San Juan County adopts reorganized Health Care Assistance Program policy

The San Juan County Board of Commissioners voted to adopt an amended and restated Health Care Assistance Program (HCAP/HCAF) policy, concluding a staff-driven reorganization meant to match current operations and contracts.

Ellen Wayne, staff member, presented the update and told commissioners, “the HCAP program is established through state statute, which recognizes counties as the responsible agency for ambulance transportation hospital care or the provision of health care to indigent patients domicile within that county.” Wayne said the packet included a redline and a clean version of the proposed policy and that the changes were primarily organizational.

Wayne said the proposed rewrite does not change the county’s eligibility thresholds: “The current policy ... sets in low income requirements of 200% federal poverty level. Individuals must have limited assets. They have to be resident of the county for at least 90 days they do not must not have any insurance and must not qualify for Medicaid coverage in order to receive HCAF funding. HCAF is always the payer of last resort.” She said the rewrite clarifies provider and patient duties and aligns the policy with the county’s existing contracts with frequent providers, naming San Juan Regional Medical Center and PMS as examples.

Commissioners moved to adopt the resolution described during the meeting to amend and restate the county HCAF policy; the motion was seconded and passed with the board voting “Aye.” The motion text recorded in the meeting was: “adopt the resolution 24 25 66 amending and restating the San Juan County health care assistance program policy and procedure manual” (resolution number referenced in meeting materials also appeared elsewhere in materials as 24 25 26; the packet copy and the meeting reference differed). The adopted policy packet and redline were part of the agenda materials.

The county manager and other staff were on hand to answer questions; no commissioner requested substantive changes during the vote. The updated HCAF policy will replace the prior policy and is intended to streamline day-to-day administration while preserving income, residency and payer-of-last-resort rules Wayne described.

The commission approved the resolution during the new-business portion of the meeting and recorded the vote as passed. Staff indicated the policy aligns with recent practice of contracting with frequent admitting providers rather than using a strictly claims-by-claim review process.