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
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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
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Medical Debt on Credit Reports
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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
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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)
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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
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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
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Hospital/Provider Transactions (N=69)
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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
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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”
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What Patients Say
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Questions?
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