Tue, April 07

My Turn: Explaining our support of Medicaid expansion

April 1, 2013 the Yavapai County Board of Supervisors (all Republican) voted unanimously to pass a resolution supporting the Arizona Governor’s (Republican) proposal to expand Medicaid eligibility. Shortly following on April 12, 2013, the Area Directors of the Yavapai County Republican Committee passed a resolution to oppose the Governor’s Expansion of Medicaid.

Is there conflict among the politicos in Yavapai County? You bet there is, but it is not just us; there is conflict statewide and even nationwide.

While I am unaware of any public discussion or polling of Republican membership regarding the resolution passed by our Area Directors, I will tell you that the Board of Supervisors had our discussion in the public. We also offered the opportunity for any member of the public to speak, be it for or against the measure.

I feel obliged to explain our unanimous decision to support the Governor’s proposal.

During the public testimony, we heard support from the Yavapai County Attorney and Sheriff, both Republicans. They spoke to the challenges of prosecuting individuals who suffer from untreated mental illness and the impact to our jail population and public safety. We are mandated by federal laws to provide medical and mental health care for those incarcerated in our jails without any funds to offset those costs which are sky-rocketing. Once released there is no consistent way to deal with mental health treatment for single childless adult individuals often causing recidivism. This places a huge burden on our criminal justice system.

We heard from executives of the two mental and behavioral health providers in Yavapai County. They offered their support of the Governor’s program because of the growing number of clients that have absolutely no financial ability to pay for the help they need. Allowing people with these types of needs to go unattended is not fair to them, their families or the public they encounter.

We received support and heard testimony from the President and CEO of Yavapai Regional Medical Center and Verde Valley Medical Center. Our regional hospitals are finding that the emergency centers are becoming the main source of primary care. The increase in uncompensated care has gone up 2 - 3 fold since the 2011 decrease in AHCCCS funding. The cost to provide uncompensated care then has to be passed on via higher prices for care to those that have adequate insurance or that can afford to pay for their care. As of last week, Verde Valley Medical Center had to implement a management restructuring and reduction in work force.

In addition to public input the Board of Supervisors considered the following financial and social impacts.

Over the past five years the Arizona economy has seen a high rate of unemployment, declines in population, businesses lost, increase in homelessness and highest rate of foreclosures since the Great Depression.

The expansion of Medicaid will inject more than $1.6 billion into the Arizona economy. It will create employment opportunities in a stable and high-paying field, health care. As those jobs are filled, it creates the opportunity for those employed to purchase goods and services from other local businesses, in turn creating more employment, business expansion and new business.

I believe the top priority of elected officials and the highest expectation of our citizens is to get the economy turned around and back on track.

By injecting the projected $1.6 B into the State economy it will act as the catalyst to right our economic ship.

Counties are mandated to provide Title 36 services. This means we have to provide a team of psychologists and evaluators for citizens that may be a threat to themselves or others. The challenge and burden to provide this service for rural counties is becoming harder to accomplish every month. The cost to Yavapai County alone has risen from $800 K this fiscal year to $1.8 M for next fiscal year. With Medicaid expansion we may be able to qualify many of these patients, lowering the dependency on property tax. If we have the means to identify and treat our citizens with mental health issues the debate for gun control could be obsolete.

We know our citizens elected us to do what is best for our County. Our vote on this issue was not without deep thought and research. We feel we have fulfilled our obligation and duty to the citizens of Yavapai County.

Chip Davis is the Yavapai County supervisor representing District 3.

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