Brazos County court previews plan to raise hospital LPPF rate from 4% to 6% to secure federal, state dollars

Brazos County Commissioners Court on May 9 heard a presentation asking the court to amend the county's local provider participation fund (LPPF) rate from 4% to 6% so private hospitals can maximize federal and state funding for care to low-income and uninsured residents, County Budget Officer Nina Payne said.

The change is intended to allow local hospitals to draw more federal and state matching dollars under programs referenced by presenters and to insulate hospitals from potential federal limits now being discussed by the U.S. Energy and Commerce Committee. "This would generate another $14,000,000 for the hospitals to pay in," said Justin Flores of Adelanto Healthcare Ventures. "I just want to make that very clear that this is not an increase on any local, tax increase on any local person. This is money that the hospital is paying themselves."

The LPPF is a financing mechanism in which participating private hospitals remit a percentage of net patient revenue into a county fund; that fund is then used to draw down federal and state matching dollars for Medicaid and other low-income care programs, Flores said. He told the court Brazos County is currently at a 4% assessment but that by statute LPPFs can assess up to 6% of net patient revenue. "Most jurisdictions across the state are at 6%. Brazos is actually one of five jurisdictions that are not at 6%," Flores said. He identified local hospitals represented in the presentation as Baylor Scott and White College Station and Saint Joseph Regional Health Center.

Michael Neal, who also represented Adelanto Healthcare Ventures, said roughly 31 counties or hospital districts in Texas run LPPFs and that only a small number remain below 6% statewide. Neal told the court that "by statute, the hospitals are not allowed to pass on these mandatory payments on to their patients." He also said legislative authorization dating to 2015 underlies the county's ability to run the program.

Payne outlined the next procedural steps the county must take to adopt the higher rate: post a public hearing notice in the newspaper for the required period, hold the public hearing, and then place an amendment ordinance or item on a regular Commissioners Court agenda for a vote. Payne told the court the county must complete the amendment by June 30. "I'll prepare everything that needs to be done for the next couple weeks, and we'll have it set," Payne said, adding she would circulate additional materials from the presenters as they become available.

County officials on the court asked clarifying questions about how the program operates and its statewide prevalence but did not take a formal vote in the workshop meeting. The presenters emphasized that the assessed dollars come from hospitals, not county property taxes or direct charges to patients.

The item will return to a regular Commissioners Court session after the public hearing and notice period; no formal amendment has been adopted as of the workshop.