Future link of area counties to South Country Health Alliance could be decided within weeks

WALKER - Whether South Country Health Alliance continues to provide medical assistance to clients in five north central Minnesota counties next year could be decided in the next two weeks.

Cass, Crow Wing, Morrison, Todd and Wadena counties joined South Country, an alliance of nine southern Minnesota counties, in 2007. Up to that point, nine southern Minnesota counties in South Country Health Alliance had been operating their medical assistance alternative to a state-run program at a profit.

Many medical service providers in the northern counties qualify for higher reimbursements, which is one factor causing the program now to run a significant deficit. Member counties twice this year have contributed additional money to the program to help offset losses.

At the last Cass board meeting, the commissioners voted to approve a South Country joint powers agreement amendment. It calls for two-thirds of the member counties to approve any new special, mid-year contributions before South Country's board can make special assessments against the members.

In a recent interview, Brian Nasi, South Country Health Alliance director, said the state human services department every other year sets an average statewide reimbursement rate for state and federal funds paid into programs like South Country.

The average rate increases have been about 5 percent statewide, but medical costs in the more sparsely populated five northern counties actually have risen 10 to 15 percent in the last year, Nasi said. The counties have been paying extra into the program this year to partially offset that difference.

South Country will submit its actuary figures for second quarter 2008 to the state earlier than its next deadline and has asked for an immediate mid-cycle review of rates by the state.

"I'm cautiously optimistic," Nasi said of the state's willingness to review the situation. He hopes to have a response back before South Country Health Alliance's next meeting July 28. If that occurs, it will let member counties know their position before an Aug. 3 deadline when member counties must indicate their willingness to stay in the program in 2009.

If South Country's state funding issue is not resolved by Aug. 3, Nasi said some or all of the northern counties could issue a notice to withdraw, but could reinstate their membership before 2009 if financial issues could be resolved before year end.

Commissioner Jim Dowson, Cass County's representative to South Country's board, said in a recent interview that resolving the state reimbursements is one of several financial issues the joint board and state are addressing in order to put the program back on a sound financial basis.

If the northern counties cannot resolve the current financial drain on member counties this year, they could vote to withdraw from South Country and seek to return to the state medical assistance program, Dowson said.

Cass County has 2,800 people enrolled in the program, he said.