Timing can be as important as substance when requesting direct grant funds from state coffers.
Progenitors of a new integrated health services clinic are discovering that reality.
Wallowa Valley Center for Wellness and Winding Waters are planning to build a combined clinic in Enterprise and are hoping for as much as $2 million in direct state aid. They had hoped to approach the legislature with the request in 2018; however, it is more likely it will be submitted in 2019 for a variety of reasons.
Those include Measure 101, concern over the state having improperly paid or allocated around $186.4 million in Medicaid funds and lingering uncertainty regarding additional funding for this past summer’s wildfires.
Each of these could soak up any money that might be on the table to help fund the clinic, supporters of the plan were told recently.
In addition, 2018 is a short session for the legislature. With limited exceptions, the constitutional changes enacted through Measure 71 limit the length of legislative sessions beginning in even-numbered years to 35 calendar days. The 2018 session begins Feb. 5.
State Rep. Greg Barreto and State Sen. Bill Hansell, who represent Wallowa County in Salem, recently suggested the delay in hopes of more favorable financial conditions.
Barreto and Hansell remain ardent supporters of the project, according to Mike Wilson of Westby Associates of Vancouver, Wash., financial consultant for the clinic who met with both legislators recently.
Both are also recommending the clinic up its request from $1.5 million to $2 million. Both have said they appreciate the fact the funding request is balanced with a strong local commitment, rather than a hand-out.
Measure 101 will be on the ballot Jan. 23. It is designed to repeal five sections of legislation enacted to increase taxes on health care insurers and others to fund gaps in Medicaid. If the referendum is successful, it would cause an immediate $210 million funding gap for the state, which means projects like the integrated clinic in Wallowa County might be snubbed.
Another $186 million gap may need to be filled in 2018 as a result of possible overpayments by the state to coordinated care organizations in the state.
Most recipients of Medicaid in Oregon are enrolled in what’s called a coordinated care organization, or CCO. It is essentially a regional network of care providers who see Medicaid patients. The state pays the CCO on a per-patient basis each month.
In late October, news emerged of $74 million in possible overpayments to the CCOs between 2014 and 2016. OHA has already recouped $10.1 million of that. The errors are likely due to misclassification of certain patients who were also eligible for Medicare, and it’s not clear how much of the money the state must repay the federal government.
Other issues have surfaced since, bringing the possible liability to $112.4 million in additional revenue. The repayments could also impact revenue available for the Wallowa County project.
The Oregon Department of Forestry estimates that to-date, the 2017 fire season has cost it $38.9 million.
Certain property owners pay a state assessment to help cover firefighting costs in addition to money the Legislature appropriates from the general fund. The state has also had an insurance policy most years since 1973 to help cover firefighting costs.
But before it can tap that coverage, the state has to spend $50 million of its own money, according to Ken Armstrong, public affairs director at the Oregon Department of Forestry.
The additional millions would likely have to be appropriated in 2018.
In addition, Eastern Oregon lost one of its staunch supporters when President Trump appointed former state Republican Rep. John Huffman to lead the Agriculture Department’s rural development office in Oregon.
Huffman’s district included territory from The Dalles on the north to Sisters on the south and as far east as Spray.
Several other changes in personnel that could have been key to a successful grant proposal in 2018 have also been moved to other positions, according to Wilson.
Wilson said he believes the project has a solid chance of receiving funding, given the remote location of the county and the sparsity of health services, particularly in mental health areas.
The funding would be requested through the committee process in the legislature and would have to be forwarded to the floor in both the house and senate to be approved, then signed by the governor.