FURTHER RESOLVED that a final report on program expenditures shall be forwarded to the Board of Commissioners. BE IT FURTHER RESOLVED that approval of the appropriation of American Rescue Plan Act-Local Fiscal Recovery Funds for programs and services by Oakland County shall not obligate a commitment of the General Fund unless authorized by action of the Board of Commissioners. BE IT FURTHER RESOLVED that the FY 2024 budget shall be amended as detailed in the attached Schedule A - Budget Amendment. Chair, the following Commissioners are sponsoring the foregoing Resolution: Gwen Markham, Angela Powell, Charles Cavell. Date: October 17, 2023 David Woodward, Commissioner Date: October 18, 2023 Hilarie Chambers, Deputy County Executive II Date: October 19, 2023 Lisa Brown, County Clerk / Register of Deeds COMMITTEE TRACKING 2023-02-07 Public Health & Safety - Presentation delivered by Keith Hearle, Special Advisor and Coordinator of Government Medical Debt Relief Initiatives, RIP Medical Debt 2023-10-11 Finance - Recommend to Board, Commissioner Raman Requested for item to be on Regular Agenda at FB 2023-10-17 Full Board - Adopt Motioned by Commissioner Gwen Markham seconded by Commissioner Charles Cavell to adopt the attached Budget Amendment: Appropriating American Rescue Plan Act – Local Fiscal Recovery Funds for Medical Debt Relief for Oakland County Families. Yes: David Woodward, Christine Long, Robert Hoffman, Philip Weipert, Gwen Markham, Angela Powell, Marcia Gershenson, William Miller III, Yolanda Smith Charles, Charles Cavell, Brendan Johnson, Ajay Raman (12) No: Michael Spisz, Karen Joliat, Kristen Nelson (3) Abstain: None (0) Absent: Gary McGillivray, Penny Luebs, Michael Gingell, Janet Jackson (4) Passed ATTACHMENTS 1. Government Initiatives Presentation Oakland STATE OF MICHIGAN) COUNTY OF OAKLAND) I, Lisa Brown, 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 October 27, 2023, with the original record thereof now remaining in my office. In Testimony Whereof, I have hereunto set my hand and affixed the seal of the Circuit Court at Pontiac, Michigan on Friday, October 27, 2023. Lisa Brown, Oakland County Clerk / Register of Deeds 1 Government Medical Debt Relief Initiatives Roadmap ●Why is Medical Debt a Problem? ●What is Being Proposed by City/County/State Governments? ●Who is RIP Medical Debt? ●How Does the Process Work? 2 Why is Medical Debt a Problem? ●Medical debt is different from other types of debts ●Many households have little savings to buffer the shocks of medical bills ●Medical debt is: ○More prevalent in communities of color, ○A contributor to poor physical and mental health, ○Harmful to credit scores, a drag on economic recovery from COVID-19 pandemic, ○The leading cause of bankruptcy in the U.S., and ○Recognized as a social determinant of health. ●Many patients with burdensome medical debt delay the care they need 3 Medical Debt on Credit Reports 4 Source:  Debt in America – An Interactive Map (Urban Institute), see: https://apps.urban.org/features/debt-interactive-map/?type=medical&variable=perc_debt_med More Prevalent in Communities of Color 5 How Are People Paying Medical Bills? What is Being Proposed by Cities, Counties, and States? ●City/County/State governments are allocating funds for medical debt relief through RIPMD 6 Families Helped Average Medical Debt Per Family Medical Debt Outstanding Funding Needed 5,000 $2,500 $12.5 million $125,000 10,000 $2,500 $25.0 million $250,000 80,000 $2,500 $12.5 million $2.0 million Similar Initiatives In Place (Or In Process) 7 Government Jurisdictions Cook County, Illinois Pittsburgh Toledo and Lucas County, Ohio Columbus, Cleveland, Akron, Cincinnati Washington, D.C.Atlanta New Orleans New Jersey, Pennsylvania, Rhode Island, Connecticut Who is RIP Medical Debt? ●A 501(c)(3) national charity that acquires and abolishes medical debt for people burdened by financial hardship ●Funded by donors (individuals, faith-based organizations, foundations, corporations, and local government) ●Founded in 2014 ●To date, RIPMD has acquired and abolished $8.5 billion in medical debt for over 5.5 million families ●MacKenzie Scott provided a $50 million gift in December 2020 and another $30 million in November 2022 ●Endorsed Business Partner, Minnesota Hospital Association ●Governed by an active, accomplished Board of Directors ●RIPMD never collects on medical debt 8 RIPMD’s Debt Abolishment Criteria ●Low-income criterion: Patient (or guarantor) household income between 0% and up to 400% of Federal Poverty Guidelines, or ●Medical debt burden criterion: The medical debt being assessed represents 5% or more of annual household income * * * * * ●Residency requirement: To use government funds, program recipients must be residents of the jurisdiction; RIP Medical Debt can use other funds for non-residents, if available 9 Hospital/Provider Transactions (N=69) 10 Health System Location Hospitals/Practices Ballad Health Tennessee/Virginia 21 Vituity (Hospital-Based Physician Company)Across U.S.5 States Heywood Massachusetts 1 (Donated Accounts) For-Profit Hospital Group1 Multiple States 5 Freestanding Children’s Hospital Southeast 1 Academic Medical Center Mid-Atlantic State 4 Hospital System Southeast 2 Hospital System Southeast 3 For-Profit Psychiatric Hospital1 Southeast 1 Freestanding Hospital Southwest 1 Multi-Hospital, Catholic Health System Multiple States 17 Hospital System Upper Midwest 6 Freestanding Hospital Upper Midwest 1 Public (County-Owned) Hospital West Coast 1 1All other hospitals are tax-exempt organizations. How RIPMD Works With Providers 11 BAA and NDA Signed Qualification and Pricing Analysis Prepared Decisions Made Regarding Transaction Medical Debts Abolished, “Return File” Provided Patients Notified Derogatory Credit Information (If Any) Removed FAP Feedback Provided Data File Transmitted Securely Communications Strategy Developed Communications Strategy ImplementedHealthcare Organization and RIPMD RIPMD Healthcare Organization PRIMARY RESPONSIBILITY RIPMD’s Debt Acquisition and Abolishment Process (2-4 Months) RIP Connects Donors/Funders with Providers 12 Debt pricing mimics commercial market: $1 can buy $100 or more of medical debt Government Allocates funds for medical debt relief Other Donations From individuals, faith-based foundations, etc. RIP Medical Debt Analyzes hospital (and other provider) files and purchases qualified medical debt Hospital Shares uncollected bad debt files with RIP for analysis and decides whether to sell/donate debt Patient Benefits •Abolish debt tax-free •Improve credit score •Relieve stress •Enhance access to care •Afford basic necessities RIPMD’s Unique Win, Win, Win Solution  Community Benefits •Address a social determinant of health •Enhance health equity •Address economic, health impacts of pandemic •Address impact of inflation and housing costs Hospital Benefits •Sell uncollectible, dormant patient receivables •Receive cash •Improve financial assistance process •Improve medical staff and employee satisfaction 13 The Win-Win-Win in Action Gregg Miller, MD, Chief Medical Officer, Vituity “We had a very positive experience working with RIP Medical Debt.  Forgiving so  much patient debt for financially vulnerable patients highlighted to our organization that we really do live our values of providing great patient care and supporting our community.  The whole team was really inspired by this partnership.” Anthony Keck, Chief Population Health Officer, Ballad Health "By removing this burden of old debt, we hope to better engage with our patients, so they access care and other services when they need them without the fear of unmanageable expenses.“ Christine M. Pearson, CPA, CFO AnMed Health System “We are so proud to partner with RIP Medical, aligning our goals to serve our community's health care needs, while also addressing the financial impact” 14 What Patients Say 15 Questions? 16