COD E R E D

EligibilityThe target population equals about 300,000 uninsured in the county at or below 200% ofthe FPL. In addition to the income requirement, eligible families must be current residents withthe intent to live in Bexar County. Families apply for enrollment at the main CareLink office orat one of the seven ambulatory centers or FQHC sites.If a family member is determined to be potentially eligible for Medicaid or CHIP, a 60-dayenrollment period into CareLink is allowed during which the individual must apply to theMedicaid and/or CHIP program. If the family member is eligible for the other public assistanceprogram and fails to apply, the entire family may be disenrolled from Carelink. Family memberswill be billed full charges and regular collection methods will be utilized.FinancingA county hospital district tax levy, equaling 25 cents per $100 valuation, is the primaryfunding source. Medicaid DSH funds are also used to help fill the funding gap in health caredelivery. The annual budget/revenue is currently about $95 million. Annual collections fromenrollees is around $11 million.Co-paymentThere is no cost for those with incomes at or below 75% of the FPL while those withincome above 75% of the FPL make monthly payments and service co-payments based onfamily size and income. A formula was developed to determine the patient’s Maximum FamilyLiability (MFL). This value is used then to determine monthly payments over a 48-month periodfor services rendered. A family’s MFL for the four years is calculated at the time of enrollmentand is re-evaluated annually. Members of CareLink only pay after health care services arerendered and a charge incurred.AdministrationCareLink is governed by the UHS. University Hospital System has a contract with theUniversity of Texas Medical School in San Antonio to provide physicians to UHS’s facilities. Italso has contracts with Community Medical Associates for hospital staff as well as the FQHCs.Denver Health xi , xiiDenver CountyDenver, ColoradoStart Date: 1997OverviewDenver County created a hospital authority that is independent from other citygovernment and links public hospitals, FQHCs, schools, clinics and the health department into aunified safety net system. The program also offers insurance products for public employeesand small businesses, and utilizes a patient payment plan based on an income and assetsrating system.D-7