While a budget fight tied to the implementation of the Affordable Health Care Act plays out in Washington D.C., local health agencies around the country are trying to get organized to deal with changes they are scheduled to face because of the law. One of those agencies is the Daviess County Health Department. “We have a lot of changes coming our way,” said Kathy Sullender with the Daviess County Health Department.
In the past, the health department might have been the place of last resort for preventative care, providing immunizations and other services for people who did not have a doctor or insurance. Now, it may become the the primary spot for those same services. “The ACHA now requires insurance companies to cover preventative services,” said Sullender. “We have now begun preparing to provide immunizations to everyone.”
Since the law requires people to now have health insurance that now means the health department has been busy trying to deal with insurance companies.
“We’ve rearranged some of our people,” said Sullender. “We worked with the state to get more computers, software, and training. We’ve already set up agreements so that we can accept some insurance companies and we’re trying to get all of them to work with us.”
Getting the local health department on the same page with the insurance companies has been a big challenge. “We aren’t used to dealing with those companies and they are not used to dealing with health departments,” explained Sullender. “They all use different forms. Sometimes their software won’t match with ours. They all have different rationales and have different ways of doing things.”
The big plus though in dealing with those companies is the potential for an increased cash flow. “We’ll be able to bill insurance companies for services and collect some fees,” said Sullender. “A lot of that will be going back into purchasing vaccines. Those are expensive, and with a lot of private providors stopping giving immunizations that will be something the local health departments will have to take on.”
The expansion of work by the local health department is coming with some direction from the state. “The state has been helpful in providing equipment and training, but a lot of this is time consuming and tedious,” said Sullender. “The state says they want us to do as much as we can, but because all of this is so new there are no step by step directions to help us get there.”
Even though the health department is anticipating offering more services it is not adding a lot of staff. “We took a part-time health educator and added to her duties to also serve as a part-time immunization nurse,” said Sullender. “That basically means we have made that person a full-time employee.”
The health department is also expecting to see some health care services shift away from the emergency rooms to their offices. “We’ll be able to provide some basic testing and medical services,” said Sullender. “People will be directed to us to provide those.”
The Daviess County Health Department may be getting ready to deal with the changes, but officials admit a lot of future under the AHCA is still a mystery. “This is all new to public health,” said Sullender, “and every county is trying to sort this all out. Now, with this shutdown we are all left in limbo. We’re like everyone else waiting and watching.”
The health care law may require people to have insurance, but local officials know they will still have to deal with people who don’t have any for one reason or another. “We will continue to provide them service,” she said.
More elements of the health care act will be going into effect in the coming months, but the arguments in Washington, D.C. have left some insurance companies and others in health care delaying making any decisions. Local health officials say they don’t feel they have the luxury of putting off plans.
“The state goal is to have every one up and running by 2014 and we’re about half way there,” said Sullender. “It’s always changing and who knows what tomorrow will bring.”