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City updates Community Care program plan, seeks coordinator and third-party administrator for July launch
Summary
Consultants updated Columbus City Council on Feb. 11 on the Community Care program design and recommended hiring a city-based program coordinator and contracting a third-party administrator to start implementation by July 1, 2025, pending final approvals.
Consultants and city staff gave City Council an update on Feb. 11 on a proposed Community Care program that would set aside local funds to contract directly with local providers to increase primary care and behavioral health access for two defined populations: indigent residents and people leaving the jail.
Bob Paskowski of PYA and colleagues outlined a program design that divides a funding pool into three broad uses: program administration (including a city-based coordinator/project manager), a third-party administrator (TPA) to handle claims and reporting, and provider pools that would pay participating primary care, behavioral-health and specialty providers. "One of the elements of disbursement would be the program administration, and that would include a community care program coordinator or a project manager," the consultants said, noting that the TPA might provide care-management functions.
Why it matters: City staff and consultants said the model is intended to reduce avoidable hospital and emergency responses by strengthening primary care, behavioral health access and a hub-and-spoke structure that treats a medical home as the entry point. The program also includes an "inmate pool" and an "indigent pool" so funds are segmented to serve those two groups.
Costs and timeline: City staff and consultants did not present a final budget at the hearing but said a design recommendation would be ready by the end of Q1 and the implementation phase could begin in July 2025, contingent on council approval of a final design and funding. Consultants recommended reserving a portion of funds for claims volatility and for 1-time investments in expanding primary-care capacity.
Council reaction and next steps: Councilors pressed the consultants on the need and role for a full-time coordinator and asked for clearer cost scenarios for TPA fees, holdback reserves and provider payment rates. The consultants and staff agreed to return with a detailed funding and operations plan for council review during the budget process.
Ending: Council did not take formal action. Staff and the consultants said they would return with a final recommended contract structure, a proposed coordinator job description and proposed TPA scope for council approval.
