Travis County Commissioners Court
May 6, 2008
Item 22
22 is receive briefing and take appropriate action on a report from health and human services and veterans service on the national association of counties, naco, precipitation discount card program.
>> good afternoon, judge and court. Staff is here today basically to give you some updated information and request additional direction from the court based on this program. As you are aware, the national association of counties has a prescription discount card program that as a member of the association -- the national association of counties, you have the opportunity to participate. So staff, through health and human services as well as purchasing and the auditor's office, we've had many of our partners to assist us with previous -- with various parts of this so we want to thank them for that. But many of us have looked at this from a lot of different ankles so we wanted to give a brief overview of the program and then request additional direction based on your level of interest. Basically the average savings that uninsured or underinsured residents in our community could experience could be anywhere from 20 to 22% off a prescription that is not covered by some other payer source. And that's important to note that we would be talking about prescriptions that were not covered by insurance or some other payer source.
>> before you go forward, identify who we're actually talking about that would be impacted. What do we end up doing here? Persons in Travis County.
>> we're talking about persons in Travis County, and that would be any person who is uninsured and without a payer source for their prescriptions, or underinsured, so they may have insurance, but that insurance doesn't sufficiently cover their prescriptions or doesn't cover their prescriptions at all.
>> so that would be the only eligible criteria?
>> yes, not to have a payer source for that precipitation. That's correct.
>> part of this program, excuse me, research and planning division. One of the interesting aspects of this discount program that also applies to domestic animals and pets. And so the majority of people do not have a payer source for that. And so if their domestic animal or pet needed a prescription medicine, then they would be able to receive 20% discount on the cost of that medicine.
>> and this card is available only on a
>> [inaudible].
>> correct. Travis County resident who has a prescription for which they don't have insurance coverage.
>> that is correct. So for example, even our own employees who may be on our health insurance plan, but if there were a prescription drug that is not covered by our plan, they would also be able to experience a discount as long as there is not another payer source for that particular medication.
>> so through our clinic system, these cards could be provided to our employees or through, for instance, the health care district clinic system, these cards could also be provided to Travis County residents?
>> they could be provided to each and every Travis County resident with that detailed of instruction on how it's to be used, yes.
>> the problem is that the majority of people that participate in the
>> [inaudible] in the health care clinics have access to 340-bo. Drug pricing so they receive a much better price even with a 20% discount. So some of this program can cause some confusion.
>> good point. Very good point. But if they have animals, it sounds like it might be beneficial.
>> we've included in your backup a little bit of research that we've done with dallas county as well as tarrant county, I believe. Both counties that are using the program, and for example, dallas county just in seven months of operating the program has reported that their residents have achieved savings of $119,000 in prescription drug costs, and as of March of this year, 704 cards were used to fill over 2,000 prescriptions. So that's dallas county. And in tarrant county, until January 1st of this year, tarrant county was number 1 in Texas in the savings over the 16-month period that they had been in the program, saving its residents over $300,000 since joining the program in July of 2006. Their most current information from March of this year indicates that there are 1,468 cards in use and that have been used to fill over about $2,200 in prescriptions. So we have included that information as well as others to show that residents in these communities receiving the information have been able to use these cards and have experienced savings. In terms of costs, there is not a cost, per se, for the program. However, the cost to the court is the continued participation in naco as an organization. So your annual decision to pay your membership fees will impact whether or not we continue to participate in the program.
>> so it won't be any additional funding.
>> that's --
>> as far as what's being asked of us today. Let me ask this. Just out of curiosity, let's say that we have the viewing public that's looking at us right now and saying oh, that sound pretty good to me. I heard what they said. I think I am qualified to participate in this particular program. How would they go about finding out acquisition, if the court decides to go this route, acquisition of this discount card on the prescription and who would they contact to ensure that they have access to what we're talking about today.
>> those would be our next steps, Commissioner. The staff -- staff today is requesting direction from the court to move forward toward implementation, which would involve receiving a contract from naco that legal would have to review and make recommendations for the court for us to put under this program a more -- a structure of some sort, you'll note in the example there is one of the counties, the purchasing office has taken responsibility for the program. In another county the health and human services department. So we would -- from your direction today go back and get into those more micro details of how does the program work. But just sort of in summary, I would expect that we would work with the health care district to use to distribute through the health clinics as well as our social services providers. I think one of the indigent care collaboration, one of the counties that we researched actually sent the cards out with their tax notices. So there's lots of opportunities for us to distribute the cards. Naco recommends that you request cards in the amount of 25% of your population, I believe.
>> above 230,000 cards.
>> repeat that.
>> for us that would be about 230,000 cards. It's 25% of --
>> okay, 25% of the population.
>> 25% of the population, yes. There's also on the card an 800 number so that if residents were to have a question about something related to the program, it would not require necessarily a Travis County contact, per se, but that they would be able to use this 800 number. So while the communities that we studied did not say that they put in a position of some source to manage this program, they did reassign responsibilities for certain staff in the areas that took on this responsibility. So I think it's important to note that. Also, your membership fee for calendar year '08 for the national association of counties was 1,487 # dollars. So -- and that membership is required in order to participate in this program.
>> well, we paid the $14,000, haven't we?
>> yes, have you.
>> and that runs from --
>> calendar year.
>> calendar year.
>> yes.
>> judge, do you think -- she brought up the different models that have already been in existence as far as this is already being performed in other counties. I guess is there a -- in other words, we have a significant increase in the use of such a discount card in different counties, we have different departments overseeing it and things of that nature. I guess what I’m trying to put my arms around and y'all help me out is that which would be the most effective -- purchasing dealing with it and h.h.s. Departments dealing with it in other places. And for Travis County, though, what would be the most prudent and most effective way as far as how we can look at it and the department that would be able to embrace it to be so we get the most effective results. I hear you all, but would this be the department where this would have to house itself and ensure that the persons out there actually have access and also effective practices for use of the card itself. Can you help me out?
>> well, I believe that, you know, while health and human services is the -- your program that works with this pop lately -- to certainly be involved in this process. Do whatever deems appropriate, but certainly health and human services would be very willing to administer this program if that's the court's interest in us doing so.
>> okay. I just wanted to see.
>> ...attorney let's take the next steps in terms of flushing out the program.
>> reduced to writing already, I was weary.
>> they have them.
>> they have them reduced to writing.
>> and they've had this for a while. I correct?
>> and dallas county.
>> perhaps we are borrow what they have.
>> what is expected of Travis County to participate and what the restrictions are, if any.
>> and judge, in discussion on that, I’m quite sure there is a whole bunch of interested folks, after hearing this conversation, there is folks interested now.
>> we don't meet on Monday so we can't do it then, so let's do it next Tuesday. Is a week long enough?
>> yes, sir.
>> yes, sir.
>> I’m looking at a simplified version but the truth, because we don't want 90 days to learn we were supposed to have this and that. The other thing is let's go ahead and touch base with rsvp directer, let him know what brilliant idea Commissioner eckhardt had --
>> [laughter] about using volunteers to help us implement this and see how he responds to it.
>> actually, that is a very good idea on your part, and I don't tell the directer that I agree with you, but the medicare part d, the drug program, hit as donut hole, and one of the counties experienced this is when medicare no longer covers the cost of the medicine and the recipient is supposed to pay, and this helps us in our medicare to reduce the cost.
>> we hear a lot from our senior citizens that deal with medicare, and you know, having, you know, food verses medication and it happens all over the place, because the increased cost in medication.
>> so as a senior citizens --
>> senior citizenses, right.
>> absolutely, but I think your point is well made, Commissioner, so residents who may be listening, we have not received approval to implement yet so these cards are not available yet in Travis County.
>> they're going to be call, I will bet you by the dollar, and asking. We'll tell them we will be back next week for sure to see what we need to do about it.
>> all those in favor. That passes by unanimous vote.
>> thank you.
>> if you're not ready next tour we will simply postpone it another we can but let's try to be ready.
>> yes, sir, thank you.
The Closed Caption log for this Commissioners Court agenda item is provided by Travis County Internet Services. Since this file is derived from the Closed Captions created during live cablecasts, there are occasional spelling and grammatical errors. This Closed Caption log is not an official record the Commissioners Court Meeting and cannot be relied on for official purposes. For official records please contact the County Clerk at (512) 854-4722.
Last Modified:
Wednesday, May 7, 2008 8:51 PM